Am I a Diva?

I am wondering if my “I don’t take bs” attitude translates into me being a diva. As demonstrated in my prior experiences, I often stand up for others and myself. I think since I have worked in so many different settings, I know what a GOOD work environment is. I know that it is absolutely possible to work somewhere that is pleasant and not overwhelming. I also know what a GOOD recruiter is and what a GOOD deal looks like, so I do not want to settle.

There are 2 main aspects of working locum tenens that sometimes irritates me and causes my “inner diva” to come out.

  1. Being overwhelmed at work. Whether it is due to being scheduled with too many patients, lack of leadership in the office, no admin time, or lack of assistive staff.
  2. When recruiters speak to me as a car salesman, acting like taking this job is equivalent to buying a car. They say things like: even though this job doesn’t pay well nor is it in an ideal location, at least you will have work.

My responses to these problems:

  1. When asked to see certain patients (last minute) I will say NO just to make a point. I will request a change from either management or from my agency. If they are reluctant to change anything I will use the “it’s my license on the line” talk. In the back of my mind, I always consider just leaving if things do not improve.
  2. “At least you will have work”. Hi, I am not desperate. I’ll just say NO if I don’t like something. For instance, sometimes a recruiter will try to get away with giving you poor housing options, such as staying at a motel 8 (ew). When you demand better options they will say “can you at least stay there for this week until we find something else?” The answer is NO. No, I will not travel all the way there for a “possibility”.

Do I overreact sometimes? Yes, I am human. But who else will speak up for myself if not me?

So am I a Diva? Perhaps at times 😛

 

Locum Tenens Myth

One of the most common questions I receive is regarding the stability of being a locum tenens nurse practitioner. Is there consistent work? Are there periods or gaps with no jobs available? Looking back at the past year, 2017, one thing is clear. I worked way too much! More so, I worked more than I originally planned. I meant to spend most of 2017 traveling abroad but accidentally got caught up in work.

As soon as I finished my assignment in Virginia and needed to be home in Miami after Hurricane Irma, I was able to start working on another assignment. The only ‘gap’ was the 1 week road trip I purposely took on my way down to Florida. Once I completed my assignment in Miami, I had another assignment waiting for me, in which I started the following Monday.

To further illustrate the consistency and abundance of locum tenens job, is how quickly I was able to obtain an assignment after leaving the site in Tampa, Florida. I decided to leave that assignment early (I made this decision on a Wednesday). The following day, Thursday, I notified my recruiters that I would be available for another assignment. Friday was my last day in Tampa, FL, and during my lunch break I was already being interviewed for another job. By Friday afternoon, I had already been offered and accepted my next assignment. This new job started the following week. Luckily, it was right after new years so I had Monday off to recuperate.

My family and friends were impressed about how quickly I was able to get a new assignment. Personally, I wasn’t surprised because that’s just part of being a traveling nurse practitioner. I work with about a dozen recruiters at any given time to provide me with as many job prospects as possible. That’s why I always encourage my readers to credential with various agencies, and not limit yourselves to just one or two. There is a primary care provider shortage in America – someone is bound to have a job opening for us! J

Locum Tenens Blogs – January 2018

Happy New Year! I hope 2018 is already treating all of you well. As always, here are some interesting articles from around the web this month about working in locum tenens.

The 5 Top Destinations for Locum Tenens Work in 2017

As we leave 2017 behind, check out some highlights of the most interesting locum tenens positions offered from California to the East Coast, and everywhere in between!

3 Reasons to Work With a Locum Recruiter on Your Healthcare Job Search

Working with a locum tenens recruitment agency brings a number of benefits to your healthcare job search. Here are a few good reasons to have a dedicated recruiter on your side when looking for a locum assignment.

How Telemedicine Technology Is Improving Virtual Healthcare Visits

New telemedicine technology is helping virtual visits mimic traditional visits more closely. These innovations can help raise the comfort level of clinicians while also improving the already high quality of care delivered in telehealth visits.

Locum tenens with a spouse: Dr. David Hubler spotlight

See how locum tenens can be right for you at any age, including those that will be traveling with a spouse or partner.

Locum Tenens Blogs – December 2017

Happy Holidays everyone! Here are some interesting articles and finds from around the web this month about working in locum tenens.

.

LocumTenens.com has a non-profit website MedicalMissions.org which connects providers with medical missions abroad. You just select which dates you are available and which country you want to go to and it will list various global volunteer opportunities. This year MedicalMissions.org honored a nurse practitioner for her time volunteering in Guatemala over the past 18 years. Read her story here.

 

Certifications for Nurse Practitioners: How to Increase Your Job Opportunities

Certifications for Nurse Practitioners can make your resume stand out, increase your job opportunities, and even boost your salary.

 

4 Tips for a Smooth Transition to Locum Tenens Work

A locum who works in ambulatory primary care settings shares four basic tips to help you get started with locum tenens jobs.

 

Is Telehealth Personal? Exploring Telemedicine Efficiency and Patient Care 

Because the technology is fairly new, patients unfamiliar with telemedicine may not fully trust it. This article illustrates two providers perspectives about telemedicine efficiency and patient care.

.

ZDoggMD and Barton Talk Burnout:

Check out this video with Dr. Zubin Damania, also known as ZDoggMD, for a recent episode of “Incident Report.” Let’s beat professional burnout in healthcare together!

 

 

Nurse Practitioner Week

This year Nurse Practitioner Week fell on November 12-18th 2017. I hope your organizations made you feel appreciated during your special week. I have partnered up with Barton Associates to share some great articles and interviews from some of our fellow nurse practitioners. Enjoy!

Happy NP Week! NPs of the Past, Present, and Future Speak Out [VIDEO]

https://www.bartonassociates.com/blog/happy-np-week-nps-of-the-past-present-and-future-speak-out-video

In the featured NP Week video, these professionals let us know what they’re most proud of and what they’re most looking forward to. Check it out!

My Locum Tenens Story: Meet John A., NP

https://www.bartonassociates.com/blog/my-locum-tenens-story-meet-john-a-np

John A. is a locum tenens nurse practitioner (NP) from Ohio. After working several permanent roles that weren’t a good fit for him, John says his locum tenens experience simply “fell into place.” Here’s what he had to say about how going locum has affected his passion for healthcare.

A Guide to the NP Wheel: Nurse Practitioner Scope of Practice Laws

https://www.bartonassociates.com/blog/a-guide-to-the-np-wheel-nurse-practitioner-scope-of-practice-laws

To celebrate National NP Week, Barton Associates fully updated their Nurse Practitioner Scope of Practice Laws Wheel with the latest state laws so you can quickly navigate NP scope of practice in your state with a fun, interactive guide!

How NPs and PAs Can Avoid Stagnant Salaries: 6 Strategies

https://www.bartonassociates.com/blog/how-nps-and-pas-can-avoid-stagnant-salaries-6-strategies

Sometimes hard work doesn’t equate to a big reward. You will likely reach a point in your career wherein you have to maneuver a little bit in order to shake out of a stagnant salary, especially as an NP or PA. This article discusses a few things you can do to avoid merely an inflation-adjusted wage.

“I Want to See a Real Doctor”: How to Talk to Patients Who Question Your Abilities As an NP or PA

https://www.bartonassociates.com/blog/i-want-to-see-a-real-doctor-how-to-talk-to-patients-who-question-your-abilities-as-an-np-or-pa

Patient management can be difficult, especially when one questions your medical expertise and advice. Here are some tips for NPs and PAs for how to respond, from a PA who has been there.

7 Tips to Help NPs Prepare for Telehealth Roles

https://www.bartonassociates.com/blog/7-tips-to-help-nps-prepare-for-telehealth-roles

As a nurse practitioner, chances are good you provide care in rural and other underserved communities — a population with a lot to gain from the accessibility and cost-effectiveness of telemedicine. How can you best prepare for a telehealth role? Here are some tips.

An Offer I Can or Cannot Refuse?

As a quick summary, I spent the past year working in Virginia for a geriatric clinic that follows a preventative care model. I am currently working in Florida for the same clinic, as they have clinics in multiple states and continue to expand.

My previous post animated part of a discussion I had with the Chief Medical Officer of the company, in regards to nurse practitioners. The main purpose of the conversation though, was for the CMO to see what my goals were and if the company could hire me as their internal locums/traveler.

I alluded to having a similar conversation previously with their Chief Financial Officer. And how I told him that I wanted to continue with my current agency for now, until I had a better grasp of the various markets.

The CMO told me that he definitely sees the value in having an internal locums, especially as they continue to grow. He said he would love to invest in me to develop into a leadership role eventually. Meaning I would either oversee a larger traveling team in the future, or even manage all other nurse practitioners in the market. He said as a contractor it wouldn’t make sense for him to invest in me, so that is one of the main reasons he wants me to become directly employed with the company.

He asked me what I was currently being paid and told me he could increase that. (Side note, I already get paid significantly more than the permanent nurse practitioners, even those with 20 years of experience, since I am a traveler). He said he could also offer me a sign on bonus and yearly bonuses as well. The company would of course cover all of my travel, lodging and licensing fees. He said they would also provide me with a weekly dining stipend, and cover flights whenever I wanted to go home in the middle of an assignment.

In addition, I would have the same benefits as the other employees such as 401K, health insurance, CME allowance, and PTO. The company would also guarantee me with a yearly schedule where I am in a different location every 3 months or less.

After the CMO made all of these offers, I think he was surprised to hear me say “we’ll see”. Financially he was offering me a whole lot, but my priority has always been freedom and flexibility. Although I would continue being a traveler, I would be restricted to practicing in locations the company has clinics in. On the bright side, they are continuing to expand and are opening up new centers in several different states by mid next year.

At the end of our meeting, we agreed to allow me some time to feel out the new center I was in and to think things through. We set up an appointment to meet again next month.

I am extremely grateful for the offers he made me, and especially for the fact that he sees something in me that would make him want to invest in me as a leader. I would be honored to manage and help other travelers and nurse practitioners.

It honestly seems like an unbelievable opportunity for me to grow in an incredible company. My main hesitation is how much flexibility will I have? Will I still be able to take time off in between or during assignments to travel abroad? Perhaps I could negotiate this in my contract. The average PCP has about 4 weeks of PTO but I will definitely need more than that even if it’s unpaid. Will I still be able to leave an assignment early if I absolutely hate the place (whether it’s the people or location)? Maybe I can have them agree that if I don’t like a center I can give a 30-day notice the same way I do with my agency.

On the plus side, they will give me a schedule so I can actually plan where I will be in advance for once. Am I ready for a commitment? I guess worse comes to worse I can always quit and become a regular locum tenens nurse practitioner again J

I would love to know your thoughts! Should I go for it???

Meeting with the Chief Medical Officer

In between completing my assignment in Virginia and starting the one in Tampa, Florida (with the same company), I sent the CMO of the company a letter about my experiences working in Virginia. I had met him several times before and thought it would be a good way to share my experience at each clinic, both good and bad.

He was appreciative of my feedback and requested a meeting with me to see what my goals are and how the company could expand an internal traveling PCP program.

As our conversation began, I could tell how new the concept of having nurse practitioners was to the CMO. When he elaborated about the collaborative agreement between nurse practitioners and physicians, he also stated that there is a wide spectrum on preparation of nurse practitioners. He said that they have observed there can be some amazing, knowledgeable, and competent nurse practitioners; but on the other hand there can also be some inexperienced, insecure, and non-proficient nurse practitioners. Personally I agree, but it’s the same thing in any profession.

The CMO continued to ask me what was the perception of nurse practitioners from the patient’s point of view. He asked how my previous patients handled having a nurse practitioner as a PCP. I told him that the concept of nurse practitioners is something new to a lot of people, especially the elderly population. Many times they do not know what a nurse practitioner is, yet once they see that we practice similarly to physicians at a holistic level, they are fine with it. I told him that of course there are patients who automatically say they do not want to see a nurse practitioner and feel as if they need to be seen by a physician. He asked me, in my experience, what percentage of patients would I say did not want to see the nurse practitioner? I responded with 5% of patients or less. Perhaps other people’s experiences vary from mine.

I found his questions to be intriguing because like I said before, the concept of nurse practitioners is so new, even to a big shot CMO like him.

I updated the other nurse practitioners at my clinic on our conversation. I emphasized the fact that only WE can be our own advocates. That we have to speak up for ourselves when either management or patients try to suppress us. For instance, any time a recruiter or manager calls a nurse practitioner a “mid-level provider”, I make sure to correct them.

In addition, when a patient calls to be seen by their PCP the day of, the front desk will tell them “Your doctor doesn’t have an openings, but you can see the nurse practitioner.” I personally don’t like the way it is said, because it insinuates that the nurse practitioner is the next best thing, and not as good. So I am trying to encourage the front desk to say instead “We can accommodate you today but you will unlikely be seen by your PCP, and may have to be seen by another provider.”

Besides being our own advocate, I think as nurse practitioners, we need to have confidence. Sometimes I hear nurse practitioners turn down a job because they are afraid they are not well trained or competent enough for the position. Of course anything new is scary, but as long as you put in the effort and the time, I feel like you can excel in anything. Physicians will look up things they are not familiar with; we can do the same without being embarrassed by it.

In my next post I will elaborate on the second major part of my conversation with the CMO.

How Treating Others Well Pays Off

Remember I mentioned I couldn’t work with my favorite recruiter at the Occupational Health Clinic because I needed a 1099 job? Fortunately, going back to this geriatric clinic meant I could go back to my favorite recruiter as well!

As promised on my previous post, I sent her some flowers and she called me in tears! I think it is extremely important to make incredible people feel appreciated. J

When I asked for my new agreement with the Tampa clinic, I noticed that the pay rate was $2/h more than I was making previously. I honestly thought it was an accident because no one mentioned anything to me and I hadn’t even asked for a raise. I asked my recruiter and she said ‘I always try to get you the best rate, and even though it doesn’t always work, this time it did!”

I was really surprised and grateful! Sure $2/h doesn’t sound like much but over 3 months it’s an extra $1000.

Perhaps some of you are wondering why I didn’t ask for an incentive to work at another market for the same company. To be honest, the company has always treated me really well and I almost consider them to be family. For instance, they gave me a $5000 bonus just for extending another 3 months. When I worked 10 hours of overtime a week, they never questioned me about it. They house me in expensive hotels (such as the Westin) and don’t mind flying me home every 1-3 months. They even randomly give me gift cards occasionally for no reason (such as Starbucks and Walmart).

Although they need me more than I need them, it’s good for me to have an option in multiple states that I can consider at any time. They are also an amazing company that I would probably work for the day I decide to go permanent (if that day ever comes).

They also agreed to fly me up to Virginia for the annual holiday party, which is sweet and more for me than for them.

Working in Tampa, Florida

After taking a brief break from the geriatric facility in Virginia, I agreed to help them out at some of their clinics in Tampa, Florida. Being in Florida during this time fall/winter is especially beautiful because it’s not too hot and not too cold. The drive up here from Miami was about 4 hours.

My first day at the new center was okay. I sort of knew what to expect since I had worked at their centers before. Upon arrival, everyone was gregarious and it was nice to see an LPN that I knew from Virginia. She had transferred to that market a few months prior.

I initially was a bit sad because it felt strange to work in a familiar setting with completely different people. The Medical Director was friendly but he didn’t nurture me the way the previous one did. The center manager was welcoming but wasn’t prepared with my laptop, new ID, and lab coats the way the previous one had been. I think I took for granted that the Virginia clinic treated us for lunch almost every day!

I thought I would jump in and start seeing patients, but I spent the majority of the morning on the phone with IT trying to set up my login and computer etc. I also called a few of my patients from Virginia to check in on them. They were extremely happy to hear from me and mentioned that they felt neglected from the clinic since I left.

Originally, the Tampa clinic wanted me to help out 3 months ago when they were short staffed. It seems like since then they have recruited A LOT of PCPs. So I sort of wondered why I was there and if I was even needed anymore. I felt like I should be at the clinic in Virginia, but knew I couldn’t go back there yet.

By the end of the day, I tried to keep a positive mindset. The clinic was new so it wasn’t nearly as busy as the ones in Virginia. Therefore, at least it was unlikely I would feel overwhelmed some days like I did in Virginia. In addition, I was mostly going to be helping with walk-ins and overflow for the PCPs. This meant I wasn’t going to have my own panel the way I did in Virginia. This was a good thing because I wouldn’t have as much responsibility or have to work overtime as I did before. The only bad thing is that I wouldn’t be able to develop relationships with the patients. But considering I spent a year in Virginia, I am glad it turned out this way because at least I can put in my 2-3 months and move on without feeling guilty.

Locum Tenens Blog – November 2017

Welcome to this month’s blog post sharing some great reads from around the web!

 

How Locum Tenens NPs Can Redefine Work-Life Balance

I love the above article from TinkBird because I often get messages from other Nurse Practitioners that are burnt out and wondering if locum tenens would be the answer for them. Fortunately, the answer is Yes! Read the article above to find out why.

 

Barton Associate’s had a lot of interesting articles too:

5 Qualities a Recruiter Looks for in a Locum Tenens Candidate: This provided some good insight into what will make a recruiter more interested in working with you and open up more opportunities to finding the perfect assignment.

Finding Volunteering Opportunities As a Locum on the Road: I actually used to be REALLY involved in volunteer work and started thinking about how I wanted to get back into that realm again. I was happy to stumble upon this resource guide to help me start volunteering while I am on new assignments.

 

Forbes had an article about the increase in Advanced Practice Nurse pay. Great read to see how nurse practitioners and other advanced practice nurses are starting to be compensated appropriately.