There are many obvious challenges while working as a locum tenens Nurse Practitioner. Some of these include: learning new electronic health record systems; always being on the move; living out of a suitcase; and having to constantly meet new people and patients.
Luckily, a lot of assignments will allow time for training to get accustomed to the new environment. This can vary from hours to weeks, depending on the length of the assignment. I know travel RN’s are often given the “cold shoulder” by their peers on the floor. Some say they know that the travel RN’s are getting paid more than them, so they should be able to figure out everything for themselves. On the other hand, in my experience as a locum tenens nurse practitioner, my co-workers have always been very friendly and supportive. They always offer to help or answer any questions I may have. They even check in routinely to make sure I am doing okay.
Most importantly, being in a new environment, we are unfamiliar with our community and patient population. For example, we may be unaware of what time the pharmacy closes or how much a medication costs there. We may not know that our pediatric population has a high influence of gang violence and drug abuse. Or we may not know that our patients are non-compliant because they cannot afford to pay for the gas necessary for them to drive to the pharmacy or clinic. We may not know that there is no orthopedic within a 3 hour distance and may have to become creative upon treating.
Depending on the geographic location we are used to, diseases may also be different. For instance, it is rare to see Rocky Mountain Fever in Florida or Dengue Fever in Oklahoma. Fortunately, we have support staff and our peers that we can ask or refer to for information. We can also begin to learn these variables throughout our time working in a new setting.
You will also have to learn the different scope of practices for nurse practitioners in each state. In some states you will have full authority, while in others you may need strict supervision. It is challenging keeping up with legislation, not to mention how challenging it is being okay with the limitations in some states and not others.
However, I think these minute challenges do not even compare to the limitless benefits of being a travel nurse practitioner.
Does anyone have any personal challenges during a locum tenens or travel assignment they would like to share?
One interesting challenge is sometimes being expected to be competent in all aspects of medicine. Sometimes they expect us to be experts in doing all kinds of procedures even though they did not initially require it, nor have the time to teach us.
As a travel RN one of the most challenging things for me initially was finding an agency and recruiter I was comfortable with and provided the right benefits for me, with so many out there the way I finally selected the ones I work with now was thru word of mouth. I think when you have the right recruiter and agency behind you it makes the transition into traveling less intimidating.
I have no doubt that as a traveling ARNP you come across challenges much that are different than mine as a traveling RN- especially when taking into consideration the differences of scope of practice and clinical setting. I’ve made brief list of all my “challenges”
1. Quick orientation! Standard new hire orientation can range anywhere between 8 weeks- 3 months. That’s the length of the average travel assignment! Traveler orientation generally entails 1-2 of hospital orientation and 1-2 days of on the floor orientation; after that you hit the ground running. Of course they know you’re new so it’s expected that you’ll still have lots of questions. By the time you know almost everything there is to know, it’s time to go to the next assignment. I carry a little notebook in my pocket to serve as my cheat sheet. It contains important numbers, codes, specific policies and routines. Until I get the hang of things, I am lost without it.
2. Not every assignment will let you pick your schedule. Sometimes you end up working whatever days they want you to. If you’re lucky, you’ll get to self schedule at the same time as everyone else. Most often your floor will let you pick days to work based on what’s available after the regular staff pick.
3. You’re the first person to float when your unit is overstaffed.
4. Rumor has it that the travelers get stuck with the worst patient assignments. Personally this has never happened to me. Maybe I’ve just been lucky.
5. Some people can be jerks about having a traveler on their floor. Most are happy you’re there because it means it helps out their staffing.
6. Packing up and unpacking all your belongings every 8-13 weeks. After a while you become an expert packer and can do it rather quickly. Nevertheless it’s still a daunting task every time I have to do it.
7. Necessity to travel light and resist buying large items. If it doesn’t fit in my car, it gets tossed or donated.
8. You can only work on units that you have experience in. A travel assignment is not the time to try out peds if you’ve only been working with adults you entire nursing career.
9. Learning new charting systems. Depending on where you go, they might still be doing paper charting! Other places use different variations of EMR- Epic, Cerner, Sunrise, Meditech, etc. Some are better than others and more user friendly. With that being said, the Epic charting you see in one hospital will be a bit different than the Epic at a different one. There are many versions of the same system that each facility modifies to their liking.
10. Everyone is new to me and I’m terrible with names. It comes eventually but it’s embarrassing when everyone knows who you are but not the other way around.
Despite all those challenges, I have really enjoyed my traveler experience. There are plenty of positive things I can say that make up for the hardships that can come
along with the job. Nursing is nursing no matter where you go. Core measures are nationwide. You already know how to assess and care for patients. At the end of the day if you hate your assignment, it’s only “X” number of shifts left until it’s over. You might as well enjoy your days off and explore that new city while you can.
Those are some great examples! Thank you for sharing, as challenges can also vary per nurse.