Pediatrics

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While in Miami visiting with family and friends, I was fortunate to find a locum tenens position 5 minutes away from where I lived. This is a big deal considering locum tenens positions in Florida are quickly filled (who doesn’t want to live in sunshine by the beach?), and because Miami is a large city so you can easily commute to work up to 1.5 hours each way.

The position turned out to be in a Pediatrics Office. The Pediatricians that own the clinic were planning a vacation for them and their children. They needed a nurse practitioner to cover ‘walk-in’ patients. They said they used to be able to just close the clinic whenever they left town, but due to insurance payment changes, they had to stay open to prevent their patients from utilizing the Emergency Room.

I was to be the sole provider while providing coverage. I was content that I did not have to do any wellness child exams, but my only apprehension was having to do newborn exams (as they cannot predict when they would come).

The Pediatricians requested to meet me before I started the assignment. I was able to pass by one morning since their office was so close to home. They were reassured by meeting me because they said that the last time they had a locum tenens provider, he looked like he was ready to retire, and the patients complained that he kept zoning out while talking to them. I was also reassured by meeting them, because they seemed laid back and even provided me with a cheat sheet on common medications and doses used in pediatrics.

My first day I thought was such a relief from working with adults. The visits were very basic, I literally had 10 patients in a row with a chief complaint of earache and that’s all! Also, the children of course were adorable and so much fun to be around. The only challenging thing for me was calculating dosages. I have always been good at math and used to be the drug math tutor when I was a faculty member in a nursing college. Yet, I realized I was spoiled by places I worked at previously which had a range of weight and proper dosing of medication already listed for you in the EHR.

At this clinic, I had to do all the dosing by hand. The more I did it though, the more I found myself memorizing dosing by weight.

Another plus at this clinic was that they have someone that inputs all of the notes in the EHR. I merely write the chief complaint, check the positives for the review of systems and physical exam, write the diagnosis, and medications I prescribed on a one-page form. Then someone inputs my findings in a more detailed note into the EHR, including billing. This makes the process of seeing patients way faster.

On a slow day I only saw about 20 patients. On a busy day I saw 40 patients. Surprisingly, I never felt overwhelmed. I had a good time working with this site. The site also appreciated my help and requested that I cover a few days the following week when they go to a medical conference.

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