I have been working as a locum tenens nurse practitioner for 4 years now. I recently realized that I have become so comfortable with jumping in and out of jobs for 3 months or less. Perhaps a bit too comfortable. To the point that I stopped inquiring about the orientation process prior to starting an assignment.
When I started my recent job in Tallahassee, Florida, I automatically assumed that the first day would be orientation. I was exhausted from just finishing another assignment the week prior. I thought my first day would be chill and figured I would start seeing patients the following day.
I was completely wrong! I arrived to the site and met the office manager, my supervising physician, and supporting staff. They got me set up with the EHR (electronic health record) and a laptop. I then shadowed the physician for a couple of patients and he showed me a bit around the EHR system. I started at 8 am and soon learned that my first patient was scheduled at 10 am!
I was a bit annoyed because I barely had time to get adjusted. I hardly knew the EHR system by the time I was seeing the first patient (it wasn’t one I had used before). Luckily, I didn’t stress myself out. I figured the easiest way to learn the EHR system is by actually utilizing it.
I definitely had tons of questions with each patient I saw, such as how to place orders and the correct process of doing things. I ended up seeing 7 patients on my first day, which isn’t too bad. I was able to have at least 30 minutes with each of them to get in the swing of things.
Although I felt cheated from having a proper orientation, by the end of the day I was over it. To be honest, I am such a locum tenens veteran that I really don’t need much time at all to dive into things.
Fast forward to my upcoming assignment in Chicago. It is a facility I have worked for previously, so I am familiar with their method of practice. However, I have not specifically worked in any of their Chicago clinics before.
Prior to starting the assignment, I texted the office manager to let her know I will be bringing my own laptop (they had me keep a work laptop from before), and that I would be able to start seeing patients on my 2nd day. Imagine my surprise when she tells me that patients have already been scheduled for my first day!
I was somewhat annoyed because in my past experiences (the 3 times I have worked with this facility before), my login access is never ready that first day. Nor am I able to prescribe/dispense medications (they use an onsite pharmacy). I also think it would be nice to get acquainted with the clinic setting and meet my fellow co-workers, prior to getting started. In addition, it has been 3 months since I worked for them last, so I would like to review their guidelines to make sure I haven’t forgotten anything.
Side note: this facility isn’t your standard private practice. It’s a clinic that focuses on geriatric patients and keeping them out of the hospital. That means frequent visits, working on polypharmacy and primary prevention screenings etc. Some specific guidelines for the practice include making sure you check PTH labs with anyone with chronic kidney disease; or doing a fall prevention questionnaire for each patient at every visit etc.
I proceeded by telling the center manager that I usually don’t see patients on my first day. In fact, when I returned to Virginia the second time, they still gave me a 1-week orientation. Not that I need 1 week, but geez can I get a day?? I then asked her what time my first patient was and how many patients were scheduled. I figured if I had the morning free, that would be fine. And if it was a light patient load then I would have time to get adjusted.
The office manager told me that my first patient was scheduled at 8 am (we start at 7:30 am) and I had a full schedule. She said she blocked my first patient so I could get acquainted. Wow, a whole 30 minutes to get settled in – how nice!
Anyways, I learned from my experience working with them in Florida. Which is although I have a relationship with them, it would be best to go through my recruiter for certain things/issues. Thus, I contacted my recruiter and let her know they had me scheduled with a full patient load on my first day which is ridiculous. So, they will need to fix that, and if that’s a sign of them abusing me in the future, I will be putting in my 30-day notice ASAP.
Just a reminder to myself and all of you seasoned locum tenens providers, don’t forget to ask about orientation BEFORE accepting an assignment! I am sure we can figure things out during a limited time span, but the whole point of working as a traveler is not to be stressed out!
