Check out this article on how working as a locum tenens nurse practitioner helped me become debt free! If you need to refinance your student loans, I highly recommend refinancing them through SoFi.
https://www.sofi.com/blog/refinance-student-loan-travel-nurse-paid-off-nursing-school-loans/
For the first time, I will be extending my current locum tenens assignment. As a big fan of short-term assignments (3 months or less), it is surprising to most that I have agreed to be in Virginia for another 3 months.
In the past, working in locums I mostly covered vacation leaves and maternity leaves. I have been asked previously to extend my assignment or to stay permanently. There have been times where I did want to stay longer, but thought it would be best for me to move on.
My current locum tenens job is a bit different. I was contracted for 3 months after one of their physicians had to retire due to medical reasons. However, the site made it clear that if everything worked out, they had other plans for me. For instance, they are permanently recruiting for my position but there will not be a physician available until July, as residency ends in June.
In addition, they are hoping I can become an internal locum for them. They have clinics in several states including Georgia, Florida, Kentucky, Louisiana, and Illinois. They would like me to become licensed in all of these states, and provide coverage when needed (such as maternity leave, FMLA, etc.).
In the mean time, they asked me to stay at my current assignment until July 2017. This would be an additional 6 months after my original contracted 3 months. As I mentioned before, I usually just want to move on. So it took me several weeks to ponder my decision.
In this case I was torn. I did want to move on and continue my versatile journey. On the other hand, I really really really enjoy working with this facility. Everyone has been so welcoming and friendly. I am constantly learning and being challenged. I also realized that I miss the “follow-up” aspect of primary care. Our patients at this clinic see us every month, so I have already established relationships with hundreds of patients.
I knew that if I did not extend, these patients would have no one to care for them. Thus, I decided to extend for another 3 months. Everyone is thrilled, and I believe they are all secretly hoping I will extend for another 3 months to meet their needs until July. I recently found out that one of the Physicians at my clinic is pregnant, and she will be due in July. Looks like they will try to keep me to cover her patients until October as well! Will I ever get out of here?
Honestly, I have been happy here. I truly enjoy my job and the location is convenient, where I can easily travel to nearby states or go home for the weekend. Although I love working as a locum tenens nurse practitioner, I want to keep a good relationship with this facility, as an option to work with if I ever decide to go back to a permanent position.
If you read my blog regularly, then you should be familiar with my bittersweet experiences working as a locum tenens nurse practitioner in California.
After spending 7 months in California in 2016, I was ready to move on. I told myself I had no reason to ever return to California for work. A few months later, I received a letter in the mail from the California Board of Nursing notifying me that my licenses were going to expire at the end of the year, unless I paid for their renewal.
I immediately thought I would renew my CA licenses since it was such a hassle to obtain them. As the deadline drew closer I realized I would have to pay several hundreds of dollars in renewal fees. This seemed like a lot considering I was not even sure I would use these licenses again.
I do not plan on going back to California in 2017, as there are many other states I have licenses in that I haven’t yet worked in. On the other hand, there are ALWAYS tons of jobs available in California. I contemplated keeping active licenses there as a back up in case I ever needed a locum tenens assignment to start immediately.
After weighing the pros and cons, I decided NOT to renew my California licenses. I worked with 4 different sites while in California, and I hated all of them. Before and after California, I have loved every single job. Thus, I know I have no intention of ever returning to California for work. I am grateful I was able to explore almost every inch of that state while I was there, and had a fabulous time doing so.
Before I accepted my assignment in Virginia, I asked about snow during the winter. The Medical Director assured me not to worry. She told me that it rarely snowed near Virginia Beach, and if it did, the entire city would shut down.
Coming from Florida, I prefer to be as warm as possible. I have seen snow several times before, but have never been a fan. Perhaps it is because snow is cold, wet, and dangerous to drive in.
When I made it safely into the New Year without snow, I believed I was impervious. The year prior, I had completed my Washington State assignment the day before it snowed!
Shortly after, a winter storm from the west was making its way to the east coast. The city became chaotic as everyone prepared for the storm. It reminded me of Florida during hurricane season.
It had snowed all night that Friday. When I awoke the following morning, I actually enjoyed the snow. The snow was powdery and soft, unlike snow I have seen before. It snowed half of the day, which was pretty neat since I have only seen snow on the ground, not coming from above.
When it finally stopped snowing, my car was completely covered. It took quite a while for me to dig it out of snow. I thought to myself – I do not see myself doing this everyday. I also wondered how people lived in the North East and Midwest where it snowed often.
The following day, the sun came out but it was still quite colder than usual. The snow started to melt, leaving an icy and slippery road. I did not leave my apartment all weekend, as I have never driven in snow, and did not want to get into an accident. Work was cancelled for Monday because the roads were still bad. Since we do not get snow that often, there is no infrastructure in place to clear up the roads when we do.
My co-workers were super sweet, as many of them checked in on me over the weekend to make sure I was okay. Other than a hint of cabin fever, I survived my first time living in snow!
For my birthday, my sister and I decided to take a trip to Iceland. In order to see the northern lights, we had to go during the winter. Although it did not snow, it was the coldest I have ever been. My face was constantly numb after being outside for 1 minute. Plus, the sun is only out for 5 hours each day during the winter.
Iceland was definitely worth visiting minus the freezing temperature and cold wind. We felt like we were on a different planet. We were often surrounded by both volcanoes and glaciers at the same time. There were visible fissures due to shifting of tectonic plates.
We really enjoyed the blue lagoon, which is a geothermal spa naturally heated by the magma underneath. It was so warm in the water that you forget how cold it is outside. There is also a bar in the lagoon so you can enjoy some drinks during your stay.
Waiting 2 hours in the middle of the night in the freezing cold was worth seeing the aurora borealis. Side note: if you ever go, make sure to bring a camera to capture the lights (iphone doesn’t work as well).
After my trip, tons of my friends have since visited Iceland or planned an upcoming trip after seeing my pictures. They have all enjoyed it too, and I highly recommended spending at least a few days there sometime in your life. It is a very unique place!
When I told my family and friends I was accepting my next assignment in Virginia, many of them looked surprised and asked me “why Virginia?” Having done my first assignments in Florida, Washington state, and California, they expected my next assignment to be somewhere “exciting”.
The reason I decided to go to Virginia is because I have tons of friends that live in the D.C. area from college. I didn’t bother trying to get a locums job in D.C. because it is so small that the probability of obtaining an assignment during the time frame I needed within my specialty, was slim.
Virginia is close enough that I can easily go to D.C. for any weekend of my choosing. It is only a 2 hour drive from where I live, or I can take the train or bus as alternative options. One of the most important factors of being near D.C., was that I needed to be in a place near New England that does not really snow much. I was guaranteed during my interview that it only snows near Virginia Beach once or twice per winter, and the entire city shuts down as a result.
Virginia is more interesting than people are aware of. There are tons of historical landmarks and museums including: Thomas Jefferson’s home, Mount Vernon (home of George Washington), Civil War Museums, American History museums, Naval museums etc.
I went to the Edgar Allan Poe museum in Richmond, VA one weekend. It was actually pretty creepy, with black cats running around and creaking floors. I shouldn’t have been surprised considering the main focus of the museum. Apparently, Edgar Allan Poe had lived in Richmond, VA with foster parents after his birth parents passed away.
In addition, I live fairly close to Williamsburg and Jamestown, which are pretty neat to visit because they still act like we are in colonial times. It is interesting to visit some of the first settlements of out forefathers.
There are also several underground caverns throughout Virginia, which I hope to visit when it warms up a bit. These come highly recommended by my co-workers. Lastly, I do not live too far from Virginia Beach. Although it is no south beach, I love to be near water!
So far, Virginia has been a great state to do locum tenens. It is close to many other states, which makes it easy to visit new places. I honestly think any state we choose to do locums in will be worthwhile, because there is always something new to learn!
I began my new assignment in Virginia and I am really enjoying it! Prior to my start date, the site seemed extremely excited for me to come. The medical director even called me on the day I arrived to Virginia to make sure I was okay!
The first week I was given orientation. I quickly learned how important patient outcomes and satisfaction was to this company. The CEO stated that “everyone is serving a patient or serving someone who is.”
New patients and follow up ER visits are 40 minute appointments; follow-ups are 20 minutes. This clinic focuses on geriatric patients, so the patients follow up minimally every month. There is an onsite pharmacy that provides pre-packaged 90-day supply of commonly used medications. Research shows that there is a lag time of 3-5 days between 30-day medication refills for many patients. Providing 90-day supply medications helps facilitate medication adherence.
Each new patient goes through a comprehensive assessment and plan which includes: new member orientation, obtaining prior medical records, baseline EKG, baseline labs, baseline ECHO, bleeding and bruising screening, depression and alcohol screening, and vibration perception threshold. The company believes in investing in the patient before they become sick.
There is onsite acupuncture and tai chai. Acupuncture is used for neck and back pain, anxiety, insomnia, and migraine headaches. Tai chai is done to help this population strengthen their balance to avoid falls. There are also on-site specialists such as Cardiology, Podiatry and Optometry.
The goal is to provide comprehensive and valuable primary care, to keep patients out of the hospital. Weekly huddles are done amongst the providers in the clinic to discuss ways they can improve patient outcomes. The average wait time for the patient between checking in and seeing their provider is 5 minutes! The patients each have a life card, in which they use to check in. This card contains their insurance information, allergies, personal contact information, and their last EKG test to provide to other providers if necessary.
This is a large umbrella organization that has many geriatric clinics in multiple states. If all goes well, we agreed that I can always help cover for them in other states. They actually originated from Miami, Florida, so it may be a good option for me if I ever decide to settle back down in Miami. Lastly, everyone that works here is super friendly, hardworking, and easy going. They have welcomed me with open arms and I am looking forward to working with them for the next few months.
After working in very busy practices in California for the majority of the year, I was afraid I would no longer be as passionate about my job as I used to be. I am glad to find that there are still plenty of great medical practices to work at. This is just another reason why working in locum tenens is so great!
What are some reasons you enjoy working locum tenens?
Since my Texas government gig didn’t work out, I needed to find an assignment to start ASAP. The only active licenses I had at the time were: Texas, California, and Florida.
For some reason, the Texas market for locum tenens positions had been dry all summer. I knew going back to California was not an option- as I promised myself I wouldn’t go back until at least next year. Lastly, Florida has a high density of Nurse Practitioners, so they do not have many traveling assignments available at any given time.
When I had thought the Texas assignment was a for sure thing, I slowly began applying for licenses in North Carolina and Virginia. I was in no rush because I thought I wouldn’t need to utilize either one of them until the following year. Lesson learned: always have new state licenses that you are working on.
Fortunately, the same day that I had turned down the Texas assignment, my Virginia license came in! During that same week, I had already had an interview with a site and accepted their offer!
They wanted me to start the following week, so everything happened pretty quickly, which I was grateful for. It wasn’t until I was on my way to Virginia that I realized Virginia requires a furnishing license to prescribed ALL medications, not just controlled substances like a few other states do.
I immediately freaked out thinking the site wouldn’t want me to start right away anymore. I was disappointed that no one from the agency noticed I was missing that licensing! Hello licensing and credentialing team! I was also upset at myself for forgetting to check the “Licensing” tab on my blog, which includes a chart of all required licenses per state. Of course the furnishing license requirement was on there, but I forgot to look!
After voicing my concerns to my recruiter, she informed me that the site still wanted me to proceed with my initial start date. Apparently the site does not allow any of their providers, including both physicians and nurse practitioners, to prescribe their own medications for the first 2-4 weeks. They have an onsite pharmacy in which providers dispense medications, so they only allow you to prescribe after formal training. In the mean time, any prescriptions I would need to order for my patients, would be placed by my supervising physician.
My family was surprised at how quickly I was leaving when I accepted the job, but it didn’t surprise me. My friends thought I was crazy when I was making my way up to Virginia without any official lodging details until the day of my arrival. To me, this was all a normal course of being a traveling Nurse Practitioner, where flexibility is always key!
Working as traveling nurse practitioners, we often consider working with government sites because we can use any state license. Some examples include the VA, naval and air force bases, and Indian Health Services (IHS). Unfortunately, government locum tenens assignments have a few drawbacks. The comments below are more specific to VA and military bases (not IHS).
I had accepted a locum tenens nurse practitioner position working with an air force base in Texas this past summer. I knew someone who had worked there previously, so I was really interested in taking a break from primary care. The job entailed performing physical assessments of air force members transitioning into civilians.
After multiple complex stunts working in California, as I detailed in my blog previously, I was looking forward to something so simple. I lucked out because usually the site requires a 6-month commitment, but since their contract with the agency was going to terminate before the end of the year, they were allowing me to commit for only 3 months.
I even decided that the pay cut was worth it. I was going to be making $10/hour less than I usually make. I even decided that not getting travel reimbursement wasn’t a big deal, nor the fact that I was only getting an $800/month stipend to pay for my apartment. Luckily, Texas has really cheap housing in comparison to other states like California. Yet, it is challenging finding short-term lease apartments for cheap, so I was likely going to spend an extra $300/month out-of-pocket. Call me crazy?!
The agency I was working through, told me credentialing would take only 2-4 weeks. I knew from a few friends that it could actually take much longer than that. After accepting the assignment, I didn’t need to start for another 2 months, so I thought that would be plenty of time. After each month, the agency would tell me that my security clearance didn’t come through yet, and it may be another 2-4 weeks. After 3 months, I decided I did not want to wait anymore. I had friends that were told the same thing before, but their security clearance wasn’t granted until 6 months later!
I was easily able to end my contract since the agency couldn’t follow through with their (2-4 weeks of credentialing) promises. I am not sure if I will try to work with them in the future, as their time frame for credentialing can be unpredictable. My belief that everything at the government level takes so long for no reason was confirmed. In addition, I typically do not like committing to an assignment for more than 3 months. In the future, I wouldn’t mind doing IHS, as their credentialing usually takes 1 month or less.
If you’re interested in working in the government sector, be aware that you likely won’t be able to start right away, unless it is with an IHS.
