Scarcity Mindset

In the Spring, I was feeling stressed thinking that I needed to find a locum tenens gig asap. There was no specific reason except my scarcity mindset. I wasn’t strapped for cash, nor for experience. In my mind, I was thinking that I last worked in clinic in October, and I didn’t want to go more than 6 months without working in clinic.

I feared that sites would no longer see me as competitive if I didn’t have hands-on experience within the last 6 months. I have heard of telemedicine providers not being able to get a job after 1-2 years without seeing patients in person. I did not want this to be me.

Fast forward to an opportunity I had to work in Florida with the geriatric clinic I often worked for in the past. They asked me if I was available, and made me an offer on the spot. Within hours, I had a contract in my email. They didn’t even ask for a CV or cared when was the last time I worked.

I ended up not proceeding with the offer, because I said on a previous post, my partner had just moved to the USA and wanted to stay in Miami longer to adjust. However, the opportunity showed me that after being a traveling NP for 10 years, I have enough contacts and networks that will allow me to always have job options no matter what. So even if I decide to take a break from being a nurse practitioner for years, I will still be able to find a job when I return.

In fact, I know a nurse practitioner that took a break from healthcare for 5 years. She worked in other capacities. And when it was time to renew your board certification, she decided to go back to being an NP. She said it was easy for her to find a part-time job (her preference). This proves what we already know – that our career is in high demand, and companies are willing to “bend the rules” to work with us.

Even though I am so used to jumping in and out of work, I no longer have the pressure to take a locum tenens assignment this year at all. I likely will work at least one assignment this year. Yet, if I decide to travel abroad instead, my career won’t be jeopardized.  

Locum Tenens- What’s Changed?

Plenty of aspects of locum tenens has changed within the last 10 years. For one thing, it has become more popular for nurse practitioners. I remember when I started, there was no information out there to become a traveling NP, hence why I created this blog. Now you can find travel NP influencers, books, and other websites.

A lot of medical facilities are now used to having locums providers, compared to when I started. At that time, other providers saw locums as “risky”. They assumed locum providers couldn’t get a permanent job anywhere else, which is why they had to do locums. Now many providers are interested in doing locums, whether on the side or even briefly between career gaps. I know plenty of full-time colleagues that asked me for locum tenens recommendations since knowing them. They now see locums as flexible and rewarding.

There are more way more agencies. Before it was just the large ones such as Barton and Comp Health. Now you have many mom and pop agencies, that tend to pay more and provider better concierge service. You can definitely leverage your opportunities by being credentialed with multiple agencies.

The pay has definitely increased. This may mostly be due to inflation and how companies had to become more competitive with pay after covid. Since starting a career as a locum tenens NP, my income has increased by 70%. That definitely surpassed the annual 3% raise you typically get staying at a full-time job.

Housing options has become more flexible. I remember initially locum tenens agencies only wanted their clinicians to stay at extended-stay hotels. It slowly turned into furnished apartments and Airbnb. Now they even offer housing stipends as an option.

It has been nice to see Locum Tenens evolve over the years, mostly for the better. Does anyone else remember any large changes in the locums space over the last decade?

10 years as a Travel NP

Wow 10 years goes by fast! I can’t believe I have been working as a locum tenens nurse practitioner for 10 years now. It’s been a lot of fun and I am glad I made the leap 10 years ago. I never thought that I would still be a travel NP until this day. I thought I would settle down after a few years.

In the last decade, I have worked in 11 different states and 26 different practices. I have learned so much as a nurse practitioner, and grown a lot as a person. Being a traveler has set me up for success – emotionally, mentally, and financially.

I have enjoyed working in different places and meeting new people. I loved living temporarily in different states and climate hacking. This means I enjoy cool weather during summer and warm weather during winter J It has been a great way for me to keep in touch with friends, family, and former classmates.

Most of all, I do not think I would be financially independent had I never started working as a travel NP. Being a travel NP, allowed me to double my income; save on housing and car; and reduce my overall taxes.

My identity isn’t being a nurse practitioner; it is being a travel NP. The travel NP that always has new experiences and something to look forward to. The travel NP that came to “save the day” and help her fellow colleagues see patients and get in patients that have waited months for an appointment. The travel NP that can decide where she gets to live and how much she wants to work.

I think every NP should take a dab into locum tenens. You don’t need to work 10 years like me, but even doing it for a few months can set you up for success. It can make you feel more confident as an NP. It can help you build your skills. It can help you pay off debt. It can help you save up to start your own business.

For the last 2-3 years I have cut down to working as a travel NP only 6 months out of the year. I remember when I first started as a travel NP, there were other locums that would come to the clinic I was at in WA, and they told me they worked 3 months on and 3 months off. I thought that was amazing. I never thought that that would be me someday – even in my 30’s!

Although I don’t know how much longer I will continue to practice as an NP, I know I will always have locum tenens as an option for me.

My Favorite Locums Job and Location

Whenever I start a new locum tenens position, my new coworkers always ask me what’s my favorite place I’ve worked. It’s a difficult question to answer when you’ve worked in over 20 different locations. It’s similar to when people ask me what’s my favorite country I have visited, when I have been to over 50 countries – aka too many to choose from.

I usually proceed with – I have two answers: my favorite job itself, and my favorite city/state to live in. I have two favorite jobs, so I often use either one to provide as an answer. My first favorite job was my very first locum tenens assignment away from home, which was the community health center in Washington state. It was a really organized practice and showed me that not all FQHC’s are the same. I also learned a lot and proved to myself that I can be successful as a traveling NP.

My other favorite job was the first time I worked with the geriatric clinic in Virginia. I mean I stayed there for almost 1 year so that says something. I learned a lot in that job and developed amazing relationships with patients. I liked being accountable for patient outcomes, which is why I have continued to work with that practice in different locations for the last 7 years.

My favorite city/state to live in or practice in also has two answers. I absolutely love living in San Diego, CA. The job there is really an afterthought. I love the diversity of the city, laid back atmosphere, perfect weather, and being able to live on the beach. My second favorite place I lived in was surprisingly Maine. I liked that it was also laid back that the physicians at work would go fishing at a nearby pond during their lunch break. I appreciated being able to go for walks and hikes during the summer since the temperature was only in the 70’s.

What has been your favorite job or location as a traveling NP?

Traveling NP Update

I finished my last locum tenens assignment in October. My partner moved to the USA in December so my priority has been getting him situated. I planned on us being in Miami for 2 months so we could spend time with my family and friends for the holidays. I rented a mid-term rental in Brickell/Downtown Miami because it is walkable. I figured that would make the transition easier since he is used to that coming from Europe. Then I was going to take a locum tenens assignment possibly in my favorite place, San Diego, CA.

However, it has been a bigger adjustment for my partner to move here than we expected. So, he would like to stay in Miami a few months longer. He would like to get more comfortable with driving here, as he never really drove in Europe since public transportation is convenient there. I am so used to moving and living in different places, that I forgot it can be a challenge to live somewhere new.

In the meantime, I have been working telemedicine part-time. This has allowed for greater flexibility. I can make the same amount I make working as a locums tenens NP full-time, as a part-time telemedicine NP. The only difference is my housing and rental car is not covered. It makes me wonder if it is worth going back to being a travel NP – if I can make double the income doing telemedicine, and/or work less.

The thought of traveling and living in new places still interests me. I supposed I can always just get a mid-term rental and pay for it myself, while working in telemedicine in a new state. Although telemedicine is easier than working in clinic, it still has its challenges. It drains me to tell patients again and again that they do not need antibiotics after being sick for 1 day; and having to deal with angry patients who think seeing a telemedicine provider is like going to McDonalds and they can order whatever they want from the menu.

I do miss working in clinic sometimes because at least there is more complexity. Vs in telemedicine I am doing simple visits such as UTI’s, erectile dysfunction, cold symptoms, and birth control, etc. It can get tedious. I also want to keep my “hands-on” experience. I believe after working in telemedicine only for 2 years it may be difficult to get an in-person job.

So, I am at a crossroads. I will have to continue working telemedicine for now, and I think at a minimum I will pick up at least one 3-month locums assignment this year.

Would you rather work part-time in Telemedicine and pay for your own housing and car for the equivalent pay of working full-time in clinic? Or would you rather work full-time as a Traveling NP and have your housing and car covered? Not to mention free travel…

My Favorite Loyalty Program

As a seasoned traveler, I have my collection of points and miles. Although it is hard to choose, one of my favorite loyalty program is from American Express. Here are the main reasons why:

-Plenty of opportunity to earn points: AMEX often has large sign up bonuses on their cards so you easily earn hundreds of thousands of points. You can also sign up for a shopping portal at Rakuten to earn Amex points for regular shopping. For example, if you go through Rakuten and shop at Macy’s, you can earn an extra 5 points per dollar spent (bonus points earned varies each day).

-Good transfer partners: I am able to transfer AMEX points to their partners to use for travel for amazing value. Examples of their transfer partners include: AirFrance, Delta, Jetblue, Hilton, British Airways, Emirates, Singapore Airlines, Air Canada, ANA etc

-Ability to travel in business class mostly “free”: I mostly use my AMEX points to transfer to travel partners so that I am able to travel in business class internationally for free. I put free in quotation marks because you still have to pay fuel charges which can range from $5 to $500 depending on the airline. For example, I often transfer 50,000 AMEX points to AirFrance to travel to Europe in business class one way. If I were to cash out the points for cash it would be less than $500 in value. By using it for business class travel, I am able to get at least $2500 of value from those 50,000 points.

-Benefits: many of the AMEX cards have perks and benefits I like to use. For example, the platinum card provides lounge access which is great for someone that is routinely in airports. Some of the cards offer travel insurance which reimburses you for flight cancellations or trip delay. They also have travel credits that can be used for dining, uber, or flights.

Check out my Travel Credit Cards page if you are interested in earning points and miles. Please be responsible in paying off the card each month, and avoid redeeming points for gift cards!

Questions from Readers – January

Occasionally, I will include a blog entry answering some of the most common questions I get from readers about locum tenens as a nurse practitioner. Feel free to comment any questions you have or email me at travelingNP.com@gmail.com.

  • Can you do locum tenens with children?

When I first started doing locum tenens I recognized it would be difficult to do with children. However, during my travels, I have met many locums providers that travel even though they have kids. There are many ways to do this. You can either bring the kids with you or leave them at home.

For providers that work in acute care, they will work their 12 hour shifts consecutively, and make their schedule so that they have almost 2 weeks off in between. They will fly to their assignment for those 3 days, and then return home for the 2 weeks. Of course, this is only an option if you have a spouse that is able to help or a nanny. The benefits of traveling when you have kids, is you get compensated more but also have more free time to spend with your children during off time.

I know another traveling NP that traveled in an RV. She was able to bring her husband and young child along. Her husband was able to work remotely and her child was under 2 so they didn’t need to be in school. She said it worked for her and they loved the adventure. She also enjoyed making a higher income so she could spend more time off in between assignments. Traveling in an RV made it more comfortable because they were able to keep their things there, and didn’t have to pack at the end of every assignment.

I met another traveling NP, that did locums assignments within 2-3 hours from where she lived. She had school aged children but would still take assignments driving distance from home. She worked four 10 hours shifts so she would have long weekends at home. Her children would stay with their father. She said she didn’t mind the arrangement because it gave her some alone time and her kids were mostly in school and doing sports during the weekdays.

Some locum tenens providers will have their spouse homeschool their children. So they are able to join them on assignment and are accommodated with furnished housing large enough for all of them.

Everyone is different and I think nowadays people are living a less traditional lifestyle. So, doing locum tenens with kids is definitely possible!