Working in Bradenton, FL – Again

This is the first time I have returned to the exact same clinic. I have returned to the same company/markets before but not the exact same clinic. I felt very welcomed on my return and it was nice to catch up with everyone. There was one major surprise though.

I thought I was coming in to help absorb new patients. But it turned out that the company fired a physician the Friday prior to my start date. Apparently, she was being nasty to the staff and wouldn’t even see one of her patients as an acute visit that was audibly and visually throwing up blood in the hallway. I was surprised because she was very nice when I met her the year prior. The other providers think she had a psychotic break from all of the stress because she became a completely different person.

Anyways, this assignment turned out to be similar to the Virginia Beach one last year, where I had to absorb a patient panel pretty quickly. This patient panel had gone through 3 physicians within one year, so they weren’t the happiest. I totally get their frustrations but physicians are real people too. Their first doctor wanted to go part time to spend more time with her kids. The second one realized she didn’t like primary care and wanted to work in the hospital. And the third one I just explained above that she was let go.

The first couple of weeks were annoying have to hear patients complain about switching PCPs again. Several of them threatened to leave the practice, but at the end decided they were going to stay. So, my first few minutes were them was just allowing them to vent. It was a bit hectic because patients were calling trying to be seen right away for various reasons, but there was only one of me to accommodate all of these patients.

Now I am two months in and things have gotten much better. I have gotten to know the patients so it makes things easier. My hospital sick days have been pretty good as well. No one really micromanages me because they are just appreciative to have the coverage. I do have a handful of psych patients that call all of the time, but I try to set boundaries with them.

The company hired a physician and a nurse practitioner to start seeing patients in February. I am supposed to finish here in mid-February, but they really want me to stay longer so that I can help train the new nurse practitioner and to provide a few months buffer while the new PCPs accumulate patients. I usually like to make this decision the month before my contract ends, because it gives me enough time to evaluate how things are going. I’ll let you know my decision soon!

Housing in Bradenton, FL

Returning to Bradenton, Florida for winter season made finding housing a bit challenging, since all of the snowbirds go down there around that time. Monthly Airbnb’s are over $7k per month in the area. I didn’t prioritize living at the beach this time since the water is too cold for us Floridians this time of year.

Fortunately, my agency found me an apartment 15 minutes from work. It’s in a new suburb community with plenty of restaurant and shopping options. It is pretty spacious and they even gave me a sofa bed for guests. There is a community pool and gym.

I moved in the weekend after getting my covid booster in November. Once I moved in all my stuff, I started to feel horrible from the vaccine. I spent the rest of the weekend just lying in bed with chills and body aches. I was disappointed that internet and cable hadn’t been set up yet. Especially since my cellphone service wasn’t that great in the area. It would have been ideal to be able to watch tv or read stuff online when sick in bed.

I was told internet and cable would be set up Monday, so I tried not to be too disappointed. However, on Monday, I received an email from traveler’s haven (a housing agency that my travel agency often uses to assist them in finding housing). The email said only cable would be set up today and I had to go to Spectrum to pick up the wifi box and router.

I was like really? Who prioritizes cable over internet? Not to mention I still wasn’t feeling 100% after that vaccine. I knew I couldn’t spend another day without internet (first world problems), so I drove over to Spectrum after work and waited an hour in line to pick up the internet boxes.

I got home and set everything up, which took forever. Before I could use the internet, I had to activate the account. When I called to do so they wouldn’t let me since I didn’t have the code, considering traveler’s haven set up the account. I called Traveler’s haven and luckily someone answered and gave me the code. Four hours after finishing work I finally had internet.

Considering I was still recovering from the covid booster, I was a bit cranky and emailed my agency telling them how disappointed I was that internet hadn’t been set up prior to me moving in. I know there is a disclaimer that this may happen, but it has never happened to me in my past 6 years traveling with them.

They apologized and told me that traveler’s haven should have never sent me to pick up the wifi boxes. That they usually use a concierge service for that, and have never seen a provider sent to pick this up. Traveler’s haven sent me an apology as well with a $50 visa gift card for the inconvenience.

At least I know now if they ever tell me to pick up a wifi router again, I can tell them to send someone else.

Top Nurse Practitioner Blogs of 2021

I am thrilled to say that this blog made it to top 5 nurse practitioner blogs of 2021! Check out the other top NP blogs here: https://www.npschools.com/blog/best-np-blogs

Thank you to my readers for all of the support! I enjoy sharing my experiences being a travel nurse practitioner and guiding those interested in starting this amazing lifestyle.

Hotel Status Saved Me

Florida is popular during winter. In fact, the average Airbnb rental for the winter months is about $4000-$5000/month. This isn’t California! So of course, my agency had a difficult time finding me housing initially.

I ended up having to stay in a hotel for my first week on assignment. Fortunately, I was able to find a Residence Inn Marriott which came with a kitchenette. However, one of the days I needed was sold out so the agency asked me what hotel I would like to stay in for that particular night.

My first reaction was to be annoyed. Who would want to move out of a hotel just to go stay at another hotel?

Then I remembered that since I am a Titanium member with Marriott they have a benefit which is a 48-hour guaranteed availability with a paid stay. So, I called the hotel and provided them with my Marriott rewards number and explained my situation. They instantly recognized my status and proceeded to find me a room on a “sold out night”.

This worked out really well because I was able to stay at the one hotel for the entire duration prior to me moving into my apartment. It was a nice surprising perk of having top tier status with the hotel. If you have status with any hotel chain, be sure to read the benefits and perks so you can be prepared when needed.

Returning to Bradenton, Florida

I worked in Bradenton, Florida at my usual geriatric clinic last summer. It was amazing living at the beach. They had hired 3 new physicians upon me leaving, so I didn’t think there would be a need to return for a while.

Since then, one physician retired and another one left for a different opportunity. So once again, they needed help. They asked me to come when I was in Virginia, but I told them I wasn’t available. And in fact, I wouldn’t be available until November.

They decided to hire another locum tenens nurse practitioner in the mean time. I was curious to see how that would turn out, because the nurse practitioner would be new to the model and would require several weeks of orientation. This is in comparison to me jumping in and seeing a full schedule of patients on my very first day.

I knew it wouldn’t work out if they held the same expectations for her as they did for me. Unsurprisingly, the locum tenens nurse practitioner only lasted a few weeks. The site decided to end her assignment early because she wasn’t meeting expectations. All I know is that she would take a long time with the patients, was always behind, and the other PCPs had to often help her catch up. This is unusual for a locums, we are typically more efficient and the ones jumping in to help the perm PCPs.

After that experience, the site said they would wait for me to come in November. I agreed to the assignment because the location is very convenient for the holidays. I will be within a 4-hour drive from home, so I can easily make it home for my week off during thanksgiving and my week off for Christmas. Not to mention that I will be in my ideal state for winter.

This is the third site I have returned to this year. That’s why it’s so important to maintain relationships and make a good impression. You never know when the site might need you again.

Malpractice Insurance Exceptions

Working in locum tenens is great because you can take off as much time as you want in between assignments. However, it starts to become complicated once you spend more than 6 months to 1 year away from practice.

Even if you were secure in your skills, the challenging part is obtaining malpractice insurance once you have been away from practice for a while. Typically, the absolute maximum time you can be away from practice is 2 years before malpractice insurance will unlikely credential you.

There is a loophole with this, and that is finding a job with the federal government. The federal government considers itself as your malpractice insurance. This means that if you were to work at an Indian Health Services facility, Veteran Affairs, the military, or some FQHC clinics, you would not need your own malpractice insurance.  So, if a patient from one of those work sites decides to sue you, it would go through the Attorney General.

Many states require nurse practitioners to carry malpractice insurance. Yet, there may be an exemption form you can complete which dictates that you practice exclusively as an employee for the federal government, so are exempt from carrying malpractice insurance.

I thought this was an interesting loophole and just wanted to share it with my readers. 

Managing 12 State Licenses

As a traveling nurse practitioner for the past 6 years, I have obtained 12 state licenses. It can be challenging to keep up with renewals and CEU requirements for each state, since they frequently vary.

I typically allow a license to expire when I am no longer working in that state. Of course, I keep my home state license active – which is Florida. Fortunately, the process for renewing expired state licenses isn’t that complicated. It just requires a renewal application and for you to pay the renewal fee. The renewal fee is often a bit more expensive after letting a license expire, compared to renewing it when it has not yet expired.

I believe renewing expired medical doctor licenses is much more complicated than for us nurse practitioners. Trying to renew a nurse practitioner license after it expires is often a quick process. I have had my license changed to active within minutes of submitting my application and the renewal fees.

My current active state licenses are: Florida, California, Arizona, Ohio, and Virginia.

My current inactive state licenses are: Washington, Colorado, Maine, Wisconsin, Texas, Kentucky, and Illinois.

Some of those inactive licenses I haven’t even used. But instead of continuing to renew them and waiting for an assignment, it just makes more sense to renew them after I have secured an assignment in that state. That way, I don’t have to waste hundreds of dollars on licenses I may not even use every couple of years.

Before renewing a license, I always double check the CEU requirements to make sure mine are up to date. I try to have 75 CEUs of pharmacology done within the past 2 years, at all times. This is because a lot of states require this upon licensure application. So, it makes it quicker to complete my new applications by having this ready.

Otherwise, I keep an excel document with all of my state licenses. This document lists expiration dates, CEU requirements, and alternative licenses needed (such as a furnishing license). I also list if the state requires a separate RN license application, or if they just use my multistate practice RN license from Florida (through the eNLC compact state agreement).