Using Travel Nursing to Retire Early

A great benefit of being a traveling nurse practitioner is you can use this opportunity to retire early. First, as a traveling nurse practitioner, your pay is higher than being a full-timer. Second, most Americans spend about 30% or more of their income on housing, and 15% or more of their income on transportation. As a traveling nurse practitioner, you can save tons of money on these costs since housing and transportation is provided for free.

So not only are you making more per hour, but you are saving money on the majority of your expenses. I know some travelers that keep their home empty while they are away traveling. If you do not want to sell your place, go ahead and rent it out because you are losing money by keeping it unoccupied.

As a result of being a traveling nurse practitioner, I am able to save 85% of my income! If I worked at a permanent job I would probably only be able to save 50% of my income or less.

In addition, as a traveling nurse practitioner you can find several ways to contribute to a retirement account. I often work with Comp Health that provides W2 pay. They offer a 401k and match. I make sure to max out my 401k with them and earn the few thousands of dollars in match each year.

When I work as a 1099 contractor, I contribute up to 25% of my 1099 net income to a SEP-IRA. This is a specific IRA for people that are self-employed. These contributions are tax deductible and lower my overall gross income and taxes owed. If you qualify for a Roth IRA or Traditional IRA, you can contribute up to $6000 per year in either of these accounts as well.

Due to my increased savings rate and being able to max out my retirement accounts each year, I foresee myself retiring early. Will discuss more in a later post!

Living in Bradenton

Last week I discussed how much I enjoy my job here. But the real best part of me living in Bradenton, Florida is that I get to live on the beach! Especially with Covid-19, there isn’t much to do these days.

I am fortunate that I get to go to the beach whenever I want. Sometimes I even go swimming at the beach after work. The good thing is the sun doesn’t go down until at least 8 pm. The water is beautiful and refreshing. Hearing the waves and lying on the sand is incredibly relaxing. The beach is probably my favorite place to be.

In the morning before it gets really hot, I like to go for a bike ride on the coast. It allows me to get my exercise in since I am not interested in going to the gym during this time.

I found this place through Airbnb. As travel is at a decline, I figured the owner would be willing to make a deal with me. If I had rented the place out at the regular nightly rate, the cost would have been $3500/month. I knew from a previous assignment in Florida that the agency’s housing budget in Florida is about $2500/month. So, I asked the owner if he was willing to rent out the place to me for $2500/month for a guaranteed 3 months of rent.

He quickly agreed because there are a lot of vacancies these days. I then gave his information to my recruiter and the agency went ahead and secured the apartment for me. As an Airbnb, the place comes furnished with linens and silverware etc. It also comes with bikes and kayaks to borrow.

I feel grateful to have this assignment that I love. I love the job itself and the fact that I am able to live on the beach. I feel especially lucky to have this opportunity as many health care providers have lost their jobs during the pandemic.

Working in Bradenton, FL

I am absolutely loving working in Bradenton, Florida. I feel so blessed to have this opportunity. The job itself is wonderful. It’s the same clinic I have worked with in the past in Chicago, Kentucky, and Virginia etc. We have only geriatric patients, and as a result of Covid are doing a mixture of in office visits and telemedicine.

This time I won’t have my own patient panel, which is sort of nice because I won’t get attached to the patients. I am helping out as the walk-in provider and seeing hospital discharges. I also accommodate some scheduled telehealth appointments that cannot fit in their PCP’s schedule.

My patient load is pretty light. On a normal day I see about 10 patients, including scheduled telehealth appointments. On a busy day I see about 15 patients, with the majority of them being in clinic for acute complaints.

The staff is friendly and appreciative. They try not to overwhelm me and communicate well; to make sure I am able to accommodate an acute patient. The medical director is also very welcoming. He is originally from Miami so we get along well.

The best part are the patients. They are so kind and normal. This is in comparison to Kentucky, where the patients were not only very complex medically, but many of them had bad attitudes. Not to mention the plethora of drug use and psychiatric issues the Kentucky patients had.

It’s fulfilling taking care of this Floridian population that always show their gratitude. I also like the diversity here. The patients I see are either African American or Haitian; Caucasian from all parts of the USA; and Hispanics from all parts of the Caribbean and South America.

After being burnt out working in Kentucky, I am so happy to have a job I enjoy again!

Staying in Florida for my Next Assignment

After taking several weeks off to be home, I felt ready to go back to work. I wanted to stay in Florida so that I wouldn’t have to travel via plane again. Luckily, the same clinics I worked with in Kentucky and Chicago have plenty of clinics in Florida. They always have a need too.

Once I let them know I was available they offered me a position on the Florida Gulf Coast. They also wanted to revisit me becoming their internal locum. We had a meeting to discuss some of the challenges. The company had grown since we last discussed this possibility a couple of years ago. So, they would need to obtain board approval on a higher PTO and salary option.

Before choosing this assignment, I was also considering going back to San Diego. There was an opening at one of the clinics I did enjoy working at while I was there before. The weather seemed ideal in comparison to Florida’s heat during summer. But I wasn’t keen on the traveling so far.

So, I have officially accepted an assignment in Bradenton, Florida. This is a small beach town south of Tampa. It is only 3.5 hours from Miami, so I can go home for the weekend easily if I want to. My brother also lives only 1 hour away. I get to live on the beach which I am excited about! Especially since there isn’t much to do these days due to Covid.

I won’t be having my own patient panel this time. The reason they need help is because one of the physicians is older than 65 years old so he is working from home doing telemedicine. As a result, they need someone to be in the clinic to help with walk-ins and hospital discharges etc.

I met with the medical director virtually, and he seemed really nice. I am looking forward to working and living there!

The Chicago Doctors are Spoiled

I sort of knew that when I started working in the Chicago clinic. But this observation was confirmed once I started working in their Kentucky clinics.

The Chicago physicians would only see less than 15-16 patients per day, and acted like they were exhausted after that. Not to mention they would finish late. Meanwhile the Kentucky PCPs and other sites I have been, see at least 21-23 patients a day, and finish on time.

The patients at the Chicago clinic weren’t as sick and complex as the ones I had seen in Kentucky and Virginia. Realistically, the Chicago PCPs shouldn’t have had patients in the hospital on a regular basis. I often witnessed them send their patients to the ER for mild things such as an abscess that could have been treated with oral antibiotics or for a cough that could have been evaluated further with an in house chest x-ray (pre-covid).

Now let’s talk about walk-ins. The PCP lead of the Chicago clinic would flip out if she had to see one walk-in per day. I thought the walk-ins were rather light at that clinic. On an average day there were only 2-5 walk-ins. In comparison, I worked at one of their Virginia clinics and there were 20 walk-ins per day there! In Kentucky, there is a decent amount of walk-ins but the PCPs see their own walk-ins. This makes sense since the PCP knows their patients best. This is different from Chicago, where the physicians would always ask me to see their walk-ins, since I was always more efficient than them.

So why are the doctors in Chicago spoiled? Because they are seeing less patients than Kentucky/Virginia – less patients that are also less complex and sick – and still have the nerve to get upset when they have a walk-in or if I don’t offer to help them.

It used to be challenging for me to keep a straight face when one of the physicians would not see her 4pm walk-in but then when the patient went to the hospital, she would tell leadership she doesn’t know why the patient went there because she already told the patient to call her if she needs anything.

Permanent Chicago Job – Part 2

Initially, I was in a rush to get back to Chicago in April so my patients would still remember me (silly, I know). But then Covid hit…so I decided to stay put in Kentucky instead. By the time I was finishing up in Kentucky, my contract was finally the way I wanted it to be. Right before I was going to sign it, I decided to reach out to my boss one more time to make sure we were on the same page. That I was planning on returning to my previous clinic in Chicago, to reacquire my previous patient panel.

He said that was fine but he wanted to talk to the new medical director of that clinic to make sure there were no issues (he had recently been promoted). The next thing I know the new medical director was requesting a phone conference with me and the PCP lead at that clinic.

Apparently, they weren’t happy with my request to come back. Mostly because to them it wasn’t reasonable for me to have my patients back. They didn’t think it was fair to the new PCP that had covered my patient panel, to lose those patients. Honestly, it was ridiculous to me that they were so against it. I had spoken to that PCP prior to me leaving asking her if it was okay for me to return and take back my patients, and she said yes. Also, it’s not like I would force the patients to come back to me. The reality is that the majority of them were still asking for me on a regular basis so I knew most of them would return to me. However, the medical director did not want me to announce my return and would only give me back a patient that asked for me directly.

I thought that was unjust, because a patient would have to incidentally see me in the clinic before they could become my patient again. I was appalled by the conversation because they were even interrogating me about the needs of the clinic. Saying there weren’t many new patients at this time and asking what I would do if I couldn’t fill up my panel. They acted as if I was in an interview not realizing that I already had the job!

The silliest part is that the new PCP who has my patients is pregnant and going on maternity leave later this year. So, she would need someone to see those patients eventually anyways. The interrogation ended with them going to ask the new PCP if she was ok with it and let me know the following day. I spoke to the new PCP again myself and she reassured me she was still fine with it (she is really down to earth).

I spoke to my boss after the phone meeting, and he admitted that the physicians are jealous of me because I constantly outshined them when I was there!

The following day the new medical director emailed me and told me my services were not needed at that clinic in Chicago. That’s it.

I was in shock. I was going to follow up with the CMO, who practically created that position for me, but I decided to sleep on it instead. The next day I woke up and had an epiphany that this was not meant to be. I had jumped through so many hurdles already, between creating that position and negotiating the terms of my contract for months.

If I went back there with the physicians in leadership against me, I would have a target on my back and more stress than I would ever want. Plus, who wants to be in such a toxic environment?

It also made me realize that I truly did not want to move to Chicago. When I was looking at housing options, I felt like most areas were unsafe. Not to mention that housing in downtown Chicago costs a fortune. I was having a hard time transitioning from paying $0 per month for housing to paying $2500/mo. I especially couldn’t picture myself living in freezing weather away from my family for at least 2 years of my life. It was just a sacrifice I was willing to make to be at a job that I enjoyed.

To be honest, I had just felt pressured to return to Chicago. Mostly by my patients that I had developed bonds with and who were expecting me back. I didn’t want to feel that guilt again the way I did when I left my patient panel after one year in Virginia. I also felt like the majority of my co-workers (the ones who weren’t jealous lol) wanted me to come back.

Once I let go of those expectations, I knew that this was a sign from God and that everything happens for a reason. I told my boss it was ok, but it was over. He immediately asked if I could help as a locums at one of their other Chicago clinics. They seriously don’t waste time asking for help….even when they screw you over.

I said no thanks, I just wanted to be close to home for now. The other physicians of that clinic and some of the support staff were disappointed that I was not coming back, but were understanding since they have to deal with the horrible leadership there on a regular basis.

If they asked me to cover that maternity leave, I wonder if I would say yes just to see my old patients or if I would say no just to be spiteful 😉

Follow up on the Permanent Chicago Job

Before starting my last assignment in Kentucky, I mentioned that my plan was to return to my job in Chicago, possibly on a permanent basis. The funny thing is that I spent my entire assignment in Kentucky (5 months), negotiating with my boss on making this a reality. My boss definitely wanted me to come back to Chicago to help out, but there wasn’t technically a need at the clinic I was previously at (since the new PCP started there before I left).

My only intention in returning to Chicago would be to have my same patient panel that I had developed relationships with. I was not interested in going elsewhere in Chicago. As a result, the CMO (chief medical officer) of the company told my boss just to make room for me at my previous clinic, whether there was an immediate need or not.

Once that problem was solved, we discussed the terms of the contract. I am used to taking 8-12 week of PTO in a given year. The 6 weeks of PTO that the PCPs get (including holidays and CME) wasn’t going to cut it for me. Fortunately, my boss offered me an extra week of PTO considering I had been working with them on and off over the past 4 years.

Next were salary negotiations. The salary offered to me is pretty much what I make now as a locums. At first I was turned off that they didn’t offer me anything higher. What incentive did I have to leave my current comfort as a traveler? At the same time I had to remind myself that full time nurse practitioners don’t make as much as traveling nurse practitioners. In fact, my boss told me I would be the highest paid nurse practitioner there if I accepted the contract.

I still pushed for more considering my history of outperforming even the physicians. The CMO once again told my boss to add some incentives to the contract. For example, once I reached a certain patient panel size, my salary would increase by 10% etc. I accepted this proposition.

They also offered me a sign on bonus which was fair, in exchange for a two-year commitment. This doesn’t include the quarterly performance bonuses.

The contract was finally where I wanted it to be. Did I end up signing? Stay tuned for part 2 tomorrow.

Home During Covid

I decided to take about 2 months off after my last assignment. I was burnt out and in need of a break. When I got home, a lot of my extended relatives didn’t recognize me because I was so pale. Probably the palest I had ever been. So, my first order of business was to get back my tan.

I was surprised it didn’t rain every single day like it normally does in Miami during the summer. I had plenty of pool and beach days which were so relaxing. I even spent a few days on the Florida Gulf beaches as well.

Additionally, I was able to catch up with some relatives, and even celebrated my sisters and my grandfather’s birthday while I was in town. Don’t worry, we were social distancing and wearing masks in very small groups…

I even learned that I am going to be an aunt for the first time! My younger sister that is married is due in December. This will make my grandparents – great grandparents. We told them via cake and they had pretty funny reaction (aka shocked).

While home I decided to re-do my LASIK eye surgery. It initially lasted me about 7 years, so this time I was doing the PRK version. The recovery was longer and more complicated than the LASIK, but I am happy to report that I have 20/20 vision again!

It was nice taking things easy for several weeks. Besides swimming and visiting family, I listened to tons of podcasts, read several books, and caught up on some of TV shows. I feel rejuvenated enough that I am ready to return to work.

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Are You Studying To Become a Doctor?

Sometimes I’ll have that one patient that thinks I am a student because they are confused as to what “practitioner” means (in Nurse Practitioner). They ask me if I am studying to become a doctor. Sometimes coworkers (non-providers) will ask me why don’t I just become a doctor? They say I am young and smart so should just go for it. Ironically, most of them are young too and work as assistive staff so I wonder why they don’t give themselves the same advice.

Anyways I usually tell those asking that I am completely satisfied with my career as a nurse practitioner. I like having a nursing background instead of just medicine, because I can encourage my patients to try lifestyle modifications and natural remedies instead of throwing medications at them any chance I get.

I especially love being a traveler and not having the same mundane life on a daily basis. I don’t have to be on call and don’t have to work more than 40 hours a week, unlike most of my physician peers. I am happy that I didn’t spend 11 or more years in school just to accumulate hundreds of thousands of dollars in debt.

And to be frank, my salary is pretty close to what a primary care physician makes. I was shocked when one of my physician colleagues told me they made $180,000 in salary per year. Everyone assumes that if you are a physician you make tons of money. But a family practice physician doesn’t make that much in comparison to the amount of schooling they had to do and the amount of student loans they acquired. This is why a lot of doctors choose to specialize because as a specialist they will easily make double or even triple what a primary care doctor makes.

So even though I work in a similar role as a physician, I find it funny that some people still want me to go back to school to become a doctor. If I had to do it all over, I would have chosen the exact same path. What are your thoughts and experiences in choosing the nurse practitioner route over the physician route?

Flying For Free

I haven’t paid for a flight in over 5 years. That was before I was introduced to the world of travel hacking. When I travel for work, of course my flights are paid for. When I travel for leisure, I use miles and points to pay for my flights.

Some of these miles I have accumulated through flying for work. Other miles I have obtained on my own through credit card sign up bonuses. For instance, Miami (my hometown) is an American Airlines hub. As a result, I have one of the American Airlines (AA) credit cards that gives me a free checked bag every time I fly on AA. I earned the sign-up bonus on this card which was 70,000 miles after spending $3000 in 3 months.

I pay off all of my credit cards each month, thus I only recommend this if you are able to do the same. With the AA miles I have collected, I have been able to book one-way flights in the USA for 12.5k miles each way. I also used them to fly on my last international trip to Australia in business class. Sometimes while on assignment I need to get home for the holidays or a special occasion, in which I am responsible for the cost of that flight. In this case I will use my AA miles.

Even through applying for credit cards just to earn sign up bonuses, my credit score remains above 800. Besides credit cards, I also accumulate miles through shopping portals. By doing my usual online shopping, I can earn extra bonus points by going through the right portal. I recommend using www.cashbackmonitor.com to see which portal is offering the most points at any given time. For example, if I need to make a $100 purchase at Macy’s, I can often find a portal offering 10 points per dollar spent. That’s an extra 1000 points just for doing my usual shopping.

I sometimes laugh at the fact that I used to pay $1000+ for a roundtrip flight to Europe in economy. Now the most I will pay is probably ~$100 in fees to fly roundtrip in business class to Europe on miles. What are you waiting for? Stop wasting your money on travel, and start collecting miles and points! Don’t forget to check out the “Traveling Credit Cards” section to see which credit cards I recommend at this time.