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I ended up working in Kentucky longer than I expected due to Covid19. Although the patients were quite challenging, I learned a lot and felt like I made a difference while I was there.

I acquired a handful of patients with congestive heart failure that were typically in the hospital every 2 weeks. Once they became my patients, I saw them in the office every 2 weeks which prevented a hospital admission. The patients were happy and proud that they hadn’t been in the hospital over the past 5 months that they were under my care.

I also had several new patients that hadn’t had a PCP for the majority of their lives. Just by doing routine screenings I was able to catch early stages of cancer in a few patients. One patient had a PSA of 210 (normal is less than 4), his prostate biopsy of course was positive for prostate cancer. Unfortunately, he had metastasis to the bone, so he likely had cancer undiagnosed for a long time. I had another patient that was a chronic 2 pack per day smoker and ended up having lung cancer. This was caught just by doing a screening chest xray. Fortunately, his lung cancer was in the early stages and was treated quickly with a lung lobectomy.

After 5 months, I knew it was time for me to go home. I felt bad leaving because the new physician wouldn’t be starting until the end of July (I was leaving at the end of May). However, I knew it was time when I broke out in Pityriasis Rosea, which is a viral rash caused by stress. Luckily, my rash wasn’t itchy, but it spread throughout my entire body which did not look pleasant. I am usually very stress free – so by me breaking out in this stress rash, I knew I was overdue for a break. I had only taken 2 days off during my entire 5 months in Kentucky. This is not my norm.

My co-workers were sad to see me go, but they spoiled me with cake and gifts on my last day. The flight home wasn’t great. All of the non-stop flights from Louisville to Miami had been cancelled, so I ended up with a layover in Charlotte, NC. That airport was packed with people. Some weren’t even wearing masks which annoyed me. My plane was full too – so much for keeping the middle seats empty… I did not enjoy wearing a mask for hours at a time while being in close proximity to a lot of people. I think for my next assignment I will look into being local so I can drive over instead of traveling via plane again.

And now, on to my relaxation….

My boss casually asked me the other day how come my patient outcomes haven’t been as good as usual during my first 3 months in Kentucky. I just told him it was because I am the only provider seeing new patients so most of them are disasters and haven’t had a PCP their entire lives. A lot of them are often hospital discharges aka frequent fliers too.

I thought about it more later and considered sending a more thorough response. I have only met most of the patients only once or twice. Thus, I am not a miracle worker. It usually takes about 6 months establishing with a new patient panel before there is significant improvement, based off of my previous experiences.

In addition, my boss (a physician) has never actually treated any of the patients in the Kentucky market. He is regional chief medical officer so oversees Kentucky, Chicago, and some of our other markets. He has no idea how the patients here are absolute train wrecks (as stated in my “Complex Patients” post).

I decided not to follow up with him because I knew my anger would subside. There was really no point in explaining my case. The reality is that I have done so well previously, that now all they expect from me is perfection. I always try my hardest in whatever I do, and that is all I can commit to.  

The other reality is that I am just a locums. There is no incentive for me to out perform my peers. The full time physicians will be getting quarterly bonuses depending on their patients outcomes. I won’t be getting anything. I think I need to learn how to obtain the same mentality as the other PCP’s. Let things come in one ear and out the other, without taking things so personally….

Update: I reviewed my performance in Kentucky and there was noticeable improvement after my first 3 months. I also did better in my first 3 months there than some of the physicians that have had the same patient panel for years. My boss made it seem like I did horrible, which is not true. I just didn’t have no patients in the hospital for months at a time like I did in Chicago.

Sadly, I was recently a victim of a DEA scam. I remember reading emails about it sometime last year, but it seems so real when you are a part of it. I just wanted to share my story to prevent other nurse practitioners and providers from being scammed.

I was at work one day when I received a phone call from the “Illinois Medical Board.” I thought it was strange since I am licensed through the Illinois Board of Nursing. The man on the phone said he was calling me about an ongoing investigation about my DEA prescribing methods.

When working in Miami as a full-timer, I had been a victim of Medicare fraud. Where some mom and pop pharmacy used my NPI number to forge fake prescriptions to bill Medicare for. Thus, I wasn’t too surprised to receive this phone call.

The man insisted he call me on my cell phone to be on a “secure line” to discuss the investigation further. He said the authorities found a car with a bunch of narcotics, my name as the prescriber. They also found over $2million dollars total under my name in several bank accounts.

As a result my nursing licenses were going to be suspended; they were going to freeze all of my assets; and there is a warrant out for my arrest.

I started freaking out inside because this seemed so extreme, especially for someone who wasn’t even involved. I convinced him that it wasn’t me and asked what I could do prevent these things from happening.

He told me the FBI really wants to arrest me, but the medical board did their due diligence and did a mini investigation themselves. The conclusion of this investigation is that someone had stolen my identity. They said it could be anyone I work with or a family or friend, so not to tell anyone about this conversation. In the mean time, they faxed me a paper saying my nursing licenses have been suspended unless I cooperate with the investigation.

I agreed to cooperate, so the man called the “FBI” as a three way and pleaded my case. It seemed a bit sketchy but then the FBI agent told him to send me a government agreement. The man faxed me this agreement to cooperate with the investigation and I read that they were requesting a $20,000 US government bond.

Once I saw that they were requesting money, I realized it had to be a scam. I proceeded by googling ‘DEA Scam US bond’ and found that previous scams included this same amount of requested money. I immediately hung up the phone, and of course the scammers called me back a million times.

I felt such a huge weight come off my shoulders. Imagine?! Not being able to work, losing all of your money, and facing prison time for a crime you did not commit??

Of course, looking back it seemed like extreme measures without being interviewed prior. But then again, innocent people are prosecuted all of the time. I also asked why the DEA agents didn’t storm my work place. The man said they didn’t want to have the person who stole my identify suspicious or they will flee.

I told my co-workers what happened and apparently one of the Physicians had just been scammed a few months back. He agreed that it seemed so real and he was also freaking out during the phone call. It wasn’t until he called HR and his lawyer that he realized it was a just a scam.

It’s so unfortunate that people are trying to take advantage of medical professionals. But just wanted to share my story so you wont waste your time if you are ever called. 

Everyone thinks working in the medical field is recession proof. I mean – it usually is. Ironically this pandemic has caused many health care professionals to be furloughed. With the halt of elective procedures, a lot of specialty offices have closed, not to mention the various hospital wings that have been shut down.

Most primary care offices have shifted to telemedicine. With a decline in office visits, many health care providers have been let go, as the practice cannot afford to keep them.

How does this affect locum tenens work for us travelers? Unfortunately, there has been a decline in available locums jobs at this time. As I have described above, there is currently a lack of need for coverage. Since many providers have lost their jobs, there is also a surplus of available providers looking to do locums.

On the other hand, there are some specialties that are still in high demand. This includes psychiatric nurse practitioners, since a lot of the services are provided virtually. ICU or Hospitalist nurse practitioners are highly requested at this time as well. States such as NY and CA are also in need of nurse practitioners just to complete covid screening and testing.

Many of my readers have asked if it this is the right time to become a locums. Unfortunately, it’s not. So if you have a secure job, I would continue working at your permanent job until things cool down. Many of my readers have also mentioned they haven’t heard back from the recruiters they reached out to. Since there is a huge decline in job opportunities, the recruiters don’t have a reason to return your call.

I know plenty of travelers that got their assignment cancelled abruptly due to all of this. If you are currently on assignment, I recommend inquiring about an extension. Once the economy opens back up, there should slowly be an increase in locums job options. Until then, we have to be patient. 

I am not sure if I have mentioned this before, but my favorite car rental agency is National. Being a traveling nurse practitioner, you can easily obtain executive elite status with them. After just 85 paid rental days with National, you can enjoy all the benefits of their highest elite tier. 85 paid rental days is the equivalent to one assignment of 3 months.

My favorite perk of being an executive elite is you get free upgrades to their cars. Their website states you have to book a midsize car to be eligible for the free upgrades. In my experience, the agency will book me a compact car and I still have the option to upgrade for free.

Usually with National, you can select the car you want from a designated lot, instead of being assigned a specific car like most other car rental companies. I often choose the Nissan Altima because the 2020 ones are very nice on the exterior and drive well. Not to mention it’s good on gas mileage.

During the coronavirus pandemic, I had to change my rental car because it was due for an oil change. At that time, I had the Nissan Rogue SUV. I knew that travel was slow so I asked if they had any luxury cars they could upgrade me to.

I saw the agent double check my elite status before saying yes. The next thing I knew, I was driving away in a 2020 Audi Q3 SUV. I forgot what it was like to drive in luxury. The interior was gorgeous and the drive felt amazing.

I always considered myself to be a ‘car’ person. But this reminded me how much having a nice car can affect my mood. Now I have mini dance parties in my car on my way to work.

In our present environment there is so much chaos going on, that it’s sort of a relief to find pleasure in the small things. 

I am honored to have my blog “Traveling NP” listed as one of the top 100 nursing blogs of 2020! I have been blogging now for about 5 years. I enjoy sharing experiences with my fellow nurse practitioners and guiding you all in finding the right assignment and navigating the locum tenens world. Thank you to all of my readers and especially those of you that actively engage with me.

For the full list of nursing blogs, check out the link below:

https://www.nursebuff.com/best-nursing-blogs/

My current job had us spend half a day doing team building exercises and made sure we felt appreciated. I was provided with this Healthcare Hero Award that included a couple of statements from my current patients. It was really nice seeing how much my patients value and admire me. I felt good knowing I was making a difference in these patients lives, even if it was for a short period of time.

In addition, my job treated everyone to dinner from Olive Garden. They provided enough food for your entire family to go home with. They wanted our families to feel the love too, since they know we are putting them at risk by continuing to work at the clinic.

Check out my interview with Leaderstat on how the coronavirus has affected my current locum tenens assignment.

https://www.leaderstat.com/knowledge-base/meet-sophia-the-traveling-np-part-2

I just finished reading a short book called “Nurses are Nuts” by Anthony Langley. The book illustrates all of the ways nurses help other disciplines in the medical field on a regular basis.

Nurses help doctors by putting in verbal orders or providing them with lab and imaging results that can easily be accessible in the patient’s chart. Nurses help phlebotomists with lab draws if the patient is a hard stick or if the phlebotomist is behind. Nurses help respiratory therapists with trach suctioning or helping set up ventilators. Nurses even help housekeepers by cleaning up spills or cleaning rooms to facilitate placing patients.

These are just a few examples of how nurses help other workers in the hospital. The book is a satire because it says nurses are nuts for allowing themselves to do everyone else’s jobs. Nurses are often short staffed and no one can really fill in that role and provide extra support. As nurses we are used to helping others, but by taking the time to fulfill other people’s job responsibilities, it is taking time away from our own tasks to our patients.

My only wish with this book is that there should be an extra chapter about how nurses can solve this problem or stand up for themselves. Yet, perhaps that will be a sequel.

Anyways I highly recommend this book to all of my fellow nurses. It was an interesting and easy read, that I quite enjoyed. I am sure you can certainly relate to most of the book. You can find it for sale on Amazon, Barnes & Noble, Walmart, or Target. Let me know what you think once you’ve read it!

Once again my California nursing licenses expired. I decided it was time to renew them because I would be open to returning there for work this year. I had one of the agencies I work with renew them for me because it costs over $500 for all of the licensing renewal fees. California is known for having steep fees.

The good part is that the process was extremely fast. I had received an email that my licenses were renewed within 5 days of doing the applications and submitting payment. Well I have to clarify that the agency licensing representative did all of the actual work.

The annoying part is that I noticed my licenses expire again 12/2020, at the end of this year! I find that to be ridiculous considering we just paid over $500 just to have active licenses for 10 months vs the standard 2 years.

If you plan on doing locums work long term, I highly recommend you getting a California license. There is always plenty of work there and depending on the location, the pay can be pretty high. Keep in mind the original licenses can take 4-6 months, but fortunately the renewal is quick.