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My first week in Louisville, Kentucky I stayed in a hotel so I could check out some apartment options in person. I didn’t like the ones that were suggested to me through the agency because they were either really old, had wall a/c or heater units (which wont heat up the place well during winter), or were too far from work (too far being more than 20 minutes).

The physicians I work with had tons of suggestions, but most of the places they recommended did not offer short term rentals. Luckily, one of the places that was recommended to me offered 3 month leases and could furnish the place at a corporate rate. I ended up moving forward with this place because it’s on the river, so you have nice views and beautiful walking trails. It is also only 10 minutes from work.

The 1 bedroom/1 bath unit is also very spacious and modern. I liked the gym facilities and how the amenities room even has a piano. Most importantly the unit has a washer and dryer – something I have grown to appreciate the more I travel. And there is garage parking – which is something else I appreciate when living in cold weather because you wont have to shovel snow or scrape ice off your car.

Below are some pictures of my place. I always like to share my accommodations so other traveling nurse practitioners can know what to expect. Keep in mind even the towels, bed linen, silverware, TV etc are provided. 

One of the perks of being a traveling nurse practitioner is that I get to stay in hotels often. I don’t mind staying in hotels because I am able to accumulate hotel elite status and points. Hotel elite status comes with certain perks such as late check out, free breakfast, free upgrades etc.

I mostly use these benefits when I travel for leisure. In the past I have been upgraded to 2-bedroom suites; been provided with lounge access and continental breakfast; been able to check in as early as 6 am; and been able to check out as late at 4 pm.

My first week in Kentucky I stayed at the Residence Inn Marriott. I like staying at this type of hotel because they provide a kitchen. I typically stay at a hotel during my first week on an assignment while I check out rental properties in person.

I didn’t find an apartment I was interested in until the end of the week, so I wouldn’t be able to move in until the end of the following week. Thus, I needed to extend my hotel stay for an extra week. My agency told me that unfortunately, my hotel was sold out next week so I would have to move into another hotel.

Moving into 3 different places within 2 weeks isn’t ideal. I remembered that since I have the highest elite status with Marriott, which is Titanium status, that I was guaranteed a room as long as I booked 48 hours in advance. In this instance, it was more than 48 hours in advance.

So, I contacted the hotel and told them my case and they said as long as the hotel wasn’t overbooked I was correct. Luckily, they were able to find some space for me and I could even stay in the same hotel room. Having elite status with this hotel chain allowed me to secure a room even when they were “sold out” and prevented me from having to move again.

Do you have elite status with any hotel chains?

Since I needed to escape Chicago for winter, my current assignment offered me to work at some of their other locations. I ended up agreeing to work at one of their clinics in Kentucky because this is where they had the greatest need at the time. I wasn’t too excited about going to Kentucky, because what’s really there? I was mostly doing it as a favor to my job since they gave me several bonuses that I shouldn’t have qualified for since I am a contractor.

However, most of my friends that had visited Kentucky said it’s nicer than you’d expect. I also asked around and heard the physicians at the Kentucky clinics were more amiable compared to the ones in Chicago.

When I got to Kentucky, I immediately felt homesick. Somewhat for Miami, since I was there for a few weeks for the holidays. But mostly for Chicago. I felt weird thinking that I was going to be working in the exact same facility but with completely different people. I asked myself what I was doing here?!

Fortunately, my first day went well. My sources were correct, the PCPs in the Kentucky clinic were very friendly. The medical director even gave me a hug – she was so excited to see me! My schedule was empty so I offered to help the other PCPs with their patients but they all told me “no thank you”. And if they asked me to see a walk-in that belonged to the PCP that was no longer there, they asked me a hundred times if I was okay with it. They wanted to make sure I wasn’t overwhelmed, which was sweet. If only they knew how much I have previously put up with.

The best part is all of the PCPs seem to get along well. They make jokes together, talk about life, and even complain about patients together. I had gotten accustomed to the poor PCP relationships in Chicago, I forgot what it was like not to be in a toxic environment.

My boss from Chicago is currently also managing the Kentucky market. He passed by to see me on my first day which I really appreciated. He told me the clinic in Chicago I worked in is already going crazy without me, and he/they can’t wait for me to come back in Spring.

I am glad things turned out well in Kentucky because it’s too cold for me to return to Chicago at this time. I can handle the 50 degree weather in Kentucky, no wind, and the sun going down at 5:30 pm (the sun goes down by 4 pm in Chicago).

Over 3 years ago, I started working as a locums for a geriatric practice that only accepts Medicare advantage plans. This company has clinics throughout the USA and continues to grow. Since then I have worked with them on and off because I truly admire their mission, and I like being accountable for my patient care. My most recent experience with them was in Chicago. I thought I was only going there for 3 months but kept extending because I really enjoyed it.

On day 1, the medical director was confident that he could convince me to become permanent. I laughed it off because that’s always the intention of sites, especially considering that his particular company has been trying to get me to go permanent with them for years now.

Surprisingly after my last extension, I was open to a discussion with him about going permanent with them. I was upfront about how I had previous offers from the company that didn’t match my needs. The medical director was also aware that it would be impossible for me to survive winter in Chicago.

Part of the offer was that I could spend 9 months out of the year in Chicago, and during winter months, I could work at one of their other markets in a warmer state. That seemed like a win-win to me.

There would definitely be a salary increase to make it worth it since my housing and car would no longer be paid for. I would also be eligible for quarterly bonuses since the particular clinic I work in is part of a shared savings plan. These bonuses can be up to $10k per quarter. In addition, if I made partner, which I easily could if I continued the way I have been practicing, I would qualify for an additional $5k bonus per quarter.

There is no time commitment, unless I want a sign on bonus. In that case I would have to commit to 1-2 years, which doesn’t seem like much.  

I was actually open to accepting the offer, considering the job only gets easier with time since you get to know your patients so well. And like I have said before, I have a special relationship with all of my patients here. However, once again it came down to PTO. When the chief medical officer of the company previously made me an offer (years ago), he would only provide 6 weeks PTO. I am used to taking 10 weeks off per year, so I could at most compromise to 8 weeks PTO.

The market president had a hard time fathoming how I would be able to provide great care to my patient panel if I am gone for 3 months (working in another market) and then gone for another 2 months (on PTO). I know it sounds ridiculous but in reality, I had already proved it can work. I accumulated my patient panel after winter (3 months of the year had passed). And throughout the 9 months I worked there I was gone for 8 weeks total for vacation.

I was still able to have the best patient outcomes in the market. I always had the least (if none) patients in the hospital. I had the highest Hedis score in the market. I was the first provider to have 80% and 90% of my patients flu vaccinated. I placed the least amount of referrals. And I was able to code high risk diseases well to get my overall risk panel significantly higher.

Since we couldn’t exactly come to an agreement, we decided to do a “trial period”. I was planning on ending my time in Chicago at the end of December due to winter. So I agreed to help them in one of their other markets for the next 3 months. The plan is for me to possibly return to Chicago in spring and pick up my patient panel there. This is a “trial” to see if we can actually make this permanent plan work.

This plan may seem a bit crazy but I honestly wouldn’t mind continuing to work in Chicago with my current patient panel. The medical director desperately wants to make it work since my clinic profited tons of money over the past 9 months thanks to me.

Stay tuned for where I am going next….

Sadly, my time in Chicago is coming to an end. Saying bye to my patients has been tough. We honestly treat each other like family. Some of them I have seen monthly or even weekly over the past 9 months of me working here.

My sister laughs whenever I talk about how sad I am to leave my patients. I think it’s difficult for an outsider to understand the bond I have with the patients. We clearly have a strong bond because I somehow made it to 80+ days without any patients in the hospital which is unheard of at our company.

My supervisors are trying to figure out a way to reward me for this but I feel like they don’t need to. It’s my job and something I enjoy doing. I ended up getting 90% of my patients flu vaccinated so my team gets an extra PTO day and $200/person. That’s a nice benefit J

Fortunately, the new physician started and we have slowly begun transferring my patients to her. She is very sweet and pretty quick, which is something my patients will appreciate. I told my patients I may come back in the spring so that has made saying goodbye a little bit easier.

I am looking forward to going home for the holidays so I can be in the sunshine state. Cold, windy, overcast weather gets old after a while. Stay tuned for what’s next.

Do you tend use the same one or two agencies to travel with?

I always recommend being in contact with at least 5 or 6 agencies at any given time. This will increase your job options. To date I have worked with 7 different agencies. I tend to use some more than the others. Ultimately, I just select which agency to work with depending on the job available at that time. It may be tedious to fill out all of the credentialing paperwork, but it will be worth it in the end. 

I am often asked what my favorite travel assignment was. After working in over 20 different settings, it’s hard to pinpoint just one. I think I can narrow it down to my top 3.

Washington State. This was my first locums assignment away from home. I had such a positive experience. I remember the clinic being well run, the medical assistants being industrious, and the fulfillment I felt for taking care of an underserved population. Had my first experience away from home been bad, who knows, I could have easily quit being a traveling nurse practitioner.

San Diego. To be honest, I did not like working at this site. However, living in San Diego was an amazing experience. It is probably the only city I would live in outside of Florida. I like that it is diverse, not too crowded, and there is so much to do outdoors. I would love to return there some day.

Virginia. This was the first assignment that I extended and ended up staying there for 1 year. I really enjoyed working at this geriatric practice that allowed me to be accountable for my patients outcomes. I especially loved forming relationships with my patients. I even briefly considered staying there permanently! I have continued to work for this site in different parts of the USA.

What has been your favorite assignment so far?

In the spirit of Thanksgiving and the upcoming holidays, I wanted to reflect on how lucky I feel and how thankful I am for my life. Here are the top 10 things I am grateful for:

1. Travel – I love the opportunity I have to travel both for work and for leisure. My favorite part about traveling is learning new things and experiencing new adventures.
   
2. Family – I am fortunate to have such a large and loving family that I can return to in Miami any opportunity I get. Of course, they always ask me the same question: “when are you moving back to Miami for good?”
   
3. Friends – I am lucky to have a vast network of friends. Pretty much in every state I travel to for work, I already know at least one person there.
   
4. Being a Nurse Practitioner – What a challenging and fulfilling career. I am grateful for every step that led me to become a traveling nurse practitioner.
   
5. Health – Over the past few years I have made my health a priority and have managed to lose a significant amount of weight. I also make sure to stay physically active which helps tremendously with mental health as well.
   
6. Being an American – As corny as that may sound, freedom and liberty is priceless. I have had an opportunity to work in Saudi Arabia for a significant salary, but there is no price for freedom.
   
7. God – He always has my best interests at heart and continues to bless me on a daily basis.
   
8. Financial Stability – Being debt free, having little expenses, and plenty of savings is uplifting. This allows me to have a carefree attitude about life and allows me to feel like anything is possible.
   
9. Knowledge – I have read 25 books so far this year. I am thankful for knowledge that allows me to keep an open mind and see different perspectives.
   
10. Culture – I feel empowered being multilingual and having a cultural background to share with my peers.

What are you grateful for this year?

Nowadays, most people look up flights using google.com. You can find a one-way flight for half of the cost of roundtrip. Many years ago, it was cheaper to book a roundtrip flight than 2 one ways. Presently, you can find 2 one ways for the same price of a round trip flight.

We often automatically search for flights in economy, not realizing you can frequently find business/first class flights for the same price, cheaper, or only $20 more.

After negotiating my recent extension, I requested reimbursement for a roundtrip flight home for Thanksgiving. I knew the flights would be pricey since this is prime time for flying.

Looking for a one-way flight from Miami to Chicago on the Sunday after thanksgiving were pricing at $680 for economy. That’s pretty expensive considering I can fly roundtrip to Europe for $680 from Miami. Regular economy flights from Miami to Chicago are usually ~$150.

I watched the flight for several weeks with no change. Then one day I decided to check the business/first class flights instead. Surprisingly, I found one way flights from Miami to Chicago on the Sunday after thanksgiving for $650 in Business/First class! This was $30 cheaper than in economy.

I went ahead and booked the flight for business/first class. I submitted the receipt to my agency, and they reimbursed me the following week. Now I get to end an incredible Thanksgiving week flying in style!

Moral of the story: always double check prices in business/first class.

A couple of months ago, I shared my experience training one of the new nurse practitioners in the Chicago Market. We’ve kept in touch since then. She reaches out to me when she has a clinical question or just to say hi. Reminder: we do not work in the same clinic.

She voiced her frustration with the Assistant Medical Director (AMD) at her clinic, who is supposed to be her mentor. Instead, the new nurse practitioner feels bullied by the AMD. Apparently, the AMD told her she should consider quitting and working at CVS minute clinic instead because it would be much easier.

Fortunately, the Chief Medical Officer (in charge of all physicians and nurse practitioners, including the AMD) said he didn’t agree with this statement and the AMD had no right to say that. He met with the AMD and told her that it is her responsibility to make sure the new nurse practitioner is successful.

I was recently able to spend a day shadowing the new nurse practitioner and have noticed she has improved a lot. She has become more familiar with the electronic medical record system and is quite thorough with her patients. She has also gained more confidence in her medical knowledge, which is a result from her studying for hours each day after work.

We discussed ways she could improve such as trying alternative treatments prior to referring to a specialist for any little thing. She also needs to work on multitasking, such as typing and placing orders while patients are talking.

The most important thing I noticed was that her patients love her. Her patient panel is mostly Polish speaking patients since she is the only Polish speaking provider in the clinic. I think that’s enough reason in itself for the company to continue investing in molding her into a better provider.

I just wanted to give an update and let you know that the new nurse practitioner is doing just fine. A little reminder for you new providers out there – don’t give up and be sure to find a mentor!