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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.

With the stay at home order, non-essential workers are forced to stay at home – whether they are able to work or not. As a result, plenty of my friends and family have tons of extra time on their hands. They are constantly asking me what I am up to and how I am keeping busy.

I have to remind them that I am still working. Although we are not seeing the majority of our patients in the clinic, I am still going to the clinic to do telehealth visits. My job wants us all in the clinic in case some of our patients need to come in for acute reasons (such as Congestive Heart Failure or COPD exacerbation). Thus, my week days are still as busy as before.

Even though we aren’t seeing as many patients in the office, many of them are constantly calling with questions all day. So, I feel more tired than usual when I go home after work.

With my free time, I have continued to be physically active. I take walks outside by the river. I also use the gym in my apartment building (there is typically only 1 other person in there).

I continue to read books, maybe at a quicker pace than usual. I can finish a new book within a week. Of course, I am binge watching TV Shows such as Ozark on Netflix and Outlander on Starz.

Every other weekend it is someone in my family’s birthday, so we all gather together on Zoom to celebrate. I have been catching up with my friends via text and phone.

I continue to work on my blog. I write entries far in advance. I listen to podcasts regularly: some about financial freedom, others about entertainment (such as the show The Bachelor).

I am an introvert so I don’t feel completely bothered by this social distancing. However, I have to admit that I do miss my family and friends and am looking forward to seeing them soon!

What have you been doing to keep busy during this strange time?

Most health care providers have been preoccupied with the coronavirus lately. Yet, last month Florida Nurse Practitioners received good news. Advanced registered nurses in Florida officially gained full autonomy!

The bill proposing independent practice for nurse practitioners was finally approved by both the House of Representatives and the Senate. Governor Ron DeSantis was quick to sign this bill into law. This has been something we have been striving for for many years.

Under this new law, nurse practitioners with at least 3,000 hours of experience under a supervising physician can practice independently. No more collaborative agreements with a physician after proving competency. This is extremely beneficial to nurse practitioners that want to own their own practice without having to pay a physician to just supervise them “on paper”.

I am really happy that my home state, Florida, is moving in the right direction when it comes to nurse practitioners!

I have really admired how well my current workplace has led us through the coronavirus pandemic. As soon as the coronavirus was spreading in China, my job formed a Covid19 committee. This committee kept us up to date with the most recent news.

Once the coronavirus started spreading in the USA, we prepared to start screening all of our patients via phone when confirming appointments. We put a ‘gatekeeper’ at the front door to check everyone’s temperature when walking into the building – both patients and employees.

We also converted the majority of our office visits to phone visits within a week. Since our patient population are all 65 years old or older with multiple comorbidities, they are high risk for complications from the virus. Thus, we needed them to stay home as much as possible.

My clinic meets on a daily basis about the coronavirus and the impact on our clinic flow. For instance, we learned how many test kits we have and when we should utilize testing. We discussed screening patients and when we should try management at home versus sending them to the emergency room.

In addition, we have weekly corporate wide virtual meetings to discuss the latest research findings about the virus and treatment options. Management has been clear about which employees can work from home and who needs to come into the clinic. They have been flexible with employees that need to work from home due to lack of child care or have health risks making them susceptible to the virus.

I respect that my job always has a plan in place and are quick to adapt. I have spoken to a lot of my friends that also work in healthcare, and how there has been limited guidance from their jobs. Many people think that healthcare is a secure career during this time, but actually it is not.

Many physicians have had to close their offices as non-urgent visits and elective surgeries are cancelled. These offices will remain closed for an indefinite period of time. As a result, there will be limited income for both the practice and their employees.

I have a friend that is a Dentist who was furloughed. Other peers that are specialty physicians were let go from their practice. Not to mention many older internists resigned from the hospital due their risk of health complications from the coronavirus.

I believe there is only security in the healthcare field if you are a nurse or physician that works in the hospital and does not rely on elective procedures. I have seen the demand for RN’s in NYC increase drastically. They are willing to pay ICU travel nurses the income of a physician!

Since my current job does not practice fee for service care, we are financially secure. We bill through Medicare advantage plans. Meaning we are paid a lump sum of money per patient per quarter from the health insurance – not per visit. In that case, we are able to manage our patients virtually and still profit from that. In fact, the profit from last year is already on hand to pay for costs of this year.  

I have been really impressed working for this company during such a time of chaos. The fact that they are also financially secure, and will not be laying off any of their employees is a plus. With the inevitable recession coming, I may have to rethink my work goals. 

In my previous post, I talked about some options I was considering for my next assignment. In reality, as the coronavirus continued to spread in the USA, I felt like I couldn’t make a decision until the very last minute. That meant my option working in the retail health clinic was out the window, because credentialing takes about a month.

I declined the offer to work at the community health center in San Diego, as I mentioned in my previous post, I was not interested in returning there. Ironically, they were begging me to accept the offer.

That left me with two last options, a primary care office in San Diego and a community health center in Chicago. The week prior to my current assignment ending, I started wondering if it was a bad idea to travel at all. I knew my current assignment would be open to me extending, since they didn’t have a new provider coming in to take my patients until summer.

Originally, I absolutely declined their offer to extend my assignment in Kentucky. Both the complexity of the patients and their “sour” attitudes had me looking forward to the end of my assignment.  

Once the coronavirus reached Kentucky, we converted the majority of our appointments to phone visits. If I decided to extend, the job would be somewhat easier since there would be few face to face visits. I figured the easiest thing to do was extend my time in Kentucky.

When I followed up with the primary care office in San Diego, they no longer had a need because I was initially going to be covering a PCP military leave. Due to the covid 19, all military travel was cancelled. I also inquired about the position at the community health center in Chicago. They were still trying to figure out how they were going to proceed with visits so could not confirm if they wanted to move forward with the assignment.

Overnight, my traveling options were no longer existent. I thought about just going home (to Miami) like I had originally planned at the end of this assignment. Although it would have been nice to be close to family, I knew I would go stir crazy being stuck at home due to social distancing. It was also impossible to tell how long social isolation/state shut downs would last. Thus, I didn’t want to be out of work for more than a month.

I contemplated going back to my last assignment in Chicago, where I had a panel of patients I wanted to return to. But there was no point in going back there just to do phone visits. And again – this would require me to travel.

In conclusion, I decided to extend my assignment in Kentucky for another month. I was a bit worried that my job would decline the extension, thinking that anyone else could simply cover my patient panel by doing the phone calls. Yet, I think the phone visits would be challenging for a provider that didn’t know my patients already. My job agreed to an extension and the other PCPs were happy I was staying. I also had an extra month left on my apartment lease that the site would be responsible paying for whether I stayed or not.

I am not sure what will happen once my extension ends. I am taking it day by day just like the rest of the world. But I am grateful to be able to continue providing care to such a vulnerable population.