Trying Acupuncture

I have been a fan of acupuncture ever since one of the clinics I work at often, provided acupuncture for free to its patients. I have seen patients find relief from their illnesses through acupuncture. Acupuncture had helped relieve their chronic headaches, anxiety, back pain, neuropathy, and even helped them quit smoking. 

Ever since I had my 3rd covid shot (2nd booster) more than 2 years ago, I have been experiencing chronic headaches. These headaches are a form of occipital neuralgia. They occur every day but only last about 20 minutes. It is a sharp pulsating sensation to the left base of my head.

While on my current sabbatical in Spain, I decided to try acupuncture for my headaches. I had the free time to go for weekly sessions, knowing that it can take at least 6 sessions for significant improvement. Acupuncture is also notably cheaper in Spain than in the USA. In the USA, acupuncture is at least $100/session depending on the area. In Spain, acupuncture is $65/session.

I had briefly tried acupuncture before at work when I had pulled a muscle and it did help.  This time in Spain, I had an authentic Chinese experience. The acupuncturist first massaged my body to drain the lymphatic system. Then she massaged by neck muscles. And then she placed needles throughout my body. I didn’t feel the insertion of the needles but sometimes depending on where it was inserted it would trigger a nerve that caused pain in my hand or jaw so I had to tell her and she adjusted the needle. 

Lying on my back, she put needles in my abdomen, legs, feet, and scalp. She left them in for 20 minutes. Then I turned on my stomach, and she put needles in my neck, back, and arms. You can feel the nerve pathways communicating, even after the needles are removed, there is often a leftover tingling sensation for another hour. 

After the first treatment, I already noticed much improvement. I stopped having the headaches daily. I only had the headache once that week after the acupuncture session, and it only lasted about 5 minutes. 

I continued going to acupuncture once a week for 6 weeks total. I stopped having the headaches so I knew that the acupuncture worked. I am happy I found a natural way to treat the headaches instead of having to take medication or do an invasive procedure. I wanted to share my personal experience with acupuncture so you can try it for yourself or recommend it to patients. 

Sabbatical 2024

I took another 3-month sabbatical in spring 2024. I spent most of it in Barcelona with my boyfriend. Normally we spend our time together traveling but this time we mainly stayed put. We got a furnished apartment a few steps from the beach. It only cost 1300 euro per month which is about $1400 USA. 

It’s pretty cheap in comparison to being a few steps from Miami Beach which would easily double or triple the price. The bathroom is a bit too small for my taste, but that’s European living. I was actually surprised at how much we could fit in the apartment if you organize well.

The apartment also had a rooftop terrace (since we were the last floor), which was nice to get some outdoor space. It had views of the water and far away- La Sagrada Familia church. 

I ended up getting private health insurance during my time in Spain because it’s cheap – only costs $68/month. I took advantage of my free time to do my annual physical and labs, dental exam, and try acupuncture. I will detail my experiences with these in a future post. 

We enjoyed going to the beach, going for long walks, and doing everyday life things (shopping, cooking, errands etc). I worked about 12 hours a week doing telemedicine so I could have something productive to do. I read books on my ipad using the Liby app, which allows you to read books for free through your home library. We also went to the zoo, a Cirque Du Soleil show, concert, and a soccer game.

After 1 month, I started to get “cabin fever” being in Barcelona. I was tired of seeing the same streets, eating the same tapas, and being around a lot of tourists. Our travel time was limited due to my boyfriend’s work schedule. We had already been to most of Spain, but we decided to spend a few days in the Basque country of Spain.

I had always wanted to go to Bilbao and San Sebastian but they are pretty far from Barcelona (in European standards). It takes 6 hours on the high-speed train to get there. I do enjoy the comfort and convenience of European train travel.

Bilbao was a cool artsy town. I don’t typically like modern art but have always wanted to go to the Guggenheim museum there. The architecture of the museum itself is incredible. Bilbao is lodged in the mountains so it was pretty cold. The tapas there are called Pintxos, which was interesting to try. 

I preferred San Sebastian because it is a beach town and the water was really nice. This was in April so the water was too cold for me to get in, but many others braved it.  San Sebastian is a popular spot for vacationers including the famous Ernest Hemingway. I heard a lot of people speaking French, so seems like the French love going there as well. 

I expect my boyfriend to move to the USA at the end of this year. Interestingly, I thought we would settle down in one place. But this sabbatical showed me that I am incapable of living long-term in the same place. I have been a travel nurse practitioner for 9 years now, and I am too addicted to the nomadic lifestyle.

I like novelty. I like being in new places, to see new things, learn new things, and try new things. I wouldn’t mind having a home base somewhere but I know after a couple of months I would just get cabin fever all over again. 

Lastly, I met up with some friends in Asia for a few weeks in May. I will write about that in a future post. It was more convenient to travel there from Barcelona than Eastern USA. The flight time is shorter and it’s easier to find business class award flights. 

I Quit Another Telemedicine Job

I had a recent post about my experience working in telemedicine again. I am still working with that company. But when I had applied for that position I had applied for several others. One of the other companies paid a guaranteed $70/hour instead of per visit, which I liked. Because sometimes telemedicine can be slow so at least you have guaranteed paid and do not waste your time.

This other telemedicine company reached out to me to start 2 months after I had applied. They had a requirement that you have to work a minimum of 20 hours per week. At that point I had decided to take the FL assignment and wasn’t going to be off for several months like I had thought. And I did not want to work an additional 20 hours per week on top of my full-time job. So, I asked them if I could defer my start date to March, since I planned on being off for 3 months at that time. They said yes!

Fast forward to March, and the company reached out asking if I was still interested. I said yes, but it turns out that they changed their pay structure. They were no longer paying hourly, but were paying per visit. -_- They said they were busy so I shouldn’t be worried about not having enough work.

I decided to move forward with them to try them out and to possibly have some additional work on top of my regular telemedicine job. Prior to my training, I had to provide 6 weeks worth of availability to schedule patients. I was forced to give 15-20 hours of availability per week. This was a bigger constraint than I had expected. I hated being tied down like that especially during my “off time”. I liked my current telemedicine position where I can work as little or as much as I want.

Then I completed the two half days of training. The program was for weight loss treatment. It was interesting to learn more about the GLP-1 medications and management. However, the training was extremely fast and didn’t cover everything thoroughly enough. Not to mention that this telemedicine company uses 10 different websites/applications in order to work there. Example: one website to communicate with other staff; one website for appointments; one website to see patients on video; one website to document SOAP note; one website to look at guidelines; one website to get quick text etc.

It was crazy enough that all of my google chrome bookmarks were taken over by this telemedicine company. The following day, I was scheduled a few hours to do async visits only (messaging ones). I reviewed all of my notes from the day prior. I managed to log into multiple websites. I found the patient visits. However, I couldn’t figure out how to open the chart and start my SOAP note and review the patient intake etc. I am definitely computer savvy and I searched around through the multiple websites but just couldn’t figure it out. I thought to myself, if I couldn’t figure it out, I can only imagine the elderly providers in my training that barely knew how to login to their email.

Of course, I could have just asked for help at that point but I took it as a sign that it’s not meant to be. I was already starting to feel overwhelmed on my “sabbatical”. I didn’t have the free time I was expecting to do things like try acupuncture, go to the beach, and other fun stuff because I had to commit so much of my time to this new telemedicine job. Plus, I was balancing my other telemedicine job, and my other side hustles such as writing articles for nursing websites and financial coaching.

So, I decided to just resign! I originally applied for the job because I wanted a telemedicine company that offers guaranteed hourly pay. This job no longer does that so what was the point? I already had another telemedicine job. Now I appreciate my original telemedicine job so much more.

There is only one main website we need to navigate. The training was very organized and thorough. The snippets are easy to use.

After I resigned (of course they tried to offer me more training so I would be comfortable but I declined), I felt so relieved! I realized that I was juggling too much and something had to give. I sometimes have FOMO when it comes to work opportunities because I am always interested in trying something new. But I have to remind myself that I should only do what brings me joy. Just a reminder that not all telemedicine companies are equal!

P.S. The following month one of my recruiters reached out about a telemedicine position for CA for 3 months. It ended up being the same telemedicine company I resigned from! I guess they are that desperate. I am glad I didn’t waste my time with the training, they ended up paying me for that which was a nice bonus.

Nurses to Riches

I was recently interviewed on the Nurses to Riches youtube channel about being a travel nurse practitioner and reaching financial independence. It’s a great channel to subscribe to because they have a lot of nurses go on to talk about their various career success stories!

Check out the video here:

Ending in Clearwater, FL

After working for 2 months in Clearwater, FL the NP I was covering came back from maternity leave. I worked with her for a few days so she could get adjusted since the clinic had opened right when she went on leave. She was a former traveling NP too so that was cool. You could tell since she was a quick learner.

I was asked if I could work in Holiday, FL for the remaining month of my assignment. The clinic is 30 minutes from where I was staying so I asked for gas reimbursement and was told yes. That clinic ended up being very well run. They were fully staffed and everyone worked efficiently. The staff was friendly and fun to talk to. The patients were really nice and straightforward. Also, the physician let me leave 2-3 hours early when I was done with my work – so of course that was awesome.

After being there for 1.5 weeks, my supervisor (medical director) asked me to change locations again. I didn’t want to go to the other clinic since it has a reputation for being a disaster. But he insisted the locums NP at that clinic needed extra help and that I would enjoy the challenging patients. My first day there, I told the other locum NP that I was there to help her. She said she didn’t know why since the medical director never told her I was coming, nor did she complain about being overwhelmed. In fact, when I looked at the schedule, there were only 4 patients that day, and no patients the next 2 days.

Side note: the other locums NP ended up being the same one I had worked with in Bradenton FL (See: Having other locums nurse practitioners). One I didn’t have a good experience with and figured wouldn’t be thrilled to see me. She initially gave me an attitude when I said I came to help. But after I explained to her her struggles at the clinic weren’t because of her but just that that place is a mess, she relaxed and confided in me. She told me the medical director there was trying to use her as his assistant. Like when he saw a patient and needed records, he told her to call the specialist office to get the records as if that is her duty.

When I went to the other clinic to help the other locums NP, I felt insulted when I learned they had a physician there that day that was only there to “babysit” us. He had no patients on his schedule, was just available in case we had questions. In my mind, I’m like ok this physician can help the locum NP see patients, why do I need to be here?

Shortly after, God answered my prayers and the medical director asked me to return to the clinic in Clearwater. They thought the NP that returned from maternity leave had an issue with her FL license (which ended up not being the case) so needed coverage there. My recruiter told the medical director that this would be the last time I am changing clinics. Because in my contract I was only supposed to work in Clearwater, and only agreed to switch to Holiday as a courtesy. Now within one day, they had asked me to switch clinics another two times.

Of course, by the time I got to Clearwater, they realized that the permanent NP there did not have a license issue after all. My recruiter messaged me and said the medical director said I can return to Holiday if I want. I think he got the point that I did not want to be at the other clinic. Everyone in Clearwater were happy to see me, and I was glad to see them too. So I decided I was going to spend the following day in Clearwater as well, to see one of my Spanish speaking patients. Then I would return to the Holiday clinic later in the week. That way, I could have the best of both worlds. And at the end of the day, apparently, I was the one calling the shots now since they had me running around like a chicken with no head.

The pro of this assignment is I was well-paid to do little work. The con of this assignment is that the clinics are new and need a ton of help. Would I return to this site? Possibly if I am going to one of the “good” clinics. Or maybe with one of their more established clinics in other states. Even though I was at the Holiday clinic for only one month, they are so sweet and surprised me on my last day. They ordered breakfast from Panera and bought me flowers, a card, and some of my favorite treats. And that my friends, is a wrap.

Working in Clearwater – Update

My first month working in this new geriatric clinic was great. But then things quickly changed. That’s why I normally wait until the end of the 2nd month to decide if I want to extend. 

One day the clinic manager told me the medical director said I would be on call one weekend in January. I told her I do not do call and will make sure my agency notifies the medical director. Which they did. That’s actually the first time as a locum I have ever been asked to take call.

Then one day HR announced that the locums NPs cannot see patients alone. There has to be a physician on site for billing purposes. That was random since the physician at my clinic had been on vacation for a week and I was working by myself the entire time. Everything went smoothly. Not to mention that I have an autonomous NP license in Florida. Normally to bill under the physician (very common for locums) they just add the physician’s name to the billing versus making sure the physician is physically in the building. Weird. 

Now working in January, it has been more challenging working in this clinic. Since they are expecting to have a lot of new patients in January and February, they changed the one hour appointments for new patients to 40 minutes. They are trying to get in as many new patients as possible. I mentioned before that the MAs take 1 hour for the intake with the new patients. This has been a struggle. It has been impossible to get them to cut that time in half. 

My first 2 days back from the holidays I was upset at work. I had a new patient scheduled at 3:30pm. The new patient visits typically take 2 hours long between them coming in late, filling out their new patient paperwork, the MAs intake, and their visit with me. There was no way I was going to finish on time at 5pm. Then the following day, I had an add on for a new patient at 11:20 am. There was no way I was going to make it to lunch at 12pm. I requested they move those patients, but I saw this as being a daily problem.

So I called the medical director and told him I wanted to change my schedule, because I did not want new patients being scheduled as the last patient of the morning and afternoon shifts. I could still see the same amount of patients but I wanted the new ones to be earlier. He said that the schedules are fixed for all of the PCPs so I could not change mine. He told me a lot of the other PCPs are also complaining but just to be patient while the clinic manager works on making the MAs more efficient. 

I think it would be better if they had the patients come in an hour early to have their intake completed by the MA, and then complete their appointments with the provider at their scheduled time slot. It’s all a work in progress since the clinic is so new. I hope they figure out the best system because we aren’t there as of yet. 

The following week, I was told that locums nurse practitioners couldn’t see new patients anymore. They wanted to bill under the physician so they wanted the locums nurse practitioners to only see established patients. Apparently, since they are a new practice, they are being closely watched by the state, so they have to do everything by the book. I felt bad for the physician in my clinic because that meant he was going to be busier. It benefited me since I no longer have the stress of seeing new patients, whose visits can take 2 hours or more. 

The work has slowed down again for me, I only see about 2-3 patients per day. One time I saw 5 patients and it was great. But I guess I can’t complain. Since the clinics are so new, there is a lot of work to be done. I am not sure what it would be like to work at one of their more established clinics, but I would be open to it in the future.