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I had worked in Bradenton, Florida on and off for 2.5 years. During that time, I became close to several of my coworkers. Clearwater, FL is a one-hour drive from Bradenton, FL. So, while I am on my current assignment, I planned a get together with some of my prior co-workers. Some of them still work at the same clinic, while others do not.

It was actually so much fun and I am glad I was able to get us together. I was impressed that 95% of the people I invited made it. There is something special about people you work/worked with. Only they can understand the good and bad times at work. We laughed the entire time, reminiscent of the past but also catching each other up with the current.

We had such a good time that everyone agreed to do it again soon. This time I may invite a few extra people. Even as a traveling nurse practitioner, I am still able to form strong connections in the workplace. Although I cant see or talk to them on a regular basis, it is still worth catching up time to time. 

I am working for a brand-new clinic in Clearwater, Florida. They just opened one month prior to me starting. They are a Medicare advantage plan clinic, seeing geriatric patients only. My orientation and training was one week long which was nice. I had a full day of EHR training which was needed. I had used this EHR before but 7 years ago. Part of the reason I decided to move forward with this assignment instead of postponing it when I was tired from my travels, was because I knew the first week I wouldn’t be seeing patients. 

I shadowed the other providers and completed HIPPA and OSHA training for the millionth time. There is only one physician at my clinic but he is really nice. I am covering a nurse practitioner that is on maternity leave. Everyone is really friendly and welcoming. The clinic itself is big, but the staff size is small. I am used to working in a similar geriatric clinic with 50 employees in one clinic vs 8 employees here. The company has multiple new clinics in the Tampa area. The company has been around for a couple of years and have other clinics throughout the USA, but they are still learning/growing. 

It has been very interesting working at a brand new clinic vs the geriatric clinic I normally work at that has been around for 30+ years. The MAs are very helpful here during the new patient visits in gathering the intake. They do half of my job by asking about the patients screenings, fall risk, ADLs, dementia screening, social/family/medical history, and medications etc. It takes them an hour to gather all of this information. This may be an issue once the clinic is busier seeing several new patients per day. So far I only see 2 new patients per day and maybe 1 or 2 follow ups. I believe in January it will be a bit busier, but no where as busy as what I am accustomed to. 

In the other geriatric clinic, I would often see 4-5 new patients per day and 8-10 follow ups. This clinic provides 1 hour visits for new patients and 30 minutes for follow ups which is nice. Since it hasn’t been that busy, it has given the staff time to figure things out. I am not a big fan of the EHR for this model. We are using e-clinical works here. For a patient that has 35 diagnoses and 15 medications, the EHR makes it difficult to multitask within the chart. So, if I am typing in my assessment and plan I cannot simply refer back to the labs. I would have to exit that area and click into the labs separately. This makes the documentation pretty time consuming. 

I prefer the other geriatric clinic’s EHR because it is an internal one they created, so it is very PCP friendly. Also, we have to send our consult notes to billing to review before we can sign off on them which is weird. Especially for managed care since we do not bill per encounter.

My current clinic is less strict about referrals which is nice. They do not have to be approved by management (for now). We don’t have a nurse to oversee the MAs or a social worker/case manager yet. I believe they will hire for this when the clinics get more busy. In fact, the MAs even have to process referrals since we do not have a referrals coordinator yet.

The patients have been very pleasant and not as complex as I am used to. Probably because the Clearwater, FL area has a higher socioeconomic community than other areas I have practiced (in regards to the geriatric population). 

It’s nice not being super busy, and being able to spend as much time as I want with complex patients. I think about how the other geriatric clinic has PCPs seeing 18-20 patients per day, which is crazy. I think the maximum patients per day seen with this company is 10-12. I do appreciate how well organized the other geriatric clinics are, but they’ve had decades to figure things out. Working for a newer company/clinic definitely has its challenges. 

For example, we do not have all the typical in house medications we would need yet such as Kenalog for joint injections or even lidocaine. The MAs are not IV therapy trained so if a patient needs IV fluids either the physician or I would have to start an IV, even though it has been years since either of us have done one. We don’t have an xray tech or an ECHO tech. We are just practicing at a limited capacity. 

I am enjoying my time so far, but I will see how things go to see if I would want to help them at other clinics in the future. 

As I have mentioned in the past, I always get a work rental through National. If you do not drive your own car to an assignment, the agency will provide you with a rental car for free. Even if the agency uses their own preferred rental car company, I always request that they book my rental car through National.

I love using National because you can choose from a multitude of cars off the lot, instead of just taking whatever the car company gives you. Additionally, once you rent with them for a certain amount of time, you easily become an Elite member and get free upgrades (meaning you can choose even nicer cars from the elite section). 

For my Clearwater, FL assignment I was happy to get an Audi Q3 as my rental car. My agency booked a standard rental car through National, and when I went to pick up my car, they had an Audi Q3 available in the elite section. So, I was able to upgrade to this car for free. I have always been a car person and used to have an Audi personally, before I gave it up after being a full-time locums nurse practitioner. 

I forgot how smooth yet sporty, Audis can be. It definitely makes my commutes more enjoyable and I find them to be more fun. I am grateful to be driving a car I normally would purchase on my own, but at no cost to me. Being a traveling nurse practitioner not only allows you to save on the cost of having your own car, but you can even drive luxurious cars for free! The best part is that I am not responsible for any maintenance but can drive a car of my choosing. As I have recommended many times in the past, travel NPs – use National!

At the end of 2023 I was interviewed on the Millionaires Unveiled Podcast.

They labeled my episode as ‘Livin’ La Vida Locum Tenen’ which I think is creative and funny. It’s only a 30 min episode so check it out in apple podcast or Spotify:

https://podcasts.apple.com/us/podcast/millionaires-unveiled/id1313152833?i=1000645991454

Public service announcement: If you have not renewed your DEA certification since 2023, there is a new requirement that you have to complete 8 hours of controlled substance training prior to renewal. 

Something to keep in mind about being a travel NP is that you can only use your DEA certification one state/location at a time. So, after practicing in Colorado, I needed to transfer my DEA to Florida. Normally the agency I work with does this for me. However, I did it myself this time since I am working with a new agency. 

You just have to go on the DEA website and change the address of practice on file. I forgot it can take a few weeks for it to become effective. Pretty much, I had to wait for the FL DEA office to approve the transfer. 

I had already started my assignment before my DEA was active in FL. Luckily, I hadn’t needed to prescribe any controlled substances yet. It took 3 weeks for my DEA to become active in FL. 

I know a locums nurse practitioner that has two separate DEA certifications so that she can keep one in each state she practices. She usually goes back and forth between two states to work without much notice so this works for her. This requires two separate registrations with the DEA.

This is something to keep in mind if you are not taking any time off between assignments and plan to work in a different state right after your current assignment. 

It can be a bit tricky finding short-term housing in South Florida or the Gulf Coast during winter months because a lot of snow birds book them up. Fortunately, I was able to find a 2-bedroom furnished house on furnishedfinder.com. The best part is that it is only 5 minutes from my job!

Living in a hotel for 4 months during my assignment in Colorado, I really wanted to live in an apartment or house for this assignment. The inside of the house is really pretty. It is modern and up to date. The backyard is right off a preserve. I don’t think I will spend much time there though since I spotted a black snake in my backyard the day I moved in. 

The location is great. It is close to plenty of shops, restaurants, and ten minutes from the beach. I even have a second bedroom for guests. It makes a big difference when your living space is comfortable during an assignment. It ended up costing the company about $4000/month. It is high for Florida but like I mentioned before, it is high season for mid-term rentals. 

See below for some pictures:

As a traveling NP, when searching for an assignment, some agencies list the jobs and pay on their website. Keep in mind that this pay rate is not concrete. The same thing goes when a recruiter emails you a potential job and it says what the hourly pay is. Remember, everything in locum tenens is negotiable.

I usually have an hourly rate I have in mind that I will communicate to my recruiter. Then depending on how well the interview goes or how eager the site seems; I may ask for a higher rate. So, the best time to negotiate a higher pay rate is after an interview with a site, once the site makes an offer to move forward.

This is the best time because the site has made it clear that they want to move forward with you. The recruiter will do everything in their power to make sure you say “yes”. As a seasoned travel NP, you may also have multiple job offers at the same time. You can play these offers against each other to have your preferred choice match the other offer from another agency/job.

It is a disservice to yourself if you only work with one agency and are only interviewing for one job at a time. This will decrease your hourly rate potential.

I also like to keep in mind if the area is rural, then they will have a harder time finding a locum. In this case, I would ask for more per hour than is offered. On the other hand, if I interviewed with a site that I know interviewed multiple candidates in an ideal location for me, I am less likely to ask for a higher rate since I know there is a lot of competition and they may go with a provider asking for less.

Don’t forget to negotiate, negotiate, negotiate. 

I know a lot of you are interested in working in telemedicine, and who better than traveling nurse practitioners with multiple state licenses. I recently wrote an article for NPSchools.com about the pros and cons of working in Telemedicine. Check it out:

https://www.npschools.com/blog/pros-and-cons-of-working-in-telemedicine

I have worked as a traveling nurse practitioner for 9 years now. Throughout my time I have worked with almost a dozen different agencies. Over that time, I have narrowed down my favorite ones and tend to work with them mostly. As I mentioned from my previous post, a recruiter from an agency I have never worked with before, reached out to me regarding a FL travel NP position. I ended up accepting the assignment with them, but it was an interesting process dealing with a new-to-me agency.

Before accepting the assignment, I told my recruiter that my DEA was expiring in December and if they would pay to have it renewed. I was already expecting them to say no, since most agencies say no until it affects their potential profit. As expected, my recruiter said no, they do not reimburse/pay for any licenses/certifications. I told her that it was unfortunate and actually a deal breaker for me.

So, she told me that what she could do is pay me an extra $20/h for the first week to cover the cost of the DEA. Although not ideal, especially because technically the $800 would be taxed, I accepted. I can always deduct the expense of the DEA on my taxes anyways.

Before interviewing for the assignment, I had told my recruiter what my expected rate was. After interviewing for the job (there were 2 of them), the site made it clear that I was the “perfect candidate”. This made me realize I should ask for a higher rate – since clearly the site is telling me I am worth a lot. I had not received any contract from my recruiter, so I told her that I wanted to increase my rate. She told me that it was too late since we had already agreed on the original rate.

I told her I had the option to go back to work with the geriatric clinic I normally work with and they would give me the increased rate. Thus, she said she would just match the rate I wanted from her end, not having to go back and forth with the site. In the end, I got what I wanted.

Next, was the challenge with housing. I did what I normally do which is look on furnishedfinder.com for furnished housing that is near the job site. I submitted the one I wanted to the agency for them to book for me. My recruiter said, since I am taking a week off in December, I wouldn’t be working enough days that month to cover the total cost of housing for that month. Therefore, would I be willing to pay the difference?

I was in complete shock over this request. I have often taken 1-2 weeks off during an assignment while working as a travel NP and having a furnished apartment. And I have never ever been asked to pay for the housing while I was gone! I understand if it was a hotel, in that case since you are paying per night, then I would just pack my things and keep it in storage with the front desk. But even when I have stayed in a hotel long term and have been gone for a few days, I haven’t been asked to give up the room. For an apartment, the agency is paying per month regardless of me working the entire time or not.

I was so irritated by the request that I simply wrote back “No, I never pay for housing even when I am on vacation and if this is going to be a problem let me know now so I can end the contract.” My recruiter responded and said “no, it’s ok we will figure something out to make it work”, and never asked me about that again.

Lastly, the week prior to my assignment starting I hadn’t heard anything from my agency. For example, is credentialing complete? What time and who do I report to on Monday? What is the orientation schedule? What is my rental car booking information? What is the address for my housing and check-in instructions? If there is an issue and it’s Sunday night, who can I call for an emergency?

Moreover, I am used to getting paid weekly. I had to wait 3 weeks to get paid my first paycheck. Then I was surprised when I didn’t get my second paycheck the following week. Apparently, the medical director had signed the time sheet a day late so my paycheck had to wait until the following pay period. I told my recruiter this wasn’t fair to me since I have no control over when the medical director signs the time sheet. I am sure in the past they have signed it late but I have always been compensated on time with other agencies. She told me I was right and would see what she could do, but of course nothing was done and I just waited to get paid the following week.

This made me realize that I have been spoiled by the main agencies I work with. I am used to them sending me all of this information the week prior to my start date, automatically. Not me having to request every last detail. I also realized they spoiled me by paying for all of my licenses, changing my DEA address for me, and never asking me to pay extra for housing.

So far I am not impressed with this agency, but if I continue to work with this client I will have to continue working with this agency. We will see how it goes and hopefully they can tailor to my needs.

After I finished in Colorado at the end of October, I was planning on taking the rest of the year off. I love being off for the holidays, and my birthday falls in November. However, a recruiter reached out to me on Linked-in saying she had a travel NP position available for Florida in the fall and asked if I was interested. 

The position was in the Tampa Bay area. It is a new geriatric clinic, in which the providers only see 10-12 patients per day. I told her I was interested so she submitted my CV and scheduled me for an interview. The medical director that interviewed me had previously worked for the same geriatric company I have often worked with as a travel NP, so he said I was the perfect locums for the job. 

I was very interested in the position; however I did not want to start working until January. They had not yet opened the clinic at the time of the interview but were anticipating starting to see patients in November. I told them I was not available until after thanksgiving – something I was fixed on. I had already committed to meeting up with my boyfriend for a few weeks in Europe in November. Additionally, it was my Dad’s 60^th birthday party the weekend after thanksgiving, and we were throwing him a surprise party. 

They said that was fine. Then I told them for the holidays I would need to take time off, and they gladly offered for me to take the week of Christmas off, which worked well for me. Since they were very flexible and it was an ideal location for me, I decided to move forward with the assignment. I was going to need an assignment in January anyways, and Florida is always ideal for me for winter months. In fact, during my time off I was planning on doing a road trip to the Tampa Bay area to meet up with some friends and family anyways. 

The site has multiple clinics throughout the USA and they plan on continuing to expand. During the interview, they mentioned they would love my help in other locations in the future as well. So, I thought it would be a good idea to get my foot in the door with them. I was exhausted after returning from Europe, having thanksgiving, and then throwing a party for my dad. I did not really want to drive 4 hours to Tampa to start my new job. I considered telling them something came up and I needed to start a few days later. But since it was my first time with this employer, I decided to suck it up and make a good impression. 

I have a lot to share, and look forward to doing so on future posts!