Extending in Colorado

So midway through my assignment in Colorado I was asked if I wanted to extend. This extension would be from October to December. I said no right away because I avoid places that snow (coming from Florida). They said they were open to me extending for as little as I wanted, even if it was just a few extra weeks. I asked around to see if it snows in October, and they said it may snow very lightly but usually melts right away. This is do-able for me so I decided to extend for an extra month.

My agency offered me an extra $5/hour for my extension. For one month, it’s just an extra $800, but I can’t complain. I like this assignment a lot so I didn’t mind extending for free. Especially because it would give me the opportunity to take November and December off like I like to do for the holidays.

Since school started, it has gotten a bit slower. I am only seeing about 8-10 patients per day now. I am enjoying fall, seeing the leaves change color. It’s cold in the morning and at night but pretty hot in the day time. No regrets.

Living in an Extended Stay Hotel

I have been living in a Holiday Inn Express during my Colorado assignment. The apartment provided by the site wasn’t available because they had another locums in it that kept extending his stay. I had a friend visiting from Florida one weekend, and I wanted to stay in Denver that weekend.

In the past, while staying at a hotel, I have the agency book me a different hotel (similar in cost) in a different town for the weekend, when wanting to explore. Pretty much, I would check out of my current hotel for the weekend and check in to another hotel in a different town. It usually isn’t a big deal since the agency/site are paying for a hotel anyways.

When I asked my agency if they could book me a hotel in Denver for the weekend, they said no because they have to send the hotel receipt to the site and they wouldn’t approve it if it’s in another city. I told them that was strange because I have done this before with another agency. They confirmed that it could not be done. I told them since I wasn’t able to move into the apartment like I was supposed to, could they at least do it as a courtesy.

The agency ended up agreeing to pay for one hotel night in Denver for that weekend. It worked out because I didn’t need to check out of my current hotel and could leave my things there.

After staying at the Holiday Inn for 6 weeks, I checked out for 1 week since I was going on vacation. When the hotel points hit my account I was surprised. I made 230k points in those 6 weeks alone! I already have plans to use these points for a trip in Asia next year. In Asia, I can easily book a hotel in that brand (such as the Intercontinental) for 10-20k points per night. So 230k points would give me at least 2 weeks worth of hotel nights abroad.

Living in a hotel without a full kitchen hasn’t been as bad as I thought. I can still cook up some meals on my hot plate and I am a queen of left overs. Earning a ridiculous amount of hotel points has been a bonus, and I am looking forward to earning more points during my stay. 

Top 6 Things to do Near Denver, CO

Colorado is an amazing state with all kinds of landscaping and scenery. Denver is a great city to work in because you have access to many outdoors activities within a 1 to 2-hour drive. These are my top 6 activities I enjoyed doing while working outside of Denver, Colorado, that I highly recommend!

  1. Garden of the Gods – This free park is located in Colorado Springs with 300 foot sandstone rock formations. There are multiple walking trails, wildlife, and even rock-climbing opportunities. Be sure to go in the morning so you can find parking. It is free to enter, but if you are interested in a tour you will have to pay and make reservations.

2. Red Rocks Park and Amphitheatre – Located in Denver, the naturally made amphitheater is a popular site for concerts and other events such as yoga. The red rocks park has 868 acres of geological marvels and wild life. There are opportunities for hiking and biking.

3. Rocky Mountain National Park – This national park is 1.5 hours north of Denver. It costs $30 per vehicle to enter, and during peak times such as the summer months, a reservation time permit is required. The mountain ranges are enormous and never ending. Plan to spend at least half a day at this park because it takes 3-5 hours just to drive through all the windy roads. There are some hiking trails but it can get difficult to breathe once you reach the summit. We saw some elk while we were there which was awesome. I recommend going at 6am because it is less crowded and you do not have to wait in line at the viewing points. I also recommend staying in Estes Park, CO before or after to make the drive more comfortable.

4. Glenwood Springs – This cute town is about a 2 hour drive west of Denver. They have a large natural hot springs pool that is enjoyable during colder months. The entry fee is a bit steep at $47 per adult, but is definitely worth it. You also have beautiful views of the mountains.

5. Day trip to Colorado Springs – Colorado Springs is a 1 hour drive south of Denver. I actually like it better than Denver because it has a gorgeous back drop of mountains and even red canyons randomly in the city. There is an opportunity to go on a hot air balloon there, and they have other tourist sites such as Caves of the Wind and Manitou Dwellings. Caves of the Wind is an underground cavern and Manitou Dwellings are Native American homes built into canyons. Check out Red Rock Canyon for more hiking.

6. Day trip to Boulder, CO – Boulder is about a 30 min drive north of Denver. Pearl Street area is a popular destination there. It’s an artsy area with shops and plenty of interesting dining options

Working in Colorado

I am working between two clinics. One of them is 1 minute from my hotel, and the other one is 15 minutes which is great. The clinic that is further out has a cafeteria which gives free lunch to providers. They have an amazing salad bar and the food is pretty good.

The town ended up being more rural than I thought. I have worked rural health before, but there is a helicopter at the clinic and a tiny hospital here with just a few beds. They consider themselves to be frontier rural since there isn’t a major hospital within 1 hour from here. A lot of the patients are ranchers and farmers.

On my first day, I was a bit nervous because I wasn’t sure if the patient population would be of higher acuity than I am used to. The physician that was orienting me mentioned they do a lot of casting and suturing, which is more like an urgent care. She also said I would be seeing things there that I have never seen before in my life.

My experience is more primary care and that is my comfort level. But they told me there will always be another provider with me at the clinic so if I don’t feel comfortable doing a procedure, I can just let them know.  The scheduling department asked me what procedures or types of patients I am not comfortable with so they can avoid putting them on my schedule.

They had me on a ramp up schedule seeing 1 patient per hour my first week, which was nice. It allowed me to figure out how the clinic is run. My orientation was only a couple of hours of introduction to the EHR. The patients are scheduled at 30-minute intervals. If they are a hospital follow up or an adult physical, they are scheduled at 60-minute intervals. That’s one thing I like about working in rural health, you get plenty of time with the patients. I am seeing about 14-18 patients per day. Even on a day when my schedule is full, I don’t feel overwhelmed.

The majority of the patients I see are with acute cold symptoms, workers compensation, sports physicals, well child checks, hospital follow ups, and other acute complaints like UTIs or back pain. They keep established patients following up for their routine visits with their PCP. I am enjoying having pediatric patients again.

Everyone here is really nice. The staff is friendly and helpful. The patients are very appreciative and are not the typical antibiotic or opioid seekers you may find in other areas. I have been seeing a lot of pediatric patients which I am happy about, since I needed that experience. Not to mention the kids have been super cute and easy patients. They are definitely less complex than the geriatric population I am used to seeing.

There are a few cons working here. One con is sometimes they accept patients that should really just go to the ER. I don’t think anyone is triaging these calls. For instance, I had a 6-week old baby with new onset seizures on my schedule (in the acute visit slot). I had to tell them to call the mom and bring the baby to the ER, as there isn’t much I could do for them in the clinic.

I also don’t like that the last patient is scheduled at 4:30pm, and we finish at 5pm. So, if the patient shows up a bit late, by the time they are roomed, it’s 4:45pm. I wish they gave the last 30 min as admin time to catch up on notes.

All in all, it’s been a great assignment so far and I am really enjoying my time here!

Reactivating State Licenses

I have a total of 12 active and inactive state licenses. I do not keep them all active at the same time because it can get pretty expensive. I just have 3 or 4 licenses active at any given time to increase my job options.

Earlier this year, I received an opportunity to help a physician owned practice remotely (per diem). This required me to reactivate all of my inactive state licenses. It has been interesting to see how each state differs from this process. Just to clarify, I am using the term reactivate, because you can only renew your licenses if it has been less than a year (in most states) since it has expired. Reactivation fees are more than renewal fees. My Florida, Ohio, and Arizona licenses were already active.  

After paying the reactivation fees, my California licenses were active within a few hours, which was awesome. Besides doing the application online, I had to upload proof of my CEUs. My Texas, Colorado, Maine, and Virginia licenses took 1 day to be active after paying the fees. I did these online and the process was straightforward.

My Wisconsin license took 1 month to reactivate, only because they needed a copy of my multistate RN license. So, they mailed me a letter with the email address to send them the document. After submitting the document, my license was active within days.

The remaining 3 states have been the most complicated ones to reactivate. Kentucky required me to obtain fingerprints AGAIN. This is in comparison to the other states that just recognize the fingerprints you already have on file from initial licensure. I am sure most of you can agree obtaining fingerprints is annoying. The facilities that do the fingerprints are only open during hours that I am working, so I try to go during my lunch break.

Then both Illinois and Washington state only accept paper applications for reactivating licenses. What are we, in the stone ages? Not to mention, I had to reactivate both the RN and NP licenses since these are still not compact license states.

Illinois requires 80 hours of CEUs which you have to submit proof of. This was crazy to me since FL (my home state) only requires 24 hours of CEUs every 2 years. I had to spend days acquiring the other dozens of hours. Additionally, Washington requests proof of recent employment in another state in order to reactivate your licenses. It took 3 weeks to get my licenses reactivated. However, even though I paid $435 to reactivate those licenses, they are going to expire in 4 months because renewal is during the month of your birthday -_-

I’ll keep in mind the states that are not as “reactivation friendly”, to avoid having my licenses lapse there again in the future. States like CA are “reactivation friendly” but the fees are drastically more expensive compared to just renewing.

Choosing to Work in Colorado

I have always wanted to go to Colorado, especially to visit the parks and go hiking. So, I decided to get licensed there. I am only interested in working there during summer months since I hate the cold. Unfortunately, Colorado doesn’t always have a plethora of locum tenens job options.  So, when a family practice opportunity became available starting in July, I jumped on the opportunity.

The site is in a small town called Limon, which is 1 hour east of Denver. I have worked rural health before, but lately I prefer being within 1 hour of a large city. One benefit of working rural health is that you aren’t swamped with patients the way you are in urban areas. For instance, at this site, patients are scheduled in 30-minute intervals. The average amount of patients seen per day is 10-15 per provider. This means, I won’t get burnt out.

Working in rural areas means there is a limited supply of housing options. The site has a house they use for their locums, but it is currently in use. Thus, I will be staying in an extended stay hotel for at least the first month. This isn’t my normal preference. Especially, because none of the hotels in Limon have a kitchenette.

They secured a Holiday Inn Express for me to stay in. I am provided with a suite which is nice, so the room is spacious. It does have a microwave and kitchenette. The hotel also has free breakfast as an option.

I asked for my agency to send me a hotplate so I can at least cook some things on a frying pan. They did not hesitate and sent me a $50 amazon gift card to purchase the hot plate and frying pan which I appreciated. Just a reminder – that you don’t get what you don’t ask for. I don’t mind staying at this hotel because I actually need to accumulate some points for this hotel brand, so I can use when I travel to Asia later this or next year.

It’s the first time I am working outside of Florida and not with the geriatric clinics in 2 years. I have to admit that I am a bit nervous about the transition. I am looking forward to working in a new state and having some new experiences.

Interviewing for Locum Tenens Positions

Before Covid, interviews for locum tenens positions were so casual. The site would call you for a brief phone interview. They just wanted to talk about the site, ask you a few questions, and answer any questions you may have. These phone calls were often merely 15-30 minutes long.

In the past, I have taken these phone interviews while on lunch break at work; driving on my way home; or cooking dinner. In fact, the geriatric clinic I normally work for, has an extensive interview process for their permanent providers. It entails 5 or 6 interviews with different leaders, shadowing one of the other providers, touring the clinic etc. Ironically, my phone interview for them as a locums ended up only being 10 minutes while I was laying at the pool. And I ended up working with them on and off over the past 7 years.

Fast forward to now, and it seems like ever since Covid happened, many sites realized they can do interviews by video now (instead of just phone). As a result, many of them are requesting video interviews. This was annoying to me while I was in Europe recently, because I had to make sure I was home and looking sharp when it was time for the video interview. I couldn’t just answer my phone on the fly like I am used to.

In fact, I was so mad at myself for moving forward with a video interview for the California job (as I mentioned in my previous post), that I didn’t really want. I remember I was traveling in Luxembourg, and had to make sure I was at the hotel in time for the interview. And guess what?! The interview took 1.5 hours! I was like ‘are you serious’?

They ended up asking me tons of questions as if I was a permanent hire. They said they had to fill out a questionnaire for HR, which is why they had so many questions. I was even more annoyed because deep down I knew I didn’t even want to work there. And here I was wasting 1.5 hours of my life when I was visiting a new country for the first time. I had to apologize to my friend as well, because I thought the interview would only take 30 minutes.

During my recent job search, I was reminded of a pet peeve of mine. Normally, the agency schedules the phone interview, then provides our phone number to the site, and then someone from the site will call us for the interview. Yet, I was reminded that Barton Associates doesn’t do it this way. They are the only agency that I know of that has one of their lead recruiters do a three-way call between you and the site.

So, the lead recruiter is listening in during the entire interview. I personally do not like that. It seems sketchy and as if I am child being supervised by my parent. I am not sure why they listen in, if it’s because they want to make sure you don’t talk numbers with the client or to see how the interview went etc.

I don’t think they even pay attention because one time the Medical Director was saying why they were so interested in me (I worked with a previous company many times that they are very familiar with). Then they spent the remainder of the interview explaining the site and how things would work. At the end of the interview the Lead Recruiter told me to explain to the site why I would be a good fit for them. Which proved she wasn’t listening because the Medical Director had already spent 5 minutes saying he knew I was a good fit since I had worked at a similar company.

Do any of you have any recent interesting interview experiences you would like to share?