Asia Trip 2024

During my 3-month sabbatical in 2024, I planned a trip to Asia with some friends. We started in South Korea, then went to Vietnam and Cambodia, and ended the trip in Malaysia. I was really curious about Vietnam and Malaysia because I have heard a lot of Americans slow travel there. The US dollar goes far in those countries. You can rent a high rise furnished apartment with views and a/c for $300/month. 

South Korea was probably my least favorite from the Asia trip. Seoul felt like being in NYC where it took 1 hour to get anywhere whether by metro, car, or foot. I expected it to be more futuristic like Japan but they wouldn’t even accept credit cards at the metro station. It just felt like being in a big city. It was my first time eating Korean food and I was impressed by the Korean barbeque and the Korean fried chicken (I normally don’t even like fried chicken). 

Vietnam ended up being my favorite place on the trip. We started in Hanoi which introduced us to the chaos of Vietnamese scooters and mopeds. There weren’t many traffic lights and we just had to cross the street and hope for the best. The humidity hit us really hard coming from Seoul. One of my favorite parts was taking a day cruise along the Halong Bay. It was absolutely beautiful! I especially enjoyed being able to kayak and swim there. Hourly massages in Vietnam only cost $7-8 so we got one daily which was a nice perk. 

We also visited Danang, Vietnam which I preferred over Hanoi. It’s on the beach (which is always a plus for me) so you had the breeze from the ocean that made it cooler. The city is more modern and it seems like they are doing a lot of construction there to build it for tourists. The water at the beach was cool which was perfect for a warm day. We spent one day in Ba Na Hills. This is where they have the famous bridge with the hands. It ended up being an amusement park similar to Epcot at the top of a mountain which was pretty cool. 

We went to Cambodia to visit Angor Wat. I had seen a similar temple in Thailand before, that I believe is almost a copy of Angor Wat in better shape. So, I mostly went to Cambodia to appease one of my friends. I didn’t look forward to spending an entire day of sweating to death. We did a sunrise tour which was worth it because by the time the sun came out and made it feel unbearably hot, we were done. It was extremely humid in the morning and everything in my purse got soaked form the humidity. I did enjoy the food in Cambodia and the people were really nice. 

We ended the trip in Kuala Lumpur, Malaysia which was really cool. I liked the city vibe because the architecture of the buildings is so unique. My favorite part of Malaysia were the night markets. I have heard from a lot of people that the food in Malaysia is amazing. Now I know why. The food in Malaysia is a mixture of Chinese food, Thai food, and other Asian foods. The night markets had so many options of cool things I have never seen before. It may even be hard to describe. 

Some things we tried were grilled calamari on a stick, huge bobba balls in ice cream, spicy soy sauce chicken, mango sticky rice, tempura potato sticks with sauce, iced coffee in a bag, layered mango crepe etc. We also went to the Batu Caves which is a Hindu Temple. It was an interesting experience and yes we climbed all of these stairs.

Overall, I had a great time in Asia. I saw so many incredible things and the people were so friendly. I am open to spending a month in Vietnam and Malaysia whenever I decide to slow travel. It was worth the 24 hours of flying to and from, and the week it took to recover from jet lag. 

Locums Needed for Northern CA

If you are interested in working as a locum in a FQHC in Northern Central California, there is a need starting at the end of July (start date is flexible). This is a high paying opportunity. Please email me at travelingnp.com@gmail.com with your name, phone number, and email address to pass along.

Trying Out Healthcare in Spain

For my 3-month sabbatical in Spain, I decided to get private health insurance there. The policy was cheap, only $70/month (including dental). I did not have any co-pays or out of pocket expenses. Since I had a lot of free time, I planned to get all of my medical check-ups while in Spain. I scheduled appointments for a physical and labs, pap smear, and dental exam and cleaning. 

My physical was interesting…. the doctor was at lunch and showed up to the appointment 1 hour late. There was no one to take my vital signs or weight – he worked solo. The doctor asked me what I was there for, I said a physical and labs. He gathered a medical history and then gave me a lab order. Since I had no complaints, he didn’t bother touching me or doing an exam at all which I thought was strange. Not to mention I didn’t even have my blood pressure taken. 

I thought Europe was supposed to have a better healthcare system than the USA? So far, it seemed like the only benefit is that private health insurance is incredibly cheap and covers everything, but the quality of health care isn’t that great. I mean how can a doctor not even touch me for a physical? At least I was able to look at my lab results online so I didn’t need to schedule a follow up.

My dental exam and cleaning went well. In fact, both were done within 30 minutes. The xray machine they used, took pictures from a 360-degree angle, just by me standing under the machine. I didn’t have to put those uncomfortable gadgets in my mouth for the xray that is often used to take pictures in the USA. The dentist there did the cleaning himself, which was similar to the USA minus the flossing. 

Lastly, my appointment with Gynecology for a pap smear was an interesting experience. Being an NP that does well woman exams, I am used to the medical assistant having the patient undress and put on a gown in private, before I go in the room. In this instance, the doctor’s office and the patient room are the same. 

So, after the doctor gathered my history, he told me to undress and put on the gown, as he called his nurse into the room. It was really awkward undressing in front of 2 strangers. Then the nurse told me to lay down on an obstetrics bed and insisted I lay with my legs open while waiting a good 5 minutes for the doctor to re-appear. Awkward. Once he appeared, the nurse donned gloves on his hands – which weren’t the regular latex/rubber gloves we typically use in medicine. They were the type of gloves workers wear at subway to make your sandwich – which of course I thought was very bizarre. 

I will admit he completed the procedure well, I didn’t feel a thing. But then he shoved a vaginal probe to do an ultrasound, which I didn’t realize is part of the well woman exam there. Everything was fine but I didn’t care to have that extra procedure. Anyways, I think I will save any future well woman exams for the USA, for a more comfortable experience. 

On the other hand, my boyfriend had public health insurance in Spain since he is a resident. His experience with the public health clinics and hospitals were absolutely awful. Similar to my experience, when he went to his primary doctor with abdominal complaints, she just ordered tests and didn’t bother doing a physical exam. Similarly, his vital signs were never taken. To be honest, all of the doctors in the clinic looked really unprofessional, wearing a white scrub top with jeans, and white crocs. 

To complete the ordered labs and imaging through the public sector, there were no appointments available until 3 months out. This was ridiculous considering the acute nature of his symptoms. We decided to try our luck in the Emergency Room, thinking we could get tests completed sooner than 3 months. Honestly, the ER there is a joke. There was no sense of urgency, and we witnessed the doctors walking out every hour for a smoke break. 

After waiting 5 hours to be seen, one of the doctors came to the waiting room and told the patients that they were full so if it wasn’t an emergency to come back tomorrow. I thought that was insane. When we were finally seen, of course the doctor was useless. He referred my boyfriend back to his primary care doctor. He said he could not order any imaging there unless it was a life or death situation (which he would have no idea if it was life or death without any tests)? He was trying to give some sorry explanations for my boyfriend’s symptoms and with my medical background I had to speak up and tell him what he said was false. Even after advocating for my bf, the doctor would not budge and said “I cannot order any tests”. Since there is no “magnet status” or patient satisfaction surveys after a hospital visit, there are no incentives for the hospital employees to actually do their job well.

Feeling defeated, my bf decided to just apply for private health insurance. It is very affordable after all, and the public health system in Spain is a joke. Having the private health insurance was like night and day. He was able to schedule himself to see a specialist right away, complete imaging and labs the same week, and follow up with the specialist the following week for results. 

I am fortunate that I do not have any medical problems so my need to use my private health insurance was just for screenings. But I really got to see the perks of using the private health system in Spain when my bf had to use it. For example, he needed an MRI which is costly but he didn’t have to pay anything out pocket. That means, somehow his $70/month premium covered it. Normally in the USA you have a $400/month premium for health insurance and several hundreds of dollars copay for an MRI. 

Additionally, the doctors in the private clinics spoke English whereas they don’t in the public system. They are also look and act more professional, and guess what – they touch you!

After this experience, I won’t generalize to say that the public health care system in Europe is great. From what I’ve heard, it is in certain countries like France and Belgium. The quality of healthcare in Spain is not good. It showed me some disadvantages of having a public healthcare system such as long wait times to have basic tests done like labs and the lack of ordering necessary tests by physicians.

I also felt like the doctors in Spain care less than the doctors in the USA – I wonder if it’s because there is a huge pay disparity between the two countries. Or it can just be cultural. The only benefit is that having private health insurance in Spain is way more affordable than in the USA. After this experience, I think the quality of US healthcare is actually really good. The main problem with the US healthcare system is that it is unaffordable and costly. Instead of it being a business and keeping hospital CEOs, insurance companies, and Big Pharma rich; it should be reformed to be way more affordable for the average American. 

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.