Questions from Readers

Each month I will include a blog entry answering some of the most common questions I get from readers about locum tenens as a nurse practitioner. Feel free to comment any questions you have or email me at travelingNP.com@gmail.com.

 

  • How long does it take to start your first assignment?

 

The answer to this question varies depending on if you are looking to work in your current state or accept a federal healthcare site position. In these cases, you can start your first assignment within 1 week.

If you are looking to travel to a new state working in the private sector, then starting your first assignment can take about 1-3 months from initiating your search.

After realizing you are interested in working as a traveling nurse practitioner, your first step would be to contact multiple agencies and become credentialed with them. Then you want to go ahead and apply for one or two licenses in another state. Check out my licensing page to see the average timeline for states licenses. Ideally for your first job you want to choose a state that will grant a license quickly such as Montana or Washington.

So that first month is really about establishing a relationship with agencies and recruiters, and obtaining licenses. In the mean time, you can search for locum tenens positions and your recruiter will present you to these sites while your licenses are pending. The timeframe between being presented to a job, interviewing, and then accepting an assignment can be 1-2 weeks. After accepting an assignment you will need to become credentialed, depending on the site this can take 1 week to 1 month.

To be on the safe side try to plan for at least 1-3 months before starting your first assignment. That means do not quit your current job until you have officially accepted an assignment. If your current lease is ending in the upcoming months, start your job search at least 3 months out.

Questions from Readers

Each month I will include a blog entry answering some of the most common questions I get from readers about locum tenens as a nurse practitioner. Feel free to comment any questions you have or email me at travelingNP.com@gmail.com.

 

  • How do I know if a particular locum tenens job is right for me?

 

Upon searching for an assignment, you can easily become overwhelmed because there are so many jobs out there. I think you will need to first narrow down your job search to a particular state. Then consider what you value the most out of a job. Is it the type of facility (urgent care vs community health center)? Is it the hours worked (day shift vs night shift/ weekends vs weekdays)? Is it the length of an assignment (4 weeks vs 6 months)? Etc.

 Remember sites are looking for locum tenens nurse practitioners because we are supposed to be flexible. So if this new job is open on Saturdays, they will likely request you to work some Saturdays. If working on weekends is not an option for you, then do not accept the position. If you are a new nurse practitioner, you should definitely stay away from solo-practice settings. This means you are expected to work alone which isn’t ideal for a new grad, because you need mentors to ask questions to.

 Be sure to ask the right questions when you are being interviewed. See this past post for more details:

Interview: Travel Nurse Practitioner

 To answer this question, there may not always be the “perfect” assignment, but as long as it meets your needs, you should be fine. The more I work in locum tenens, the more I narrow down my job search to meet my maximum patients-per-day ratio. If a job is in my ideal city with a 30 patient per day schedule, I would rather choose the job with a 20 patient per day schedule in a city 1 or 2 hours further away. This way I know my work-life will be less stressful.

Extending My Assignment Part 2

In continuation of my last post, I wanted to animate more details about extending my current assignment – logistically speaking.

A lot of times, when a site wants you to extend your contract, they are willing to increase your hourly rate. Unfortunately, the site could not afford to increase my hourly rate. It didn’t matter to me because I am already paid at a high rate, and an extra $5/h is insignificant over the course of 3 months.

Instead, they offered an extra round-trip flight home of up to $450. I had received mileage reimbursement for getting to Virginia, and will again receive mileage reimbursement when I return home at the end of my assignment. So this airfare is primarily meant for me to use in between ending my original 3 months and beginning my next 3 months here. I probably won’t use it until I plan on going home prior to my next vacation in March, but it’s a nice bonus.

My recruiter asked me if I wanted to stay at my current apartment or move elsewhere. I am satisfied with my current housing so I opted to stay.

My only concern was about my requested time off. Usually when I accept an assignment, I provide the weeks I need off beforehand, so I am guaranteed those days before I start. To me, the best part of doing locum tenens is I can take off as much time as I want, since I like to travel abroad.

I discussed this with the medical director, and she guaranteed that my requested time off would all be approved as long as I give advance notice.

Of course a new contract was drafted and signed. All of this was done 2 weeks prior to the end of my current assignment. I am confident that I made the right decision, but lets hope that I do not get too antsy staying in the same place.

Extending My Assignment

For the first time, I will be extending my current locum tenens assignment. As a big fan of short-term assignments (3 months or less), it is surprising to most that I have agreed to be in Virginia for another 3 months.

In the past, working in locums I mostly covered vacation leaves and maternity leaves. I have been asked previously to extend my assignment or to stay permanently. There have been times where I did want to stay longer, but thought it would be best for me to move on.

My current locum tenens job is a bit different. I was contracted for 3 months after one of their physicians had to retire due to medical reasons. However, the site made it clear that if everything worked out, they had other plans for me. For instance, they are permanently recruiting for my position but there will not be a physician available until July, as residency ends in June.

In addition, they are hoping I can become an internal locum for them. They have clinics in several states including Georgia, Florida, Kentucky, Louisiana, and Illinois. They would like me to become licensed in all of these states, and provide coverage when needed (such as maternity leave, FMLA, etc.).

In the mean time, they asked me to stay at my current assignment until July 2017. This would be an additional 6 months after my original contracted 3 months. As I mentioned before, I usually just want to move on. So it took me several weeks to ponder my decision.

In this case I was torn. I did want to move on and continue my versatile journey. On the other hand, I really really really enjoy working with this facility. Everyone has been so welcoming and friendly. I am constantly learning and being challenged. I also realized that I miss the “follow-up” aspect of primary care. Our patients at this clinic see us every month, so I have already established relationships with hundreds of patients.

I knew that if I did not extend, these patients would have no one to care for them. Thus, I decided to extend for another 3 months. Everyone is thrilled, and I believe they are all secretly hoping I will extend for another 3 months to meet their needs until July. I recently found out that one of the Physicians at my clinic is pregnant, and she will be due in July. Looks like they will try to keep me to cover her patients until October as well! Will I ever get out of here?

Honestly, I have been happy here. I truly enjoy my job and the location is convenient, where I can easily travel to nearby states or go home for the weekend. Although I love working as a locum tenens nurse practitioner, I want to keep a good relationship with this facility, as an option to work with if I ever decide to go back to a permanent position.

California Licenses Expiring Soon


If you read my blog regularly, then you should be familiar with my bittersweet experiences working as a locum tenens nurse practitioner in California.

After spending 7 months in California in 2016, I was ready to move on. I told myself I had no reason to ever return to California for work. A few months later, I received a letter in the mail from the California Board of Nursing notifying me that my licenses were going to expire at the end of the year, unless I paid for their renewal.

I immediately thought I would renew my CA licenses since it was such a hassle to obtain them. As the deadline drew closer I realized I would have to pay several hundreds of dollars in renewal fees. This seemed like a lot considering I was not even sure I would use these licenses again.

I do not plan on going back to California in 2017, as there are many other states I have licenses in that I haven’t yet worked in. On the other hand, there are ALWAYS tons of jobs available in California. I contemplated keeping active licenses there as a back up in case I ever needed a locum tenens assignment to start immediately.

After weighing the pros and cons, I decided NOT to renew my California licenses. I worked with 4 different sites while in California, and I hated all of them. Before and after California, I have loved every single job. Thus, I know I have no intention of ever returning to California for work. I am grateful I was able to explore almost every inch of that state while I was there, and had a fabulous time doing so.

Questions from Readers

Each month I will include a blog entry answering some of the most common questions I get from readers about locum tenens as a nurse practitioner. Feel free to comment any questions you have or email me at travelingNP.com@gmail.com.

 

  • Should I apply for state licenses during the search process, or wait until I have accepted an assignment?

I personally apply for state licenses as I go. Most of the time sites will want someone who already has their state license or at least pending (already started the application process). Sometimes agencies will work with you and assist you in obtaining licenses in states that are plentiful with jobs (such as Arizona, Oregon, California etc). I think new locum tenens nurse practitioners think that the process often starts with accepting an assignment and THEN getting the license. However, obtaining a license can often take 1-2 months (since we need both the RN and ARNP license), so sites typically do not want to wait more than 1 month for their provider to start. On the plus side, if you keep all of your receipts then the site/agency will reimburse you for the licensing costs once you start the assignment.

Snow Day

Before I accepted my assignment in Virginia, I asked about snow during the winter. The Medical Director assured me not to worry. She told me that it rarely snowed near Virginia Beach, and if it did, the entire city would shut down.

Coming from Florida, I prefer to be as warm as possible. I have seen snow several times before, but have never been a fan. Perhaps it is because snow is cold, wet, and dangerous to drive in.

When I made it safely into the New Year without snow, I believed I was impervious. The year prior, I had completed my Washington State assignment the day before it snowed!

Shortly after, a winter storm from the west was making its way to the east coast. The city became chaotic as everyone prepared for the storm. It reminded me of Florida during hurricane season.

It had snowed all night that Friday. When I awoke the following morning, I actually enjoyed the snow. The snow was powdery and soft, unlike snow I have seen before. It snowed half of the day, which was pretty neat since I have only seen snow on the ground, not coming from above.

When it finally stopped snowing, my car was completely covered. It took quite a while for me to dig it out of snow. I thought to myself – I do not see myself doing this everyday. I also wondered how people lived in the North East and Midwest where it snowed often.

The following day, the sun came out but it was still quite colder than usual. The snow started to melt, leaving an icy and slippery road. I did not leave my apartment all weekend, as I have never driven in snow, and did not want to get into an accident. Work was cancelled for Monday because the roads were still bad. Since we do not get snow that often, there is no infrastructure in place to clear up the roads when we do.

My co-workers were super sweet, as many of them checked in on me over the weekend to make sure I was okay. Other than a hint of cabin fever, I survived my first time living in snow!

Cool Iceland Trip

For my birthday, my sister and I decided to take a trip to Iceland. In order to see the northern lights, we had to go during the winter. Although it did not snow, it was the coldest I have ever been. My face was constantly numb after being outside for 1 minute. Plus, the sun is only out for 5 hours each day during the winter.

Iceland was definitely worth visiting minus the freezing temperature and cold wind. We felt like we were on a different planet. We were often surrounded by both volcanoes and glaciers at the same time. There were visible fissures due to shifting of tectonic plates.

We really enjoyed the blue lagoon, which is a geothermal spa naturally heated by the magma underneath. It was so warm in the water that you forget how cold it is outside. There is also a bar in the lagoon so you can enjoy some drinks during your stay.

Waiting 2 hours in the middle of the night in the freezing cold was worth seeing the aurora borealis. Side note: if you ever go, make sure to bring a camera to capture the lights (iphone doesn’t work as well).

After my trip, tons of my friends have since visited Iceland or planned an upcoming trip after seeing my pictures. They have all enjoyed it too, and I highly recommended spending at least a few days there sometime in your life. It is a very unique place!