This series is a deeper dive into what it’s like to work as a locum tenens provider. For this article, we spoke to nurse practitioner Katherine Allen. She shares how locum tenens allows NPs to take control of their schedule, visit new places, and really focus on patient care.
“I think I was sick of my job,” says nurse practitioner Katherine Allen, when we asked why she decided to quit her permanent position and try out locum tenens instead. “Not that my job was bad,” she quickly adds. “I just didn’t want to live in that city anymore.”
Eventually she Googled the question: “How do you travel as a nurse practitioner?” As it turns out, she had never heard of locum tenens. But what she read captured her imagination and made her want to learn more.
Three years later, Allen is a successful, engaged, happy locum tenens NP. During her off hours, she’s an even happier beach bum, to use her own term for what happens on her days off.
A way to take charge of your life
“I could just lay on the beach all day every day,” Allen says. “I love it!” That’s why she usually looks for locum assignments near the water. She also likes hiking, learning to cook new foods, going to museums, checking out historical sites, and wine tasting. All great hobbies if you have time to explore. Not so great if you’re tethered to the same location with limited opportunities to travel!
As a locum tenens NP, however, one thing is certain: Allen is anything but tethered. She takes assignments where she wants and even carves out space between assignments for more traveling. She’s used locums to create the life she wants, with no excuses.
So far Allen’s assignments have ranged anywhere from three months to a year. She works Monday through Friday, regular business hours, and says that her pay is “significantly more” than when she was in a permanent position. The only time she’s ever worked a weekend was when she wanted to earn some additional overtime. Now, if she wants two weeks off between assignments for an extended vacation, she can have it. A month? No problem.
A chance to learn something new every day
Fellow providers often ask Allen what she likes best about working locum tenens. Of course, there is the opportunity to see and enjoy new places. This is huge on Allen’s list. But she’s also fond of the fact that as a locum tenens provider she no longer has to deal with office politics. At work she’s focused on patients — doing her job the best she can. When the day is done, she goes home.
Then there is the benefit that she wasn’t expecting — the one no one had told her about. “The other thing I love is that I get to learn something new about medicine everywhere I go.”
Recently she completed an assignment in Martha’s Vineyard, “the Lyme capital of the United States,” according to Allen. “I got to learn all about Lyme disease, and in a lot more depth than I ever would have or could have living in, say, Louisiana. Because there you would never see it. I did another assignment at an Indian Health Service facility, and I learned about Native American culture and some of the related health issues there.”
Always the new person, but not for long
Allen’s locum assignments usually start with some kind of onboarding and orientation experience. This is where she gets a feel for the clinic’s physical space, an overview of the electronic medical record system, and an understanding of the clinic’s patient census. According to Allen, not all orientations or onboardings are equal, however, and she’s prepared to make do with whatever information they give her. Sometimes the introduction is thorough, with plenty of time for questions. Sometimes “they throw you a little bit to the wolves,” she says, which means she could be evaluating her first patients before lunch.
That said, Allen says she doesn’t feel like the new person for long. She describes the typical locums routine: “I get to work. I check my schedule to see if there’s anything that needs to be prepared in advance of a patient’s visit — like records. I check my labs and messages and refills. And then I see patients.”
Continuity of care for a locum tenens NP
Like any job, locums has its downsides. For Allen, the one she thinks about most is continuity of care. Wherever she goes, the patients are new, their medical histories completely unknown to her. In many cases, the provider who worked before her kept accurate, comprehensive documentation, but it isn’t always the case.
“Say you’re coming behind somebody who’s on maternity leave. Most of your patients will be for that provider, and you learn his or her style pretty quickly based on their notes,” she says. “But say you’re going to a clinic because they have trouble keeping full-time staff. In that scenario, you’re more likely to get poor documentation, and it becomes more difficult to figure out what’s really going on.”
Allen says the level of support you’ll get in these situations usually corresponds to why the clinic is bringing in a locum tenens NP in the first place. “Some clinics have trouble maintaining permanent staff, and that’s typically related to how they treat the staff. So you can just assume that maybe the treatment of the locums will follow suit.”
Making a home away from home
Allen brings her dog along wherever she is assigned, so finding a place to live that allows pets can sometimes be a challenge as well. “He’s old. So I either have to be close enough to my clinic to make it home and let him out during lunch, or I need some kind of arrangement where maybe the landlord lives next door and can help. This is definitely an issue if you’re bringing a pet. Some areas have a lot of dog-friendly options, and then I did one job where there were literally only two.” She recommends making sure you will be able to find housing you want before you say yes to a job.
While it’s not the hardest part, moving to a new home every few months isn’t easy either. “If you’re flying to your new location, then you’re buying things that you’ll likely have to buy again for the next assignment,” she says. “So there are some additional costs to locums.” That said, she says her take-home pay as a locum tenens NP is still more than what it would be as a permanent provider, which more than makes up the difference.
Making the most of locum tenens
Allen says that the key to getting the most out of the locums experience is maintaining proper expectations. “You have to factor all of the positives and negatives together. What’s the pay? What are the work hours? Where is the job?” she says. “Sometimes you put up with a not-as-wonderful clinic experience because the location is great. It’s not just one thing that should be factored into whether a job is right for you or not.”
The right job for Allen is one that empowers her to achieve her goals and live her dreams — and for now, locums is doing exactly that.