How can I help?

I think some are confused at this point.  I think some of you truly think I'm a recruiter for BlocHealth or National Anesthesia or some other company.  Some think that I'm some fancy dude that is just rolling in bank.  I hate to tell you that this is just so far from the truth.  

I'm a CRNA.  I've been a CRNA since December, 2009.  I have made my way through the locums world since 2011 and have been relatively happy.  I share my experiences and what I've learned along the way.  Yes, I've learned the hard way because honestly half the most out-spoken people just don't know everything and if they say they do... ask yourself if you know everything after being a XYZ of 10-20-30 years.... I'm betting the answer is no.  I prefer to state that I'm no lawyer or accountant but this is my experience, as it's the truth.  I'm not a financial expert or licensed as such so to give counsel... I can't do that.  I can tell you the things I have done or the people I have talked to.  

I can tell you what has and hasn't worked for me.  That's what this site is about, educating you so you don't make the same mistakes I have or collectively understanding where we are and where we go from here.  Giving you options and helping you to be able to figure out decent people to work with.  I can't tell you they are all perfect because part of the information is gathered from our peers to make this a more wholistic site.  I'm trying to give you all the information and not just one perspective.  

So, I'm not a recruiter because I don't call hospitals and get contracts for work.  I don't place CRNAs with hospitals or groups. I ask people to say that I referred them to all the agencies (when this site is instrumental in doing so) when they are going to go the agency route as the referral helps me make this site stronger for you and helps support the number of hours put into this resource. 

How many have looked at the other links at the bottom of the main page?  Anyone see the Store, Financial information that has Accountants and Financial advisers, Mortgage information, and maybe even the Where we go page that has the article by one of our own on RV'ing it across the country?  Take a moment to see all there is to offer.  Jobs come and go from the job board too.  

Any time I discuss with someone I try to make sure I ask.. How can I make this better?  What would help you more?  So, I'll leave you with my E-mail LocumCRNAs@gmail.com  

I did get a request from an undergrad resource wanting to place links to anesthesia schools and feel that first one has to be done with school and should get their practice down before considering locums... so unfortunately, I declined that request.  I'm trying to keep this a clean but solid resource.  so... How can I help?

Calendar

i don’t know about you but it’s pretty crazy around our household.  My calendar for January is looking busy. Next week will be a crazy time and my husband might disown me.  

Wednesday, like all days I’ll be up and going to work at 6 AM.  The difference is that the movers will be walking in the door at 6AM.  They are packing everything then loading the Uhaul.  Then, I’ll get home from work and we drop off the keys, fobs, and say see ya later to Philadelphia.  We are to make it 2.5 hours south into Maryland.   

Sounds totally easy right?  We only have to put the dogs up front in the Uhaul.  Get the kid in the back seat of the Jeep and have everything packed/loaded in 10 hours.  The next morning we have to leave by 7AM.  If not we miss the walk-through on the home that has caused some stress over the past weeks.  

We’ll drive another 2.5 hours and arrive immediately at the house.  Park in the driveway walk through the home and make sure all is in good order.  We’ll rush to the hotel and drop off the dogs, check in for my parents and us for the two whole nights.  Then it’s again off to closing in Virginia Beach.  When that part is done we’ll again be home-owners.   

It doesn’t sound like too much.  But, I start work the following day so again it’s up to Francisco to get things unloaded from the Uhaul and unpacked.  my parents are coming to help install, set-up, baby-proof, and shop.  I don’t know if they are ready for what they are in for!

The one-day move and in-between contracts.  It’s going to be a bit stressful but i know we can do it!   

The rest of the month is just surrogacy, 3 work places and contracts, two birthday parties, and having a fence built.  

Planning just like all things is key but being able to maintain the plan as a fluid work is key.  Happy almost New Years! 

Motivation

I was listening to someone talk in the lounge saying they would never leave this area.  Her husband was offered an amazing opportunity and they said no as it wasn’t in the city.  Their kid was going to college and they begged to have them closer to home and now they think they might return to the same city.   

I guess this idea of staying in one place for life or not entertaining moving for career or home is foreign to me.  I’ve moved around and met new people my whole life.  Freinds of the long term capacity can be hard to come by.  However, within the military life of moving i found lifetime friends.  I know moving has allowed me to make friends around the country and understand different types of people, culture, and demographics. 

I tend to think anyone could do the locum life if they were so inclined but I’m learning that the more rigidly settled a person is the less likely for them to do locums.  Per diem in multiple hospitals in the area might be their perfect gig and while it may be 1099 it is unlikely to be billed as locum.  Others find a w-2 job that will allow them to work 2 full time jobs.  I see them race from call shift to call shift and i wonder how they do it when i know how it feels working 60-80 hour weeks and how lovely it can be at 40 hours.   

I think it all comes down to motivation.  Part of my motivation is to keep up in all areas of practice so I’m well rounded.  My goal is to be flexible, work a fair amount and over.  I want to be capable of going into any room and being comfortable.   I love new sights and allowing family to see all that surrounds us and our opportunities as we grow together.  Others, look for safe, secure, & what is known.  Others look for moving up the ladder of success in leadership, research or business as they grow and that is their motivation.   

Its fun to learn where people are in life.  Then it is nice to remember those people and in going to new places meet those who might also mesh well with others and who might build people up to their potential.   

So, dream big and bring others along the journey.  Find a passion and a motivation!   

Taking time

One of the things I truly forget about is... myself.  Taking care of myself, taking time for myself, and just taking time with family.  

I get so involved in the number of hours, case types, and thinking ahead to length of assignment/finances/bills/investments that I lose sight of self.  I forget the 70 hours of work and 40 hours of sleep is 110 hours in 5 days 5x24 120 doesn't leave a lot of time when you drive an hour a day.  Most weekends I am off which helps but notice I say most because I offer myself up to any days.   

So, as I mentioned I'm planning our family vacation to Hawaii to see my brother and sister-in-law.  This takes financial and self awareness.  You'll recall I'm 1099 which means paid vacation does not exist.  I have to make sure all standard bills will be paid while gone and that $$$ exist for hotel/AirBNB, tours, and the like.  

This week long vacay may only be a week but I've decided to do something that 50% of people say horrible things to me about and the other half... support.  I'm going to get my gastric sleeve.  Not because I can't just go on a diet and lose some weight.  It's because I can't get myself to completely change my habits.   Why?  When I diet I can rationalize that this workout or diet for three days means I can go with friends to X restaurant have drinks and dinner and enjoy... then the next day I just skip the workout because I'm tired and have a beer with dinner because man I worked so hard.  The wagon is broken.  I'm changing the ability to rationalize by saying my body has been altered and despite all things and what people say .. I'm limited in ability to fall.  Yes in 3 years if I want to screw things up... I can.  Have you changed everything for three years and decided to return to a life you didn't like?  My hope and goal is to do this drastic thing to myself to force a change in habit.  Right or wrong I'm doing this so I am around for this family.  I feel like if I don't I'll be that 40 year old in the ER with a heart attack.  I'm hoping at 37 this will allow me to physically change and reverse the negative effects on my health before they are permanent.   No it's not because I don't want to exercise.  In fact, I walked 6 miles today with elizabeth.  It's not because I hate healthy food.  I love it... too much.  It's portion re-training:  yup, I'll have to break the Diet Coke addiction too.  

That's two things I'm doing for me... but that's in November.  You can't just take a week every 3-6 months and feel fulfilled.  I think at least every couple weekends you need a little just for you or just for family time so you see the fruit of the labor.   

What do you do? 

Fun plan

Today I was at a third hospital and people say things like I can't believe you remember from place to place what you need to do.  The good news is anesthesia is anesthesia.  Knowing where everything is even at a place you've worked for a year has a bit of a relativity factor.  Meaning you get used to a place fairly quickly and if you get a halfway decent OR crew, anesthesia tech and are surrounded by decent people... it's probably going to be ok.  

Now, Fun.  Seriously, you have to go to work having fun!  Plan each day to be exciting and happy.  If you drag people down everyday and you are around people stressed and unhappy. Where will your job satisfaction be?   

You have to have fun on the weekends, after work, and plan vacay!!! Life isn't just work.  What you do outside of work leads to your whole self health.  When I get off work I'm going to.... 

If your friend said when I get off work I'm going to take my daughter out for a walk along the river, see the urban culture of a melting pot of people at a skatepark to skulling for their college crew teams, then shower and have a relaxing corona by the pool.  Would you think they were negative about the city or bored?  If you are on an assignment you have to be the person that makes your afterwork and weekend plans.  You have to be the friend that says hey let's go to Atlantic City.    

Every place is what you make of it and it's important to keep yourself and others excited about what you do.  That first plan was my night tonight.  It cost 2$ for the beer and otherwise it was a free nights entertainment.  Your colleagues, nurses, techs don't need to know when you spend $1000 on a trip but they should hear how excited you are about what's happening in their backyard.  It also leads to your overall satisfaction by not becoming TV bound or complacent.  

Best of luck and add some fun to your plan!   

Let's talk skill set.

A recent question was posed about skills and the fact that some of us get rusty or haven't done XYZ in a ... while.  What do you say? How do you talk about them?  Let's use pediatrics as the skill in question.

First, have you just not done any kiddos 0-18 in years and you want to start doing them again?? Maybe the case is you want nothing to do with kids but over 12 is ok?  Where does your comfort level sit?  

When you talk to agencies you should know they want to be realistic with where you are and where you are willing to go.  Are you willing to do pediatric cases but want a hand in the room until you are comfortable??? The first 5 - 10 cases or maybe you say I'm not comfortable and don't want to go a place I'll have to do pediatric hearts or solo pediatric ER intubations.  

This is all ok.  But, you have to realize each case type you can't do or won't do may limit your opportunities.  It totally may have zero effect.  My current hospital will put you where you are comfortable.  No blocks, heads, hearts, cvl's, art lines, peds... it's ok.   

Important! Don't tell them you do and you can't do!  You should get a credentialing packet that will ask your comfort with procedures, cases, and numbers (estimated) per year.   

Please, let your agency know where you are and be optimistic about what you do and what your willing to learn.   

Continue to show your education, CEU's, ask questions, and when you are at your assignment take initiative.  Ask questions, act interested, & be ready for opportunities. 

So close to return

Good morning!  

Today, we head back to New England.  We'll fly into Boston and then back to our apartment for a couple days and then get ready for our trip to Philly!

Planes are great, airports are not my friend. 

OK, why write today?  Well I just hear a Locum was all set to go for my next assignement next week and they backed out last second.  Have I told you how bad that makes you look?  Have I said that it might blacklist you from going with that agency in the future?  Why burn a bridge?  If it was for more money, why didn't you negotiate for what you would work for in the first place?  

This disrupts my ability to get a schedule but thankfully means I'll get more hours.  I wonder if they'll give me 80?  That's do-able for a time but will get to burnout soon enough.  I'm typically around 60 so not a big jump :)  

Ok... gotta go catch a plane.  Someday, I'll have to describe all the business stuff that goes through my head and thought process :).  Continue the journey

Skills

Skill and Presence are left in the things that make a good locum.  First... Can you believe I started this little site one month ago?  If I can do all this in a month, imagine what the future holds.  Well, honestly that means we are so very close to going back to work. It seems like I was just at work.  Tomorrow, marks another travel day in the life.  We will be flying back to Massachusetts from Kansas.  If anyone is in Worcester or wants to say hi in worcester we might be able to do the evening on the 30th of June.  I'll open it up on the FB page.  

Skills.  

I usually say something like... say what you mean and mean what you say.  This would be in the same category.  Know your skills and do them well.  You have to be able to do the cases the facility needs you to do.  So for each assignement I ask what typical cases are and that I'll be set in the rotation to do all the cases.  I love my A-lines and Central lines.  I love Pediatrics and neonatal cases.  I enjoy a good heart and major vascular case.  Neurosurgery for a tumor or a neuromonitoring back.  C-section for breach twins or an eclamptic that needs a stat section are all in a days work.  It's not uncommon for me to go in and find my schedule changed to something else because they added XYZ case.  It goes back to being flexible and they know I am. I have the flexibility because they know that in my pocket of skills and case-load I have the ability to do what they need.  They can take me out of the Total joint and put me into the emergency add-on trach.  They also know that I'll ask questions or make sure things are ok in the event something isn't right.  I'm not a cowboy and I'm not going to try and do what I'm not comfortable with.  

You have to develop the skills and types of cases over your career.  If you are a new grad, you're untested and an unknown quantity thus most places ask you to get a minimum amount of experience in a facility and I would say get a year or two at a semi-independent site.  Completely independent sites will normally do more bread and butter and dominating supervised practice can be so crippling to a career that it'd be better to go locum as a new grad.  So, I can't say what you should definitely be doing.  You should be capable of blocks, and basic a-lines and IV's, general cases, spinals and epidurals.   If not, when you start locums ... state this upfront to your recruiter or if independently contracting, you need to let them know.  Then you might want to learn.  If it is a long term assignment they may take a couple days to help you learn.  

Develop your skills and continue to give yourself variety so you can stay marketable.  

5 Bucks

Since I'm not driving at the moment I'll say my hello.  I'll also make my case for stopping the nurse mentality of taking an across the board pay.  

How much is five dollars worth to you?  It's s Starbucks coffe... or maybe not even...so is it really important to try to get that locum contract at 110 instead of 105/hour?  They said it's as good as they can do and no one would ever say what they could do first.  You negotiate your house purchase price, haggle for that $1000 on the car, take coupons to the store to save 5 bucks at the store. Why is it we have a problem asking for a raise?  

Lets talk about that $5 you aren't worried about because you like the area or are kind of comfortable.  5 dollars multiplied by an less than full time 2000 hours in a year.  That's 10,000 dollars.  So, is it worth it?  I've been locums for 7 years.  That's $70,000 dollars... is it worth $5?  

   I always try to tell people they have options and need to negotiate.  Think about ways that both can be happy.  Then, go to work and kick butt.  You can't be a slacker, be lazy, be a poor clinician and ask for more $$.  Be strong, and with each assignment try to be happy, confident and ready to go each day.  These places will be more willing to negotiate, want you back, and keep having you over and over again.   

Well that's my 2 cents... back to vacation.  

Getting things done.

OK, here is the deal.  I'm on vacation in between contracts in Massachusetts and Pennsylvania.  I am getting alot done on the rental houses to be.  My husband is tired of obliging my desire to do these but always loves just how well my dad gets the homes ready to go.  It is pretty darn impressive.  All I do when I get into town is have a ton of meetings, write the checks, and manual labor of paint, haul, and yard stuff.  Thankfully, Dad was released from the hospital yesterday but I am hopeful this gives him the minimal fortitude to take it a little easier and not stress so much.  However, that means I have to pick up more.  

I was asked, by the client hospital to start a week earlier so now we are trying to arrange this through the agency.  I don't know what the problem could be with doing that.  However, it is a week and while it sounds awesome to my wallet there are a few things to consider. This means no great move-in time or quick vacation to DC/NYC before starting.  It means very few options of dry run to drive to the facility.  It means the first few days will be a mad dash to purchase a few critical furniture pieces as we got rid of in Massachusetts and Kansas as our apartment just shrank a few hundred more square feet.  

All of this said, I still have no PA license and I'm pretty sure that due to the critical need and nature of the contract.  Credentialing should be done and even if not.  Orientation can still be completed.  Locum work is not for the faint of heart as each time it seems to truly come down to the wire for things.  

I am assured on the side of the client group, agency and state that things will all come together but I bring a bit of a pessimists perspective and tend to over analyze.  It's just the opposite with the Rental Homes. The scarier the project and all that needs to be done, the more intriqued I am.  

It's almost 7:30AM. I hope they don't get to mad I'm mowing the yard. Today is going to be a very busy day as we have three homes to get ready.  Tuck U Inn B&B, my AirBNB and then my parents guest cottage all in Aitchison, KS.  Atchison is the birth place of Amelia Earhart and has a large private college (Benedictine College).  I am already looking forward to about 5pm when all has to be done :).  

Best of luck to you in your locum journey.  Let me know what you are doing!