Locum Travel

I love being a locum, on most days. This is definitely one of those days!! I am so happy I chose to become a Locum CRNA.

I am not traveling extravagantly; but, Francisco and I were able to take airline miles, bumped from flight $$ and get our coach tickets to Paris!  Ok, so we spent ~$150 on air United tickets. 

We packed our baggage (you can see my SwissGear luggage on the store of the website). We used the United Airlines mileage card to sit in the club for our forever long layover to have drinks and food.  We did do Starbucks as we went for our walk in the airport just before getting on the airplane. 

Unfortunately, I forgot my most loved wired Apple headphones in the car on the way to the airport.  Because I worked hard the last two weeks, I decided to get my first ever set of AirPods!  I’ve always liked the fit of apple headphones and now I like these with no wires!!!!

We are about to land and we’ll have some time to clear customs, baggage and coffee!!!! Then, it’s off to the train to London. 

Ok, so travel or really time off is a benefit of being a Locum CRNA but it’s about using the leverage of your travels as well.  If using a credit card are you taking the benefits from that?  If at a hotel, did you add your rewards number to the reservation?  The only rewards I’ve found I can’t get are the car rental rewards as the reservations with Avis was at a higher cost for adding the rewards. 

We also have two free nights in the Best Western because I had some nights that a hospital put me up at the BW.  So, we are paying food, fun, & 8 of 10 days in an AirBNB. 

This isn’t to brag about vacation, but it is to tell you that you can take more vacation, plan, and have some rewards that make it more affordable! 

New Apple EarPods  

A long trip in coach... we survived! 

Eurostar to London

Packing List for CRNA Locums

Have you ever had luggage show up late or been to your destination to realize you don’t have the basics of what you need? Have you gone on vacation or to your assignments and realized you brought too much stuff? This goes with my YouTube video: Here’s my basic packing list:

Things I do:

1. Pack for just 7 days.

2. Have a set of dress casual clothes for day 1 at work.

3. Have my laptop and phone fully charged and have the cables.

4. Pack imperative items for the first day of work in my carry-on luggage.

5. Have all my assignment details either memorized or printed. It’s horrible to get in the rental car and not know where your going because your phone died as you were listening to that amazing audio-book on the plane.

6. Have something you love to do with you.

7. If you work out everyday but forgot your favorite gear. That will make you alter your routine or put you in a funk from the beginning.

8. Make sure you unpack on arrival and know exactly what you have to go to work with in the morning. Take the time to have your paperwork printed and ready to go.

9. Follow a routine so when you are packing you have checked your list and not just brought everything from home that you won’t use.

10. Don’t over analyze and pack for unlikely contingencies. Pack your everyday items for one week.

Walking into a new environment

I’m just about to walk into week 3.  It’s amazing to find a new place to work.  Each new place has its’ nuances and differences.  

I find that each place has a few people that are challenging to work with that challenge the way in which we are used to working.  This comes full circle into relationship building.  Most of the time I do awesome at saying “this is what I’d like to do and this is why”.  For the first time ever (as I recall) I found someone that didn’t respond to that and has been a bit difficult to work with.  However, I have tried to maintain a high road and be respectful.  I try to daily go in positive on the day and the work that has to get done.  With each case and with each good day I feel the rest of the group becoming more relaxed in understanding that I bring some ability to the practice.  

I take every opportunity to tell the person running the board I’m available and ready to work.  I come in a little early and set-up my room.  I have my coffee early and don’t assume I’ll get out right away for a break in order to get coffee or breakfast.  I try to be available and flexible in order to get the work done so others can go home.  I don’t ask to get out early assume that I’ll be afforded the same opportunity to either go home or take a break.  Most places I go to seem to want to test any new CRNA in case types, personality, proficiency, & the willingness to do within the group.   

This all comes down to relationship building and interpersonal communication as much as it is about CRNA skills.  A place can usually work with someone that needs a skill or a case set more than they can teach flexibility and good attitude.  So, continue to grow in personal development as much as your CRNA development as you continue your journey.  

Change is inevitable

It’s Thursday and I’m in my last two days of Massachusetts. This is what I’m doing.  I’ve confirmed my credentials for Texas and started the credentialing in Virginia. Virginia is a different group as the previous took 8 months and came back with telling me I would have to resubmit everything and starting over.  I’ll never deal with a group that does that again.  

So, I’m preparing my luggage and work bags.  I’m making sure copies of hotel bills are sent to the agency.  I’m making sure the final hourly bill is sent tomorrow after work.  I’m slowly packing and getting things ready to go.  I’ll be doing homework the next two nights so more time can be spent with family when I get home.   

I sent in my foreign corporation documents by fax and mail to Texas.  This took 4 minutes from searching the foreign corporation and Texas Secretary of State.   

Min the meantime I’ve been in contact with my accountant.  Talking about the change of location.   

I’ve tracked my route to Texas and planned the day of start in Texas so that all is ready and done for a good and quick start.  I have a badge and person that I’m meeting.  Hotel is set and ready to go.  Seems all I need to do is show up and get started. 

Otherwise we are working on the real estate.  We are offering currently on another potential rental, but we are only getting it if it’s at a deal level. The market is turning again to a buyer level in some environments like where I invest, YouTube for Francisco (growing and getting ready to monetize with ads), and getting Elizabeth set for schools and bank accounts (preparing to pay her annually for work). We are finally hunting for what may be our November vacation as we haven’t done a just Francisco and I vacation in a year or two ;).  The journey continues.   

Leveraging Relationships

  you relationship building and keeping up with your previous facilities, colleagues, and friends?  Are you taking opportunity to go to state level CRNA meetings for continuing education?  

Everyday facilities are looking at the cost of anesthesia and if they can keep expenses low.  Groups are turning over, people go on vacation or maternity/sick leave, & independent practitioners are looking for quality people that don’t want their job but can come in and help.   

Update your resume and keep people aware of your ability to help them given your scheduling.  Keep your files up to date so your credentialing would be easy.  Keep some of you appointments at facilities you might like the opportunity to return to.   

Maintain quality interactions and keep your social media up to date and appropriate so that people know your personal and business life are together.   

Why?

Multi-Level companies ask the important question that isn't always looked at from a job perspective or from a daily perspective.  I had someone ask me in passing what is the end point.  What is the goal and why are you doing what you are doing?  Not asking why I was a nurse but why I traveled and was spending time away from the family.  

I didn't feel like chatting.  I said so I can retire in 5 years.  So I can work less and spend time with the family.  I either compress the work down by working more hours, get a raise, or I live in a way that I don't desire.  This is why I do locums in big hospitals.  I get a large number of hours and call.  I have worked with these companies before and they know how I work.  I get paid pretty well.  This way I earn more than is spent... most of the time.  

Surrogacy and family building have been a focus of ours.  This has increased the debt load and thus I'm working away from home for a period of time to cover those bills so that credit card interest doesn't really cost what apps like Credit Karma would say it'll take to pay off debt.  

I'm also working on Taxes as I spent the money that came in and little things added up.  I don't recommend getting in as deep as I did.  It's a difficult hole to claw out of.  Every interaction and purchase needs to have a why.  To what end is this thing going to be of benefit.  What will this do in the coming days, weeks, months, or years.  So, I'm asking myself, as things come up, "why"?  

It turns out a year ago I would have sat down and bought a new laptop "for school" when my excel version didn't have what I needed and the computer was somewhat slow.  Today, I bought office but not the recurring monthly billing and not a new computer to go with it.  I dind't save 2000$ but at least I didn't spend it.  

My goal is to be working 1-2 days a week by the time Elizabeth is 5 years old and living about the standard of living we are currently living.  It's a challenge... especially when that is 3.5 years away. That means developing our spending in the right ways.  That means developing our business in the right ways.  That means finding my why for each thing I do.  

People wonder about the going back to school piece.  I happen to question myself a lot at the moment as I'm doing my most disliked statistics and algebraic equations course.  I love business and simple math.  I don't like big math.  I think I should be able to use a spreadsheet and be able to do basic math skills that most calculators can do.  Beyond those things.... there are applications and computers to help compute what might be needed.  I know someday I'll tell Elizabeth she just has to do it to advance to the information she needs to learn... so I'll tell myself the same.  But, school is costly right?  In this case I have the GI Bill and it wasn't transferrable.  It was to the time of use it or lose it.  This will allow a free education and allow extra minimal income toward bills.  It's a time loss though.  Sometimes, I wonder how I can fit it in.  I study and keep thinking I'll learn something that I can use in the future.  

Why is definitely a hard question when I have to answer why I'm away from my family. Why I'm working 60+ hour weeks.  Why is because we enjoyed life for years and now it's time to be ready for Elizabeth to have her time.  I want to be there for her school events, her trips, and her development.  We want another child in our family so that is part of why I'll continue this pace until all is done and paid for.  Then it's time to settle into life and have things set on auto for a while.  Work with a little family balance.  Tip the scales to the side of enjoyment. Bikes, hikes, and family time.  

So, Why are you thinking locum work?  Why are you afraid to travel?  Why are you doing what you are?  It's definitely worth finding your Why and what is the end point of it?

The busy locum

Another busy week looms in the balance on this Sunday evening.  I am well on my way to paying down the bills as we spoke on in weeks passed.  My Sep IRA through e-trade was set-up and funded.  I’ve traded in the truck for a small SUV that now is less than half the payment and has a better APR with half the balance I was paying.  I’ve also paid off 20k in credit cards.  I still have a long way to go and am paying my dear old Uncle Sam dearly with every paycheck so I can get in the good graces.

Today, I worked at the hospital ... from pediatric code to sepsis and multiple cases in-between it’s been a crazy day.  I was able to get back to my hotel in time to spend some time on homework.  My math class work for the week is complete and now it’s on to business analysis with its’ primary focus being communication this week.  The MBA program is challenging my time management and my brain in ways that I haven’t managed in a while.   

This week is a 60+ hour week and call for the entire next weekend.  I keep my focus on the benefits I see in the long-term as right now I sacrifice time with the family to get us ahead. We are seeking some freedom from the absolute need to work for thought of if things went sideways “what would I do if...” scenarios.   

I’d say in just a few weeks I’ve learned a good amount on every level and look forward to the coming weeks in engaging with colleagues, growing businesses, learning in the structured university education, and then managing life around the critical elements.  

This weekend I spent time on the farm with my favorite veterinarians and did c-sections for sheep.  What an amazing opportunity and so glad I spent a little time with family.   

What an amazing life we lead.  Now it’s off to laundry.  Feel free to e-mail me anytime locumCRNAs@gmail.com

Lesson from the movies

I went to the movies and I'm sure I didn't take from the movie what they hoped.  I tend to take little bits out of life and try to make them part of my life.  From Financial Independence to Anesthesia I take a little bit from every day.

I went to the movie "I Feel Pretty".  It's a little different now that we are raising a little girl.  I don't know why it is but the way I look at movies and media in general.  I also look at many things that come at me from my MBA program (I'm in week one)  to Anesthesia and Locum work.  

I feel pretty tends to try to show that it's not about how you look.  Great story on confidence and looks.  If you take this concept and expand it to the comments of: 

It's what you know

It's not what you know but who you know

It's all in the experience

It's all about the environment (Nature vs Nurture)

It's the fact that you had an education that not everyone could

I'd say "it" is about all these things and none of these things.  This movie can take all those things and say It isn't about just those things but the APPLICATION of each of these things and the most successful people take all the principles and they apply them in different ways.  

I say that because you can know all the right people but if you don't apply the lessons from each person "the 5 people your closest to" can't change you.  You have to change you. You have to be open to the application of lessons learned.  

You hear about this or that and think you want that ... but you have to be "on the ball" and do what has to be done to "be" the change you want. 

It's the same idea of me always listening to financial reports and to stories of those that developed business and climbed the non-existant ladder of success.  Very few people just rise to the top without taking specific actions in those areas above.  

So, for today, I'm leaving you with the actions you take and the application of the principles mentioned that will elevate your practice, life, education, and the bring the road into focus to where you want to be.  So, take action and apply yourself to becoming better each and every day. 

Start getting involved

Today, I’m supposed to see one of my congressmen at MYA.  While I appreciate the attempt to make it easier for a non-political person such as myself to see our representatives I think it’s less likely to see dramatic changes when I’m going with the idea of three bullet points.  Not one has specific actions.  Not one has to do with the key function that opens the door to the full practice and autonomy that full billing rights does.   

I say this quite possibly out of naivety.  My idea is that if we can bill independently at 100% for all of our services then the right to work autonomously would be a natural progression.  

I see the ASA involved in so many layers of government and see our CRNAs in so few places.  Honestly,  the MYA was much more expensive than I expected and less well attended than I expected.  

I went to the Region 2 update and was impressed to hear about our reactivity to each of the bills in each state.  I heard of 1-5 bills presenting legislation in each state that would better AA, ASA or decrease CRNA practice.  IN EACH STATE!!! I didn’t hear that we presented bills, we sat on these committees and task force set-up by.   I heard the AANA did a first ever state leadership retreat to Vegas though.  Several were happy about this.   

I see that the Cultural Assessment is in full swing and I know people cried for this but the membership slid down a few more points this year.  I guess I don’t understand the cultural piece as this is a business and professional organization that should be fighting for CRNAs based not on culture, ideals, or in an unbiased opinion.  I think the political piece is a large part of what should be our organization but we don’t even raise 3 providers income among 50,000 CRNAs in any given year to work with.   

I offered to put a link on the locumCRNA.com page that would say to support the PAC and was told that it was illegal to do so.  I learned something new.   

I don’t know what is in our future but am quite aware that we need to do better as a professional organization and we all need to be more involved than we are.  Billing rights and autonomy of practice will be paramount principles for independent practice and advancing our profession.  As a locum that enjoys nearly all practice environments I think that this focus and becoming more involved in each states organization can only help us.  But, involvement means action, knowledge, and fricking membership for those that aren’t even a member of our professional organization.   

You have seen my financial information and I’m still a member of our AANA, donate to the PAC monthly, and despite my poor political affiliations I am here trying to learn and grow just to maintain or improve our profession in the future.  I am starting to get some of the knowledge beyond just being a provider, or clinical educator in the OR. 

Please take some time to go to the state meetings or national meetings and start getting involved in what we need to do for ourselves.  Consider a contribution to either the AANA which is tax deductible or to the PAC which is not.  Both advance us as a professional organization just in different ways.   

Just my 2 cents.