I'm negative $500K+

It may seem easy to say I'm broke but to say and feel that burden of the debt that I have and the understanding that I am not getting ahead by working my butt off can be depressing.  I look at the FI or Financial Independence/ FIRE Financial Independence Retire Early and wonder if it's possible at 38 years old if this might still be possible.  

Why did I get to this point and what happens?  I have 9 revolving credit accounts.  I have interest rates from 9.99% to 22.5%.  It's when you see that interest per month accounts for easily $3500/month... that means before I decrease me debt I have to make greater than $3500.  Even at a higher level of earning that, I have to make 42K/year.  Granted in the world of advanced practice nursing that pays that amount... it becomes overwhelming.  To have that amount after taxes I have to consider it takes almost $84K to pay that $42,000 if I were W-2.  

This doesn't begin to include my real estate business.  I own 6 homes outright in Kansas.  One completely needing a full rehab and one needing minor rehab.  Two are full time rented, and one is Airbnb rented or long term rented separately.  These start at $6000 to $42K on initial buy price and needed anything from $5000 to $40K in fix-up expenses.  Although these are paid in cash, they don't bring in the cash-flow, at this point, that one might expect.  If you are wondering where the money came to take care of these... I put expenses on the credit cards until I could pay that money back.  Is this what made it all so bad?  Not exactly.

We started a journey of surrogacy.  The surrogacy process was expected to be $48,000 and was going through Mexico ... we started this process just over 3 years ago.  We started out so excited and then two egg donors, multiple surrogates, a miscarriage, and 7 embryo transfers we finally had a pregnancy that resulted in our daughter.  Then I was stuck in Mexico for 7 weeks attempting to get out of the country legally with our daughter.  Over $150,000 in lost wages and fees for surrogacy later we had our daughter back in the US and then started the Legal work that one year later resulted in the 2nd parent adoption for my husband.  More lost wages, and legal expenses later we had everything done.  Is that all... No. 

Given the length of time working for Elizabeth, we decided to start the surrogacy journey for a sibling and decided that the US would be a better option.  We found a surrogate, moved our home to Virginia with the purchase of a new home.  That was $7000 down on 379K in home debt but you have to live somewhere that is good for school, and a safe neighborhood right?  So, one would think we had it all together getting to Virginia and having found the Surrogate, did the legal documentation, found the surrogacy agency and found our egg-donor.  We made four embryos and went through two failed embryo transfers and found ourselves not pregnant... we had effectively lost approximately $51,000 and we have to look to starting over in this.  I had contracts set-up to be able to work and due to inefficiency the contracts didn't start.  They failed to do their due dilligence in making sure I could start work.  

Now I'm traveling states away while the family is in Virginia.  I spend weeks away trying to make sure I'm able to provide for family and bills.  I look to the FI possibilities and the amount lost each month and cringe.  Despite being able to cover the bills... this is not what I anticipated as a Travel independent Nurse Anesthetist.  I always looked at being a highly skilled provider and said I was good for the funds.  I'm looking at the future and wondering how I can dig my way out of this.  

I'm putting this here, not to get sympathy or to get comments.... I put this here so I have the accountability in getting the debts paid down.  Oh, I didn't mention that I have a paid off Jeep, a very high car payment on a truck, and finally I acquired a personal loan to help pay for things at some point along the way.  Did I forget that I didn't pay taxes yet for last year... yup it's tax time and I have only paid in $10,000 in the taxes for last year and have about $40K to come up with over the next few months.  

So, If you are interested in continuing to follow my journey to FI... you're going to notice on this blog that I will also add updates on when I pay off credit or loans and where I'm putting $$ earned each month.  I hope it's ok to use you guys for some accountability and making sure I get my life back to healthy on the financial concepts.  

Think

Every day I spend time with podcasts or learning in some way.  I listened to multiple this week.  Some of the things I learned this week. 

Be Better:  Every day or every week work on how you can be better.  A little change that will help you approach your goal or commitment.  It doesn’t have to be something earth shattering.  If you do 52 weeks of little changes toward your goals you will find yourself inching toward it and be there before you know it.  I read my books this way.  I’m paying down my debt this way. I’m growing the websites this way.  I grow my life, family, & relationships by spending seconds or minutes to interact and tell people thank you or awesome job.  Make a commitment and not get overwhelmed by doing something everyday.  

Attitude:  The attitude you approach something with is how it’ll go in most instances.  You can’t say I hate I hate I hate and then get to the point of doing and expect not to hate it.  I get to work and genuinely say good morning, hi how’s today and yup I’m annoyingly upbeat.  I do this for everyone and myself.  If people see me pissy and depressed everyday I’m adding an attitude that just brings down the whole team.  I’m there to work... not to complain, be unhappy, & just be a body.  I’m there because these groups have people that act this way or they can’t keep people because they are all stressed... if I can be a stress-free person at work.  I’m more likely to be asked back. I’m more likely to feel like my days go well.  I’m more likely to truly have fun and make the days go by.  I miss my family at home and I’m so excited to see family pictures or video and I share this with the people I work with.  Kids and dogs make everyone light up a little.  

Stick to it:  If I sign a contract or give my word.  That’s it.  I’ve said I’ll do something. I’m going to darn well do it.  I’m not going to tell someone that I said I’d do their room tomorrow then not because I found out the surgeon I like has just two easy cases for the day.  If I get what I want and ask for ... I honor what I said I would do.  This makes me reliable, dependable, the person to go to, and sought out for as a provider.  I’m reasonable in my expectations, experience, and what will come.  I know the business of anesthesia, each hand in the cookie jar and the expenses that come after the reimbursement income and how the expenses trickle down.  

These are just some of the things I’ve learned this week and application is always the challenge in what I learn.  I choose to hear most of my education, so I then proceed to the application and notes to myself in how I can apply it towards my day/week/month.   

I’d like to tell all to have an amazing weekend!   

Due diligence!

I just want to make sure you know what doing your Due Diligence means.  Before you say “hmmm, the recruiter said it was a great deal” look at it & run all the numbers.  Are you having to pay to work?

What do I mean by having to pay to work.  Are you getting a stipend but you have to get your own housing?  Did you check out the deposits, fees, pet deposits, taxes, total costs for the time you are going for and if you get your 30 day notice right away?  Is your parking taken care of? Have you found out your mileage reimbursement and is it at least the IRS reimbursed rate?  

Food?  Does it cost more at your assignment?  Is there a kitchenette where you are going?  Are you getting a daily food per diem when you work especially if you are going to an area where the cafeteria seems to charge more than any should?   

Malpractice.  Is your insurance covered by your agency or the group you are traveling too?  Ask for a copy of the COI (copy of insurance face page).  Are you making extra to cover your own insurance and have you checked to make sure your insurance covers the location or that it won’t be significantly more expensive?   

Taking on the expenses and being reimbursed.  Are you trying to get the credit card miles, cash back or other points?  Does your contract state that you are being paid for each aspect and how long until it is paid? Do you have to submit receipts?  Are you certain you are fully covered on the reservations and no cancellation fee if they don’t get you credentialed?  

Please don’t take what the recruiter says as gospel that what they are paying will cover things.  Make the calls and find out the true costs if you are doing all inclusive or stipends.  

Lets journey on. 

Traveling attitude

It’s another traveling day and of course I’m up way to early.  I have two options though.  #1 I can say I hat the airport, the rental car return, the drive, getting gas, & generally people at airports still act as if they have never seen one.  #2 I am sooooo excited to be on my way, I was upgraded on my 20 minute first leg of the flight and I see the family in just a few hours!   

Mind-set is everything right?!  It’s the same way when going to work.  If it’s a locum job, a full time gig, or your kiddo doing the chores they have been assigned.  It’s in how you approach it.  Yes, I understand that bad things happen and unforeseen circumstances can change things but ... by and large this is the everyday approach.  If you want to love locums, love the time that you spend at many places... you have to decide that it’s going to be good.  If you have decided that hospitals, people, this job, and working with medical professionals suck... you won’t be happy ANYWHERE.  So, find some joy, work on finding why you want to do this, then reach out with all your positive energy and let everyone know just how great you think things are.  Happy people are infectious.  People, surrounding the upbeat, are more relaxed.  These people are perceived as more personable.  These are part of the reasons people are invited back or not invited to return to facilities.    

I’m told over and over of people that are extended or given notice because of their attitude.  I’m also told that places are more flexible with those that have better people skills.  That may be that the individual is flexible or the work place is flexible?  I wonder if both are true at the same time.   

I get an earful of complaints here or there and find that misery loves company.  I had a nurse in the room that said I can’t stand so and so... they always lean-in the room and say “you good?” Thumbs up!  “It’s like he’s trying to run away as quick as possible”.  I say well... this is his first job... he was trained here and it’s what the other nurses do in his room... he’s been here a year right?  So, is this a person issue or is this what he’s been trained to do over the past year?  We are training people by what we exude, show, teach, act out, what’s said, and the daily attitude we display.  So what are you teaching those around you? 

Sunday Day off or Work Day?

It is Sunday, today.  What is your philosophy for Sundays?  Work day or day off?  If you are a locum you could consider it as either.  Even if you are not physically in the hospital.  I am one that is always learning.  It doesn't much matter on the topic but it is important to have down time.  I can honestly say that there are not to many days that go by that I haven't learned something.  Here is my weekend in a nutshell....

This weekend isn't much of an exception to the learning thing.  I try to have each day be a learning thing by reading or listening to podcasts or watching YouTube videos.  I try to share what I learn through different outlets such as this site, my family, Facebook, or other.  I try to share my experience when people message me or call.  

Yesterday, I had someone ask me about setting up a fee structure for a small hospital locum contract that just kicked the group out and the hospital still needed the CRNA to come up for a scheduled time.  I worked about an hour on my presentation for Education Adventures in Costa Rica coming in June.  It's still not where I want it.... but it's coming along.  I learned about backyard gardens for about 2 hours and am going to take people up on the learning they offered!  I listened to three podcasts. I lost $100 at the casino this was a major reminder not waste money and time at casinos.  I discussed two rental home projects that are in process, and the financials. I went for a haircut which was major down time and depressing to see how many were in-line... I think I should own the hair salon but that is a different investment I don't have money or time for.  Elizabeth (my daughter for all unfamilliar) went to the doctor yesterday for a sick visit and needed a nebulizer treatment for what sounds like a chest cold.  I spoke with two agencies about how I can work with them in presenting jobs on-line they might have, being a liaison of sorts for when questions or comments are shared, and discussed some options for feedback that are anonymous and not discussing specifics but will keep them aware of negative (negative are not shared immediately and specific details are not shared) or positive feedback on great recruiters or pay.  I think this is a way that can improve the interaction especially when they know a large forum discusses pay, agencies, independent contracts, hospitals, and the process of being a locum.  I seriously think it scares some. That was my Saturday.  

Today, I will again go to the gym (like I did yesterday) and hope not to see a kid eat treadmill. I have three hours driving that will be broken up by conversations with a small Anesthesia Management Group that is CRNA run.  They are looking for hospitals, surgery centers, endo suites or other to add to their portfolio.  I think we will have a great conversation.  I'll visit some family and see a sheep farm which will be a nice change of pace.  Then it's the drive home and some podcasts.  I'll continue to read two books that I'm in the middle of and prepare for my 60+ hour week coming up.  I'd like to say that I'll be on top of it and plan my garden but I'm not sure that I'll get that far today but I think after returning home I'll be building the garden and getting it ready for planting.  It snowed here last night so I don't think I'm behind yet :).  OK... just my laid back weekend.  I hope yours was awesome.  I know I loved mine :)

Locum world

CRNAs glamorize locum position thinking that life is greener on the other side.  It can be nice but it can have its negatives.  It depends on your attitude, expectations, experience, and what you plan to walk away with.  It’s not all roses.   

I look at being a locum as slightly higher paid than the average CRNA as I risk not being able to find work, having to travel with or independent of my family, having to find my benefits, and learning the business end of anesthesia.   

Why am I needed?  When a place has a strained relationship, malignant personality, change in practice type, change in group, or people move-on/retire/pass away.  These are the typical reasons I get called to a group.  The less likely reason, albeit valid at times,  is vacation coverage.  This is typically a nicer reason or maternity leave can be more fun in small places.  

I don’t say this to whine or complain.  This is what goes with the job.  I am still expected to go in happy and excited to be at work.  Happy and excited to work with that Anesthesiologist or surgeon that people warn can be “a little challenging”.   

I would be remiss in not telling you that there are negative things that come with being a locum just like come with W-2 jobs.  You are very unlikely to find a perfect 7-3 m-f no call no overtime on some days and you can do everything you want and or say I don’t do XYZ.  That’s hard to find permanently much less as a fill-in worker.  Flexibility and optimism are definitely needed in our work.  

I am not saying you have to do what’s unsafe for the job.  Please don’t think that.  I’ve shipped out and cancelled cases that needed to be.  I’ve done some cases that were not wanted by others though because they had to be done.   

Please please as you walk into the land of Locums know it’s not all roses... even roses have thorns.  :).  

Is it difficult to set-up a sep-IRA?

I have been a CRNA for quite some time, as you might be aware.  I have tended to keep my earnings and retirement away from the stock market.  As many would chastise me for not taking advantage of tax sheltering, and even I wish I were a better saver.  

I have always invested in real estate.  For a while it was my own home.  Then it was the start of rental property in Kansas.  I am still invested in Kansas and started on my current home in Virginia.  

I have avoided the stock market though.  I have used an E-Trade account as if it were a casino.  I haven’t been an investor but a speculator.  I have invested over the years in the military Thrift Savings Plan ... 1% for 9 years... you know how little that is.  I forget to take time to learn about those things.  I know I need to shelter my taxable income so I am actually doing this.  

I went for weeks totge website for Vanguard but then they said they couldn’t verify me.  Then I had to fax things for the Solo 401K but... I missed 2017.  So, I decided I would do a simple Sep-IRA if I could.   

I was checking my E*TRADE to make sure my Roth IRA transaction went through and then I had an epiphany.  Why not try to set up just an IRA.  I saw the set-up a retirement account button and so I clicked on it.  Bam, Sep-IRA option right there.  Two minutes later i had $6k coming out of my account to fund a Sep-IRA for 2017.  I have until my taxes are filed toget those dollars cought up. I would prefer a Solo-401k but I didn’t get it set-up in 2017 which means no $$$ can beplaced in it for 2017.  So, i now have a sep and I’m working on saving a tax bracket or two by saving more pre-tax dollars toward retirement as my rentals are post tax.

Is it possible to invest in retirement with real estate?  Yes, but have I done this... no.   

Every year, I will try to be more active in my tax planning and save betterfor my family and child or children (someday).   

Taxes and Investing

Many times our default is to say I don't know anything about taking care of the taxes or the accounting.  Maybe it's time we take on the task of learning as we continue in the understanding of the business of anesthesia.  

I'm not that smart and I don't know either investing or tax code.  But, I am taking control of the time to learn about these things.  I'm investing in my own understanding so that I can utilize the Locum world and combine it in order to provide for the family without providing more than my share to uncle sam, provide educational opportunities to my family, and increase my available time home.  I have to save the taxes in order to fund the financial/investing side.  I currently invest in real estate but hope to someday expand on that into the business, real estate, and stock markets as I learn.  

What are you doing?  I ask this not to sound like I'm doing much but just to be real.  I take the time to learn in each aspect by reading the business books, listening to podcasts, and continuing to ask questions.  

Recommended learning... Consider listening to the Bigger Pockets Podcast on Real Estate.  They have two Tax episodes by Amanda Han... so I would listen to those.  The application is to the 1099 type of income however passive income is different than active... so be careful on the full application.  Business books that I like include things like 4 hour work week (not for the 4 hour part but understanding how to maximize your time), Rise and Grind (the effects of early work and long term benfits), and Motivational books that will inspire increased relationship building.  

That's all I have for today.  

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?

Check

it’s always interesting going new places.  I love it.  I have fun and treat people as if I’ve known them for years.  I have fun at work while getting the serious things done in a quick and efficient manner.  I believe that this relaxes the crew and the patient.  I always state that I’m not new to anesthesia but am new to the facility and why I’m going through the paperwork a little more. 

I expect to be checked on a little more or observed more closely if in a “Care team”  model.  CRNA group the same happens just because they don’t know me or what I do/don’t know.  It’s just how things go.  I also expect them to vary the assignments from big to little to tiny and see how they wish to utilize my skill-set... it’s a way of interviewing me.  They see if I complain or fumble or have issue with those that have the most awesome personality.  These things are part of the locum political environment. I generally say that I stay out of the politics by being a locum.  I should have been saying that I remain outside of the political arena that most ACT CRNAs are in.  It’s not that it doesn’t exist ... it’s just significantly less than full-time staff typically experience.  

I have some docs and CRNAs that try to teach me at times ... from how I should hold my Miller to doing a CVP fall whenever doing a central line.  I’m not above learning and I’ll simply nod or oblige if they want something simple that’ll re-assure them that my intervention is done safely and efficiently.   

I guess what I’m saying is that each place I go I expect a period of assessment in some way.  I expect to be thrown in to the mix quickly and handed around to the different personalities and surgeons.  I always listen too.  When I hear “oh, they put him there...” I know it’ll be an interesting day.  I think we, as locum providers, need to know whom the client is, how to handle interpersonal communications, and have to be more knowledgeable in a broader scope of practice than most institutions utilize.   

I think it takes about 4-6 weeks for a place to get used to a new provider whether it be locum or permanent... then 5-9 months to understand how a place operates and if they are a good provider fit.

These are just my thoughts on the day.