Sophia Khawly, ARNP, MSN, explains how the locum tenens landscape has evolved over the decade she's been working locums as an NP.
Working as a locum tenens NP for the last 10 years, I have worked in 11 different states and 25 different practices. These last 10 years have been the best times of my life, during which I have witnessed the locum tenens field for NPs continue to evolve and improve.
Locum NPs have gained more acceptance
When I first started practicing as a locum, many providers were curious about my job. They assumed locum clinicians could not find a full-time permanent job, and were ‘stuck’ being a locum. Now locums has a better reputation. NPs and other providers are more familiar with the benefits of being a locum, such as increased flexibility and pay.
Being a contractor is more common after the pandemic and the Great Resignation. As a result, more NPs have started locums, searching for ways to manage burnout. As a locum, I feel welcomed by staff as if I am there to ‘save the day’. Many of the full-time providers are now interested in trying out locums themselves.
More job options than ever before
Some NPs are afraid to jump into locums because they think they will not have consistent work. This could not be further from the truth. Over the last 10 years, I have witnessed increased job options for locum NPs. Locum tenens usage is actually on the rise. I typically have multiple simultaneous job offers to choose from. As the baby boomer generation starts to retire and age, there is a higher demand for NPs.
Job options range from hospitals, correctional facilities, primary care clinics, federally qualified health centers, urgent cares, occupational health clinics, home health, and more. Additionally, telemedicine has become increasingly popular for advanced practitioners. It has expanded locum tenens beyond geographic limitations, which has benefited rural areas and behavioral health.
Nurse practitioners are offered better pay
My pay over the last 10 years as a locum NP has increased by 66%. This is not your average 3% per year annual increase you would typically find at a permanent job. Because of inflation in recent years, I have seen locums nurse practitioner pay increase significantly. When I first started locums, it was common for locum NPs to make $50-70/hour working in outpatient primary care. Nowadays, it is common for the same type of NP to start at $90/hour without even having to negotiate. Locum NPs can also ask for extension bonuses or raises if asked to extend their current contract.
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Availability of better technology and resources
Previously, we had to submit our timesheet via paper and have a supervisor sign it. Currently, most agencies allow you to submit your timesheet online, and a supervisor will approve it electronically. Agencies even have their own mobile app now, making it more convenient than ever. They also have job boards with active locum tenens listings on their website/app, allowing NPs to search for jobs easily. There are digital staffing platforms that match providers with facilities directly as well. This will enable NPs to bypass having a recruiter altogether.
When I first started locums, there was not much information on the topic out there. Now there are plenty of blogs, YouTube channels, and social media pages you can follow to learn more about locum tenens. Many agencies have their own blogs or may host educational webinars.
Easier licensing and credentialing
More states have joined the nurse licensing compact. This has enabled me to use my compact RN license from my home state, Florida, to apply for my NP license in other states. Before this, I had to apply for both the RN and NP licenses in each state separately, which was time-consuming and expensive. Many states currently offer expedited temporary licenses, which can fast-track the start time of locum assignments.
Over the last decade, credentialing has become more automated. Originally, credentialing teams had to mail you piles of paperwork to fill out, sign, and then return. Now, all of this is done electronically, allowing you to e-sign important paperwork. As a result, onboarding has accelerated, and there are fewer delays in the credentialing process.
What does licensing for a locum tenens entail? Here's everything you need to know
10 years later, I’d still choose locums
After a decade of locum tenens work, I’ve seen firsthand how the field has evolved—and improved—for nurse practitioners. With more flexibility, better pay, and easier access to jobs and licensing, locums continues to be a rewarding and sustainable career path for NPs seeking autonomy and adventure.