Sophia Khawly, ARNP, MSN, explains how to begin working locum tenens as an NP.
Working locum tenens as an NP can be a flexible and rewarding career choice. Not only do you get the chance to travel to different locations at the expense of your employer, but you can also practice in various clinical settings and work with different patient populations while filling temporary staffing needs. Additionally, locum tenens NPs can choose their own hours and are compensated more than staff NPs.
As a locum tenens NP for the last nine years, I am sharing what NPs should know about locum tenens.
Work with the right agency
Find a reputable staffing agency that will match you with locum tenens positions. You’ll be connected with a recruiter to discuss your work experience and job preferences.
Don’t be afraid to contact more than one agency — doing so is expected and will increase your job opportunities. You’ll have the opportunity to review multiple job options and decide if one meets your interests. Your recruiter will then help you schedule an interview with the site and negotiate your pay. It’s important to work with a recruiter who understands your needs and provides comprehensive support.
Not sure how to select an agency? Here’s how I choose which locum tenens agencies to work with.
Prepare for the interview
Once you’ve shown interest in an assignment, you’ll need to speak with someone at the facility. Interviews for locum tenens assignments are less formal than interviews for permanent jobs, so don’t be nervous.
They can vary from a 15-minute phone conversation to a 30-minute video interview. Sometimes, the initial interview is set up with someone from HR for screening purposes. Then, they will set up a second interview with their medical director.
Be prepared to give a brief background on your experience and answer any clinical questions they may have. You should also have a list of your own questions to ask.
Negotiate your pay
Working in locum tenens offers competitive pay. NPs tend to make $15-20/hour more than working a permanent job. The pay can be even higher if you choose to work in rural areas or in high-paying states such as Massachusetts and California.
When an agency has a job listing with the expected hourly rate, that is usually the smallest amount they are willing to pay. Always negotiate for a higher rate. The best time to negotiate pay is after the interview when the site makes an offer and desperately wants you to work for them.
Before signing or agreeing to a contract, be sure to review it thoroughly. The agency will typically have a clause that states you cannot leave a contract early without giving a 30-day notice. If you are not comfortable with this, you can try to negotiate the time period with your agency.
The contract should state the compensation structure, travel reimbursement limits, and assignment length. It should also include any benefits and malpractice insurance that will be covered.
Apply for licenses and certifications
NPs must be licensed in each state where they intend to practice. Applying for multiple licenses can be tedious. Fortunately, agencies can help with the process and fees.
If your residential state is part of the Nurse Licensure Compact, make sure you upgrade your RN license to a multi-state license. This will make applying for other state licenses easier because you’ll be able to use your residential state RN license to apply for the new state NP license.
If you don’t have a compact state RN license, you’ll have to apply for both the RN and NP license of the new state, which can be time-consuming and costly. Some states require an additional license to prescribe medications, so be sure to read licensing requirements thoroughly.
To use your DEA certification in a new state, you will have to apply for your DEA to be transferred. Depending on the state, this can take a few days to a few weeks, so the sooner you can transfer the certification, the better. Some NPs prefer having multiple DEAs so they can bounce back and forth between states quickly, but this can be expensive.
Learn about scope of practice laws
Locum NPs should be aware of the scope of practice laws for the state in which they will be working. They may require a supervising physician to sign off on a percentage of their charts.
Some states also have different laws regarding controlled substances. For example, gabapentin is considered a controlled substance in certain states and not in others. NPs may have limitations on how many days they can prescribe controlled substances for acute pain.
Start early on credentialing
Locum tenens NPs need to be credentialed with the healthcare facility prior to starting their assignment. Depending on the site, credentialing timeframes can vary from one day to several months.
Hospitals or hospital-owned clinics typically require at least three months to complete credentialing. This can delay an NP's start date and is not ideal if you’re looking to start working right away. Make sure your provider profile on CAQH is up to date, as this is typically required for credentialing.
Keep scanned copies of all your documents online so you don’t need to search for them when you are at work or out of town. Having the necessary documents accessible will speed up the onboarding process for new assignments.
Examples of documents to have available are:
- Updated CV
- BLS/ACLS
- Immunization records
- State licenses
- National certifications
- DEA
- Driver’s license or passport
- Diplomas
Other things that you’ll need for credentialing are peer references, copies of prior malpractice insurance, and accessibility to obtain university transcripts.
Organize housing and travel
Although not all locum tenens assignments require travel, most of them do. Before starting an assignment, you should sign up for common airline and hotel reward programs so that you can earn points during your flights and stays. You can use these points to travel for free during your leisure time.
Most agencies have a travel team that will book your housing, flight, and rental car. Usually, these are booked last minute once credentialing is completed. Don’t be surprised if you’re a few days out from your assignment starting and don’t have housing booked yet. Agencies want to make sure they have all their ducks in a row with the facility before paying for large expenses.
Travel like a pro: The ultimate guide to locum tenens travel
Many locum tenens NPs like staying at extended-stay hotels because they can collect loyalty points and get free cleaning and toiletries. This is ideal for shorter assignments that are less than one month.
I personally like to stay in furnished apartments which I find on FurnishedFinder.com. You can find furnished homes for assignments over 30 days at affordable rates. I usually choose the home myself and then forward the listing to my recruiter to have it booked.
Embrace schedule flexibility
The nice thing about locum tenens is that you don’t even need to travel. You can have a full-time job and pick up some extra locum tenens shifts near you. This is great if you need to earn some extra income on the side.
Locum tenens allows for plenty of flexibility because you can choose an assignment that fits your schedule and desired lifestyle. For example, you can decide to work only a few weeks at a time or choose a 4-10 schedule, which allows more time off to be home. Locum NPs can also avoid working holidays or weekends if they have other personal factors they need to prioritize.
Learn to be adaptable
At the same time, sites want an NP that can adapt to different work environments and jump right in. Locum NPs should be quick learners who can learn the EHR and system protocols.
Some NPs are afraid to start locums because they’re unwilling to learn multiple EHRs. Honestly, once you learn a few, they are all quite similar. Sites want someone who is willing to see all types of patients and comfortable doing different procedures. Some sites may want you to work at multiple facilities, and you will have to be comfortable traveling between multiple locations.