Sophia Khawly, ARNP, MSN, shares her tips on the questions you should ask your locums recruiter before accepting an assignment.
Your recruiter will present a locum tenens assignment to you with the basics: location, pay, dates needed, and EMR (electronic medical record) used. Before I accept an assignment, these are the top questions for your recruiter or the site during the interview.
Will I have a supervising physician there, and what does that relationship look like?
Depending on the state, having a supervising physician may be required. The site may designate the medical director as your supervising physician and provide a collaborating agreement. You will want to know how to contact them when needed. Other sites may have an on-site physician supervise you, which may offer more availability and access. This is a good time to find out whether you are expected to work solo on some days or if there will be other providers on-site to consult with. You can also find out if there will be routine chart audits.
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Do they currently or have they previously employed nurse practitioners?
It will be a more seamless transition to work in places that have previously employed NPs. The site will be more familiar with the scope of practice for NPs. The staff and physicians will be more competent at collaborating with NPs—as well as more welcoming. Patients will also be more comfortable seeing NPs.
How many patients per day am I expected to see?
I only take assignments where I am comfortable with the patient-to-provider ratio. It is challenging to see more patients than you are comfortable with, which can easily lead to burnout. The site will typically explain how long the appointment slots are, such as new patients versus follow-ups. You should find out if walk-ins are expected to be accommodated and how much admin time you are allotted. Some assignments may provide admin time either daily or weekly.
How much supportive staff will I have?
It is helpful to know whether you will have multiple medical assistants and/or nurses to assist with patient care. For instance, a site that expects you to see a high number of patients should be able to offer more than one assistant to help with patient turnover. You should inquire whether you will have a dedicated person for scheduling, referrals, and even a scribe. The more supportive staff you have, the easier the assignment will be.
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How much training will I receive before seeing patients?
If you are not familiar with the EMR, you want at least one day to learn how to use it. It is effective to have a few hours shadowing other providers to see the clinic/hospital flow as well. For example, some facilities expect providers to do covid/flu testing, whereas other places will have medical assistants or nurses do them. Some sites will offer a ramp-up schedule, meaning you will start with a lighter schedule to give you time to adjust and familiarize yourself with the EMR. Then they will increase the number of patients scheduled each week.
What is the reason the site needs coverage?
I like to know why previous providers left. Is locum tenens coverage needed for maternity leave or a recent retirement, or does the site have ongoing challenges hiring or retaining clinicians? Sometimes the facility will give you some insight, such as that previous clinicians have only lasted a couple of months there. That usually means the workplace may be stressful and not an ideal place to work.
What type of procedures will I be expected to perform?
The types of procedures offered vary by facility. Working in urgent care or the emergency room may require you to know how to perform sutures and casting. Primary care clinics may need providers who can complete pap smears and joint injections. Whereas rural federally qualified health centers offer their patients more specific procedures, such as toenail removal and IUD placement. It is good for the site to know your level of comfort with different procedure types and for you to know if there are opportunities to learn how to do procedures you are inexperienced in.
What on-site services are offered?
It is beneficial to know what services are offered at the facility as a convenience to patients. You should ask if there are on-site lab drawings, x-rays, or other imaging. Also ask about specific services, such as mental health and social worker/case management. Usually, the more services offered on-site, the higher the patient satisfaction.
Asking these questions upfront won’t just help you pick the right assignment — it’ll help you walk in prepared. If you’re still getting your bearings on locum tenens as an NP, our beginner’s guide is a good next stop.