Locum tenens 101: A beginner’s guide for NPs and PAs

Illustration Beginner's guide for NPs and PAs

Chances are you’ve heard the term “locum tenens,” whether your clinic had some extra help on a long weekend, your fellow up-and-coming PA and NP students were curious about other options, or you’ve been in the field for years and are ready for something different. Here are the basics about how locum tenens works for physician assistants and nurse practitioners.

What, exactly, is locum tenens?

The Latin definition of locum tenens is “to hold the place of.” Locum tenens providers hold the place of full-time PAs and NPs when a clinic needs some extra help. Locum tenens PAs and NPs will visit the facility temporarily for assignments that typically last anywhere from two weeks to more than a year — or even a weekend.

How PAs and NPs use locum tenens in their career

Some locum tenens PAs and NPs just take an extra shift on the weekend. Others work locum tenens full time for their whole careers. And others see locum tenens as a great way to transition into retirement.

Physician assistant Jessica Bastidas was working a traditional job in Chicago, but the cost of living left her feeling like she needed extra income. She worked her full-time job at Mount Sinai, and after work she went to the Cook County Jail where she cared for inmates. Working multiple jobs became hectic, so she decided to start a full-time locum tenens job.

RELATED: Why one PA became a full-time locums

PA Cara Bosco quote on working locum tenens

Using a locum agency vs doing it yourself

With such a shortage of NPs and PAs, it might seem tempting to work locum tenens without an agency and take home more money. However, that reward comes with risk. Agencies have entire departments that take care of licensing, lodging, contracts, and more. And recruiters can find locum tenens jobs that are the right fit in terms of location, timing, and specialty.

PA Jason Raehl explained that housing is a particularly great benefit of working with a locum tenens agency.

“When we show up for an assignment, it’s like checking into a hotel or Airbnb where you grab your keys, the house is furnished, there’s linens, there’s kitchenware, and the cable, the internet, and the utilities are set up,” said Jason. “That’s a huge flexible advantage, and we’re not spending any money on housing, which is amazing.”

PA Jason Raehl quote on housing

How do locum PAs and NPs get paid for locum tenens work?

How locum tenens works for PAs and NPs in terms of compensation depends on the agency. Some agencies pay per hour on a contract basis using a 1099, while other agencies — like CompHealth and Weatherby Healthcare — hire NPs and PAs as employees with a W-2, meaning they get benefits like 401k contributions and health insurance. Plus, most agencies cover the costs of travel, lodging, medical malpractice insurance, credentialing and licensing, and more.

“Having a 401k is a huge advantage,” said Jason. “Any time that you can have money set aside for retirement, especially tax-free money, and also having a company match, is a huge benefit.”

RELATED: 5 things to know before accepting a 1099 NP position

Tips for choosing a locum tenens agency and recruiter

When it comes to choosing an agency and recruiter, it’s all about advocacy and trust. The need for NPs and PAs is so great that there are hundreds of jobs available. But that means you need an advocate to find the right job. Once you’re on the job, you also want an agency and recruiter you can trust in case there are any issues.

Jessica explained that her recruiter, Tracia, is both an advocate and a friend.

“The recruiter is a person you really want to get to know and not be afraid to express how you feel about certain things and really be honest if anything is going wrong. And then she backs you up 100%,” said Jessica. “When it comes to your recruiter, they’re there to help you.”

Jessica Bastidas quote on recruiters

PA Cara Bosco was extremely grateful to have a recruiter when she had a couple of issues with her housing on an assignment. “It was 8 at night, and I called my recruiter and told her this housing just wasn’t going to work because of a mechanical issue. Almost immediately I was relocated to other housing — and I had my dog with me!”

NP perspective: How I choose which locum tenens agencies to work with

Things to consider before you work locum tenens

Like any job, locum tenens jobs for NPs and PAs have their own set of challenges. The excitement of traveling can turn into uncertainty, and the short-term nature of the jobs can make it hard to say goodbye to new colleagues. And the nature of locum tenens work means that you’re working in places where you’re in high demand, where things can get busy. But that’s where the benefit of being paid hourly — with overtime pay — comes in.

“Typically, when a clinic needs a locum, there is a specific reason that they need one. Either they’re understaffed or they have a lot of turnover,” said nurse practitioner Sasha Dunbar. “You can walk into situations that can be quite challenging, dealing with different patient populations and the social aspects of whatever is going on in a particular location.”

Advice for new locum tenens PAs and NPs

How locum tenens works for PAs and NPs at the beginning of the job comes down to doing research, being flexible, communicating openly, taking advantage of your resources, and jumping in.

Jessica recommended staying curious. “Don’t be afraid to ask a lot of questions,” said Jessica. “Understand that sometimes not everything is going to go as smoothly as you’d like and you’ve got to ride the waves as they go, but the recruiter and people working with you are doing their best to make it run smoothly for you.”

Jason recommended embracing the uncertainty. “You have a team of people behind you who are supporting you, but sometimes there’s a little bit of an unknown there,” said Jason. “There’s always plenty of time to plan ahead, but there are going to be times where you just have to be flexible and take a deep breath and know that it’s all going to work out.”

How to choose a locum tenens assignment as an NP and PA

A locum tenens job has three main factors to keep top of mind: where, when, and what. While looking for a job, consider where you want to be. Do you want to stay close to home, or is there a spot you want to explore? Do you prefer large cities or rural areas? Also, consider when you want to work. Do you want a short-term project to test the waters, a part-time role to help you earn more, or do you want to jump in and take a long-term project? And consider what you want in a job. Do you want a large hospital or a small clinic? Is there a new technology you want to work with?

RELATED: Choosing a locum assignment: What to ask and what to avoid

Your recruiter can help you with these questions, and once you find one that seems like the right fit, they’ll walk you through the application process.

Set yourself up for success as a locum tenens NP and PA

Knowing where to begin, what questions to ask, what to expect, and what your options are can give you a leg up in an industry that can be life changing.

“I absolutely see myself doing more locums in the future,” Bosco says. “Locums enables me to love my job and my life at the same time.”

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