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Life in Emergistan

Life in Emergistan

Rules for Locums: Be Prepared, Be Nice

Leap, Edwin MD

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doi: 10.1097/01.EEM.0000490523.76516.39

    I made some mistakes during my locums adventure, and hopefully these pearls will prevent you from repeating them. Primary among them: Put your spouse or partner in charge of tracking your schedule or run it past her frequently. This will ensure that you don't work on important days and help avoid conflicts.

    Be a prepared traveler, especially if your assignment requires long drives or flights. Correspond closely with the travel representative from the locums company. That person can be your best friend, and can (if you're nice) help you get the kinds of airplane seats, hotel rooms, and possibly even rental cars that you prefer. Keep her number handy for after-hours crises. A flight inevitably will be canceled or some other last-minute crisis will require her assistance.

    Track your frequent flier miles, hotel, and rental car rewards and all the rest. They'll eventually pay off.

    Learn to pay attention to bad weather. And pay equal attention to time zones when you're estimating your last-minute rush to the airport. It could be an embarrassing mistake. What? Me? No, I never ... well, maybe.

    I suggest you get debit and credit cards to use exclusively for your locums work. This makes it much easier to track expenses for which the company might reimburse (like tolls and baggage fees) and those, like meals, you'll simply want to apply toward your corporate taxes. Be aware that sometimes debit cards lock down out of their normal area, so tell the bank you're traveling. This has happened to me more than once, and it can be very inconvenient.

    Air travel being what it is, you may occasionally be stuck in an airport. Notify your company; they know you can't help it. And be sure your carry-on holds the things you want: food, books, music, toothbrush, toothpaste, etc. (I find extra socks to be a great delight when stranded in a concourse watching everyone else melt down.) Years of night shifts have made it easy for me to sleep in a snowed-in airport concourse, so there are worse things.

    If you're arranging the rental car yourself, never count on being able to go to the counter and get one without a reservation. You'll need that car in a new town with the kind of shifts we do.

    A Nice, Clean Room

    Hotel? Check the distance to your facility long before you leave. You don't want to be driving a long distance to and from shifts, especially after overnights. You won't usually be staying at the Ritz Carlton, but you should have a nice, clean room in a nice facility. If you aren't satisfied, nicely ask the company for a change and give your reason.

    Occasionally, a hospital will put you up in a call room on site or in an apartment it owns. This can be nice, but on one occasion I stayed in the back room of a mental health facility, miles from the hospital, after hours. It was a little creepy, so I asked to be moved. The company wants you to be happy; your rep makes money for the work you do, so it is incumbent on him to keep you coming back. Likewise, the hospital is contracting with you because it has a need as well. Just be reasonable in your requests.

    Hotel time, by the way, is great for catching up on correspondence, CME, and whatever projects you have that are portable.

    What about food? Ask ahead of time if meals are provided, if there is a cafeteria, if it's open for three meals a day, and if there is any local fast food. This matters, especially if you're doing a 24- or 36-hour shift. Sometimes you can leave and get sustenance, but be certain it's an option.

    Ask in busier centers if it has a stocked call room or physician lounge. These can be life-savers. If there isn't much around, pop into WalMart or your preferred restaurant and take food to go. This sometimes ends up being a fun way to try local restaurants and cuisine. (Thank you, South Bend Chocolate Factory!) Remember, it's easier to get out of shape when you're faced with a lonely hotel room at the end of the day. Eat well but carefully. The gym, by the way, is usually free.

    Look ahead of time at local travel destinations. If you're working a string of shifts with a break in the middle, you may need to clear your head in a tourist attraction like a national park or museum. But be careful while traveling alone. Notify loved ones (and probably the hotel staff) when you go out. I almost developed altitude sickness in Rocky Mountain National Park on a simple drive to the visitor's center!

    Pack as much as you need but as little as you can. You'll need less than you think. Get a set of phone chargers, earbuds, and other useful gadgets that you can commit to travel and keep in your bag. I also recommend keychain multitools and a flashlight. I usually travel with a pocket knife, but that means I have to check my bag. (Bonus point: Check your backpack for ammunition before going through security. Why, you ask. It's a funny story....)

    You know this one, but I'll say it. Play nice and be humble in your various assignments. Kindness plus competence will mean you get asked back over and over again, and may even mean higher rates over time.

    Finally, stay in touch. Call, text, Skype, and FaceTime your loved ones often. It cuts the loneliness for you and for them.

    Good luck, fellow travelers! I hope to see you on the road someday!

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