1099 CRNA

January 2019 update

I haven’t been writing or “vlog” -ing lately.  I think it’s important to occasionally update you on the site.  Where we are and are headed can help you see the new information and point to available resources.  

we had a conversation with Bonnie about her career as a locum CRNA via Skype which was transferred to YouTube.  She comes across quiet due to recording via Skype.  In the future we’ll go back to zoom as it records better. I had a couple other recordings but CRNAs decided they would prefer not to post.  Conversations don’t have to be 45 minutes or longer!  Even a recorded question or two would be great, if you want to post for the benefit of the group!  

We are adding to the CRNAandSRNA.com site many of the resources that are part of the LocumCRNA.com site.  The Amazon Store has added books and common travel needs for CRNAs.   

We added a financial advisor with MassMutual who was at the VANA conference and have asked about some guest posts for our blog.   

On the CRNAandSRNA.com site we added CRNA owned companies that are not just CEU or recruiting agencies.  Recruiters can post on the job board that is relatively new on both sites and CEU companies (all CRNA owned) have there own static page always available to you!   

Needs:

I need people willing to discuss on the YouTube channel.  

I need to update the CEU listing for current programs. 

i need to finish all state boards of nursing and CRNA licensure requirements, all state boards are linked to their respective website but I haven’t completed listing their individual requirements.   

I’d love to get more of the CRNA owned companies on the website and maybe list by state.  I think many would be reps like R&F and I think if that’s the case we can put a primary post for the company then each individual that sells.... I can’t have 100 R&F companies as many would quit looking after one scroll.   

I, also, would love to get more information on helpful static pages.  I am going to work on one for student loans as this is always a re-post on the sites, otherwise I need to know what would be most helpful for you?  

Thats your update for January 2019!  Email me at LocumCRNAs@gmail.com if you have suggestions or want to help-out! 

 

LocumCRNA.com and a new investing page?

I’m thinking it might be interesting to go through investments?  We work hard and make a decent income. What do we do with that income, or how do we invest and protect our investments? 

I’m thinking about using my continuous growth in showing what I have been up to on the investment space.  I can show the websites and what I’m working on in that space.  I can go through real estate holdings and what that looks like.  Not to forget sep IRA V’s Solo 401k and stock market investments.  Then businesses and the different types of investments that I look at and consider. 

I wonder if this is something you would want as a page as it only somewhat relates to our site because locums is the way I finance life and the investments?  

Another 6 Great Reasons to be a Locum CRNA

6 Great Reasons I love being a locum nurse anesthetist. CRNAs work hard and locum CRNAs go location to location to provide much needed respite to CRNAs and groups across the US. Be sure to follow-us and subscribe to our YouTube channel as well at https://www.youtube.com/channel/UCosn5QjtJBZt_g2Mbu12Szg

When you are booking a hotel for a long term stay.

I put a video up about this topic at locumCRNA.com under videos.  However, I forgot to mention ... 

Don’t forget hotel taxes.  Hotel taxes and fees can be significant.  So add that cost into your calculations.  Also, be sure to ask when those are refunded.  Typically on a long term stay those are refunded or a portion is refunded when you become more of a long-term VS transient guest.  

This is of course if you are not checking out for weekends but might be a good way for you to keep a portion of what your negotiated fees are for housing or if you negotiate an all-inclusive rate you can keep more of your hourly when not having significant taxes and fees taken by the hotel.   

As far as I know the fees and taxes will stay the same for AirBNB and VRBO but those would need to be scrutinized so you have a true idea of the expenses.  

If this is helpful please subscribe to the YouTube channel and if you want to support us ... next time you are purchasing on Amazon click on one of our links in the store and any purchase on Amazon for 24hours will give us a small commission.  Have a great day and let us know how we can provide more content you like at locumCRNAs@gmail.com

Walking into a new environment

I’m just about to walk into week 3.  It’s amazing to find a new place to work.  Each new place has its’ nuances and differences.  

I find that each place has a few people that are challenging to work with that challenge the way in which we are used to working.  This comes full circle into relationship building.  Most of the time I do awesome at saying “this is what I’d like to do and this is why”.  For the first time ever (as I recall) I found someone that didn’t respond to that and has been a bit difficult to work with.  However, I have tried to maintain a high road and be respectful.  I try to daily go in positive on the day and the work that has to get done.  With each case and with each good day I feel the rest of the group becoming more relaxed in understanding that I bring some ability to the practice.  

I take every opportunity to tell the person running the board I’m available and ready to work.  I come in a little early and set-up my room.  I have my coffee early and don’t assume I’ll get out right away for a break in order to get coffee or breakfast.  I try to be available and flexible in order to get the work done so others can go home.  I don’t ask to get out early assume that I’ll be afforded the same opportunity to either go home or take a break.  Most places I go to seem to want to test any new CRNA in case types, personality, proficiency, & the willingness to do within the group.   

This all comes down to relationship building and interpersonal communication as much as it is about CRNA skills.  A place can usually work with someone that needs a skill or a case set more than they can teach flexibility and good attitude.  So, continue to grow in personal development as much as your CRNA development as you continue your journey.  

Researching your next Locum CRNA Position

Everyone has a different strategy for researching a Locum position and what they want in a position so this is going to be variable and be flexible.  

Most people know that for the most part I use a recruiter to do Locum positions however this long-term assignment just came by word of mouth.  I say that because however you go about finding your Locum positions you need to let people know what you are looking for.  If you call a recruiter and say that you want a very specific type of place it may be challenging but if you say that you are looking in a wide area or with-in several states or locations that typically have some needs you are more likely to get feedback. Likewise, having a cover-letter that states your typical set of cases or specialties you might be well qualified for and what you are looking for in a position it may be significantly helpful when trying to be placed or knowing if you are a good fit for a position.  

If you independently contract I would think it just as important if not more to be able to send a CV and cover letter that explains a little of your background and your wide variety of cases.  When dealing with solo and CRNA only places make sure you highlight independent situations or practice.  Side-note, ask a surgeon you work with either independently or 90% independently to write a letter of reference so that not all your references are CRNAs or friends.  

Highlight your flexibility and also provide awareness of any dates that are non-negotiable and must be off (family vacation).  I don't feel you need to explain why.  Just the dates you need off as upfront as possible.  

When talking to a facility ask about case types, variety, cases you would be expected to do and also tell them if you do things like: Pediatrics, OB, Neuro, Traums, Hearts, Transplant and Vascular.  Sometimes, your experiences might outweigh another applicant for a position.  These can also be a method to command a higher pay structure as not all CRNAs have this experience. 

I ask questions about the type of city, size, accommodations, expectations, call, pay differentials, length of contract and escape clauses.  I ask if anyone has been there before and if they would ask one of the people having been there to call me so I have a good idea what I'm in for.  How often will I be paid and by whom?  I ask them to never put my pay on my timesheet.  I do not want my information to be a source of contention with staff or other locums.  

I ask what type of environment they use, CRNA only, Solo CRNA, Anesthesia Care team as medical direction or supervision. Each of these are not like the other.  Solo CRNA should likely come after CRNA only group, CRNA only group might come after a few years of anesthesia care team (ACT).  Each type of practice requires a base of experience and a base level of ability to discuss on a collegial and appropriate level with either anesthesia providers or surgeons and each requires a strength of practice that grows with experience.  I have worked in each of these environments as a Locum and some as a w-2 employee.  Each will need a different level of care and attention.  Each will likely come with differing roles and responsibilities, and experience.  For example: I would not take a solo position if I was not routinely comfortable with lines, big and small cases along the age spectrum and being able to discuss with ICU/ER/Surgeons and other attendings that are non-anesthesia providers.  

Each place also takes some breaking in period where the providers will assess your comfort level as well as getting to know your practice.  Some ACT environments have Anesthesiologists that think they have to push drugs they didn't draw up.  This is typically a control struggle and I don't try to engage that other than to say something like.  I was planning to just give Xmg of Propofol because you know this patient has XYZ diagnosis.  That way I get what I want without just addressing the drugs.  I try to always address in such a way to say "this is what I want to do and this is why I want to do it".  This shows thought and gives them the rationale ... if they go against it, I chart drugs per Dr. so and so.  They may be on the chart but something I do not agree with will be charted as done per them and they can fight it if they want.  I do agree that their name is on the chart and the care is shared but if you do something they don't agree with or that causes harm they'll say you were physically with the patient and it's your license.  Please be careful.  I have only once had to tell a doctor that I did not agree blatantly and this still causes a negative dynamic.  I would try my best not to blatantly disregard a discussion if it is not going to cause harm.  Most of the time I respond with this is what I would do and this is why, and almost always they take the discussion or will say that they were thinking XYZ and say why.  Then it's a collegial discussion and a plan can be made.  

Just my thoughts for the day.  Please see the YouTube channel under videos and subscribe for future information as I continue both written and video content.  Sometimes it will be similar and likely, most of the time, be completely different.  

Here to help you in the journey as a Locum CRNA, business, communication, and more.  

 

Change is inevitable

It’s Thursday and I’m in my last two days of Massachusetts. This is what I’m doing.  I’ve confirmed my credentials for Texas and started the credentialing in Virginia. Virginia is a different group as the previous took 8 months and came back with telling me I would have to resubmit everything and starting over.  I’ll never deal with a group that does that again.  

So, I’m preparing my luggage and work bags.  I’m making sure copies of hotel bills are sent to the agency.  I’m making sure the final hourly bill is sent tomorrow after work.  I’m slowly packing and getting things ready to go.  I’ll be doing homework the next two nights so more time can be spent with family when I get home.   

I sent in my foreign corporation documents by fax and mail to Texas.  This took 4 minutes from searching the foreign corporation and Texas Secretary of State.   

Min the meantime I’ve been in contact with my accountant.  Talking about the change of location.   

I’ve tracked my route to Texas and planned the day of start in Texas so that all is ready and done for a good and quick start.  I have a badge and person that I’m meeting.  Hotel is set and ready to go.  Seems all I need to do is show up and get started. 

Otherwise we are working on the real estate.  We are offering currently on another potential rental, but we are only getting it if it’s at a deal level. The market is turning again to a buyer level in some environments like where I invest, YouTube for Francisco (growing and getting ready to monetize with ads), and getting Elizabeth set for schools and bank accounts (preparing to pay her annually for work). We are finally hunting for what may be our November vacation as we haven’t done a just Francisco and I vacation in a year or two ;).  The journey continues.   

 

Leveraging Relationships

  you relationship building and keeping up with your previous facilities, colleagues, and friends?  Are you taking opportunity to go to state level CRNA meetings for continuing education?  

Everyday facilities are looking at the cost of anesthesia and if they can keep expenses low.  Groups are turning over, people go on vacation or maternity/sick leave, & independent practitioners are looking for quality people that don’t want their job but can come in and help.   

Update your resume and keep people aware of your ability to help them given your scheduling.  Keep your files up to date so your credentialing would be easy.  Keep some of you appointments at facilities you might like the opportunity to return to.   

Maintain quality interactions and keep your social media up to date and appropriate so that people know your personal and business life are together.   

 

Debt reduction as a locum.

I’ve been so fortunate that Francisco is an amazing parent!  Elizabeth has been at home with Francisco 90% of the time and we found a great babysitter through a friend.  Francisco has been knocking it out-of-the-Park with his YouTube channel/ website ConMuchoSabor.com.   

I looked at our debt 7 months ago and was so stressed that we were over $250k in debt not including our home.  I traded my truck for less than half the cost new SUV.  I went to work on locums and raised my rate while telling the place I needed any hours or call I could get.  I’ve been away from the family returning about every 4 weeks for a few days to a week.  We’ve still had time to visit family and a good “working” vacation.  I’m happy to report that our net worth is positive and debt is below 100K.  I’m going to a 2 week on 2 week off lifestyle with intermittent days on my weeks off that will allow us to keep decreasing our debt and allow me more time at home!  Our rental properties have picked up and are now paying for one new property per year and paying thier own expenses.   

I have approximately 3 more weeks away before getting started on my new locum contract!  I’m 12 weeks into my MBA carrying a 3.8 gpa and learning weekly.  I get to pour over financial reports and am doing better each week with my own reports as well!   

I continue to consider business opportunities and think that with time 1,2 or 3 could become something just like the rentals, YouTube or the websites.   

I just wanted to check in and thank you all for the positivity and thank our Locum professionals for keeping us in great standing so we can work, travel, & provide for our families!  We are so blessed!   

 

Flexibility with Travel, Work, & Vacations

The flexibility & vacation time in working locums drew me in and kept me as a locum nurse Anesthetist.  

Work flexibility with a few facilities around the country has allowed the opportunities to do more with my time. 

Recently, my family visited Costa Rica and extended family!  I was able to speak and although I was a little excited, nervous, & even got a little lost in speaking; it was great to see other CRNAs and have them meet the family.   

We moved to Virginia for surrogacy and failed our first attempts.  It was a true and sad failure but due to locums I’ve been able to pay down the debt that occurred for this attempt.   

We’re paying down our debt load and continued to build the real estate venture over the past 6 months.  It’s been amazing to follow a move and family changes over the past 6 months.  I’ve been able to build on relationships and although working a lot... we are still well on our way to continued financial success in our lives.  Although, I know it’s possible to do this in one location with one job, it’s getting done on a condensed schedule.   

Life, flexibility and continue strong work ethic are leading to change as I continue all the things that are important in our family life.   

Finally, school is just about to finish the first 10 week term toward the MBA.  Nothing game-changing but working on a business mindset continues to be a fun opportunity for change despite my whining and complaining :).   

Totally looking forward to the coming weeks and months!  More to come.