travel nurse

Is it difficult to set-up a sep-IRA?

I have been a CRNA for quite some time, as you might be aware.  I have tended to keep my earnings and retirement away from the stock market.  As many would chastise me for not taking advantage of tax sheltering, and even I wish I were a better saver.  

I have always invested in real estate.  For a while it was my own home.  Then it was the start of rental property in Kansas.  I am still invested in Kansas and started on my current home in Virginia.  

I have avoided the stock market though.  I have used an E-Trade account as if it were a casino.  I haven’t been an investor but a speculator.  I have invested over the years in the military Thrift Savings Plan ... 1% for 9 years... you know how little that is.  I forget to take time to learn about those things.  I know I need to shelter my taxable income so I am actually doing this.  

I went for weeks totge website for Vanguard but then they said they couldn’t verify me.  Then I had to fax things for the Solo 401K but... I missed 2017.  So, I decided I would do a simple Sep-IRA if I could.   

I was checking my E*TRADE to make sure my Roth IRA transaction went through and then I had an epiphany.  Why not try to set up just an IRA.  I saw the set-up a retirement account button and so I clicked on it.  Bam, Sep-IRA option right there.  Two minutes later i had $6k coming out of my account to fund a Sep-IRA for 2017.  I have until my taxes are filed toget those dollars cought up. I would prefer a Solo-401k but I didn’t get it set-up in 2017 which means no $$$ can beplaced in it for 2017.  So, i now have a sep and I’m working on saving a tax bracket or two by saving more pre-tax dollars toward retirement as my rentals are post tax.

Is it possible to invest in retirement with real estate?  Yes, but have I done this... no.   

Every year, I will try to be more active in my tax planning and save betterfor my family and child or children (someday).   


Write off or included in your contract?

Here are a few things I didn’t think about when negotiating my next two weeks.  

1.  How am I getting to the airport?  I typically drive to every assignment so when it came to the airport I didn’t think about ... Will I Uber there?  Do I leave my car in airport parking?  Do I assume my husband will take me?  Ok the later is typically true but, now he is sick and didn’t want to take me.  I have$7 in tolls just to get that trip to the airport.  

2.  When I get the rental car in Massachusetts will they pay the tolls to and from the airport?  It’s not in my contract per say.   

3. I have clothes for a week but they don’t have baggage as an expense for taking the flight so now I don’t have enough to wear for two weeks without doing laundry.  Has anyone been reimbursed for laundry?  I also can’t take fluids or razors so no toothpaste, shaving cream, razor.... that stuff can be expensive right?  

4.  It’s a travel day before my assignment starts ... a day with no family and a day that i can’t work.  Non-productive and a loss of income.  Does anyone get paid a travel day on either end?  Usually if I drive ... I at least get travel expenses.   

These are a few things we might look at for future travel contracts.  does everyone consider these written off expenses or do you get them paid out so you get to save the expense in the first place?

Busy Life

Can I just say how fast life is flying by?  I have been in Philadelphia a month and a half!  We are settled in and Rosie has broken 2 Leashes... it's a miracle the little Frenchie is not DEAD.  We live in the very busy downtown area of Philly and there are highways and significant throughways all around our apartment!!

We must be getting busy because we are talking about how busy we are and how much we have to do.  That usually means we are settled in a place and are just becoming cranky that life is catching up with us!  We love getting to do all these things here in the city but housework is not loved by anyone!  

So, when you decide you are going to locum.  You have to think about what you are going to do and how you will live in the city.  Francisco loved the hotel where they came to clean each and every day.  Life was totally different pre and post Elizabeth and the hotel was almost do-able before the little girl blessed us ... but now we move.... EVERYTHING EVERY TIME.  We plan for long term options and what we can do in the event things change.  

I have to look at what the best options are for us and where the opportunities exist.  We also look at cost of living.  We are also down to one car as our truck wouldn't fit in the parking garage here.  We only did this for a short time in Dodge City years ago but we had bikes and other activities in a small town.  Now we have lots of activities but two dogs, two of us, and the kiddo soooo we are again a little limited.  

The great thing is we are paying bills and getting ready to pay off the Jeep we have with us!  I'm so stinking excited.  Each month I see the total debt reduced in a significant way, I'm so happy.  It makes the amount of work worth while!  

Francisco is starting his food channel on YouTube and talking to me about the food truck again.  I think someday we might work on a restaurant but it will be so difficult to bring that into the mix.  

Just my thoughts on today!

To Sep or Solo

A big question asked often is weather to Sep IRA or Solo 401k.  Of course, I must make the statement that I am not a tax or financial advisor of any kind.  Now, I talked to Vanguard about starting a Sep IRA or a Solo401k.  

I talked to a business advisor and not just the personal finance advisor.  I had them and said I'm a 37 year old 1099 earner with my own Llc S-corp with flow through Gross X amount and taxable net income amount of X.   

He said, ok so for a Sep IRA you can do up to 25% (up to 52-54k) business contribution in basically any investment vehicle through a brokerage account.  A Solo401K you can do 25% (up to 52-54k) business contribution plus $18000 personal addition to your 401k.  They will only allow vangaurd funds for the Solo 401K.   These are also different if over 50 years of age.   There are eligible catch-up contributions as well depending on the IRS regulations.  (This is where a tax/financial broker will help.)

I said ok, if I have others in ownership of my company do I have to pay out the same amount or percentage to them?   

Yes, if they are paid owners from your corporation then they will require the same amount as a percentage of their income in retirement for either the Sep or Solo but personal contributions don't have to match. 

No, if they are unpaid. 

So, I clarified again that both are pre-tax IRA investments and should decrease the overall taxable earnings in the future with the understanding that taxable income in the future would likely be less in retirement than right now.  They agreed.   

I have asked for the information on the accounts and will include them as attachments to the Blog if possible.  I will also add the supporting IRS fact sheets for both the Sep and Solok.   

The phone number for Vangaurd Business Solutions is: 800-992-7188

I chose Vanguard based on the discussions on the Dough Roller Money Podcast based on the simplified minimal basis point costs and overall low fee structure.  Low fees and good management history points toward a possible growth in the future despite my negativity on the overall stock market.   

I also have questions on rights of survivorship so will review the forms for potential to rollover on death to other family as a paying IRA in the future.



Individual 401(k) New Plan Kit Vanguard

Fun plan

Today I was at a third hospital and people say things like I can't believe you remember from place to place what you need to do.  The good news is anesthesia is anesthesia.  Knowing where everything is even at a place you've worked for a year has a bit of a relativity factor.  Meaning you get used to a place fairly quickly and if you get a halfway decent OR crew, anesthesia tech and are surrounded by decent people... it's probably going to be ok.  

Now, Fun.  Seriously, you have to go to work having fun!  Plan each day to be exciting and happy.  If you drag people down everyday and you are around people stressed and unhappy. Where will your job satisfaction be?   

You have to have fun on the weekends, after work, and plan vacay!!! Life isn't just work.  What you do outside of work leads to your whole self health.  When I get off work I'm going to.... 

If your friend said when I get off work I'm going to take my daughter out for a walk along the river, see the urban culture of a melting pot of people at a skatepark to skulling for their college crew teams, then shower and have a relaxing corona by the pool.  Would you think they were negative about the city or bored?  If you are on an assignment you have to be the person that makes your afterwork and weekend plans.  You have to be the friend that says hey let's go to Atlantic City.    

Every place is what you make of it and it's important to keep yourself and others excited about what you do.  That first plan was my night tonight.  It cost 2$ for the beer and otherwise it was a free nights entertainment.  Your colleagues, nurses, techs don't need to know when you spend $1000 on a trip but they should hear how excited you are about what's happening in their backyard.  It also leads to your overall satisfaction by not becoming TV bound or complacent.  

Best of luck and add some fun to your plan!   


1st weeks

The first days in a new place are the hardest as one doesn't know the Doctors, CRNAs, Surgeons, Techs or admin.  

I had a lot of fun getting to do a variety of cases.  I'm hopeful that in the coming weeks I will have even more fun with the group here.  I have gotten back into hearts after at least a year or two off from them.  The surgeon is pretty nice and relaxed.  I've had a good group of people to work with and I truly look forward to the days to come. 

 I'm supposed to be going to multiple hospitals so next week will start a whole new day 1 process and a getting used to the system at a new hospital.  I'm excited to see this group and how they work together.  

It's interesting dynamics hearing what people do and don't like and how they express themselves.  It's not difficult to read people and see that they have reservations or dislike or like what they do.  

I have not seen it all and done it all.  I had a new experience of a doc on group text stating their displeasure with a call schedule and they will resign next week if it isn't changed.  It's just a whole new experience.  

I get a little perspective into other facets of anesthesia and management as I continue to work with people through this site, these facilities, and continually keep in contact with others.  The interesting thing is that it boils down to .. "just business".  What we do on a daily basis is truly the personal touch and a true people profession.  Please don't let me detract from that but the where we do, how we do, and when we do ... those things come down to business.  Some politics in how much hands are tied and what has to be done and how.  The thing is that business drives those decisions.  

When a new anesthesia management group takes over.  It's not because one was liked more or less or even that a group did a sub-par job.  It comes down to the buck.  Places get comfortable and complacent and happen to think they won't be taken over by another but they also have to realize that the board for the hospital, anesthesia group, surgical center, or whatever company ... may not be in the same profession.  They may have an MD/MBA and have never practiced medicine.  They may not have either a MD or MBA title.  The owner of a company may still outvote a board of directors that is supposed to be running the company.  All this is said to remind you that a contract is a contract and all have a term to them.  When things change it is business.  It is not because of the individual or that something happened.  

So, one week down and the business of anesthesia shows as a new group has merged with these hospitals and it seems to be eggshells for some.   I try to be mindful of the stress and go in happy and excited to be here.  There are things that help and happy patients are very important as the surgeons, anesthesia, and all parts of the group are more easy going and perceive a positive experience.  So ... the 1st week has to be a good week :)

Journey forward with me as we go :)

Getting things done.

OK, here is the deal.  I'm on vacation in between contracts in Massachusetts and Pennsylvania.  I am getting alot done on the rental houses to be.  My husband is tired of obliging my desire to do these but always loves just how well my dad gets the homes ready to go.  It is pretty darn impressive.  All I do when I get into town is have a ton of meetings, write the checks, and manual labor of paint, haul, and yard stuff.  Thankfully, Dad was released from the hospital yesterday but I am hopeful this gives him the minimal fortitude to take it a little easier and not stress so much.  However, that means I have to pick up more.  

I was asked, by the client hospital to start a week earlier so now we are trying to arrange this through the agency.  I don't know what the problem could be with doing that.  However, it is a week and while it sounds awesome to my wallet there are a few things to consider. This means no great move-in time or quick vacation to DC/NYC before starting.  It means very few options of dry run to drive to the facility.  It means the first few days will be a mad dash to purchase a few critical furniture pieces as we got rid of in Massachusetts and Kansas as our apartment just shrank a few hundred more square feet.  

All of this said, I still have no PA license and I'm pretty sure that due to the critical need and nature of the contract.  Credentialing should be done and even if not.  Orientation can still be completed.  Locum work is not for the faint of heart as each time it seems to truly come down to the wire for things.  

I am assured on the side of the client group, agency and state that things will all come together but I bring a bit of a pessimists perspective and tend to over analyze.  It's just the opposite with the Rental Homes. The scarier the project and all that needs to be done, the more intriqued I am.  

It's almost 7:30AM. I hope they don't get to mad I'm mowing the yard. Today is going to be a very busy day as we have three homes to get ready.  Tuck U Inn B&B, my AirBNB and then my parents guest cottage all in Aitchison, KS.  Atchison is the birth place of Amelia Earhart and has a large private college (Benedictine College).  I am already looking forward to about 5pm when all has to be done :).  

Best of luck to you in your locum journey.  Let me know what you are doing! 

My last day!

Another day in the life of a locum CRNA.  You get kind of used to last days.  It's been over a year at this facility and these people are like family.  I truly have been blessed to have known them and worked with them.  Many things happened in my life with these CRNAs and MDAs.  I lost my Grandfather after a long life.  We suffered a miscarriage at 5 months pregnancy and we had our biggest blessing of Elizabeth coming 6 weeks early and my getting stuck in Mexico for nearly 2 months because of law changes and inability to get a birth certificate.  These guys stuck by Francisco and I and poured out support for us.  Tomorrow, is a business day.  It's the day where I say the contract had an end and for reasons of business, I'll be moving on.  I have grown as a CRNA as I do in every environment.  I hopefully have also broadened their expectation and anticipation for Locums in the future.  

Tomorrow, will be another fun day.  I love fun days.  I get to see everyone, smile and give them a happy good morning / afternoon / or evening.  I thank them for the opportunity and say that they never know, our paths could cross in the future.  I try to leave them with a great lasting impression of not only me but all locums so they know we are here when they are in need.  

Today, I called to verify the UHaul.  I verified our stops along the way to Kansas in order to take those things we over-packed and maybe purchased or replaced in the past year.  Hotels were booked.  The truck had it's maintenance.  I verified the bank accounts and deposits for the Massachusetts apartment we will be leaving, the amount for the Philadelphia apartment we will be going to, and then the incidentals we will come into as we go across the US.  

Tomorrow, I will also ensure to take out a minimal sum in cash just in case anything crazy happened and the credit cards caused a problem or there was any number of oh crud moments.  We will return our modem for the internet.  Don't worry ... almost everything works on these smart phones... albeit a tad more challenging.  

Finally, Saturday will come and I will get the UHaul, the movers will show up to help for 2 hours in packing our trailer, and finally we will set out for Buffalo.  

We have a pretty tight schedule to adhere to but one of these days we really want to enjoy some of our extra time off.  :)  

As the plaque on the wall says... Life is in the journey

Getting ready for my new assignment

Francisco, Elizabeth, Bentley, Rosie, and I are all getting ready to change places of work.  We are packing up from Massachusetts after being here for about a year and a half.  We will soon be heading to Philadelphia for what looks like another year or so.  We have looked for an apartment and taken on the risks that come with signing for an apartment in the city.  We have looked for the best option for us as we will look for our daughter, and dogs.  We also have to figure out how to be mobile.  We are downsizing to have just one car which will limit Francisco in going out, taking care of all those things that we have to do in a normal week.  But alas our truck is too large for parking garages and the parking place rental is more than 10% of the rent.

            Pre-assignment I generally call the agency or get an agency call that says the contract is finishing in 30 days or I will be ready to go from a place in 30-90 days.  (I try to plan ahead by 90 days to be ready for credentialing, state needs, and to have time for vacation as I try to take them between contracts.)  If I have a vacation planned I ensure it is a non-negotiable in the contract.  So 60 daysout I like to have a plan of where I am going and be well on the way through credentialing and have my signed contract.  I tend to ask a ton of question pre-contract. 

Where is the assignment. 

What part of the city? 

What city and what is nearby? 

Then the more important things like the hours desired and required? 


Is there any of my favorite types of cases? 

Are they going to make me do my least favorite cases? 

What type of practice is this? 

Why are they looking for help?

Then other important questions:

Rate?  What is the hourly rate?

Where are we going to stay?  Is this lodging going to work for our family?  Can they do a lodging allowance? 

Daily stipend for meals or other?

Daily/weekly mileage or car allowance?

How does all of this work out to an hourly based on a 40 hour work week?  Then is subtract out expenses of malpractice, lodging and any incurred expenses that are beyond what is paid by the agency. This might include licensing, AANA dues, PAC payments, and Student Loans.  Then I look to see if that number works for me. 

After all this is worked out.  I sign a contract.

Once a contract is signed.  I’m going to that assignment.  I don’t back out, I don’t change my mind and I don’t shop around.  Keeping my contracts and obligations is one of the things that keeps me solid in the eyes of the agency and the groups I go to.  I have cancelled after 30 to 60 days with discussions with the agency and a plan of who what when and where. 

Inevitably there is some paperwork to be done so I get that and generally complete it over a weekend and mail it back ASAP. 

Then it’s just waiting out the end of the contract and a vacation.  Moving time comes and we pack/unpack over a period of about 4 days with a Uhaul. 

In the new town I will drive to my hospital so I know GPS is correct for getting there and construction doesn’t have me totally messed up.  I scout out what I’ll need such as gyms, groceries, movies, pediatricians, vets and get the lay of the land. 

The morning of the start.  I generally arrive earlier than when paperwork states to arrive.  I do this because if they are short… I’ll be in the OR day 1 hour 1 and I like to have a clue of what I’m doing.  Second… If I’m there with the chief or before… they can’t see me as lazy or showing up late. 

What many people forget is what happens or is fact may not be reality.  Perception is reality until proven otherwise.  Having to prove otherwise means we are starting in the hole.  One of my assignments had multiple locums come and go and one of the last had taken the patient to the PACU turning blue and had not recognized the patient had gone apneic.  (at least that is what I heard from multiple sources)  Either way… when I arrived MDA’s were anti-locum and CRNA’s didn’t trust that I had a clue what anesthesia was.  One of my first cases I went to push my drugs and the MDA began to scream at me that the state law was XYZ and that’s how they practiced here and I could leave if I didn’t like it.  I nearly walked out and left him with the patient.  Weeks turned into months at this facility and the demeanor shifted.  My perception of them shifted some but I expect AMG’s with MDA supervision of CRNAs to act in a certain manner where I expect a CRNA only group to function in certain ways… and no they are not the same expectations.  AMG and MDA supervision… it’s how they operate and I do what I need to in order to keep the patient safe.  Second, the MDA’s name is on the chart. If they are insecure and petulant I show them that I’m not an idiot.  I call them when something occurs so that when out of the room they can handle a post-op cardiac work-up or manage the ICU setting.  They are close to or as liable as we are despite presence not being in the room.  If I question something or if anyone in the room says should I call the doc… I don’t take offense and say “please”.  Even an OR nurse can make life a disaster if you are managing a complication but they feel you should call the MDA.  They will go sing to the congregation whether correct or not. 

Otherwise, I try to maintain a generally happy-go-lucky attitude, smile, and be kind to all.  Sounds crazy but that is probably the number one factor in my staying at facilities longest or returning to facilities time and time again.