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For the past decade there has been multiple attempts to award full practice authority to Nurse Practitioners in California. On September 29, 2020, AB290 was signed into law by Gavin Newsom and Assembly member Jim Wood (D-Santa Rosa) finally making full practice authority a reality. The serious shortage of primary care physicians was the main driving force catapult this law in order to improve access to quality healthcare.

“A significant percentage of physicians are over retirement age and new physicians are not keeping up with the need,” said Wood. “Of course, we can increase funding for medical residencies and loan repayment programs, and I have always supported those, but the reality is it’s not only an expensive solution but the number of residency programs will never be enough to meet the current and future need in California.”

A majority of physicians practice a specialty where incomes are usually higher. Nurse Practitioners are often found working in underprivileged rural areas. “Quality of Primary Care by Advanced Practice Nurses: A Systematic Review,” have concluded that nurse practitioners provide care of comparable quality as physicians, even when practicing without physician oversight.

On February 19, 2019 a final report was released by the California Future Health Workforce Commission which addressed the states shortages of primary care and behavioral health providers. The expansion of the Nurse Practitioner role was on the top 10 list. More than 80 organizations supported AB 890, including individual physicians.

The History Of The Nurse Practitioner Profession

Currently, there are more than 290,000 licensed nurse practitioners in the United States. Back in 1965, the United States expanded their Medicare coverage to include low income women, children and the elderly. At this time the US was experiencing a physician shortage particularly in urban areas servicing children.

Loretta Ford, EdD, PNP, FAAN and Henry Silver MD were called to action and founded the first NP program in 1965 at the University of Colorado. It became a master’s degree program in the early 1970’s. The U.S. federal government contributed money to NP education in 1987 and spent $100 million.

Although the NP profession continued to grow, Nurse Practitioners did not have full provider status in the eyes of the federal government and were not eligible for reimbursement. NP’s continued to fight to legitimize their profession. The role of the Nurse Practitioner has become important as more patients are covered by The Affordable Care Act and more states grant NP’s full practice authority. Today, 82.9% of full-time NPs are accepting Medicare patients and 80.2% are accepting Medicaid patients.

The term “Full Practice” means state practice and licensure law provides for all Nurse Practitioners to evaluate patients, perform diagnostic tests, initiate and manage treatments, including prescribing medications under the exclusive licensure authority of the state. Full practice authority varies in every state and due to tireless legislative advocacy, the state practice environments are constantly evolving.

What Nurse Practitioners Offer

Along with increased access to care, the AANP also lists these additional benefits to having full practice authority NPs: 

• Streamlined care. Allowing FPA removes the delay in care that can occur when an NP must consult or work with a physician to deliver necessary care. 
• Cost savings. NPs are more cost-effective in general, but FPA also avoids unnecessary service duplication. 
• Upholds patient autonomy. Some patients prefer to work directly with NPs and may even feel more comfortable sharing health care concerns with primary care NPs. 

California is the 23rd state in the U.S. to offer full practice authority to its Nurse Practitioners when it goes into effect in January 2023. AB290 requires the California Board Of Registered Nurses to define the minimum standards for an NP to transition to independent practice and once that has been met the NP can perform specific functions “ordering and performing and interpreting diagnostic procedures certifying disability and prescribing, administering, dispensing and furnishing controlled substances.” Full practice authority details vary from state to state. It’s best to contact the local boards of nursing to find out more regarding practice, prescriptive licensure, Practice acts and other details.

Who are we? MedCare Staffing is a small, veteran-owned, family-oriented team. We start every day with gratitude because we LOVE what we do! We are a team on a mission to make a positive difference in the lives of our clients and providers.

What we do: We place Physicians, Dentists & Advanced Practitioners in Locum Tenens, Contract Positions and Permanent Jobs

To contact MedCare Staffing, call 888.474.3380 or visit or website by clicking here

References

How Does Nurse Practitioner Authority Vary By State?

https://www.aanp.org/about/all-about-nps/np-fact-sheet

50 years of the nurse practitioner profession

https://a02.asmdc.org/press-releases/20200929-governor-signs-ab-890-assemblymember-jim-wood-providing-full-practice

Are You a Locums Newbie? Checkout These 5 Tricks For Guaranteed Success On Your Next Assignment!

If you’re a “Newbie” in the locum tenens game, you’re first day on the job can feel like that awkward first day in middle school. You don’t know anyone, you don’t know what to expect, and you probably forgot your lunch! The locums landscape of forever changing assignments can sometimes skyrocket your anxiety through the roof.

You may be working in a new city, embarking on a new commute, entering into an unfamiliar office space with new coworkers and administrative staff. Science says people are “hard-wired” to feel anxious in pretty much any new situation. However, moderate levels of anxiety can facilitate and drive performance. The stress of wanting to make a good impression on your first day of your new Locum Assignment can also add to your anxiety. 

Health care professionals with higher levels of anxiety and frustration were more than twice as likely to report workplace burnout, compared with those with lower levels of anxiety and frustration, according to a study of primary care professionals published in the Journal of the American Board of Family Medicine. Moreover, primary care physicians reported burnout at double the rate of other health care professionals in their practice settings.

Fear not newbie! All is not lost, and your anxiety can be controlled with these 5 tips:

1. Be Aware Of Your Stress Level And Anxiety Triggers

            Caffeine, skipping meals, bills and taxes can all be triggers too anxiety. Try and limit         these as best as possible before your first assignment. Perhaps pay your bills or write         out checks and be confident that they will be taken care of to decrease your anxiety. Prescriptions like birth control pills and OTC cough and congestion medications may            create sensations that become anxiety triggers for you. 

• Be Confident And Smile

            If you have too much anxiety it can derail your performance. Confidence in your clinical skills is key to success. Trusting your own judgement and abilities along with valuing   yourself worth can curb your anxiety. Body language can help boost confidence. Practice an open body posture. Don’t put your hands of your hips or slouch. Smiling and         practicing open communication will project an energy of confidence.

• Get Informed

            Before your assignment, try and get informed about what is expected from you as           much as possible. Does the clinic you are going to work at require you to have a health      physical, urine drug screen, TB, and COVID test? Having these done before starting your           first day on your locum assignment will create less stress. Ask your recruiter as many           questions as possible in order to get informed on what to expect. For example, what             type of charting will you be doing? Paper or electronic? Do you have the option to work      telehealth? Where will you be parking and is it secure? Who is the person you will be             reporting to at the clinic?  How many patients will you be seeing? The more you know,    the better.

• Brush Up On Your Skills

Brushing up on your skills before starting your first day in clinic can help boost your confidence level and decrease your anxiety. Classes for skills like CPR, PALS, ACLS, suturing techniques, and several others can be obtained online easily. You may even want to check out YouTube for videos that will help you refresh your skills like adult physical exams, pediatric physicals, new baby exams, sports physicals, and pap exams.

• Network And Connect With Your Support Staff

            Getting to know the clinic staff and communicating your needs can help minimize your    anxiety. Introduce yourself, smile and be cordiale. Find out if you will be working with       the same medical assistants on a daily basis or if you will have a new person with you.          Ask them what the standard routine is of the clinic and how they usually work with         healthcare practitioners. Communicate what your needs are and don’t be afraid to let       them know your weaknesses.

Following these tips will help to decrease your “Newbie” Locum Tenen jitters and quantum leap you forward to success. The more confident you feel with yourself, the better your assignment will be. Anxiety can be overcome ensuring you a happy and productive assignment.

“Experience is not what happens to a man, it is what a man does with what happens to him.”- Aldous Huxley

Who are we? MedCare Staffing is a small, veteran-owned, family-oriented team. We start every day with gratitude because we LOVE what we do! We are a team on a mission to make a positive difference in the lives of our clients and providers.

What we do: We place Physicians, Dentists & Advanced Practitioners in Locum Tenens, Contract Positions and Permanent Jobs

To contact MedCare Staffing, call 888.474.3380 or visit or website by clicking here!

SLEEP. Snooze It Or Lose It: Why It’s Important To Get Your ZZ’s At Night!

Sleep, it does a body good. You find yourself tossing and turning unable to shut your eyes. It’s 3 am and you are wide awake looking up at the ceiling contemplating the universe wishing for Mr. Sandman to bring you a dream.

Blame it on the elections, daylight savings, or that last latte you had at 5pm, you are not the only sleep deprived person in the world. More than 50 to 70 million Americans suffer from disorders such as sleep apnea, insomnia and restless leg syndrome. The US Centers For Disease Control and Prevention state that a third of Americans get fewer than 7 hours of sleep per night.

Less Sleep Equals Greater Human Error

Studies show that sleepiness and fatigue contribute to greater human error. Fatigue contributes to human error and accidents in technology-rich industrialized societies. On March 24, 1989, the Exon Valdez oil spill released the equivalent of 17 Olympic swimming pools of oil into Prince William Sound, Alaska. The Exxon Shipping Company failed to provide a rested and sufficient crew for the Exxon Valdez.  Short- and long-term economic effects were felt which included increased sickness from the cleanup crew.

Is Sleep Deprivation Your “Normal?”

Lack of sleep on a nightly basis can become habitual. Because not sleeping a full 7- 10 hours a night, is not be your ‘normal,’ you probably don’t even realize you are sleep deprived. You are yawning and sleepy by day trying to stay awake with that extra cup of coffee or energy drink while seeing your 10^th patient. Anxiety and depression take over while your body is seeking to find balance.

Sleep Hygiene

Sleep hygiene is a behavioral practice developed in the 1970’s to help people with mild to moderate amounts of insomnia achieve adequate amounts of sleep.  Insomnia is often caused by bad habits. Some tips we found on SleepFoundation.com offer this for better sleep hygiene:

• Prioritize rest: treating sleep as a priority in your life is crucial. Targeting a nightly bedtime along with a wake-up schedule could optimize better nights rest.
• Develop a bedtime ritual: budgeting 30 minutes each night as wind down relaxing time, which may include a warm bath, light stretching, reading or soft music.
• Focus on relaxation.
• Turn off all electronics at least 1-2 hours before bed and dim your lights.
• Use excellent bedding.
• Set cool comfortable temperatures.
• Block out light with heavy curtains and or sleep masks.
• Drown out noise with ear plugs.
• Try calming scents like lavender to induce a calmer state of mind.

Daytime routines such as exercise, decreasing caffeine intake, and reducing alcohol consumption can also help you get better Z’s at night. Getting enough sunlight is important since it’s one of the key drivers of circadian rhythms. Avoid late night meals that can be spicey and heavy. Digestion during sleep can also cause disruptions.

Could Repressed Trauma Be Causing Your Sleep Issues?

“If a person has been diagnosed with chronic insomnia, the only treatment that has been shown to have long-term benefit is cognitive behavioral therapy, “says Dr. Kushida in a study conducted in 2018. “Medications really should be considered short-term treatments, because patients tend to develop dependence on, or tolerance to, hypnotic drugs. Dr Kushida further states “A person might be an OK sleeper for several years, and then suddenly experience a traumatic event, such as the loss of a job, a divorce, or the death of a loved one, resulting in very poor sleep,” says Dr. Kushida. “Down the road, that person might obtain a better job, overcome grief, or find a new relationship, but continue to experience insomnia. We think in some cases the transition from acute insomnia to chronic insomnia occurs because the behavioral event triggers something in the person’s physiology that may lead to long-term changes. Once they are in a chronic insomnia phase, we tell patients that CBT is the only truly effective intervention.”

Getting the appropriate amount of sleep on a nightly basis is key to a safe and productive work and personal lifestyle. Not all sleep strategies may work for everyone. It’s best to experiment with different techniques and find out what works best for you. If you have tried various sleep hygiene and lifestyle enhancement techniques and you are still tossing and turning, it’s best to consult a healthcare professional.

.

References

https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1365-2869.1995.tb00220.x

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6281147/#b11-ptj4312758

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6045928/

https://www.sleepfoundation.org/articles/sleep-hygiene

Wanting to stay healthy during COVID-19? Airborne particles, bacteria, and miscellaneous germs are nothing new for Healthcare Providers. COVID-19 has brought personal health, mental health and wellness practices into the limelight. The increased stress of the pandemic has unfortunately cost various healthcare providers to take their lives. Now more than ever, it’s important for all healthcare providers to make both their physical health and mental health a top priority.

Mental Health Concerns Among Healthcare Professionals

Healthcare providers have been bombarded with many mental health issues during the COVID -19 crisis. Some of these include social isolation, acute stress disorder, depression, alcohol abuse and the fear of death. These mental health concerns all add an enormous stress on the body further decreasing it’s immune response.

Those Healthcare providers who have been coming in close contact with COVID-19 patients and are potentially exposed to the virus may exhibit symptoms of PTSD due to the potential for increased illness, death and supply shortages. PTSD (post-traumatic stress disorder) is a chronic psychiatric illness that develops subsequent to experiencing a significant traumatic event. Studies show that those healthcare providers who have decreased social support are more susceptible to PTSD. People living with PTSD commonly start to manifest a dysregulation in the systems that regulate the stress response. This can lead to somatic inflammatory response and autoimmune diseases.

Healthcare providers tend to be selfless and put all others first. But, COVID-19 has sounded the alarms on personal health. It’s a huge wake up call for everyone to starry healthy.

Focus On Self-Assessment

As healthcare providers, we typically assess our patients before we give them a diagnosis. It’s important to take pause and complete a mini health assessment on yourself and ask yourself these questions:

1. Are you feeling overly fatigued?
2. Has your mood taken a vast shift from the normal?
3. Are you experiencing feelings of guilt, anger or shame?
4. Have you lost interest in pleasurable activities?
5. Are you having trouble sleeping and or experiencing recurrent nightmares?

If your answer was yes to any of the above, then you need to stop and listen to your body and follow these 5 important tips:

1.Improve Your Diet And Boost Your Immune System

The food and supplements you put in your body can make a dramatic difference in your mental health as well as your body’s immune response. Chronic stress will decrease your body’s immune system, further making you susceptible to disease. Decreasing caffeine and alcohol intake will decrease your inflammatory response helping your immune system to function better.

Increase vitamin C through citrus fruits or supplements (75 mg/day for women 90 mg/ day for men). Eat a diet rich with foods like broccoli, bell peppers, garlic, ginger, spinach almonds, papaya, kiwi, poultry and shell fish. Decrease complex carbohydrates as well as limiting refined sugars. Getting enough vitamin D through diet and or sunlight is also important to mental health as low levels can cause depression, problems losing weight and bone loss. Supplementing with Zinc will boost your immune system and help fight of colds.

2. Exercise and Meditate

Another thing we take for granted is exercise. COVID-19 has shut down many gyms and exercise facilities around the country, but simple activities like walking, swimming, dancing and jumping rope can help boost your mood as well as keep the extra weight off. Meditating for 10-15 minutes a day is a great way to decrease stress as well as increasing mental focus.

3. Take Breaks While At Work

Yes, healthcare providers have a tendency of sometimes working straight through their shifts without taking any breaks. Breaks are crucial and, in many states, legally mandated for all healthcare providers. Make yourself a priority during your busy day and take a power nap or go for a walk. Make a point to get off all electronics for at least 10-15 minutes and regroup with yourself and get grounded. You’ll feel more energized and empowered to finish your day.

4. Phone A Friend

Technology has made communicating easy yet complex. Many of us quickly resort to texting when we want to communicate. But hearing someone’s voice and connecting with someone on the phone or through facetime, who will let you just vent while they simply listen can do volumes for your mental health.

When working in high stress environments, designating a friend who understands that sometimes you just need to vent and let the emotions out is key. Perhaps have a couple of designated friends that understand that you need to do this. If they are unavailable, sometimes just going to your local coffee shop, or supermarket and engaging in idle chit chat with another human being will also help. Many apps are available for mental health support as well as in person mental healthcare providers who can help you navigate through difficult situations.

5. Becoming Conscious Of Your World And Environment

It’s always best to be as conscious and aware of your present state as possible. When things get rough and or chaotic it’s a good practice to take stock of how much you have achieved in your life. Take a pause, be conscious of your surroundings, the present moment, and take a deep breath. Finding a creative outlet like painting, coloring, writing, playing music and or dancing can also help uplift your mood and disconnect from your work life.

We as humans have the ability to shift our moods and create our environments. Like Viktor Frankel wrote in ‘Mans Search For Meaning’ “Everything can be taken from a man but one thing: the last of the human freedoms—to choose one’s attitude in any given set of circumstances, to choose one’s own way.” You are the master of your universe and in charge of your own health and wellbeing. It’s up to you to focus on what keeps you healthy and able to function at your highest capacity. After all, your health is in your wealth!

If you are someone you love is thinking about committing suicide, please call the National Suicide Prevention Hotline for help 1-800-273-8255.

Who are we? MedCare Staffing is a small, veteran-owned, family-oriented team. We start every day with gratitude because we LOVE what we do! We are a team on a mission to make a positive difference in the lives of our clients and providers.

What we do: We place Physicians, Dentists & Advanced Practitioners in Locum Tenens, Contract Positions and Permanent Jobs

To contact MedCare Staffing, call 888.474.3380 or visit or website by clicking here!

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4992603/

https://ods.od.nih.gov/factsheets/Zinc-Consumer/

The hottest debate these days is not in politics, it’s all about what appropriate face covering to wear to keep Healthcare Providers and the general public healthy and free from COVID-19. Some experts prefer face shields to cloth masks. Others say face shields have no effects. Experts are torn. So, what’s a healthcare provider, working with the patients in an in person setting on a daily basis, to do?

The Centers For Disease Control (CDC) is recommending cloth face coverings for the general public as a simple barrier to protect from droplet spread from traveling in the air and onto other people. COVID-19 spreads among people who are in close contact with each other (within 6 feet). A simple surgical mask can also prevent droplet spread.

Many people in the general public are making DYI face shields (Do It Yourself) from recycled plastic bottles. But do these really work? And should our patients be wearing them?

Plastic face shields in health care are nothing new. Healthcare providers have been wearing them for many years. A study in the journal of Occupational health found that healthcare providers can inhale infectious airborne particles when a patient cough. Face shields can substantially reduce the short-term exposure to healthcare workers to large infectious aerosol particles, but smaller particles can remain airborne and flow around the face shield more easily to be inhaled. The study further recommends that face shields be used in adjunct to proper respiratory protection when needed. Face shields are generally not used alone, but in conjunction with other protective equipment like cap, mask, goggle, and are therefore classified as adjunctive personal protective equipment. 

Important Facts To Consider When Using Face Shield’s For Healthcare Providers

–Snug fit: The face shield must be snugly fitting around head without any gaps between forehead and shield. The readymade plastic bands are not tight fitting and may fall off with repeated use. Use of sponge in between forehead and face shield gives good comfort, but such face shields should be used as disposable as sterilization of sponge is incomplete.

Disposable/Reusable: Disposable face masks should be disposed of in the appropriate location. Reusable face shields must be removed carefully and disinfected with the utmost care.

Methods of handling: Never touch the front of the face shield. Remove face shield with gloved hands. Dispose along with gloves.

Methods Of Sterilization:

            1% Sodium Hypochlorite solution for minimum of 10 min.

            Drying in Sun light and cleaning with Sanitizers with gloved hands.

2% Glutaraldehyde for 10 min, wash it with normal saline, again dry it.

Healthcare Providers Who Are Testing Patients for COVID-19

Healthcare providers interacting with ill or suspected to be ill with COVID-19 patients, need professional respirators such as N95 respirators which are designed for medical use. N95 respirators fit snuggly around the face and filter air to further stop transmission of droplets from person to person. Face shields and eye goggles should also be worn.

Guidance on the use of face shields vs. face masks remains unclear. When in doubt, it’s always best to consult the hospital or facilities policies that any healthcare provider may be working at. As a rule of thumb, always err on the side of causation and protect yourself as best as possible.

Who are we? MedCare Staffing is a small, veteran-owned, family-oriented team. We start every day with gratitude because we LOVE what we do! We are a team on a mission to make a positive difference in the lives of our clients and providers.

What we do: We place Physicians, Dentists & Advanced Practitioners in Locum Tenens, Contract Positions and Permanent Jobs

To contact MedCare Staffing, call 888.474.3380 or visit our website by clicking here!

https://www.tandfonline.com/doi/full/10.1080/15459624.2013.877591?cookieSet=1

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7191263/

https://www.cdc.gov/coronavirus/2019-ncov/hcp/testing-overview.html

As COVID 19 struck the United States, healthcare providers faced drastic changes to the healthcare system. One of those changes was the zealous takeover of telehealth. Even though many healthcare organizations were already using some type of telehealth technology prior to COVID 19, it still was quite a surprise for the majority of healthcare providers that brought on a tad bit of a technological learning curve.

Telehealth vs. Telemedicine: What’s The Difference?

One of the earliest uses of telemedicine was in 1950’s and early 1960’s when a closed-circuit television link was established as being established between the Nebraska Psychiatric Institute and Norfolk state hospital for psychiatric consultations. The Health Resources Administration defines telehealth as the use of electronic information and telecommunications technologies to support long distance clinical health care, patient and professional health related education, public health and health administration. Technologies include videoconferencing, the internet store-and-forward imaging, streaming media and wireless communications. A healthcare provider in one infrastructure uses telecommunications to deliver healthcare services to a patient typically in a rural location.

So, what’s the difference? Although both telehealth and telemedicine basically fulfill the same goals, telemedical refers specifically to remote clinical services while telehealth can refer to non-clinical services. These non-clinical services include provider training, continuing medical education, or public health education, administrative meetings, and electronic information sharing to facilitate and support assessment, diagnosis, consultation, treatment, education and care management.

Better Access To Healthcare

The main promise of telehealth is greater access to healthcare especially in the underserved populations. Currently, the 2 most common forms of technology being utilized in telehealth are telephone communications and video communications.  There is a widespread belief that healthcare costs can be reduced, while improving patient healthcare outcomes. Telehealth allows for better 2-way communication with healthcare providers.

The Real World Of Telehealth

“I’ve seen it all now. Telehealth patient smoked on a visit today and last week a lady sipped a cocktail,” stated a Family Nurse Practitioner in a recent Nurse Practitioner Facebook forum. Many Nurse Practitioners were sharing their telemedicine stories on various forums as telehealth made its COVID-19 debut. Some stories were quite comical while others incredibly insightful.

“I was visiting with a patient who had uncontrolled Diabetes Mellitus for years. I noticed a box of cornstarch on an end table in the living room as I was having a tele visit with her,” remarked a nurse practitioner on the Facebook forum. “I assumed she had a rash, so I asked her about the cornstarch. ‘Oh that? That’s my snack!’ she said. I further found out that she has been eating 3-4 boxes of cornstarch a day for more than 25 years.”

Hidden gems that can potentially save a persons life like these may go unseen in a normal day to day clinical setting. Telehealth captures patients in their natural habitat, most likely their home environment where they feel comfortable to be themselves. In a sense it’s like watching a reality TV show, which may lead healthcare practitioners to better understand their patients and detect interesting answers to complex problems.

The Pros And Cons

The benefits to telehealth are many. In the past there were several barriers to telehealth such as licensing and reimbursement.  On March 17, 2020, the Health and Human Services Office of Civil Rights stated that no penalties would be imposed for the good faith provision of telemedicine during the COVID‐19 public health emergency, even if the technologies used may not fully comply with HIPAA requirements. The CMS announced on April 30, 2020, it would temporarily increase payments for telephone visits to match in‐person and video visits. Barriers to interstate licensure have largely been lifted. Most states have momentarily waived interstate licensure requirements. Other states have allowed rapid provision of medical licensure during the current public health emergency.

 Some Other Pros Include:

-Lower transportation costs for patients in rural areas

-Reduce worker absences

-Improve access to specialty care

-Decrease office no shows for office providers

-Better patient outcomes

 A few important ‘cons’ to consider:

-Technical training and equipment: Some patients may not have access to telehealth services. Also, there is a technology learning curve to be addressed with both patients and providers.

-Time and Costs: It takes time for providers to learn different forms of technology as well restructuring IT support as well as purchasing equipment.

-Accessibility to patient records, privacy and continuity of care: Patient privacy must be given thoughtful consideration with telehealth.

-Fewer in person visits: The human one to one in person connection may be lost. Also, vulnerable patients with no access to technology may be left behind.

-Healthcare laws, licensing, credentialing and reimbursement: Although many restrictions that were in place before the emergency COVIID19 pandemic cleared much of the red tape that these issues brought into telehealth, all providers need to be aware of them in future as things shift.

It might take some getting used to, but it looks like telehealth is here to stay and the new ‘normal.’ A tip for health care providers using new technology for the first time is to keep an open mind when using telehealth, and not be so hard on yourself. It’s easy to get frustrated with new technology. Remember, with everything new, comes a learning curve. Keep in mind you are experiencing new territories and getting a better picture of your patients natural environment. Those natural environments and the hidden treasures that they hold, can actually help you save their lives and make a you a better healthcare provider.  

Who are we? MedCare Staffing is a small, veteran-owned, family-oriented team. We start every day with gratitude because we LOVE what we do! We are a team on a mission to make a positive difference in the lives of our clients and providers.

What we do: We place Physicians, Dentists & Advanced Practitioners in Locum Tenens, Contract Positions and Permanent Jobs

To contact MedCare Staffing, call 888.474.3380 or visit or website by clicking here!

Ersilia Pompilio RN, MSN, PNP

References

https://aasldpubs.onlinelibrary.wiley.com/doi/10.1002/cld.971

https://www.healthit.gov/faq/what-telehealth-how-telehealth-different-telemedicine

https://www.cdc.gov/phlp/publications/topic/anthologies/anthologies-telehealth.html

https://www.aafp.org/media-center/kits/telemedicine-and-telehealth.html

https://www.ncbi.nlm.nih.gov/books/NBK207141/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5041366/

Community health centers exude cultural diversity. They are fun and exciting places to work as a healthcare provider. Most Community health centers can be found in inner cities and rural farmlands which offer opportunities to connect on a more intimate level with diverse populations.

The experience of working at a Community Health Center usually starts on the streets before you enter the clinic. You drive by acres of rural farmlands that offer the sweet scent of manure as migrant workers pick their crops. You may pass many make-shift tents that serve as housing for the homeless population in an inner city. You may walk by street vendors making savory tacos that make your mouth water while small children walk hand in hand with their parents. As they see you, they may start screaming “Doctora, Doctora” and offer a sweet smile and a kind waive with their hands because they remember who you are. This scenic landscape before entering through the community health center’s doors begins to tell a story of what terrain your patient’s may have conquered before presenting themselves to you in your exam room.

“I usually have diarrhea from my mouth, but today it’s coming from my butt!” A quirky 5-year-old Latino American girl sits on my exam table and blurts out the phrase trying to stifle a laugh with her hands pulled immediately to her face. Her mother just rolls her eyes and smiles while her ‘abuela,’ sits back in her chair, eyes bulging, looking mortified. I laughed and ask, “Are you trying to be Sarah Silverman?” “Who’s that?”  she squeals as she proceeds to giggle and spew off several more jokes as I try and examine her. This family of 3 had to take several buses through an overcrowded urban city to show up at the clinic as a walk in. It also saved them a visit to the Emergency Room.

Community health centers are unique and special places. And yes, on many days they can resemble comedy shows which adds to the fun of working at them! One of their main purposes is to serve underprivileged communities, increasing access to timely care and to avoid costly Emergency Department (ED) admissions.

When you are working at a Community Health Center, it’s not just about the patient you are seeing, but about the whole family structure. It’s not uncommon for a mother, father, siblings, grandparents and even great grandparents to be present at a newborn’s first well check. This offers a great opportunity for assessment and teaching on so many levels as a practitioner.

Originally, community health centers were started in 1965. They were launched as a small demonstration program in conjunction with President Johnson’s ‘Office Of Economic Opportunity’ with a main focus on medically underserved communities. Today, clinics can be found in inner suburban cities servicing the homeless population to rural locations servicing migrant farmworkers.

Approximately 1400 community health centers provide healthcare to 28 million people throughout the United States. The main source of funding for these clinics is Medicaid along with other sources of funding which include Federal Community Health Center Program 330 Grants, Ryan White Funding, Title X Funding, and local county funds. The Affordable Care Act also offers additional funding.

Many clinics deliver a broad area of services which include mental health, dental, podiatry, maternal child health, pediatrics, HIV services, and Transgender services. They specialize in diagnosis and management of chronic illnesses such as diabetes, asthma, heart and lung disease, depression, cancer and HIV/AIDS. One of the main goals is to reduce mortality, health disparities and risk of low birth weight with the care they deliver. Services such as transportation, translation, case management, and health education are offered to ensure continuity of care.

Working with a lower socioeconomic population can offer challenges as well as a variety of learning opportunities which may include language barriers, poverty, and compliance to healthcare regimens. Community Health Clinics offer healthcare providers an opportunity to flex their creativity, employ a sense of humor and have an open mind in order to better meet a patient’s needs.

Community health clinics are great places for Physician’s, Nurse Practitioners, Nurses, Dentists, and Psychologists to practice. They offer an abundance of experience that can only be acquired at the rural clinic level and inner city. It’s a rich cultural exposure that can be incredibly humbling. You don’t necessarily have to be a comedian to work at one, but it doesn’t hurt.

Ersilia Pompilio RN, MSN, PNP

References

https://www.chcchronicles.org/stories/community-health-centers-chronicling-their-history-and-broader-meaning

https://pubmed.ncbi.nlm.nih.gov/26153303/

What is a Community Health Center?

What is a Community Health Center?

Can Locum Tenens Be Your Sweetest Gig in Healthcare?

Healthcare is in a constant state of flux with an evolving landscape. There are many specialties to choose from with lots of diverse opportunities. As a healthcare provider, making a choice on where to practice and what specialty to specialize in can often be difficult. Could working as locum tenens be the answer?

What is Locum Tenens?

The word “Locum” comes from the Latin term meaning ‘place holder.’ A provider working as locum tenens is a person who temporarily fulfills the obligations of another. Therefore, In healthcare, a locums provider can be employed at a hospital or community healthcare facility that may be short staffed or need temporary coverage when another provider is on leave.

Locums providers are employed by private agencies. Working as a locums offers many opportunities to experience working in a variety of environments and specialties which may include for-profit agencies, academic health centers, state agencies, federal sites such as the Indian Health Service, individual hospitals, and or international staffing companies.

Are you a new physician not sure what area to work in? Or an Advanced Healthcare Provider looking for a change of scenery? Do you want to travel and work in a diverse area in your state or try a new state? Are you a provider who is ready to semi retire but would like to still maintain some kind of professional practice? Locum tenens may just be your sweetest gig!

Locum tenens work offers a broad range of experiences. Flexibility is also a desirable advantage. This ‘gig’ can fulfill your career and economic goals. It offers short term assignments as well as long term assignments that can lead to permanent placement is so desired. If you are looking for a healthier more controllable lifestyle, locum tenen is your gig.

What is Locum Tenens?

 Locums may open up many career opportunities you never thought were possible. The gig can lead you to bigger and better career journey with an opportunity. You can meet interesting patients, learn about local culture, see how practices are organized, learn adaptability, and broaden clinical skills.

As a provider, you may be approaches by your facility for a more long term assignment that can turn permanent. It’s best to evaluate what type of lifestyle you are looking for? If you are just looking to make extra money on a short-term assignment or an opportunity into something more long term. Those are all possibilities. It’s best to communicate your availability and career goals with your locums recruiter and facility you may be assigned to.

A long-term repeat assignment may offer you creative ways to contribute that may benefit both you and the facility you are working assigned to. It’s best to evaluate your personal career goals as well as family obligations.

Credentialing

Credentialing is the process of assessing the academic qualifications and clinical practice history of a healthcare provider. Any licensed, independent, healthcare professional who has been permitted by law and regulated by a licensing organization to provide services and care without supervision or direction within the scope of the individual’s license needs to be credentialed.

While every state has unique laws regarding medical practice, simply having a license in a healthcare profession does not mean one can start doing anything they want. For example, an advanced nurse practitioner cannot independently start to prescribe medications, or a family physician cannot begin inserting central lines. Even independent nurse practitioners have to follow specific rules, and in certain states, they work under a physician. Simply being licensed does not mean the healthcare professional is at liberty to perform all types of clinical services.

Locum Tenens have in house licensing teams that will professionally walk you through the credentialing process. They do all the work for you and send all your appropriate credentials to specific licensing boards. They may also proactively license you for assignments paying the state fees.

Work-Vacay

Always wanted to travel and get paid for it? Locum Tenens can also be considered paid the ultimate ‘Work-Vacay’ Experience. It’s literally paid tourism. You can work in amazing places that offer historical and local attractions that will add to your work life balance.

All Roses Have Thorns

While working locum tenens may seem all roses, there are some ‘thorns’ to consider. Various assignments may have you learn new EMR (Electronic Medical Records) programs. The facility may offer you a training period to learn their system. Each facility may have a different credentialing process. You may have to undergo drug testing, and physical exams for each new facility you are assigned too.  Flexibility is key when working for locum tenens.

Locum Tenens offer a variety of diverse experiences and the opportunity to see how various healthcare systems work. Locums also offers a diverse patient population from working in inner city to working in rural farmlands. If you are a health care provider looking for a change, are open minded, adventurous and flexible, you should definitely give Locum Tenens a try. It just might be your sweetest gig!

Ersilia Pompilio RN, MSN, PNP

References

Nurses, Advanced Practice Healthcare Professionals, Physicians and Dentists work in hazardous environments. They are riddled with different types of biological exposures; diseases, chemicals, environmental hazards, physical hazards like radiation, and sometimes violence. Still, healthcare professionals are often viewed as immune to injury or illness. Many times, hospital, healthcare management and administrators tend to turn a blind eye to complaints of unsafe work environments.

With the COVID19 pandemic many nurses and healthcare providers in general were denied Personal Protective Equipment. Providers were told that they would lose their jobs or be placed on suspension for bring their own from home. Others were told to clean and recycle masks.

There are more than 18 million healthcare workers in the United States. PPE’s are used to protect healthcare providers from disease as well as protect immunocompromised patients. Improper use or lack of there of place employees and patients at greater of transmitting disease. Dysfunctional safety standards in healthcare settings have recently imploded like a weeping abscess. Fearing for their safety and the safety of their families, healthcare providers have walked off their jobs.

In recent years the number of violent assaults against Nurses and healthcare providers has increased. The Occupational Safety and Health Administration reports of nearly 25,000 workplace assaults reported annually. 75% occur in health care and social service settings. Workers in healthcare settings are 4 times more likely to be victimized than workers in private industry. A 2014 survey on hospital crime attributed 75% of aggravated assaults and 93 % of all assaults against health care workers to patients or customers.

What Can You Do To Ensure A Healthy And Safe Workplace Environment While On A Locums Assignment?

Nurses and Advanced Healthcare Providers need to empower themselves to take full accountability of their own personal safety and of their work environment. Employees perceptions and attitudes can differ regarding current safety standards. For example, what an administrator who has had no patient care may see as safe, a Nurse or advance healthcare professional with many years of patient care experience may beg to differ.  

Locums work can take you to a variety of healthcare environments which may not be so safe. Some tips Nurses and Healthcare Professionals can employ when working in a healthcare new healthcare care setting are:

-Be aware of your surroundings: Always be aware of your surroundings when you are on assignment. If you are working in a city or neighborhood you are not familiar with, do your research. Do a computer research on crime statistics, ask fellow coworkers regarding safety of the area. Make sure you have proper supplies and protective equipment before starting your workday.

-Propper PPE’s: Before taking an assignment, it’s best to ask your recruiter and or healthcare facility where you will be working, what their PPE availability along with quantity and reuse.  If they are lacking in supply, you may need to ask if you can supply your own.

-Trust your intuition: Your intuition is your best guide to safety. Per Gavin De Becker the author of “The Gift Of Fear, he states “Nature’s greatest accomplishment, the human brain is never more invested than when it’s host is at risk. A strong intuition comes from experience. If you are feeling uneasy about your surroundings or a certain situation, it’s best to stop and evaluate how you feel and why?

-Ensure your own safety: You are in charge of your own personal health and safety. If you do not feel safe in, then it is your responsibility to report it to your supervisor, office manager and your recruiter. If you and your management team cannot agree on proper safety measures then you may have to re consider your assignment and your options.

The safety of Nurses, Advanced Healthcare Providers, Doctors and Dentists is not an option, it’s a requirement. When healthcare employees are made to feel safe on the job, their patients and patient care will also be safe. All healthcare providers need to take full accountability of their own PPE’s and the safety of their environment.

Ersilia Pompilio RN, MSN, PNP

Medical school comes with a hefty price tag for most people. Hopefully, you were lucky and had the help of those around you or scholarships to help keep your debt to a minimum. Still, with help or without help, after graduating, you have to face the debt that comes from furthering your education.

And this debt is all too real. According to an article written by the Association of American Colleges, as of 2016, the average medical student graduated with around $190,000 in loans. And approximately 74% of new graduates were experiencing education debt. These estimates have only increased over the years, and will most likely continue to do so. You may feel like you’re swimming in this debt and that being able to make your last payment is miles away. When you do make that final payment, you’ll feel exponentially better. So, how can you reach that final payment day, faster? We’ve compiled some tips and tricks to help you get there.

1. Create a budget and stick to it.

List all of your expenses and compare them to your current take-home pay. It’s likely that if you have included your student loans into this equation, you’ll be at a negative number. Try your best to reduce your expenses as much as possible; it will help ensure that you have more left-over than you previously did. Yes, as a healthcare worker, you may have a good income, but you do not want to be indebted forever.

2. Try to stay out of consumer debt.

If you learn nothing else from student debt, learn that there is no such thing as “good” debt. Your income could be too high to write off having mortgage debt. Plan to get out of debt and stay that way. When it comes to credit cards and student loans, try and pay more than your minimum required payment as often as you can. Doing this can help to diminish the total interest paid on your debts. 

3. Pay your highest percentage loan first.

It may feel great to have your smaller loans paid off first, but you’ll pay less in the long run if you try and pay off the highest interest rate first. When your highest one is paid off, move on to the next highest, and so on. If you have to make monthly payments on multiple loans, you could consider having them combined. But it would be best if you only did this with ones that are at the same interest rates. 

Pay off your private loans first, and don’t combine private and government loans. You will want to rid yourself of any loan that your estate would end up being responsible for. 

Pay off your government loans last. Stafford and Perkins loans tend to have lower interest rates. Try and make the minimum payment until you pay off other loans. Then ensure that your emergency fund is sufficient; that way, if you find yourself out of work, your family will have resources. Once you have a 6-month emergency fund in hand, go ahead and pay these off.

4. Make more money!

When you’re in debt and currently working, you are in a unique position. As a locum tenens provider, you have the opportunity to pick up additional shifts and even be paid more than you would in a permanent position. A MedCare Staffing recruiter can help you to get the best rates for your services. Being able to work evenings, nights, or weekends, that provides even more opportunities to earn more money.

With locums positions, you have a chance to be more flexible with your scheduling and shifts. Whether you’re trying to make an extra loan payment or you’re building an emergency fund, take advantage of these options. You can choose when you want to work and pick shifts at a better rate. Being able to get out of medical student debt is worth working a little extra. 

Once you get out of debt, you will feel such a great sense of relief. When you finally make that last payment, go and celebrate! 

Who are we? MedCare Staffing is a small, veteran-owned, family-oriented team. We start every day with gratitude because we LOVE what we do! We are a team on a mission to make a positive difference in the lives of our clients and providers.

What we do: We place Physicians, Dentists & Advanced Practitioners in Locum Tenens, Contract Positions and Permanent Jobs

To contact MedCare Staffing, call 888.474.3380 or visit or website by clicking here!