Archive | February, 2012

Things I’ll ask before accepting my next assignment…

25 Feb

Starting travel work is certainly a learning process!  I have been fortunate to pick the brains of a few seasoned PT travelers and a PT traveling newbie like myself throughout this experience.  As I undergo the process to find an assignment in Arizona, these are some questions I ask during the client phone interview.  Many of these questions are applicable across practice settings.  Do you have any suggestions to add to the list?

Get specific about productivity standards.  Are the standards different from assistants versus therapists? Are the standards different between contractors versus full time employees?

Daily caseload expectations.  How many patients is each therapist expected to see in a workday?  Is documentation time allotted?   How many patients are you expected to see in one hour, and how much 1:1 time do you have with each patient within that hour?

Supervisory roles.  How many PTA’s will you be supervising (whether at one or multiple facilities)?   This is important to maintain compliance with state practice act rules.  Every state can be different.  Additionally, Medicare has rules for supervision.   If the state’s rules are stricter than Medicare’s, or vice versa, follow the most stringent rule.   It is also important to have an expectation for the volume of supervisory tasks you will have.  Cosigning, conferencing with your PTAs, updating plans of care, recertifications and discharges typically aren’t considered “productive” time (even though we, as clinicians, know these are certainly productive uses of our work hours).

Overtime.  What is the facility/clinic’s policy on overtime?  How is work load adjusted to ensure a contractor does not go into overtime?  If the facility/clinic will not pay for overtime, will your staffing company do so if it is nominal?

Location hopping.  Is there the possibility of traveling between locations?  If so, travel time should be paid (and thus included within your 8 hour work day, for example).  Is mileage also paid (if not, you may be able to keep track of it for your taxes)?  How far are sister facilities or satellite clinics from your primary location?  If there is the possibility to travel between sites and you are open to it, have it included in your contract.


So life just handed me a lemon. Now how to make lemonade…?

20 Feb

I planned to write my next post around the halfway mark of my current assignment (there’s nothing “travel” about it, really, except my daily commute 20+ miles from home).  Unfortunately, it turns out this first assignment has been cancelled after 7 weeks.  Now I am scrambling to come up with a short-term “Plan B”.  Based on the projected 13 week contract, I should have been hitting the road the first couple of weeks in April.  Now I feel back in the holding pattern I was in this fall, uncertain about the plan, stressed about my budget.  But, like when I’ve been hit in the face with a tennis-, soft-, basket- ball (I blame this recurrence on my large, easily-targeted head size), I have to shake it off and focus on the game.  Here is the back-up game plan I suggest when faced with a bump in the travel therapist road:

Maintain a few bridges, avoid burning them.  This is particularly applicable if you are in your home area.  Departing on your adventure as a travel therapist is a whole new direction and life experience.  Sure, there may be factors at a current position that catalyze your drive to seek a new experience; however, becoming a traveler is different than heading to the facility across town.  If you could see yourself returning to a current position in some way, make sure you get that point across.  Establish when you may be available to provide your services again, and keep contact with these connections sporadically while on your assignments.  If possible, have a few options in your back pocket.   As I’m learning currently, established staffing ratios or actual needs can change at your former workplaces.  It’s also easier to fill your work week if you have a few options simultaneously.

Embrace that it is difficult to plan ahead.  This one is especially hard for me.  When I worked as a PRN/per diem therapist, floating between facilities to maintain a full work week, I would schedule myself out on my calendar as far in advance as I could.  Not knowing when you may be called with the “We’re good to go!” on your next assignment makes this challenging.  Having a few employers with which you have a good rapport and are understanding and flexible for your situation is helpful, but know that the sometimes last-minute nature of getting an assignment may limit your ability to commit to days they need coverage further out on the calendar.

Be proactive.  Cast a wide net.  I learned from this first assignment that seeming desperate can lead to perhaps settling for less worthwhile opportunities.  You lose some negotiation power.   You feel pressured to rush your acceptance of an offer.  However, it’s a double edged sword.  You may seem desperate because you do, in fact, feel desperate.  That was my situation in the fall: little activity and few leads from the staffing company and a lot of time tick-tocking away.  My friend, Hindsight, has taught me that it is important to work with more than one company on finding an assignment (I waited too long to do this back in the fall).  If not only to decide which company you feel best about, but also to have more people working for you to find a position.  I have also learned there is a benefit to showcasing your proactivity yet downplaying the desperation that you needed to have an assignment way before now and you just need something, anything, please!  A  PT friend of mine who used to travel advised me recently:  “You need to think of yourself as a small business owner, and you are the small business.”  This is true.  The ball is in your court.  You are the business, you have the skills, you bring in the dough.   Without you signing a contract, the company doesn’t make money from their work with you.  Avoid being overeager, make them work for your business.  It is common for travelers to work with more than one company when still learning what best meets their needs or when looking for a particular area for an assignment.  I’ve been told to be honest about having contact with multiple companies, but don’t feel overly loyal to just one until your experiences lead to earned loyalty.

Casting a wide net is not only important for companies, but also for practice settings and locales.  I have practice settings that I prefer, but am I open to new ones?  It can offer the opportunity for new skills and also improve the possibility of clinching an assignment more quickly.  But, be honest with yourself and in your interviews with what you feel comfortable and capable. Most clients expect you to hit the ground running, be effective, and productive.  There are also particular travel destinations in which I am interested.  If you’re having difficulty getting placed in a timely fashion, are you open to widening your radius?  There may need to be creative approaches to reaching your ideal location.  Could you live in that place, but commute to an assignment from there?  Could you be placed close enough for day trips or weekends?  Maybe work in a less preferable practice setting if it is in your targeted region?

How fast can you make it happen?  With this assignment ending unexpectedly, the first call I made was to my aforementioned “bridges” to find immediate work.  My second call was to my housesitters to update them on the changes.  Luckily, they are flexible, willing and able to arrive here sooner.  Although my list of “Things to Do” to be prepared for being on the road 7-ish months and to have housesitters live in my house is incredibly daunting, I will have to ramp up my productivity.  Reevaluate your initial timeline.  Could you get your affairs in order and get on the road to a travel assignment sooner?

Motor homes and fifth wheels and bumper pulls, oh my!

6 Feb

I like to think of myself as independent, but becoming a homeowner solo taught me all the things that it’s nice to have a helpful and knowledgeable hand readily available.  Thank goodness for unlimited text and calling when I’m on my island of one (that’s right, even at 30, I’m not ashamed to call my parents for help).  And despite all my independence and learned comfort with being alone, the motor home is like homeownership on wheels!  The “how to’ s” of it sitting in the driveway are anxiety producing enough!  The great beyond and cell phone towers everywhere… prepare!   I’m going to use my “phone a friend” lifeline frequently, I’m sure.   For me, knowledge can be power and also paranoia-inducing.  This experience will hopefully teach me to not obsess so much about the “what if’s” and just deal with them if they arise.

To increase my knowledge base and, thus, my comfort level for living in an RV, I was given “The Complete Idiot’s Guide to RVing (2nd edition)” by my full-time RV-ing mom.  Idiot: check.  RV: check.  Perfect!  {Note: No book review here. This is just my own anecdote on my RV decision-making.}  She instructed me to skip reading the chapters on RV selection and purchase, knowing it would just perpetuate my over-analysis of a decision I had already made (the motor home had already been purchased by that time).  I, of course, ignored her advice and started to skim these chapters.  She, in turn, was absolutely correct; and I started down my road of “what if” ‘s and “Did I make the right choice?” ‘s. Quickly, I stepped away from the book.  I remembered my lengthy pros and cons debate with myself (under the guidance of my full-time RV’ing resource-people) and embraced my decision.

A motor home and tow dolly for my car was financially a better plan for me versus purchasing a bumper pull RV plus a vehicle to tow it.  Size-wise, it also felt more manageable.  Driving my 23.5 ft motor home doesn’t feel much different than driving a U-haul.  A downside is that adding the car-in-tow makes maneuverability more challenging—you can never ever back up— and the tow dolly itself is cumbersome for manually moving and storing (600 pounds, if memory serves).  A motorhome is also a convenient and secure choice for the single female traveler.  When on the road and in need of a rest or a bathroom break, I can climb from the cab to the “home” portion without having to exit the vehicle, if it seems unsafe to do so.  The motor home (versus hotels/motels) also makes on-the-road overnight stops with two large dogs a bit easier.

If you are considering an RV for yourself, finances, size, and practicality are certainly important points to consider.  My expert advice, however, ends there.  I highly recommend finding the RV’ing book of your choice to learn the ins and outs, the pros and cons, and all that jazz.  Other than that, we’ll figure it out as we go!