With locum tenens, you don’t have to choose between your love of medicine and life’s other priorities. Take Surgical PA Jackie Tank: she had a dream of traveling the world, before parenthood and the need to earn a living put those dreams on hold. But with locums, she has the flexibility to do both. Now, she spends half of each year making a difference in communities that need surgical care, and the other half checking off her travel bucket list.
What led you to become a PA?
I originally went to college for elementary education, but I was naive to how expensive everything was. After two years of school, I realized I didn’t want to be a teacher—and then I found out I was pregnant with my daughter, so that changed the course of my life. Several years after I had my daughter, I realized I wanted to be in the medical field, and I went back to school to become a Certified Surgical Technologist. Eventually, I worked my way up to becoming a surgical first assistant.
I knew then that surgery was my passion, but I wasn’t earning as much as a Certified Surgical First Assistant. I also had the added challenge of not being a traditional student, while working and having a family.
When I considered whether to go to medical school to become a surgeon, or to pursue my certification as a physician assistant, a lot of the decision came down to finances and family: could I afford it, and how would going back to school affect my family?
I spoke with five different surgeons to get their opinion on what I should do next, and all of them recommended becoming a PA over becoming a surgeon, each for different reasons. I am so grateful I followed their advice, because I think it was the best route in the long run. I think a lot about how I am seven years out from school now, and if I’d gone the route of becoming a surgeon, I would still be in training.
As a PA, I get to continue to do what I love, while also making a livable wage.
What is your favorite part about being a physician assistant?
I absolutely love surgery. It is my happy place. I love the technical skills involved, I love the environment, I love the people. I love being able to see a problem and then help fix it. It’s so rewarding.
As a PA, I also have a lot more responsibility because I don’t just do surgery. I also work in the clinic and see patients on the floor. I love working with patients: helping people accept their diagnosis, educating people on their treatment plan, and providing comfort when people need it.
In my current job, I have a lot more time to connect with patients, and I really enjoy that part of the job. I get great feedback from patients that they feel comfortable with me, because I explain things to them in a way that makes sense. They’re so grateful to have someone to help them understand what’s happening to them.
What drew you to locums work, and how has it shaped your career?
It was always my dream to travel the world. Then, when I got pregnant at twenty years old, that changed the course of my life. I thought travel was something I would never get to do.
Locums provided that opportunity. Three years ago I got divorced, and my daughter is 24 now. Working with so many patients that have cancer, I realized that nothing is guaranteed. I’ve seen so many people wait until they retire to pursue their dreams of traveling, and then when they do retire, they don’t have the finances or health or the desire anymore. So I thought, if I don’t do it now, when will I? There are no guarantees. Too many people my age have cancer, and I don’t want life to pass me by before I do the things I want to do.
Ultimately, my goal isn’t to retire younger, but just work less every year. I would love to do 6 months of locums work per year, and spend the other 6 months traveling. It’s taken me some time to work up to that. During my first year, I only had a couple of state licenses. But now I have 16 state licenses, and I’ve taken on a longer-term assignment this year, so I’m able to work a little bit more.
I’ve also gotten to travel as part of my locums assignments. In addition to traveling around the world, I want to travel to all the states, and so far all of my locums work has been in other states. I had a job in New York four blocks away from Central Park, and I’ve gotten to visit National Parks.
In the last year, locums has helped me make some dramatic changes in my life. I’m truly a nomad: I stay with friends and family when I’m home, and the rest of the time, I’m either working a locums assignment, or traveling around the world. With locums, I can come in to provide a much needed service, impact as many people as I can in a positive way, and then move on to the next adventure.
What do you find most rewarding and most difficult about locums?
The nice thing about locums is that they have an urgent need, so they’re so grateful that you’re there. You get to swoop in to save the day.
Locums also helps you expand your skill set. Being able to work in general surgery clinic has added to my skill set, which makes me more versatile: in one of my locums positions, I was assigned to a clinic that treated all kinds of cancers I’d never worked with before. Through that experience, I was able to learn a lot in one month about so many different specialties.
The most difficult part is leaving. You make connections every time you take a locums assignment, and it’s hard to leave those behind. I have a job in Rhode Island right now, and it’s the longest I’ve been in one place for a long time. I just went home to visit family and friends, and I had this moment where I missed home, and I realized I was thinking of Rhode Island!
So it’s hard to leave those connections. But when it comes to the work itself, I haven’t found it difficult to find a rhythm with new assignments. Adaptability is key to being successful in locums, and in life. My motto has always been adapt or die. So with every job I take, I just jump in and learn how to do things the way that hospital does things.
Are there any favorite moments from your career as a PA?
During my assignment where I worked with so many cancer patients, I gained an even better understanding for how to connect with people, because they’re dealing with something very scary, and you have to be direct, but also empathetic. I’ve had to give a lot of patients the news that they have an unexpected diagnosis, and explain the best and worst case scenarios for treatment. It takes a lot of practice, but you just have to learn to connect with people.
It’s a running joke around here that I’ve made so many patients cry. I can tell when they’re upset, and I’ll ask them if they need a hug. More often than not, they’ll say yes, and I’ll hug them and they’ll break down in tears.
If you just spend a few minutes with patients, they are so appreciative of that connection. They’re scared and lonely and they don’t feel well, and they just want some empathy.
What are some things you wish more people understood about PAs and APPs in general?
People don’t always understand how much we assist in surgery. Of course it’s surgeon-led, but we assist quite a bit.
There are some stereotypical mindsets that people can have when you’re a PA. I sometimes also get patients seeing me in scrubs and asking if I’m a nurse—and of course there’s nothing wrong with being a nurse, without nurses, I don’t know what we would do—but once I fill them in on the role, they respect it.
There’s also sometimes a mindset among doctors that PAs couldn’t get into medical school. But education as a PA is modeled after medical school, so we’re learning many of the same thing, but in a shorter period of time.
I think it’s important to continue educating people about PAs, because there’s a lot of people who don’t understand how much work it takes. The reason PAs choose this path is often related to factors like work-life balance or finances—it’s certainly nothing to do with intelligence or a desire to work hard.
But the more people understand what goes into it, the more they realize how important PAs are, and on the whole, I feel like more people understand what the role is than they used to. I get really positive feedback for my work, and I also hear positive feedback about PAs in general: that patients spend more time with them and feel seen and heard.
Do you have any advice for PA’s who are considering locums?
I think it’s important for people going into locums to have at least three years of experience under their belt. The first two years is almost like a residency—it prepares you for the rest of your career.
It’s important to understand as a PA what your limitations are, and not to be afraid to speak up when you don’t know something. Locums jobs are all very different. Different facilities manage things differently, and there are also differences in the kinds of patients you see.
If you’re going to do locums, it’s very important to be able to think like a provider. There are some surgeons who will trust you more with autonomy and help you learn to think like a provider instead of just following dictations. In the role I am in now, I work independently for the majority of my hours. During surgeries, I work with my surgeon, but other than that I come to the hospital, work with the patients, put in the orders, perform bedside procedures, make the decisions, and then consult with surgeons. I still have someone I’m accountable to, but I manage almost every patient, which has helped me get more comfortable managing many different conditions.
