Rural locuming

After booking: When I am working in a new location, I always ensure that I have a chat with the practice owner before the locum shift to discuss what my requirements are and what their requirements are. During this conversation, we would agree testing times, the length of the lunch break and the financials. If the location is new to me, on occasion, I will drive to the practice to meet the staff and the owner also. I understand that not everyone will do this, and I know I don’t have to, but it provides me with invaluable information such as how long it will take me to get to the practice, how it is set up and generally what to expect.

The night before: Locuming in a rural area, during the winter months I have to keep an eye on the weather and check local reports because roads can often become closed off and routes to practices may change and take longer.

I also make sure that my kit is clean, ready to use and packed. I take all of my equipment with me under the assumption that when I get to a practice there will not be the things that I need or equipment may be different to what I am used to. While I don’t have a uniform as such, I always make sure that I am dressed smartly in a shirt and trousers.

After checking the weather and my planned route, I add on an extra 20 to 30 minutes for the unexpected and set my alarm accordingly.

I always ensure that I have a chat with the practice owner before the locum shift to discuss what my requirements are and what their requirements are

8.30am: On arriving at a practice, I’ll have a tour of the testing room and ensure that all of the equipment is in a position that I am comfortable with. As more and more practices use computerised systems during the sight test and many are slightly different, I take a little time to run through this. The arrangement of these systems, which require practitioners to record their findings during the sight test, can have an impact on my normal routine so I want to make sure that I am comfortable.

8.45am: As a MECS-accredited optometrist, if this is something that I am required to take on in a practice that day, prior to beginning testing, I will request that morning’s list of potential patients and go through the triage notes with support staff. At the end of the day when we finish, I will make sure that each triage has been completed satisfactorily and follow-up has been recorded or performed when required.

 
9am: I am testing. Testing in a rural area means that sometimes when a referral comes in that is not urgent, follow-up is not done there and then due to dilation, for example, and the patient having driven to the practice. If this is the case, I ensure that I take detailed notes and pass on all of the required information to another optometrist, the support staff and the patient. However, for all referrals, it is about working out the best option for the patient in the specific circumstances. Sometimes this means working through lunch or at the end of the day to be able to provide the required treatment, while at other times it is about getting it done there and then.

1pm: During my lunch break I am not one for sitting in the testing room – I like to refresh my mind from work by interacting with staff. I am a qualified dispensing optician and I am happy to help out in the front of house if needed. If it is not, my lunch break is simply about eating and relaxing.

On arriving at a practice, I’ll have a tour of the testing room and ensure that all of the equipment is in a position that I am comfortable with

5pm: After my last patient, I go back through my notes for the day to double-check that all patients who needed attention have been followed up.

Furthermore, if I am locuming in a busy multiple practice, there is a recognisable hierarchy in place and I will make sure that I provide the manager with a detailed verbal handover. During this discussion, I cover any referrals and follow-ups to ensure that they are aware of everything that has been done, as well as anything that may be outstanding.

7pm/days off: When it comes to administration, invoicing is very much electronic; gone are the days when I would hand over a printed invoice at the end of my shift like I did when I first became a locum. I save all of my admin on my computer, with a folder for each location that I work in. In my diary, I keep information on practice location, mileage, hours and fees. When it comes to invoicing, depending on what the needs of the practice are, I either do it at the end of the day or add it to my list of things to do.

• As told to Emily McCormick.