“Locuming has given me so much experience”

I became a locum because…

I was a resident optometrist, and some of my friends were making the move to locuming. They told me I needed to do it too. I was umming and ahhing. And then I thought, well, I’m living at home, I’ve got no commitments and no mortgage; if I don’t take the risk now I never will. So I did, and I’ve never looked back.

When I started as a locum, I wish I had known…

When I was first starting out, a lot of people said, “You won’t get a lot of work. Locuming is dying down.” That made me quite hesitant. But actually, I’ve found that there’s always work. Barring the pandemic, in the last 20 years, I’ve always had locum work; I have never been short of it. A lot of people are put off by thinking that won’t be the case.

That’s what I would say to someone who is thinking about going into locum work: you will always get work. You may get variations here and there, depending on the time of the year, but there will always be work.

I realised this when…

When I started, I’d been a resident optometrist, so I had to give three months’ notice. From that point onwards, I started booking up my locum days. When I eventually left, I had already booked three months in advance. So, I knew at that point that it wasn’t as bad as people were saying. Six months down the road, I’d realised I was constantly booking up three months ahead. It didn’t take long for me to realise that it was a lot better than people were saying.

The event that made me realise this was…

I had a couple of friends in the years above me at university who had already progressed into locum work at that time, and they were encouraging me and saying that I wouldn’t regret it. They really did push me, and they gave me the confidence to take that step. If it wasn’t for them, and if I had listened to other people, I probably wouldn’t have taken the risk.

It has helped me because…

Locuming has given me so much experience. Working as a locum, you go into so many different practices: you see how they work, and get insight into different companies and different modes of practice, and meet so many different people.

I’ve also worked in domiciliary as a locum. I probably wouldn’t have taken that as a residency job, but as a locum I was able to do one or two days a week, and get that experience. It really was rewarding working in domiciliary.

I don’t think there’s much of a spotlight on domiciliary. I know a lot of domiciliary companies do offer shadow days, where you can work for them, get paid, and shadow another optometrist. I think that’s a good idea. There’s not a lot of information about what happens as a domiciliary optometrist, but it can be one of the most rewarding jobs. These people often can’t get out to an optical practice themselves - they’re housebound or they’re in a home - so for you to go there, test their eyes and give them glasses so they can actually see, is a godsend for them.

My biggest locum challenge is…

I’ve been doing this for 20 years now, so I feel confident wherever I go. It probably takes me 20 or 30 minutes to get used to the testing room. I know a lot of people like having their comfort zone; having a testing room where they know where everything is. If you’re going somewhere new, you will find that it’s a bit more difficult to know where everything is. But that’s something that you get used to. And the more you do it, the more competent you become..

When you’re in a situation where you’ve got a patient there who needs a referral, and they’re sitting there, you can’t really be looking around to work out what to do

When you go to different practices, you do need to know the referral guidelines or referral criteria, and the pathways for the area you’re working in. That’s something you will need to research. If you’ve never worked in that area before, the pathways may be different to where you’ve previously worked. If I was going to work somewhere I hadn’t worked before, I would research that beforehand. Maybe go onto the area’s Local Optical Committee website, and find out what their referral guidelines are, how to refer, what the pathways are, whether to use email, fax, etc. That is quite important. When you’re in a situation where you’ve got a patient there who needs a referral, and they’re sitting there, you can’t really be looking around to work out what to do.

The advice I’d give to new locums is…

When you go into a new practice, it’s important to get to know the staff. You have to rely on them, too - they’re there to help you. At the end of the day, they want their patients to be having the best service. So, if you need any help, don’t be afraid to ask. A lot of complaints or grievances from practices are that the locum just sits in their room and they don’t tell us anything: they never did this, or they never did that. But practice staff are there to help, and they will. So, if you need any advice or you aren’t sure, just ask. Get to know the staff. Everyone is on the same side, in terms of always giving the patient the best experience possible and doing what’s best for them.

Practices can make life easier for locums by…

There are practices that have a little booklet with details on referral pathways and what to do. That is quite handy. It’s helpful, if you do have a problem and you do need to refer someone, to have all the information there and ready. Also having things like referral pads, or all the stationery provided within the room, and always stocked up.

One change I’ve seen whilst working as a locum is…

We’re doing a lot more, not necessarily from a locum point of view, but from an optometrist point of view. When I started, we didn’t even have fundus cameras in practice. A sight test consisted of looking at the back of the eye, doing the refraction, and that was it. Now a lot more is involved: obviously fundus cameras; optical coherence tomography. There’s a lot more that we need to do; a lot more that we need to look at and assess in terms of the patient.

Testing times have increased because of the pandemic, which is good. I would say that’s probably the main thing that’s changed. There’s a lot more involved. We’ve got a lot of Minor Eye Conditions Services; we’ve got a lot of enhanced services. There are a lot of pathways that weren’t there when I first started. This is the way we should be going. There’s a lot more emphasis on our skills, which I think is a good thing for optometry.

Working in so many different places has given me the confidence to feel that I can work anywhere, and that I wouldn’t feel out of place

My favourite thing about being a locum is…

The variety that you get: the flexibility over which days you want to work, and when. It’s brilliant. If you’re working in one sector, you’re only getting one side of the story, and one side of the experience. You could leave that job and work somewhere else, but to actually leave a job is a big jump. If you’re working as locum you can work in one part of the sector, and think, well, actually, this is not for me. So, you don’t work there again. You get that variety of working in so many different places, and it gives you the confidence to actually feel that, no matter where you work, you’re happy within yourself and happy working there. Working in so many different places has given me the confidence to feel that I can work anywhere, and that I wouldn’t feel out of place. For the last 20 years, it’s really given me a lot of experience and a lot of confidence.