Packing for every eventuality
Locum optometrist, Shamina Asif, shares insight into what her average day in the life of a locum looks like and how planning for every eventuality begins the night before
07 October 2019
9pm: My typical day begins the night before when I research how far away the practice I will be working at is and how long it will take me to get there. This is so I know what time I need to get up in the morning and I can set my alarm accordingly before I get to bed.
Previous roles: Resident optometrist in a multiple setting, chair of Dudley LOC, WOPEC examiner, pre-reg tutor and founder Optom Academy
Based: West Midlands.
7am: I get up, shower, get ready and have breakfast before I leave. I take a packed lunch in case I am running behind and haven’t got time to go and get something to eat at lunch. I have my own equipment that I carry with me when I locum, not just my retinoscope, but things like fluorescein strips, tropicamide 1% and phenylephrine 2.5% in case the practice that I am in has run out. I have experienced this in the past and it can happen to any practice.
8.40am: I always arrive at a practice that I have not locumed at before early so I can find out who the staff are and introduce myself. The practice manager will usually show me to the testing room and talk me through the equipment; if not, I ask. If there is a piece of equipment that I want to try before my first patient, a member of staff will usually volunteer to sit for me so that I can check I am using it correctly. So far in practices I have locumed at, the staff are really supportive and will not hesitate to help. I also like to check what is and isn’t done at pre-screening and have a look around the pre-screening area so I am aware what equipment they are using and what the field machine is like, for example.
At a new optical practice, I like to arrive, not on time, but around 10 minutes early so I can settle in, turn the computer on, log in and set up
8.50am: I ask for a list of the patients that I am scheduled to see that day and will usually be given a printed list. I keep a track of patients on the list to make sure that I am running to time. At this point I also check what pathways the practice runs and what enhanced services they are accredited for. Knowing this information means that if a patient comes in with a minor eye condition, for example, I can treat or refer them accordingly.
9.00am: I am all set and ready for my first patient to come in. Once my clinic begins, I start testing.
5.30pm: As the end of the day nears, I will review any patients who I have seen that day if I need to. For example, if someone needed repeat fields, I will have written their name down and at this point I will look back for the results to make sure that it was done and to make sure a referral was sent off if needed. I will do this just before I leave for the day and if that means I stay a little longer, I do.
You do have to budget time to do this admin in order to stay on top of it
6.30pm: I have a folder where I keep any petrol, parking and food receipts so that I can file them when I get home. In addition, I actively keep a log of any work that needs doing on my car as it is my mode transport to and from work. I have found it important to keep on top of this paperwork and not leave it until the last minute as this is when things can get lost and go unclaimed for.
9pm: In the evening, the process starts from the beginning again when I look at where I am going tomorrow.
When did you decide to become a locum and why?
I became a locum optometrist in 2014 after realising that if I wanted to progress my career in the direction that I hoped, locuming was going to be the best route for me due to the flexibility that it affords. In the years leading up to this decision I had joined my local optical committee, had got involved in commissioning at a local level, was completing further education and was driving forward the Healthy Living Optical Practice scheme in Dudley. Balancing all of these aspects of my professional life with working full-time meant a need for an increasing amount of time off and I found myself with little annual leave left for an actual holiday.
What advice would you give an optometrist considering becoming a locum?
My top tip for anyone considering becoming a locum is to make sure you know everything you can about the practice you are working in before you arrive. Be clear about your role and how you are comfortable working to particular testing times. Know your limits and stick to that as you are the person who is responsible that day.
Recently, I have noticed that independent practices are beginning to provide locums with an information pack prior to them attending practice. The packs that I have received have contained information on where to park, where to eat, what equipment is available and what is charged, and who the staff are. I have found it hugely beneficial to know who the receptionist is and which dispensing optician will be working with me before I arrive in practice.
What do you most like about being a locum?
I think the best thing about locuming is the flexibility that it offers. It allows you to pick and choose your working days and if you want a weekend off, you can take it. The other good thing is that you get to see what it is like to work in different places. You see how different independents operate and how this can differ to a multiple, as well as different patient demographics.
What do you least like about being a locum?
What I least like is that I can’t follow-up with my patients. This can be quite stressful if someone has presented with pathology and I have referred them. When I was working as a resident optometrist, it was very useful to be able to follow-up after a dilation or hospital visit, for example, and as a result my knowledge increased drastically. Feedback is so important.
The other thing is travel. As a locum you have to travel to where there is work and sometimes this can be a longer distance than is desirable. It can also be a little daunting when you first arrive at a new practice and there is equipment that you are not familiar with or the record card is structured in a different way to what you are used to.
What do you know now that you wish you knew when you first became a locum?
As a locum you really do need to be super-organised. I also wish that I’d known how much time was involved in keeping track of invoices and receipts, and paperwork in general. You have to keep on top of this all year round regularly. If it’s left until the last minute it can be very stressful.
My advice to optometrists who are newly-qualified would be that it is not a good idea to start locuming straightaway. I strongly believe that it is a good idea to be a resident optometrist for a period of time so that you can follow-up with patients and learn a lot on the job. I think it is difficult to become good at detecting pathology and knowing what it is when you haven’t been able to follow a patient up.
- As told to Emily McCormick.