“It keeps it fresh when you work in different places”

Before I became a locum, I was working...  

As a full-time, employed optometrist. My first job was for Dollond & Aitchison, where I’d always wanted to work, because it had been my opticians when I was a child.  

After I left them, I went to David Clulow, and I was a mobile optometrist for a couple of years. Then I was at Specsavers for about a year, before I ended up becoming a locum. 

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

How different practices are, in terms of operations, management, staff, and environment, as well as consulting rooms, testing times, and the equipment available.  

As a locum, that side of it becomes a real positive, because it helps your skillset develop. It’s also a confidence builder. In terms of character building, you’re going to have to throw yourself out of your comfort zone. That never changes. 

I realised this… 

Quite quickly. Probably within a few months, you realise how flexible you have to be, and how practices have different expectations of their optometrists. You have to go with it, but also whilst maintaining your integrity as a professional, first and foremost. 

The person who helped me as a locum was… 

Another female optometrist, Bernie. We didn’t always work alongside each other, but we worked for the same director, at his various practices for about 14 years.  

Right at the beginning, I was covering some days at a Specsavers practice. Bernie was locuming there, and it was really busy, with rolling clinics. My employed job at a specific Specsavers practice was ending, and I had three months working through a redundancy period for other Specsavers practices that needed cover. I ended up doing three months of that, while also trying to find more employed work. 

It was Christmas, and there wasn’t much work around. Bernie told me all about locuming: how it works and how you get set up. She explained what she loved about locuming. I thought, ‘I’m filling gaps at practices for Specsavers. I’m already locuming, in a way. This could work.’ It was really her who set the wheels in motion for me.  

I ended up getting work with two independent practices near my home, which both needed a maternity cover. I worked six-day weeks and thought, ‘This is good. I think I’ll keep doing this.’ I had a lot of work, and then I had my first child in 2005, and decided to stay in this capacity and do three-day weeks on average. 

Locuming has been helpful to me because...  

It has allowed me to feel more in control when my kids were little, certainly in terms of balancing my days. My husband’s profession used to involve shift work. When I would get myself locum work, he would look after the baby. We would share it between us and our wonderful, flexible child minder. I’d sometimes work more weekends, and sometimes more during the week.  

Over time, if you’re doing good work for people, your reputation gets around, your name gets passed on to other practices, they make contact with you, and hence your work continues. Locuming has got its pros and cons, but it works on the whole, certainly nowadays. I am lucky to not need to use agencies, for now. 

Over time, if you’re doing good work for people, your reputation gets around, and people call you and your name gets passed on, and your work continues

My biggest locum challenge is… 

You will go through phases where you’ve got too much work and you’ll go through phases where things suddenly change quite quickly. Whether a director has retired, a practice has become owned by a new director or group, or they want more employed optometrists – you can find that something has shifted or changed, and suddenly you’ve lost a couple of promised days’ work. The biggest challenge is anticipating periods like that. 

Equally, there are periods when there is too much work – more than you want in order to retain a work-life balance. It can be hard to say no. It does ebb and flow, and you have to be prepared for that. 

As a locum, I’ve adapted my days by… 

Sometimes taking slightly shorter days, with shorter lunch breaks, or working a half day, when the children were younger. Certainly, independents are quite open to that. It’s all about rapport with the practice, but also knowing how to fit in with a practice overall, alongside what works for you in your life. 

Practices can make life easier for locums by… 

Making sure all the equipment is working, that the trial lenses are there, and that the systems are up and running. The little things like that mean we can just come in, set up, and get going. Clear contact with the locum before their first day, discussing how the practice operates, is great. 

It’s always bit strange when you’re in a new place. I find that sometimes it takes a bit of time for me to get into my flow. With computer systems, if they are easy to use and running smoothly and are already familiar, it makes it a lot easier. 

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

The technology, which has changed hugely in the past 10 years. Sometimes I joke that examining eyes is easy – it’s using the software that can be tricky.  

These days, I would estimate eight or nine practices call on me for cover and even then, there are probably six or so different computer systems. Practice management software is 100% the biggest change. Using your brain for computers, as well as testing eyes with patients and engaging with them at the same time, and not being too distracted by how the clinical records need to be filled out – it is tricky. 

With that, modern-day computerised equipment for diagnostics is an example of how we deliver patient care differently now. It’s much better for the patients, and much more rewarding for us, because we’re getting more insight into solving patient problems, thanks to the digital equipment that we have at hand. Your brain has to be good at multitasking all round.

My favourite thing about being a locum is…  

The variety of people. Going into different practices, and that different environment, is what I enjoy. It’s always lovely, when you’re welcomed with a smile by the staff, and they are pleased to see you return. It’s also confirmation that you are doing a decent job. You could also say that as an employed person, but I think it keeps it fresh when you work in different places. 

Of course, you’re getting such a variety of patients too. You get different patient demographics. Communicating with patients is a skill, and you have to be able to adapt to that. When you’re in different types of practices, that keeps you on your toes. I enjoy all of that. 

“In the first few years, you need to see the things you’re referring for, and see the reports back more regularly”

My advice for new locums is...  

I think it’s important that optometrists don’t go straight into locuming the minute they qualify. It’s important they spend a few years settling into the profession.  

It’s about gaining confidence, and seeing the same patients over and over. You get the best of both worlds if you’re regular locum for a while at a practice, because you’re getting that returning patient and that loyalty and rapport. You miss out a bit if you’re just somewhere once or twice, because you don’t see what is coming back to you. In the first few years, you need to see the outcomes of the issues that you’re referring for, whether that is via the patient or hospital reports. 

Also, when you start locuming, be prepared to be flexible and work in different types of practices. Always be professional and friendly, not just to the patients, but to the people you’re working with. Always show the same care to all your patients, even if you’re only there for one day. Be involved with the practice: don’t keep the door shut and hide yourself away if you’re not examining eyes. Interact with the staff, and try to act like a member of the team.  

Practices will always call you back, if they get good feedback from the patients. That’s number one, and patients do give feedback. Giving off good vibes, whilst also doing your job properly, makes a difference as to whether practices will call you back. 

My last word on locuming is... 

This is for all optometrists in High Street practice. In the early years, I did feel the pressure to compromise too much at times, and I never liked that. I did sometimes have to stand my ground about our laws and our regulations, and I still do. I actually find that directors respect me more for this. We are a profession, but at the same time, we’re working in a practice that is a business and trying to make money, so we have to also bear that in mind. 

In the first couple of years, I didn’t quite get that 50/50 understanding. It takes time. 

Stay true to yourself, and why you went into this in the first place: it’s about patient care, being a people-person, and science, and medicine. It’s important to not compromise your professionalism for extra appointments and conversion rates, while also being very aware that they are a business, and if you can positively enhance that for them within your eye exam, that’s a good thing. It’s always been a tricky balance.