An NP on your permanent staff tells you they're leaving to do locum work. They aren't leaving urgent care, and they may not be leaving your town. They want to work under different terms.
That gives an urgent care operator more options than a normal resignation does. This post covers what to ask, what a permanent role can change, and how to keep that NP on your schedule by the shift. It applies to PAs as well.
Ask the NP What They Want to Change
The reasons differ from one clinician to the next, and each has a different answer. Why urgent care NPs and PAs choose locum work covers the reasons from the clinician's side.
Ask four questions:
- Is it the schedule: which days, how many shifts, or how time off gets approved?
- Is it the work outside the exam room: meetings, committees, projects?
- Is it how the pay is structured?
- Do they want to work less, or work at more than one clinic?
The answers tell you whether a changed permanent role would keep them, or whether locum work is what they want.
What a Permanent Urgent Care Role Can Change for an NP
You can change some of this without ending the employment.
The schedule. Offer a part-time role, a fixed number of weekend shifts, or self-scheduling inside rules you set. An NP who wants two fewer shifts a month may not need to resign to get them.
Non-clinical duties. List what you ask of your NPs outside patient care. Drop what nobody would miss.
What only a permanent role offers. Benefits, paid time off, a collaborating physician they see regularly, and a path to a lead role. These count only if they're real at your clinic. Don't offer a lead role that doesn't exist.
Check the employment agreement and your own policies before you offer different terms to one clinician. Your employment counsel can tell you what a change to the agreement involves.
Keep the NP on Your Urgent Care Schedule as a Locum
If the NP still wants locum work, the next question is whether they'd pick up shifts with you. An NP who has worked at your clinic for two years knows your EMR, your staff and your patients. A clinician who's new to your clinic has to learn all three. What locum turnover costs a clinic covers how to price that difference.
Settle these before their last day as an employee.
How they'll be engaged. Per diem employee, independent contractor, or through an agency or platform. Whether a worker is an employee or a contractor depends on the facts of the arrangement, and the rules differ by state. Ask your employment counsel and your accountant before you decide.
Malpractice coverage. Coverage you carried for them as an employee may not cover shifts worked under a new arrangement. Ask your broker or carrier how those shifts are covered and what happens to the old policy when employment ends.
Collaboration or supervision. State law sets how NP and PA practice is supervised, and the rules differ. Confirm with your medical director and your state board that the arrangement in place still meets them after the change.
Their file and their access. Keep the credentialing file current, track license and certification expiration dates, and decide whether the EMR account stays active between shifts.
If they'll work through an agency or platform, read the agreement first. Some agreements attach fees or limits to booking a clinician you already know. What to check in a staffing agency agreement covers those terms.
Offer Shifts the Way a Locum NP Needs Them
A former employee who now works by the shift chooses your clinic each time. Three things decide whether they keep choosing it.
- The rate is stated up front. They see it before they commit, and it doesn't change from month to month without a rule.
- Shifts are posted ahead. They're planning a month across several clinics now. A shift offered the night before goes to whoever's free.
- A no is accepted. If turning down a shift brings pressure from a former manager, they'll stop answering.
Plan the Hours a Departing NP Leaves Open
The NP's old schedule is now open. Decide how much of it to fill with a new permanent hire and how much to cover with locum shifts, including shifts from the NP who left.
Base the decision on which hours were hard to cover before. If the open hours are steady weekday shifts, a permanent hire fits. If they're the weekend and evening shifts the NP no longer wanted, the next permanent hire may not want them either. Urgent care hybrid staffing covers how to split a schedule between the two.
Review What Your Urgent Care Asks of Its Other NPs and PAs
One departure is a reason to look at the roles of the clinicians who stayed. Ask them the same four questions, and act on what you can change. A schedule change costs less than a replacement hire and the first shifts that come with one.
Rediworks is a self-service marketplace for urgent care locum shifts. You post the shifts you need by clinician type and date, and the rate is on the listing before a clinician applies. Sign up to post shifts.