I'm interested in becoming a cardiothoracic surgery locums PA but scared
I, a 27YO F, am seeking advise, opinions, and experiences from other cardiac surgery/cardiothoracic/cardiovascular surgery PAs/NPs/Nurses/Doctors/recruiters. Essentially, I am very interested in becoming a CTS locums tenens PA, but I am worried about experiential inadequacies as well as the logistical challenges of this change.
Currently, I work as a cardiothoracic surgery PA in Indiana at a level 2 center that does around 600 pump cases per year in addition to hundreds of TAVRs, thoracic cases, and limited vascular cases. This was my first job out of school, and I have been with my group for just under 3 years. Our program covers 2 separate hospitals as 1 team. I work in 2 ORs, 2 ICUs, 2 stepdown units, and 2 outpatient offices regularly.
Roles vary slightly between my PA colleagues, and my role is slightly more OR-focused. I took well to endoscopic vein harvest right away, and I am proficient with EVH using the Maquet/Getinge VasoView system. I have also been doing open radial artery harvest and can do open saphenous vein harvest when needed. I have first-assisted 7 different surgeons so far at this job, and feel that I have adapted to assisting each of their unique styles very well.
Regarding our inpatients, the PAs come in between 5-5:30 (sometimes earlier if census is large) to pre-round on 3-6 patients per person. At 6:30 we round as a team, or split off to round as surgeon/PA pairs. Sometimes I feel that the PAs have valuable input or information, but most of the time I feel like the surgeon already generally knows what they'd like to do regarding the plan/orders. This is fine, but sometimes I do end up feeling like more of a scribe than a PA. PAs write notes and put in the orders. Surgery start-time is usually 7:00. It can be difficult at times to complete this work and get into the OR on time especially to ultrasound the leg for CABG cases. I feel generally comfortable with routine post-op cardiac/thoracic management, but not so confident with more complex post op courses. I feel comfortable enough in the outpatient setting. Our EMR is Cerner.
I take call once throughout each week and one weekend per month. Excluding POD0, we take first call in the ICU and step down units and are on call for emergency surgery, which is not infrequent. Our group regularly does dissections, ECMO, and thoracic trauma emergently. No VAD or transplant experience. The day after taking call or the Monday after weekend call we really try to let that PA be the first out, or even have the day off. It doesn't always work out that way, but I know this is better than what many programs can do. We are paid an extra flat rate each time we take call in addition to our salary.
Our program often feels like 'feast or famine'. There are sometimes weeks that things are controlled and I actually work close to the 40 hours that I'm paid for. But regularly I work 10 to 14 hours per day, including weekends when I'm on call. In the last Friday-Friday (8 days) I worked 82 hours in the hospital and was on call 96 hours. Weeks like this are not exactly rare...and make enjoying life, let alone taking care of myself or anything else, feel nearly impossible. This, along with a slight underlying narrative at my hospital that the PAs are not competent enough, not doing enough, and are spoiled/lazy, is making me feel that it might be time to move on. I love being in the operating room and helping with heart surgery so much. I want to stay in heart surgery, expand my knowledge, but find a little more freedom. This is why I'm interested in becoming a locums. I am worried my limited years of experience will set my up for failure.
I am married with 2 dogs, and no kids. My husband does not work from home. He also works 60+ hours per week on-site as a carpentry superintendent. He is supportive of me traveling and wants me to do what will make me happy. Unfortunately, he does not feel like he is able to/wants to travel alongside me. He would stay at our home-base in Indiana. I would be more comfortable if he was with me, but I suppose to lessen the burden, I would be interested in shorter assignments anywhere, or standard-length assignments closer to home. We both agree our marriage will be fine; we are very independent people with individual interests and hobbies, but it does make me sad knowing he won't be with me.
I have spoken with 2 current CTS locum PAs. One said I can definitely do it and she almost always has positive experiences. The other said I can do it, but it is extremely challenging. They are both 1099, I think I am more interested in W2, but unsure. This is because I believe I would travel for a few years until finding a permanent spot with better work-life balance in order to start a family. Overall I'm scared, but feeling like something needs to change.
My concerns:
3 years of experience with my current program may not be adequate
This lack of experience will prevent me from being hired for desirable assignments.
Locums may not actually offer a better work-life balance, or could strain my marriage.
Opinions, advise, or discussion would be greatly appreciated. Thank you.