The role of the Nurse Practitioner (NP) has evolved dramatically in the last few decades, becoming a cornerstone of modern healthcare. With the growing demand for healthcare services and the increasing shortage of physicians and permanent staff, locum tenens Nurse Practitioners (Locums NPs) have emerged as a vital solution to fill the gaps in patient care. I’ve seen firsthand the critical role locum tenens NPs play in healthcare, from addressing staffing shortages to improving patient aeccess in underserved areas. This article provides an in-depth examination of the Locums NP role, offering insights that healthcare professionals can use to make strategic decisions in staffing, operational integration, and policy planning.

The U.S. healthcare system is currently facing a massive shortage of healthcare professionals, particularly in primary care and specialized fields such as geriatrics, psychiatry, and emergency medicine. According to the Association of American Medical Colleges (AAMC), the U.S. could face a shortage of up to 139,000 physicians by 2033. Nurse Practitioners, with their advanced clinical training and ability to practice autonomously in many states, are increasingly seen as a solution to bridge these gaps. However, the demand for permanent NPs also surpasses the available supply. This is where locum tenens NPs step in, providing much-needed flexibility and helping healthcare organizations manage the ebb and flow of patient needs.

The locum tenens model originated as a way to cover temporary staffing needs, such as when permanent staff took leave or during peak patient periods. However, over time, this model has evolved into a long-term staffing strategy for many organizations. Locums NPs have become essential to many hospitals, clinics, and healthcare systems, especially in rural and underserved areas where recruiting permanent staff is particularly challenging.

Locums NPs allow healthcare systems to address fluctuating patient volumes without committing to long-term hires. They can be deployed for short periods, filling roles quickly where staffing shortages could otherwise lead to disruptions in care. With the flexibility to work in multiple settings—ranging from emergency departments to telehealth platforms—locum tenens NPs have become a crucial asset in maintaining healthcare delivery standards.

The ability of Locums NPs to deliver high-quality care across various settings is one of the model’s most compelling benefits. These NPs often step in where care gaps exist, particularly in underserved communities that may not have access to permanent healthcare providers. In rural areas, where access to specialized care is limited, locum tenens NPs have become the lifeline for patients who would otherwise have to travel long distances to receive care.

Moreover, locum tenens staffing allows for greater flexibility in scheduling, which helps avoid burnout among permanent staff. Overworked clinicians can lead to diminished quality of care and increased errors. By leveraging locum tenens NPs, healthcare organizations can alleviate some of this pressure while continuing to meet patient needs effectively.

Locum tenens NPs are highly versatile professionals who can adapt to a wide range of clinical settings. Their role is often highly specialized, depending on the particular needs of the healthcare organization. Unlike permanent staff, who may be accustomed to a consistent patient population or clinical focus, Locums NPs must be able to adapt quickly to new environments and diverse patient demographics.

One of the major advantages of Locums NPs is their ability to practice autonomously in many states, thanks to progressive state-level nurse practitioner practice laws. These NPs can diagnose conditions, prescribe medications, and manage treatment plans without direct supervision from a physician, depending on state regulations. This expanded scope of practice is critical for healthcare facilities that rely on the flexibility and independence of locum tenens NPs to function smoothly, especially in rural and underserved regions.

For example, in full practice states, NPs can act as primary care providers (PCPs), independently managing patient care, including chronic disease management, wellness checks, and acute care. In contrast, in states with reduced or restricted practice laws, Locums NPs may need to collaborate with a physician to deliver care, but their clinical skills still play a significant role in improving patient outcomes.

Locum tenens NPs are increasingly sought after in high-demand specialties. Psychiatry, for instance, has one of the most acute shortages of providers, and locum tenens NPs specializing in mental health are filling essential roles in both outpatient and inpatient settings. Emergency medicine is another specialty where locum tenens NPs play a pivotal role, providing fast, efficient care to high volumes of patients, especially in trauma centers or during crises such as the COVID-19 pandemic.

Additionally, with the rise of telemedicine, Locums NPs are finding new opportunities to deliver care remotely. Telehealth has expanded access to care for patients in remote or underserved areas, and locum tenens NPs have seamlessly integrated into this model, leveraging their adaptability to provide virtual care.

One of the challenges locum tenens NPs face is managing temporary patient populations. When stepping into a new role, these NPs must quickly build rapport with patients and integrate into the care team. Continuity of care can be a concern, particularly for patients with complex medical histories or chronic conditions. However, skilled Locums NPs are adept at reviewing medical records, coordinating with the existing healthcare team, and delivering care that is consistent with the patient’s established treatment plan.

Healthcare organizations that use locum tenens staff must prioritize thorough handoffs and communication to ensure that patient care remains seamless. Locums NPs are particularly skilled at facilitating these transitions, but the system itself must support them with clear documentation, access to electronic health records (EHRs), and robust communication protocols.

Integrating locum tenens NPs into a healthcare organization requires careful planning, not only to ensure a smooth transition but also to optimize the cost-effectiveness and efficiency of their placement. There are several operational considerations that healthcare administrators must account for when using locum tenens NPs, including onboarding, cost structures, and managing the overall impact on productivity and workflow.

The onboarding process for locum tenens NPs is often more complex than for permanent staff. These professionals are brought in for short-term assignments, sometimes on very short notice, which means that the credentialing and licensing process must be expedited. Locum tenens agencies typically manage much of this process, but healthcare organizations still need to ensure that the NP has the appropriate credentials to practice in their state and is familiar with the facility’s specific protocols.

One common challenge is the variability in state licensure requirements, especially in non-Nurse Licensure Compact (NLC) states. When a locum NP is deployed across multiple states, they may face bureaucratic hurdles that delay their ability to start work. Healthcare facilities must anticipate these issues and collaborate with locum tenens agencies to streamline the credentialing process.

While locum tenens NPs offer flexibility, they often come at a higher cost than permanent staff. Healthcare organizations must consider both direct and indirect costs when hiring locum tenens providers. Direct costs include the higher hourly rates that locum tenens NPs typically command, as well as agency fees and costs related to travel, housing, and malpractice insurance. Indirect costs may include the impact on productivity during the onboarding period, as well as any disruptions to workflow caused by a temporary staff member.

That being said, locum tenens NPs can often be more cost-effective than permanent hires in specific situations. For example, organizations facing seasonal patient volume spikes or a temporary increase in patient acuity may find that short-term staffing solutions are more financially prudent than bringing on a permanent provider. Additionally, locum tenens NPs help avoid costly delays in patient care that could arise from staffing shortages.

The integration of locum tenens NPs into an existing care team can sometimes disrupt workflow, particularly if the facility has not prepared adequately for their arrival. However, organizations that have established best practices for incorporating locum staff can mitigate these issues. For example, ensuring that Locums NPs have access to the facility’s electronic health record system (EHR) prior to their arrival allows them to hit the ground running. Involving locum NPs in interdisciplinary team meetings and care planning can also facilitate smoother integration into the care team.

The best way to ensure that locum tenens NPs are productive and effective is to treat them as integral members of the team from the moment they arrive. This means providing them with the same access to support services, mentorship, and resources as permanent staff. Effective orientation and clear communication about the organization’s expectations are essential to maximizing the impact of locum tenens NPs.

Navigating the legal and compliance landscape is one of the most critical aspects of managing locum tenens NPs. From licensing and credentialing to malpractice coverage and contractual agreements, healthcare organizations must be vigilant in ensuring that locum tenens NPs are fully compliant with all relevant laws and regulations.

One of the significant challenges for Locums NPs is the complexity of multi-state licensing. While the Nurse Licensure Compact (NLC) has streamlined licensure for NPs in member states, many states still have their own individual requirements, which can complicate the deployment of locum tenens providers. For example, NPs working in non-NLC states may need to apply for a new license, which can take weeks or even months. This can delay the NP’s ability to start their assignment, leading to gaps in care for patients.

Healthcare organizations and locum tenens agencies must collaborate closely to manage these licensing and credentialing challenges. The preparation process should begin well in advance of the NP’s expected start date to avoid delays. In some cases, agencies may have to provide support in navigating state-specific continuing education requirements or other administrative hurdles. For NPs moving between multiple states, understanding the nuances of each state’s regulations is crucial to ensuring compliance and avoiding potential legal issues.

Malpractice insurance is another critical consideration when hiring locum tenens NPs. Unlike permanent staff, locum tenens NPs often require temporary malpractice coverage, which may either be provided by the locum tenens agency or arranged directly by the healthcare organization. It’s important to assess the specific malpractice coverage that locum tenens NPs carry, as coverage can vary depending on the agency and the type of contract in place.

Healthcare organizations must also evaluate their liability exposure when using locum tenens staff. For example, if a locum tenens NP practices in a state where they do not have full practice authority and must collaborate with a physician, both the NP and the supervising physician could be held liable for malpractice claims. Clear communication of the NP’s scope of practice, the delegation of responsibilities, and the documentation of all care-related activities is essential for reducing liability risks.

In addition, healthcare organizations must ensure that locum tenens NPs are aware of the legal and ethical guidelines in the specific state where they are practicing. This includes understanding the legalities of patient hand-offs, the use of electronic health records (EHR), and any specific documentation requirements that may differ from state to state.

The contractual agreements for locum tenens NPs are often more complex than those for permanent staff due to the temporary nature of the assignments. It’s important that both the healthcare organization and the NP have a clear understanding of the terms of the contract, including the duration of the assignment, hours of work, compensation, and any non-compete clauses.

One of the key contractual considerations is the structure of compensation. Locum tenens NPs are typically paid on an hourly basis, and their rates can vary significantly depending on the specialty, location, and length of the assignment. Healthcare organizations must ensure that the compensation package is competitive but also cost-effective, taking into account the added expenses of agency fees, travel, and housing.

Non-compete clauses are another important aspect of locum tenens contracts. Some contracts may restrict the NP from taking a permanent position at the facility where they have worked as a locum, or from working at competing facilities within a certain geographic area. Both the NP and the healthcare organization must carefully review these clauses to ensure that they align with long-term staffing goals and do not inadvertently limit the NP’s future employment opportunities.

While locum tenens positions offer a wide range of benefits, they also come with their own set of challenges. From a professional perspective, working as a locum tenens NP provides opportunities for career growth, flexible scheduling, and the ability to work in diverse clinical environments. However, there are also trade-offs, including potential instability, the need for frequent travel, and a lack of long-term benefits typically associated with permanent employment.

One of the most significant advantages of working as a locum tenens NP is the opportunity for professional development. Because locum tenens NPs work in a variety of clinical settings—ranging from rural clinics to large urban hospitals—they are exposed to a wide range of patient populations, healthcare systems, and treatment modalities. This diversity of experience can significantly enhance clinical skills and knowledge, particularly for NPs looking to gain expertise in specific specialties.

In addition, locum tenens assignments can provide NPs with opportunities to build a network of professional contacts across multiple regions and healthcare organizations. This can be particularly valuable for NPs who are interested in pursuing leadership positions or specialized roles in the future. The flexibility of locum work also allows NPs to take on part-time or temporary assignments while pursuing further education, such as a Doctor of Nursing Practice (DNP) degree or other advanced certifications.

On the flip side, locum tenens work can sometimes lack the stability that comes with a permanent position. While some NPs thrive in the dynamic and varied nature of locum tenens assignments, others may find the uncertainty of short-term contracts less appealing, particularly if they are looking to build long-term relationships with patients or pursue a specific career trajectory within one organization.

One of the primary reasons many NPs are drawn to locum tenens work is the flexibility it offers. Locum tenens NPs have more control over their schedules than those in permanent positions, allowing them to choose assignments that fit with their personal and professional goals. For example, an NP may choose to take a six-month locum assignment in a rural area, followed by a few months off to travel or spend time with family. This level of autonomy is difficult to achieve in a traditional, permanent role.

However, this flexibility can come with challenges. Locum tenens NPs are often required to travel frequently, which can be disruptive to personal and family life. The need to adapt to new clinical settings and teams also requires a high degree of resilience and adaptability. For some NPs, the constant change and lack of long-term stability may be a deterrent, while for others, it’s precisely this variety that makes locum tenens work appealing.

Locum tenens NPs often earn higher hourly rates than their permanently employed counterparts, making it an attractive option for those seeking to maximize their income. However, the lack of traditional benefits—such as health insurance, retirement plans, and paid time off—can be a significant drawback. Locum tenens NPs must often take responsibility for securing their own benefits, whether through private insurance or by setting up independent retirement accounts.

Healthcare organizations that rely on locum tenens NPs should be mindful of this trade-off and consider ways to support their temporary staff, such as offering stipends for health insurance or providing access to short-term housing. While these additional perks may increase the cost of hiring locum tenens NPs, they can also enhance job satisfaction and improve retention, particularly for longer-term assignments.

The role of locum tenens NPs is expected to continue growing in the coming years as healthcare systems grapple with persistent staffing shortages, rising patient demand, and evolving care delivery models. Several factors are driving this trend, including technological advancements, shifts in healthcare policy, and an increased focus on value-based care.

One of the most exciting developments in the locum tenens space is the growing role of telemedicine. Telehealth has expanded rapidly, especially in the wake of the COVID-19 pandemic, and locum tenens NPs are well-positioned to leverage this technology to provide care to patients in remote or underserved areas. The ability to practice telemedicine allows locum tenens NPs to deliver care across state lines (where permitted) and to work with multiple healthcare organizations without the need for extensive travel.

Telemedicine also enhances the ability of locum tenens NPs to provide continuity of care, even when their physical presence in a healthcare facility is temporary. By maintaining virtual follow-up appointments or consultations, NPs can continue to manage patient care beyond the duration of their assignment. This ability to bridge in-person and virtual care adds another layer of flexibility and value to the locum tenens model.

Ongoing changes in healthcare policy are also likely to impact the future of locum tenens NPs. As more states adopt full practice authority for NPs, the demand for locum tenens NPs with the ability to practice autonomously will increase. Additionally, federal policies related to Medicare and Medicaid reimbursement for NP services will continue to shape the utilization of locum tenens providers, particularly in rural and underserved areas.

The move toward value-based care, which focuses on improving patient outcomes while reducing costs, is another trend that will likely influence the role of locum tenens NPs. As healthcare organizations prioritize cost-effective care delivery, the ability of locum tenens NPs to provide high-quality care at a lower cost than physician counterparts will make them an attractive option for both short-term and long-term staffing solutions.

While the locum tenens model is most commonly associated with U.S. healthcare, there are opportunities for locum tenens NPs on a global scale. In countries with nationalized healthcare systems, such as the UK and Australia, the use of locum healthcare providers is common, particularly in rural or underserved regions. U.S.-based NPs who are licensed to practice internationally may find opportunities to work as locum tenens providers abroad, gaining valuable experience in diverse healthcare systems and settings.

Additionally, lessons from other countries may help inform the future of locum tenens staffing in the U.S. For example, in countries with centralized credentialing systems, locum tenens providers can be deployed more quickly and efficiently than in the U.S., where state-specific licensing requirements can create delays. By streamlining the licensing and credentialing process, the U.S. healthcare system could further optimize the use of locum tenens NPs and reduce administrative barriers to care.

Locum tenens Nurse Practitioners play an essential role in the modern healthcare landscape. Their ability to provide flexible, high-quality care in a variety of settings makes them an invaluable resource for healthcare organizations facing staffing shortages, fluctuating patient volumes, and the challenges of delivering care in rural or underserved areas. However, integrating locum tenens NPs into a healthcare system requires careful planning, attention to legal and regulatory requirements, and a focus on maintaining continuity of care.

As the healthcare industry continues to evolve, the demand for locum tenens NPs will only increase. Their versatility, adaptability, and ability to fill critical gaps in care delivery make them an indispensable part of the healthcare workforce, especially in the face of ongoing provider shortages and the growing need for patient-centered, value-based care.

Healthcare organizations that strategically incorporate locum tenens NPs into their staffing models will not only enhance their capacity to manage fluctuating demands but will also improve access to care for populations that might otherwise be underserved. The integration of locum tenens NPs is not a stop-gap measure; it is a long-term solution to a complex and evolving healthcare environment.

In reflecting on the role of locum tenens NPs, it’s clear that these professionals are not just filling temporary positions but are essential contributors to the sustainability and adaptability of our healthcare system. Their ability to provide high-quality, specialized care in diverse settings, combined with the flexibility to meet shifting patient and organizational needs, underscores their growing importance in the workforce.

While challenges such as multi-state licensing, integration into care teams, and balancing cost-effectiveness with quality remain, solutions are emerging as the healthcare sector continues to adapt to new realities. Whether through enhanced telemedicine platforms, streamlined credentialing processes, or innovative staffing models, the role of the locum tenens NP will likely expand further, offering even greater opportunities for both providers and healthcare systems.

For healthcare organizations, the question is not whether to use locum tenens NPs, but how to use them effectively. This requires forward-thinking workforce strategies, investments in technologies that support remote and flexible care delivery, and a commitment to integrating locum tenens providers into the broader care team. By building strong partnerships with locum tenens agencies, streamlining onboarding and credentialing processes, and fostering a collaborative culture that supports temporary staff, organizations can fully realize the benefits that locum tenens NPs offer.

Looking ahead, the locum tenens NP model will continue to be a key component of workforce management, ensuring that healthcare systems can deliver high-quality care to all patients, regardless of location or circumstance. By embracing this model, healthcare leaders can not only address current staffing challenges but also position their organizations for future success in a rapidly changing healthcare landscape.

At Collaborating Docs, we understand the critical role that NPs and PAs (Physician Assistants) play in today’s healthcare landscape, especially as the demand for flexible, skilled practitioners like locum tenens NPs continues to rise. As highlighted throughout this article, the ability for NPs to practice independently and adapt to various healthcare settings is invaluable to the delivery of high-quality patient care. However, gaining the practical experience and physician collaboration required for independent practice remains a significant challenge for many NPs and PAs.

That’s where Collaborating Docs comes in. Founded by Dr. Annie DePasquale, we focus on bridging this gap by connecting NPs and PAs with qualified collaborating physicians across the United States. Whether you’re an NP looking to explore opportunities in locum tenens work or aiming to establish a more permanent practice, we streamline the matching process, helping you find a collaborating physician within 14 days. We handle the legal aspects, from compliant agreements to malpractice insurance assistance, so you can focus on what truly matters—delivering exceptional patient care and advancing your career.

For healthcare organizations, we offer customized solutions to ensure that your NP and PA workforce is supported with the right collaborations, helping you integrate flexible staff like locum tenens NPs seamlessly into your team. Our extensive network and expertise allow us to match NPs and PAs with collaborating physicians across all specialties and state regulations.

If you’re ready to take the next step in your career as a Nurse Practitioner or Physician Assistant, or if your organization needs support in expanding its NP and PA workforce, Collaborating Docs is here to help. Let us remove the barriers to professional growth and provide you with the tools you need to succeed. Contact us today to find your perfect collaboration match and take control of your future in healthcare.