Match the role to your actual practice
Your established practice is the starting point when considering locum tenens for nurse practitioners and physician assistants. Begin with the patients you would see and the responsibilities you would hold. Have the clinical leader describe an ordinary day in the proposed assignment. Compare that description with the work you currently perform independently and the work for which you seek consultation.
For an NP, review the destination nursing board’s requirements for your role and population focus. Texas illustrates why that check matters: its board ties APRN practice to the licensed role and population focus as well as the clinician’s individual knowledge and competence1. Treat that as Texas guidance, then check the actual destination. A job title alone leaves too much of the assignment undefined.
For a PA, take the proposed duties to the destination’s medical or PA board requirements and compare them with your experience. Discuss procedures and patient groups that would be new to you. Keep a clear distinction between work you are ready to undertake and work that requires further preparation. The first assignment should let you assess locums itself without quietly adding an unplanned change of specialty to the experiment.
A job title alone leaves too much of the assignment undefined.
Make collaboration usable on the day
Establish which collaboration or supervision arrangements apply to your profession in the destination state. Ask the practice to explain how its arrangement meets those requirements and who is responsible for maintaining it. Resolve a legal uncertainty with the relevant board. Keep the written arrangement and the day-to-day consultation process in the same conversation.
Find out who is available when you need a clinical discussion and how you reach that person during your assigned hours. Ask what happens when the usual collaborating physician or supervisor is away. If your role includes evenings, test your understanding against an evening rather than only a weekday clinic session. The arrangement needs to make sense during the hours you will actually work.
Discuss how the practice handles a concern about the limits of the assignment. Explain the point at which you would want another clinician involved and ask how that fits its usual process. Where you have questions about responsibility for follow-up, work through them before the first clinic day. You should be able to describe the consultation route plainly, including the alternative when your first contact is unavailable.
Look at the panel behind the schedule
Request an anonymized example of the clinic or service schedule. Ask about the balance of new and established patients, the expected visit lengths, and work that falls outside the booked appointments. Find out whether you are covering a particular clinician’s panel or a broader service. Those details will give you a more useful picture than a patient count on its own.
Discuss how the practice handles results and messages during the assignment. Establish who takes over outstanding items when you are away and at the end of the contract. Include any inpatient work or call in the same review if it forms part of the role. The facility controls patient volume and scheduling, so get a clear description without treating the initial conversation as a guarantee that each day will be identical.
Ask how the opening days are arranged for a clinician learning the local EHR. Request time to understand the workflows you will use and the route for technical help. Compare the planned start with the clinical responsibilities expected immediately afterward. If the first day combines several unfamiliar duties, discuss how the practice will make that transition workable before agreeing that the proposed arrangement fits.
Build locum dates around your state license
Check the licensure route before treating a proposed start date as settled. Ask the relevant board what is required in your circumstances and track the application against its current instructions. Leave room for questions that need a board response. A schedule opening and an approved license are separate milestones in your planning.
PAs should take particular care with compact headlines. The PA Compact’s August 28, 2026 update reports that no states were actively issuing compact privileges and describes early 2027 issuance as projected2. Use that update to avoid assuming that a state joining the compact provides an immediate route to work. Recheck the commission and destination board for any subsequent operational announcement.
Once the licensing route is clear, bring the proposed dates back to the clinical discussion. Confirm the assignment’s scope and support arrangements together, including the final day and responsibility for unfinished follow-up. Choose a start that allows the practice to provide the orientation you have discussed. Your next step is to request a written role description and compare it with your current practice before reserving the first block of dates.
