What to Expect on
Day One of a Locum
Tenens Assignment
The clinical work is what you already know. The building, the team, and the EMR are what you learn fast. Most clinicians work more deliberately on day one because they’re learning a new system, not practicing unfamiliar medicine. Expect the workflow to speed up quickly as the environment becomes familiar.
The Principle: Find the Person Who Knows the Place
In every clinical setting, one person on shift knows the operation better than anyone else there that day. Not the medical director, who knows the site strategically. The person who knows how today runs is whoever has been there longest, works across enough shifts to see patterns, and gets asked when something goes sideways.
A locum clinician who introduces themselves to that person in the first 30 minutes — names that they’re new to the site, asks where to direct workflow questions — moves their first-day capacity from 60% toward 80%. The person’s title varies by setting:
- Hospital department: The charge nurse on shift — in EDs, they hold the operational picture. In inpatient settings, they handle bed assignments, flow, and staffing.
- Outpatient clinic: The senior medical assistant or office manager — knows which patients are complex, where supplies are, which patients can flex in a tight schedule.
- Dental office: The senior hygienist, front-desk lead, or practice owner.
- Urgent care: The longest-tenured clinician on shift, the lead nurse, or the site manager.
- Surgical or procedural setting: The senior tech or OR coordinator.
Ask on arrival who that person is. The introduction takes two minutes.
Before You Walk In: Five Confirmations
Confirm these the night before or morning of day one:
Parking
Where, whether a pass is required, which lot
Entry
Which door at the time you arrive (many sites have separate clinician entrances)
Arrival time
Most sites want you 30–60 minutes before the first patient
First contact name
Who to ask for on arrival
Dress code + badge
What you wear, what the site provides (scrubs, badge, locker key)
Ask for the Supply Tour
Ask for a supply tour on day one rather than improvising. Where the IV kits live. Where the EKG machine is parked. Where the medication dispensing cabinet is. Where the controlled substances log lives. The tour takes ten minutes. The alternative is spending forty minutes during a busy stretch searching for something you need urgently.
EMR Triage — What Matters First
Day one in a new EMR runs uniformly slow. Focus on four functions before the workflow gets busy:
Log-in
Confirmed before the first shift. If credentials don't work, EMR support is the first call.
Basic order entry
How to place the common orders for your specialty.
Documentation template
Where to find the note template, how to sign and finalize.
Help line
The on-shift EMR support number.
Mastering the EMR on day one isn’t the goal. Performing these four functions without slowing patient care is.
Self-Introduction
In the first 30 minutes, introduce yourself to the people you’ll work with that day:
"I'm [Dr./your title] [name], [specialty]. I'm covering [today's shift / this week]. I'm new to this site — please flag anything I should know about how things run here."
Six sentences, repeated three or four times. This signals that you know you’re the new person, respect the site’s institutional knowledge, and are open to local guidance. That signal pays dividends throughout the shift.
The locum clinicians who struggle on day one usually try to figure everything out alone. The ones who do well introduce themselves widely, ask early, and let the site’s expertise do the heavy lifting on workflow while they bring their own clinical judgment.
Day One Roadmap
Arrive (30–60 min early)
Find your first contact
Request supply tour
Introduce yourself to 3–4 key team members
Log in to EMR, run test functions
First patient encounter
