BSN to PMHNP for better financial stability?

FullGlass, BSN, MSN, NP · Jul 22

Only you can decide if it is worth it to become an NP. Your child's age is not a factor. If you plan to move to CA and work as an RN here, just be aware that CA RNs are paid the highest in the nation, up to $200K a year or more, even for permanent employees with benefits. That means that becoming an NP will likely not increase your pay and you would make less than an experienced RN for a few years.

If you are interested in becoming a PMHNP, you can get your BSN and go straight through to become a PMHNP (without working as an RN). It doesn't matter what people on this forum say, unless you want to be an acute care NP, working as an RN is not necessary or beneficial. Search on my name for a mini review I posted on this topic.

As you complete your RN rotations, think long and hard about whether you want to be a provider. These are very different roles. As a provider, you will be responsible for assessing, diagnosing, and develping treatment plans. RNs carry out orders. A lot of RNs who became NPs have posted here that they are unhappy in their new roles.

Personally, if you really want to be an NP, I strongly urge you to get an FNP. The experience you will gain in primary care will be invaluable in treating mental health outpatients. You can then get a post-master's PMHNP. I started out in primary care and am very glad I did.

FNP is the most versatile NP degree with the most job opportunities. Pay for FNPs is increasing markedly, at least in areas with a shortage of primary care providers.

The PMHNP role offers the most flexibility as there are many telehealth jobs available, as well as part-time jobs.

Best wishes

Advanced Practice Columnist / Guide · Jul 23

OP won't start at 200K a year even in highest paying hospitals in California as a new grad. UCSF pays the highest in all the UC system and RN's start at $80.76 per hour working 36 hours a week which translates to around $151K annually. RN's do quickly go to $94.27 per hour with 3.5 years of experience.

wage tables

FullGlass, BSN, MSN, NP · Jul 23

Corey Narry said:

OP won't start at 200K a year even in highest paying hospitals in California as a new grad. UCSF pays the highest in all the UC system and RN's start at $80.76 per hour working 36 hours a week which translates to around $151K annually. RN's do quickly go to $94.27 per hour with 3.5 years of experience.

wage tables

I'm not saying they will start at 200K per year. NPs don't either. But they can get up to that with a few years experience. I am in charge of recruiting for my employer and I see RNs who are making over $200K per year as employees with benefits for various employers in the Bay Area and Sacramento area. I even checked the public wage information for their employers and they were truthful. I've seen perm employee RN pay as high as $115 per hour.

Starting pay for FNPs is now generally $120K to $130K in CA. In areas with shortages they may pay higher and often will offer a sign on bonus and relocation assistance. But that is only in areas with shortages which are usually inland, not on the coast. They should be making $140 to $150K per year within a few years. Some NP specialties, like pain mgt or PMHNP pay more. I have 4 years experience as a PMHNP and am making $105 per hour as a perm employee.

So if a CA RN has 5 years experience and lives in the Bay Area, let's say they are making $190K per year (a lot make more than that). They complete their PMHNP and are interviewing for their first PMHNP job. They are NOT going to get paid $190K per year to start. They will take a pay cut of $10 to 40K per year to start. However, that should increase quickly with good performance.

Daddie O, BSN, RN · Jul 25

I disagree with the above response, suggesting that working as an RN is not necessary or beneficial. The experience you gain working as a psych RN is invaluable. Seeing how different mental health issues present, recognizing comorbidities, learning and honing therapeutic communication techniques, and becoming familiar with psychotropic medications will all help you in your future PMHNP education and practice.

I also disagree with the advice to go to FNP first. The pay differential between FNP and PMHNP is vast. In California, FNPs get paid less than acute bedside nurses fresh out of BSN school. In a PMHNP program, you will learn advanced health assessment and pharmacology before moving on to psych-specific assessments and pharmacology. Whether FNP or PMHNP, job opportunities abound. PMHNPs get paid nearly double what a FNP gets paid. Psychiatrists get paid more than general family practitioners as well. As a PMHNP, you will be headhunted.

dln0616 · Jul 25

Daddie O said:

I disagree with the above response, suggesting that working as an RN is not necessary or beneficial. The experience you gain working as a psych RN is invaluable. Seeing how different mental health issues present, recognizing comorbidities, learning and honing therapeutic communication techniques, and becoming familiar with psychotropic medications will all help you in your future PMHNP education and practice.

I also disagree with the advice to go to FNP first. The pay differential between FNP and PMHNP is vast. In California, FNPs get paid less than acute bedside nurses fresh out of BSN school. In a PMHNP program, you will learn advanced health assessment and pharmacology before moving on to psych-specific assessments and pharmacology. Whether FNP or PMHNP, job opportunities abound. PMHNPs get paid nearly double what a FNP gets paid. Psychiatrists get paid more than general family practitioners as well. As a PMHNP, you will be headhunted.

I hear conflicting opinions regarding the demand for PMHNP. Some were saying the field is over saturated & that it's becoming a "trend"? I think I'd definitely skip over the FNP portion personally. & certainly I'd be working in psych while in school- I love the specialty & am not sure what else I would be doing as a nurse if it's not psych.

FullGlass, BSN, MSN, NP · Jul 25

Daddie O said:

I disagree with the above response, suggesting that working as an RN is not necessary or beneficial. The experience you gain working as a psych RN is invaluable. Seeing how different mental health issues present, recognizing comorbidities, learning and honing therapeutic communication techniques, and becoming familiar with psychotropic medications will all help you in your future PMHNP education and practice.

I also disagree with the advice to go to FNP first. The pay differential between FNP and PMHNP is vast. In California, FNPs get paid less than acute bedside nurses fresh out of BSN school. In a PMHNP program, you will learn advanced health assessment and pharmacology before moving on to psych-specific assessments and pharmacology. Whether FNP or PMHNP, job opportunities abound. PMHNPs get paid nearly double what a FNP gets paid. Psychiatrists get paid more than general family practitioners as well. As a PMHNP, you will be headhunted.

dln0616 said:

I hear conflicting opinions regarding the demand for PMHNP. Some were saying the field is over saturated & that it's becoming a "trend"? I think I'd definitely skip over the FNP portion personally. & certainly I'd be working in psych while in school- I love the specialty & am not sure what else I would be doing as a nurse if it's not psych.

The PMHNP field is oversaturated now. Crappy for-profit schools are churning out subpar PMHNPs. There are fewer PMHNP jobs than FNP jobs, so it is not that easy to get a PMHNP job.

Whether you agree with me on working as an RN first is irrelevant. I wrote a mini-review based on actual EVIDENCE. As NPs, we practice EVIDENCE-based medicine.

If you want relevant experience, go for the FNP, work in primary care for a couple of years and also work on the post-master's PMHNP while working. Do you know who provides most psych care in the US? PCPs do. An FNP or AGPCNP will be treating less severe cases of mental health issues such as depression, anxiety, and insomnia. That will be far more valuable than working as an RN. NP experience trumps RN experience.

I have posted elsewhere about FNP jobs now paying a lot. There are places in CA that will start new grad FNPs up to 160K per year, with an additional sign on bonus, with relo assistance, even mortgage subsidies, and student loan repayment. Frankly, I have yet to see such offers for new grad PMHNPs.

I also find it odd that someone who isn't even an NP would think they know more than me about the best route to becoming an NP.