PMHNP

myoglobin, ASN, BSN, MSN · Jan 16, 2020

Also, one of the potential "downsides" of ARNP is that you may end up working "six on and six off" that is the way all of the PA's who work for the Trauma team at my hospital have to work (we do not currently use ARNP's in our hospital). To me that would be a nightmare considering the never ending stream of procedures that they must perform ranging from central lines to assisting the MD in surgery (and most of the trauma MD's are pretty far towards the type A personality style).

myoglobin, ASN, BSN, MSN · Jan 16, 2020

I can do 12 hour shifts as a PMHNP in Wash. working outpatient since my primary job is staffed from 0800 until 2030. The problem is that I used up my savings and credit in school so I’m working seven days per week between three jobs. Plus they all pay a flat 70% so I don’t get paid until the insurance pays. Thus, I’m likely to earn 300k this year, but have to sleep in my minivan and shower at Anytime fitness. At least I’ve gotten my alternate day fasting up to only eating once every 48 hours (sadly Seattle doesn’t have cheap buffets where I can gorge every two days).

Flightmed123 · Jan 16, 2020

Interesting... sounds like you have a plan. Best of luck and Thanks for insight ?

umbdude, MSN, APRN · Jan 17, 2020

On 1/16/2020 at 12:16 AM, FullGlass said:
Don't quote me on that! ? But do some research on hours for inpatient jobs.

Inpatient psych attendings (PMHNPs or psychiatrists) don't work "shift" hours. The number of hours vary from 2 to 8 hours daily depending on the person, but they usually have to show their faces to patients Mon-Fri. The only setting I can think of that requires shifts is psych emergency.

Flightmed123 · Jan 17, 2020

Any good use of doing a dual concentration to battle the hours or be more marketable? If so, do you all suggest FNP/PM

Flightmed123 · Jan 17, 2020

Cont. -HNP or AGACNP. Some say dual is a waist but I’m pondering work life balance now. What could you do with these combinations as well?Suggestions?

myoglobin, ASN, BSN, MSN · Jan 17, 2020

I think that FNP and Psych are a good combination in states with IP practice since you could efficiently run an integrated care clinic that offered both medical and psych management.

FullGlass, BSN, MSN, NP · Jan 17, 2020

8 hours ago, Flightmed123 said:
Cont. -HNP or AGACNP. Some say dual is a waist but I’m pondering work life balance now. What could you do with these combinations as well?Suggestions?

If you are PMHNP you will be expected to work full time in psych. If you want to do psych, then get the PMHNP. You can add the FNP cert later if you want.

myoglobin, ASN, BSN, MSN · Jan 17, 2020

I was thinking of a scenario where you aspire to "own" a clinic in an IP state. It would be a theoretical advantage to be able to manage all of your client's needs (both medical and psych) at the same location. This would be facilitated (in part) by having both certifications. Such integrated, holistic care could have advantages for both clients and providers. Of course once you have the ANCC psych certification (or FNP certification) the question become whether it makes sense to go back to school at all or if one does go back to school whether to pursue an FNP post masters (to sit for the FNP ANCC exam) or to simply get a DNP and stay pure psych. Alternatively, since I am 50 I might start a PhD with the goal of transitioning to "teaching" as an adjunct professor around the age of 65 or 70 as a form of "semi" retirement.

FullGlass, BSN, MSN, NP · Jan 19, 2020

On 1/17/2020 at 2:06 PM, myoglobin said:
I was thinking of a scenario where you aspire to "own" a clinic in an IP state. It would be a theoretical advantage to be able to manage all of your client's needs (both medical and psych) at the same location. This would be facilitated (in part) by having both certifications. Such integrated, holistic care could have advantages for both clients and providers. Of course once you have the ANCC psych certification (or FNP certification) the question become whether it makes sense to go back to school at all or if one does go back to school whether to pursue an FNP post masters (to sit for the FNP ANCC exam) or to simply get a DNP and stay pure psych. Alternatively, since I am 50 I might start a PhD with the goal of transitioning to "teaching" as an adjunct professor around the age of 65 or 70 as a form of "semi" retirement.

While an interesting idea, there are some issues with trying to do both psych and primary care, especially in independent practice. First, psych pays more than primary care. From a financial perspective, this isn't the way to maximize earnings (doing both). Second, opening up a primary care practice costs a lot of money. One needs suitable office space, equipment, furnishings, and staff. In contrast, all that is needed to open a psych practice is an office and standard furniture. A lot of mental health providers don't even need any staff. Third, there are already plenty of clinics that provide primay care, psych, dentistry, and other services in one location.

umbdude, MSN, APRN · Jan 19, 2020

There are some psych settings where having FNP/AGNP is beneficial (e.g., a facility with little to no internal med support), but overall I don't think it's worth the time/money to get, and then maintain, an additional cert if your main interest is to practice psych.

Flightmed123 · Jan 19, 2020

Great advice!