NPvampire

Chuckle yes I’m metro Atlanta. I wish it were Miami! We have had literally ten people quit in the past year, and countless clerical, nursing, counseling, and other positions quit. Admin doesn’t care. Our nps went to travel RN, do Botox or mlm stuff, retire forever, or leave the profession…they’re not even staying nps. An extremely nasty entitled student I had last year was the final straw. I’m really tired. At this point I’m eyeballing remote work for another state. And yes, for some reason Georgia lets everyone into psych specialty programs with zero psych experience. I mean zero. Sometimes not even any real RN nursing experience. Can you imagine a cardiac program accepting like that?! It doesn’t produce good results and it’s not helping patient outcomes. And most hate psych and leave anyway. I try to stay positive but it’s been a really rough year. ?

Wow….I get 20 min fups, 30 min transfers and 60 min new evals. And we’re still getting lectures about being productive. We also have a huge substance abuse comorbidity population and I’m coming home crying or screaming or both in the car most days. I’m at year 10 and exhausted. If I had money I’d leave the profession.

Wow I would love to know where everyone gets these salaries that isn't coastal California. I'm pmhnp who was in psych 6 years before going to grad school. I'm in the deep south, and suburban to the largest city in the south. After 9 years of NP, I make a piddling 110 a year with no paid CE, no licensing/certification pay, and 2 weeks vacation. And before someone starts in about well, your house cost....nope. Houses in real school districts are now 400-700 thousand and that's for 30 to 40 year old garbage with leaking polybutene pipes. New build is already presold for 350 studio to 950 thousands family house. But hey, I guess we have reasonable taxes and you can own whatever guns you want pretty much. We also don't have ice or snow to deal with. And the movie industry is here now too if you want to get into that life. This state flooded the market with lazy, dumb, shiftless NP grads and they have depressed the salaries to nothing. ? I wish I were kidding but we just hired someone I KNOW failed anatomy 3x back in pre-nursing classes. And it's not just online programs. The state U chooses poorly too. As soon as my spouse finally retires in six, we're leaving!!

Wow. People are talking about NP residencies only paying 80k per year. Where y'all live-- cause I've been working for 7 years in PHMNP in public health no less and it took 7 years to get above 80k. My initial hire salary was 30 per hour and that was without benefits. They offered 25 for FTE. our LPNs are hired at 10 per hour. The market is oversaturated here, no unions, and we are not an autonomous state , bad combo. I'd move tomorrow but family won't go. And don't you have to be fluent in Spanish to get a job in California? Or Arizona?

Wooow. Thank you. Yes, I have been eyeballing New Mexico and AZ for years, in fact, I am attempting to learn Spanish to be more marketable. But unfortunately my family won't move at this stage. My hope is to do telemedicine to AZ in 3 years or so, or whenever I become much more fluent. In my current state, which lacks AP, we can bill 80% of Medicare that an MD would bill (that's national of course) and about 67% for our current state Medicaid MD reimbursement, which is still equal to roughly 80% of medicare as our state pays more money for Medicaid services than medicare. None of the NPs on my staff make anything even close to either of those figures. :( We're mostly salary and scheduled 20-30 patients per day or equivalent. If I were part-time I'd get a whole $3 per hour more, who HOOoo! (That doesn't help--our state health exchange / market is worthless and our state law does not mandate part-time benefits). Our state board of nursing and composite medical board also allow NPs to work outside of their specialty in psychiatry as long as contracted with an MD as long as blah blah blah ..meaning we compete for jobs with every FNP that the schools are pumping out, too. They never stay, and I can't imagine how they're billing medicare/medicaid, but it lowers the salary market for our specialty. Not only is it not an AP state, it is a very unfriendly labor state to any type of work. *sigh*. Not only that but the climate is misery 10 months of the year; I'm not a heat-lover. Or mosquito-lover. But hey, it never snows. I hate it. I love what I do in general but am tired. My spouse retires in 10 years and then we are LEAVING this swamp, telemedicine aside!

In Georgia we can only prescribe c3-5. And our salaries suck. Hour per hour I make as much as a teacher with the same exp, degree, etc. This is outside ATL yes.

Da#n I work in suburban ATL and I don't make that after seven years. I am so ready to move.....

Ah, don't go into psychiatry for the money. It won't last. And in my state--which has NO autonomy at all-- it's taken me seven YEARS to get to my piddly salary that barely grazes 100. To put it in another perspective, a teacher with the same number of years experience and the same degree makes just as much per hour here. The cost of living isn't cheap either. Where are y'all making 170?!!!!

Starting a business depends on your state's autonomy, too. Here, you can't start your own business to work independently, nor can you just pay a doctor to oversee your charts. The doctor has to be the owner of record of the business and "invite you" to work for them. Not surprisingly, our salaries are low on the average here.

Ugh, guys, I'm turning green! I'm psych NP with 5 years NP and 11 years total nursing. I am so ready to move to AZ!!! Our state is one of the worst in the union for autonomy and the pay shows it bigtime. We also have no union to defend us or save our sorry benefits or rights. 80% of a doctor's pay? Yeah, right, try 1/3 of the lowest, newest, part-time MD on our staff. If it weren't for family, I'd be out there looking at my own cactus garden right this minute! :)

It depends on your specialty, and your state. In my state, we have very restricted NP practice. I have had offers ranging from $30 hour W2 no benefits!! to $65 after 5 years experience and that is 1099/contract labor. And everything in between. To put it in perspective, RN with the VA top 100k plus in our state and I used to make $42 hour on evening weekends (w2 no benefits) at a large urban hospital - that was 7 years ago. This is in mental health - dermatology, cardiology, endocrinology, ENT, bigger money by far. Now states with autonomy...one of our gals just left to earn 150k a year for part-time work no insurance but w other benefits, status W2. I have seen many similar offers say, on "indeed" and other sites. I'm not talking about the bay, NYC, etc where you will spend all of your money on housing and taxes, but other states, even rural areas. See where you think you want to live, or how flexible you can be, and then see what the average salary and level of autonomy is. Higher that is, higher your pay will be, generally. See what your family goals are - I got tired of being gone every weekend and holiday once the kids were in school. It was lonely and discouraging, one reason I chose to go back to grad school and do outpatient work.

I wanted to add - the type of DEA that you can get by working for your state/public health, etc (the "free" one) cannot be used in any other setting or employer, same state or not.

I've been in psych for 11 years now, going strong. #1 if you've ever read harry potter, "constant vigilance!" Never forget where you are or why the patients are there. They did not get to the hospital by an accident. They are there because they have a history of instability or violence to themselves or others. Do not assume because they talk sweetly or are intelligent, and so on that they will not beat/mess you up. It is like jail in some ways. #2 Avoid power struggles. The old saying - don't wrestle with a pig, you both get dirty but the pig likes it? Yeah, that applies to psych too, especially the axis 2 population. You will never win and it will only get ugly - 90% of violence I have seen was due to a power struggle that could have been much avoided. Know and use your hospital policies and stand by them. #3 pick your battles. You will learn when to intervene and when to let things go. I have also seen the worst violence start over trivial things that were not a threat that staff felt required that level of failed intervention. For example, consumer has a plastic paper clip and threatens to kill himself. He weighs 100 pounds and is a foot taller and 10 years younger than the fittest staff you have on hand that day. The staff attempted to rassle it away, and ended up with 3 grown men in hospital and woman with permanent kidney damage. Patient didn't get a scratch. He also didn't kill himself. That wasn't worth the threat. Now, second case, patient goes into seclusion and ties her clothing around her neck and is turning blue. That is where you will have to intervene, the threat is real, even if she went into seclusion for an attack on staff. #4 As in any nursing job, take care of yourself, and do not allow the employer to work you to death/like a dog!

I'm like that also, shy, and tend to isolate. Our pre-nursing orientation blabbed about how what great friends we'd become, solidarity. Right. I would not have been surprised to see one slit another's throat in the parking lot to get ahead. Backstabbing, gossip, cliques, cheating, attacking teachers (figuratively) on and on. Bodes poorly for our profession sometimes.

We had this problem at our school too - students would get the questions from the class before them and use them any way they saw fit. One of our worst cheaters is now a CRNA; I'm sure she cheated through grad school too. Scary to think of those people putting you to sleep, caring for you, difference between life and death. Sometimes the school will crack down, sometimes the school just gives up due to the huge legal mess of expelling a student. Our school choose to do the latter.

I was married and became pregnant my final semester of nursing school. I would STRONGLY vote to wait until done with clinical and possibly school, maybe even a year of nursing work. I didn't see your age, but "waiting" more was not an option for us - we were approaching that age where eggs go bad. If I had been twenty-something I would have waited. Not only was I constantly sick during clinical, and exposed to gross things galore, I couldn't get a job out of nursing school either. You try to "hide" the pregnancy, they will still find out in pre-employment stupid health screening and fire you. You admit to it, you may not be hired. I know, federal law protects, blah blah. But they will phrase it as something else to get rid of you. Even if you get a job, many residency RN programs /training make you work for them 1-2 years to pay it back and you might not have enough time with them to be protected by FMLA when you have baby; you may be forced to repay thousands in "training costs." Finally, nursing school is an incredible endeavor of hard work and long hours and balancing that with a new, first baby - I can't imagine. You also can't predict how you will recover from the birth, etc. IMO wait until done with school and a year of work as an RN. If your age reasonably permits.

Yeah, my spouse did this too. Actually he stalled around, and refused to get a job, delaying my entrance to nursing school. Then his family started in, I should have gotten a job, any job, so that he could pursue his art degree prospects. Right. Then more family started in, why didn't I continue my last career of tech during the biggest recession since the 1930s? Surely my job didn't really go to China! (yeah, I assure you, it did.) Applied for jobs for a year unsuccessfully to appease their moaning and whining. deadpan evil eye look. We rued that later, a whole year of lost income and experience. When I began school and all he did was complain. Then it went to me not "working hard enough" after I go my RN. blah blah, always something. Then went to grad school, tired of bedside, tired of the asylums closing and no more job. He still c/o constantly and made me do my schoolwork after he went to bed, so to not interrupt his life. GRRRR. Rough years, and sure, we needed counseling, still do, but eventually he came to terms with it and can't imagine living without my income now. You need to do what is right for YOU and your children, the spouse may not always be around for a number of reasons. When I was between RN And grad school, my spouse finally got off his tush and went back to school online part-time. The tag-youre-it school relay didn't hurt anything. You're ready to enroll. He's not. You go first.

I went to RN school with the hopes of NEVER going to any more school as long as I lived. Family demands of time and hours led to my advanced practice. Getting up or home for those "12s" in a hospital setting at 4 am or 3 am respectively, working every holiday ...not conducive much to family life. I was an RN for 6 years before my MSN and I even worked some as an RN after my grad degree and licensure - certain settings the money was equal for years or was easy to squeeze in a shift here or there. But I notice a lot of my classmates and students that I precept now, in psychiatry, have never worked in psychiatry before. How can an APRN program (and I've seen online AND B&M) admit for a specialty you have never even worked in!? I think a lot of young'uns are in for a rude shock when they hit the APRN and it's not all scrooge-mcduck money pits and doctor status and an easy life. I work harder in an office than I ever did at the hospital - including the asylum. And the docs, at least in my restricted state, treat us like garbage and we earn peanuts compared to what we can bill medicare/medicaid. Most experienced RN in a hospital make more than I do, too. Think about why you want to be an APRN ,the cost of the education, and consider what state you plan to reside in also. And the only reason I left my RN employer when I became an APRN is because they told me "we don't have room to hire you." Well, ok, see you.

I did PMHNP not FNP and the classes were reasonable, sustainable workloads, IMO. I had toddlers, worked baylor, and did it okay. I am not one with a ton of bounding energy. However - if you are the online type of program, they (at least used to) make you find your own clinicals. their idea of "helping" which they pitch so hard in the beginning, they will assist, blah blah.....was telling me to look in the yellow pages. Even going to live in Ohio and using their brick&mortar preceptors was declined. "Those are for our live students." Start looking for a preceptor YESTERDAY! Start the paperwork for the chosen ONES (pick more than one person in case an emergency arises) and at least 6 months ahead of the first clinical class. If the school decides that your preceptor is just a contract (2-3 days approval) or a lengthy, lawyer-ridden "agreement" that can take 6 or more months. It is not easy to find a preceptor on your own. I was working 3 RN jobs and on good terms with old ones. I had made probably a hundred inquiries of failure and was in the process of meeting military recruiters just to get a preceptor, when I finally found an angel to do mine. Do not assume your current job will allow you to precept either, I made that mistake as well. The doctors who were so friendly in work basically told me where to go when I suggested following them. I even tried to offer compensation, still NADA. In spite of the clinicals drama, and the price of the education, I am glad that I did it through them and online. B&M school in our state was one program 3 hours away one way and that wasn't happening, ever, at all.

I graduated in 2012 and my offers ranged from $30 hour part-time W2 but no benefits to $55 hour contract work 1099's. Full time with benefits seems to run maybe 80 grand/year/40 hour weeks +/- 10% right out of school in today's time. Many places won't count your RN experience. I do know someone with experience, an NP about 12 years worth, who works inside the prison system in Florida for $145 a year with benefits. Depends on your specialty too - endocrinology, dermatology, ENT, etc is much more money than the public health family practice.

I also suggest the blood test. The results are done when they're done and don't require some subjective glance or measuring or prodding to interpret. The test itself is harmless, blood draw any time of day. Finding a lab to do it...that is a bit more tricky, they have to have a special test kit just for the test on hand and it has to reach a certain lab in a certain timeframe or results can come back invalid. I've done these for 6 years now because I don't do PPD anymore - mild allergy to something in the serum, probably the preservatives, that confuses the interpreter of the test anyway.

Yeah, I did the ignore, remain silent, "brush it off," until they decided to bring their 'complaints' to HR and I was given the writing on the wall. Their complaints were that "I had allergies," "Jesus had told her I was evil," and "I had talked to her about her dress code." The last one, yes, I did, she was going BAREFOOT in a nursing station on a psych ward. Um, yeah. The other complaints were ludicrous. Some people are just nasty and there seems to be a lot of that in nursing. As it was "suggested" to me, I left the job quickly and got a much better one to boot. My advice - if brought in front of HR, bring a tape recorder.

I've done it, and liked it fairly enough, but I stopped doing it all the time due to money and computer paperwork necessary eating my time up. I felt like I was working for $10 per hour when it was said and done. But the hours are much better than hospital. Also it can get creepy sometimes if you are alone with a psychotic or intoxicated patient.

Yes, get experience first, even if it's just PRN. You may love or hate it depending on your actual working experience--which is usually more dramatic than the protected student clinicals.