umbdude

I wouldn't judge it based on one experience at one facility. I went into nursing specifically to work in psych. My psych rotation during my BSN was not good, but I already worked in an inpatient psych unit at a research hospital, so I knew that's the specialty for me. Other nurses not interacting with patients doesn't mean you have to do the same. Being awkward and not knowing what to say is not unusual for people new to the field. It's a skill that can be developed over time. Try to think about whether being a psych NP is really what you want to do. If it is, get a little work experience as a psych RN then proceed.

It doesn't hurt to apply, and you can always apply to different positions within the same hospital.

sadly this is not an exaggeration...heard this crap too many times and irritates the heck out of me. Most of them want the cheapest, easiest, most convenient program so they can continue working full-time (often not even in the same specialty) and never have to set foot into a class.

"DIY" education. Unfortunately, these days that is the norm rather than exception.

FNPs can specialize too (e.g. neuro, derm, onco, cards). When I had my shoulder surgery, my follow up appointments with my ortho NP were at least 20-30+ minutes. Also, many PMHNP jobs don't offer 30 min follow ups. Plenty of PMHNPs are required to see 20-30 patients per day. And as another poster pointed out, even 30-min follow ups with psych patients back to back can be draining. Ability to work remotely is not a guaranteed and most employers now require at least hybrid. Furthermore, although there are a lot of PMHNP jobs out there, most of them these days are junk and/or 1099 basis (I.e. zero benefits, income not guaranteed). I would seriously research your area first.

This job sounds pretty terrible (seriously, no pay raise?). Are there a lot of PMHNP jobs in your area? Are you able and willing to move? The southern region has the lowest pay, fewest opportunities, and most restrictive statues for PMHNPs. PMHNPs are paid more than FNPs (usually a lot more), so your pay should not be based on a new-grad FNP's pay. My suggestion is to interview as many places as possible to get an idea of what people will pay and have several offers in hand to negotiate. Talk with your professors and other local PMHNPs to see what's an appropriate salary.

Never heard of this but not surprised. The field is getting flooded with new grads and when practices know they can replace us quickly, they'll do what profit them most. 50/50 split is terrible if it's 1099 with zero benefit. If I were your wife I would start looking elsewhere. Good luck.

There are quite a few of those. One practice I worked at used practice fusion (separate from their EMR). Other ones I've heard of are office ally, MD toolbox, DrFirst etc.

So your total compensation is base salary and % of collection? If that's the case, it would be: $100k + (0.2*$500k) = $100k + $100k = $200k $500k total reimbursed is very high. How did you come up with that estimate?

I work for and interviewed a number of NP-owned practices. They're not much better. Hence I started my own. There's a ton of work and financial risks that come with starting a practice, then the op expenses pile up as it grows. These aren't shared by employees or 1099s. So unless the employee or contractor is bringing in their own full panel from day 1, I wouldn't compensate them much more than market rate.

I don't see how administering and monitoring ketamine and esketamine tx are in PMHNP's wheelhouse. I absolutely would not feel comfortable being the one monitoring patients undergoing this type of anesthetic unless I have some years of doing cardiac resuscitations. For this reason, the ketamine clinics I see that are owned by non-physicians are owned by CRNAs. I had seen several jobs posted by ketamine clinics doing these "monitoring," and they were hiring ACNP. Where I see PMHNPs come into play is doing screening, referring, and following up to assess efficacy. I would be cautious and thoroughly learn the protocols when deciding whether it is an appropriate role for PMHNP.

I hear ya. Love the specialty (I've been a PMHNP for 2+ years), but the constant back-to-back patient interactions can be pretty tiring. I do find part-time tolerable, but full time work would not. I think there are options...teaching, insurance companies, and perhaps pharma (either sales or medical science liaison). If financially feasible, you can even try something else totally outside of the field.

I'm glad OP is speaking out in details. It's important to point out what these schools are like. Essentially, these programs are handing out degrees without providing any added educational value.

Having access doesn't mean you have permission to search anyone you want. You need consent permission to view an individual's private medical record.

I don't know about legality, but certainly should never view someone's medical record without consent unless you're caring for that person as a provider. Again, most likely HIPAA violation.

Highly unethical and a HIPAA violation.

Don't have much knowledge about this but I would just consider the benefits since the VA supposedly have superior benefits (vacation, low healthcare premium etc.) compared to other organizations.

If you're a permanent resident of Montana and only visiting VA couple months a year, and you're exclusively seeing patients in Montana while you're physically in VA, my belief is that you do not need to be licensed in VA. The regulations in VA doesn't apply since VA board of nursing has no jurisdiction over Montana residents. I would check with the Montana BON about whether you need to be licensed in VA to practice telehealth while you're physically in VA (any cross-state licensing requirements), although https://www.cchpca.org/ doesn't have anything specific about it, meaning that most likely there is no such requirement.

Not sure about my panel size but anywhere between 8-14 patients a day at one job and the other I'm just starting so fewer. I provide 1-hour intake and 30-min follow ups. Outpatient setting isn't homogenous so it's highly dependent on where you work (some employers want you to see 3-4 patients an hour). I don't spend a lot of time (if any) charting after work, but I'm responsible for clinical questions or problems or refills. Admin tasks again depends on where you work. I know PMHNPs who are constantly having to respond to patients, other prescribers, and therapists. It can get hectic.

I've found ziprecruiter to be more accurate in my area (northeast). Actual comp depends on where you work (outpatient could be FQHC or private practice), psychiatry experience, and negotiation. $200k revenue or net income? Big difference there. Most likely a startup will take quite a while to get to that point and dependent on many factors.

Join FB small business group. A lot of good info.

Most PMHNP review courses have test banks that you can purchase or subscribe to. Board vitals provides good rationales but very expensive (~$300 for 6 months) and doesn't really match ANCC question styles. I would pre-read Stahl's psychopharm and DSM before your psych courses. For many, these texts really require several re-reads to sink in. Good luck!

You'll be starting your PMHNP program or starting to prep for ANCC board? If you haven't started your PMHNP program, it's way too early to study for the boards. If you're going to a decent program and you study well, you probably don't need much review for the ANCC exam anyway.

There isn't a UWorld-equivalent. The ANCC board exam is nothing like the NCLEX and there isn't any good exam prep. The ANCC question bank (the one with ~100 questions) is the closest to the questioning style in the ANCC board but because there're only 100 questions, it's not a good source for review. The purple book and class notes should suffice for review. I also used Boardvitals, which is close to UWorld in terms of difficulty and it's a great learning tool for yourself, but it's not very useful for the ANCC exam prep because the questions are nothing like those on the exam.

Ultimately you would need to speak with these companies individually to ask about supervision and training. In my experience, the large, fully-remote, telepsych companies that popped up during covid are not places new grads should go to (most don't hire new grads, and if they do it's because they're desperate). These places are profit driven and clinicians are either paid only when they see patients or hourly. Most NPs and MDs simply aren't going to train someone brand new if it takes up time that they can use to see patients. There are some private practices that might be willing to train new grads (and many PPs are still doing telehealth). In my experience, PPs are also profit driven and do not provide a great deal of training. In my area, the best places for new grads is definitely FQHCs and/or CMHs.