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harmonizer's Latest Activity

  1. harmonizer

    New Grad FNP. Work in FL or AZ?

    Family is important. But if you are talking solely about job aspect and pay and autonomy, Arizona is generally better. If you are young and feel like wanting to explore and meet new people, go to Arizona. Don't know can't decide for you. One thing to remember about AZ, there is income tax in AZ 4.5% and sale tax can be quite high in some area like 8%! However, cost of living is not that high... just want to add to your calculation
  2. harmonizer

    NP Pay

    I would say jump the offer if you are not satisfied with the pay. First, unless the benefits and PTOs are great, it is better to start high because you can use your salary to negotiate for next job for even higher pay. Secondly, you do not know how long you would be stuck with your first low-paying job as a new grad just to get experience. You may end up liking the place and not wanting to move. I had this problem. I moved across the state to accept a job that paid better but I did not realize that I was underpaid by 15k or more. It was a great place to start with great working environment but I was stuck with that low pay for more than a year before I can move on. I regret that I did not negotiate and counteroffer at the time. I think you are worth more than you think as a new grad. Lastly, you do not know the demand/supply in the future. It might be harder to move between jobs even after obtaining experiences at your first job..
  3. harmonizer

    NP Pay

    I really think the cause of low pay is multifactorial.” The supply and demand does not explain everything. There are other health professions where supply and demand are quite in equilibrium but the pay is still pretty decent. The example are pharmacy and psychology. Well.. I guess they have more student loan so they are more adamant in demanding higher salary. One of the issue with us is the lack of negotiation and willingness to accept low pay and the fact that we all come from lower paying scale RN job does not help. Many new grad NP already feels grateful with 10k or 20k more for salary as a provider but they did not consider the added responsibility, stress, and the percentage comparison with MD pay. For example, in my specialty, there is still” demand in my area but the full-time salary is still staggering at low 100k-120k. Some private practices pay more but with poor benefits. One of my colleague told me I should settle down for salary job of $110 because of benefits and stability bla.. bla.. bla.. I am tired of hearing the similar comments. The number did not add up to the difference of 70k difference with my current contract even with insurance, PTO, retirement and etc. I am giving up on finding a decent salary job and continue to accept the instability as a contractor. Some places still give you like 2 week PTO with salary. Even with contract job, we are still making only 60% of MD contractor counterpart. I want to move to Southwest or Northwest in the future for better pay but I like where I am living now.
  4. harmonizer

    NP Salaries/Location/Specialties

    Post-master certificate. In some states, only DNP option is available so you can do DNP with psych concentration. I would not pursue only for job availability though, only if you like it. It has its own stress. Like Jules said, our rate are decreasing as well. There are more graduates now thanks to increasing class size. In some areas of the country, it does not even pay that good, maybe just a bit easier to find job in some areas. Just like anything, the demand won't last. I still like psych enough to do at least part-time if the pay get worse and the field get saturated and then find some other things that pay better or worth my time to supplement income. Just hopefully not too soon...
  5. harmonizer

    NP Salaries/Location/Specialties

    Thanks. Jules. Nothing last forever. All about supply and demand in every field. More supply. The class size at our local university doubles 3 years ago and we have more post-master students now. Regardless, here our rates are better now but it has been much lower before. Hope I save enough and figure out what to do before it gets worse :)
  6. harmonizer

    NP Salaries/Location/Specialties

    Location: Southeast. (need collaterbation/supervision) non-independent practice. Specialty: Psych Compensation: Two contract jobs: telepsych and local contracts- working 5 days per week. $182,000 but I took 7 weeks off (35 working days) this tax year. But.. this is contract with no benefit so comparable salary would only be around 150k- 160k I think (deducting the health insurance and self-employment tax and no 401k matching). No one paying that much here for salary so I continued with 1099 for a while now. I know.. this is below average comparing to what is posted here. I am surviving but in long-term, I would like relocate to NW or better paying states.
  7. harmonizer

    NP Salaries/Location/Specialties

    I am so doing telepsych as well. You rate is great. How many patient do you have to see per hours and how many patient per days on average? I only make $90/hr for contract rate for about couple years now and am thinking that I should negotiate or do something else better. It is contract-- no insurance and benefit and $90 is not that much. I can survive coz the cost living is not too high. I have not left yet because the workload is still reasonable. I am seeing 30 min follow-up with one hour initial and 1/2 hour paperwork with some no-shows or cancellation and no "same day waiting list. (or at least not getting to that point yet)" So ending up being about 10 patients on average-- it's less before and now the workload is growing... so I don't know if workload will continue to be sustainable for the compensation... I know people are getting more but if I get paid like > $100/hr and having to see 4 patients per hour with 15 min med checks with crazy workload, I probably would stay where I am at for now. Also I have seen these patients for a long time and I know them... looking for something better but hesitant...
  8. harmonizer

    Psychiatric NP- percent of billed salary

    Try 70%-75%. I was offered 60% in the past but heard that some people are getting 70% or even 80%. 60% is too low. They are probably taking advantage of new grads. Don't sell yourself short.
  9. harmonizer

    Interested in Psych NP but in FNP prog

    If your states allows, you can just practice psych with FNPs (if you are comfortable about scope of practice issues)- usually the states that allow this is not independent practice state and they are ok with this since there is supervising psychiatrist anyway. Regardless, you just have to consult BON for this. Extra training is not as important as finding someone to hire you. In some states (OR,AZ,WA,IA, MD, and Texas too I think), the mental health practice is restricted to only psych NP. I still think post-master is the best option in case you have to travel to other states that require this. Even though it is not require, some employers prefer the board certification anyway.
  10. harmonizer

    FNP in a psychiatric office?

    Joebird21, it does not make any difference. The states (OR, WA,MD AZ, IA and etc) that needs certification to practice in certain specialty will continue to require it. It may just give you peace of mind in the other states in term of practicing within the scope b/c of some verified training. Why do we need to make things more complicated? There are post-master/post-DNP PMHNP out there that people can enroll so that credentials will be accepted in every states. Creating residency for an existing established specialty unnecessarily complicates the issues. I do not understand the point of this. I think the profession would benefit more in term of post-grad training to further specializing skills of PMHNP eg. psychotherapy, substance abuse, DBT rather than this residency idea.
  11. harmonizer

    FNP in a psychiatric office?

    Bottom line---This topic came up so many times. It really depends on the BON of each state. Unfortunately, in some states, there is no specific clause limiting advanced nursing practice in within certified specialty, which would allow FNP to work in psych setting. I am personally against this. I understand people said that you can learn med management from experience and so on. But this is not just meds. Psych visit also involves diagnosing and assessing and good history taking. Some clinic allows 30 min follow-up appointment and you can do and bill some supportive therapy, which includes the concepts learned from psych experiences and psych theories, not included in FNP curriculum. It looks bad for the profession to allow members to practice in an area without verified standard education. You do not see family physician treat complicated psychiatric issues and bill for it but in nursing we can (in some states). If this is the case, why are we specializing for? We can just all do FNP. However, nothing can be done since there are no clear rules. Please call the BON and read the rules-- that's it. But another thing to consider.. I heard the rumor that some insurance companies may require board certification for credentialing..
  12. harmonizer

    Work clothings for PMHNPs

    No white coat at all. Business casual. I hate wearing suit or white coat. I want to bring me to the same level as patient as much as possible to built rapport, which is less important in other nursing specialties. So.. I try not overdress but look professional at the same time. I know some people like wearing white coats in hospital setting but I don't it is appropriate. White coat is highly impersonal. Putting on suit is too much.
  13. harmonizer

    NP Salaries/Location/Specialties

    , No, it is not!! Did you read? She sees 4 pts/hour and works 12-16 hour days. She gets paid per pt she sees. well I just read again-- $220k after tax.. I guess it is possible if you work that long hour and see so many patients but personally I would not do it.
  14. harmonizer

    NP Salaries/Location/Specialties

    Yep. Yep. Yep. It's HELL on earth to have 4 patients per hours. I see 2 patients per hour and if I work 6 days per week, I would make that much with CONTRACT, not salary. I am already feel overwhelmed with my schedule booked up. Imagine 4 psych patients an hours! 32 patients per 8 hr shift!! When does this NP got to document? Yep. On her weekends or night time or at dinner time!! And remember more documentation for psych than medicals... Remember that this is probably not a salary. It is probably a contract job per patient paid. So she needs to take 6.75% out of that salary for self-employment tax, may be $15,000 out for PTO, $6000 per year out for health insurance, and may be $15,000 out for 401k, and may be 1/3 of her salary adjusted for seeing that many patient- normal pace is 2 follow-up per hours. Adjusted salary would be around $140k, which is far less than that!!
  15. harmonizer


    Yes. But I recommend on-ground or at least hybrid program. You will get more well-rounded education.
  16. harmonizer

    Non-psych NPs working in psych

    I believe you! "Top" people will always find work .. with one exception lower or stagnated salary/wage :) It is the law of supply and demand. No matter how top or good you are, you are not likely be paid above market rate.. but money is not everything of course. But it has to be "fair."