VA Psych NPs

I really like the VAMC. I interned there. Loved it. Quick and easy access to ECG, labs, CT, MRI, etc. Pharmacy consults. Ready admission to inpatient psych. Integrated PCP referral.

However, like you say, the pay sucks, the application process is long and arduous, and I believe you have to justify, in writing, your qualifications thus salary boarding.

I did this to upgrade my pay as a BSN and it took a bit time but it wasn't horrible, sort of like writing a quick paper for school however and correct me if this has changed it will not negate the years as a practicing NP that are required and again last time I checked the highest rate, for like a billion years in practice, was low $100,000s.

I think it maxes somewhere around 113k sans COLA. I made some really good contacts when I worked there. My precepting NP there told me one day "everybody here likes you." I even felt welcomed there as a student. It was really a nice site and consistently ranks very highly in the VA system. Unfortunately, they're initial salary, speculating would've been 60k less than my salary is where I'm at now.

There are a lot of pros and cons. One, I don't have a nurse, but I plan to hire one within the next four to six weeks. The folks at the VA I trained at didn't have a lot of admin support, but in my present job I have tons. The VA did indeed have "better benefits," but as you note the benefits are not worth the 60k I'd forgo if I went to work there. I would see substantially less patients each day, but I find that boring to some degree. I don't want scheduled hour long evals and half-hour med checks. (I used to always see the psychiatrists roaming around the campus and later figured out that they spent like 15 minutes on an eval so they had all these 45 minute blocks of time to kill each day.) Again, it would be awesome to have the lab, imaging, and inpatient unit at my disposal, but I've grown to live without it. Not of all of the offices had windows. I have windows. I related well with the veterans. It was a fairly consistent patient population to work with - generally men 23-66. I liked that...a lot. Here, I have the whole gamut, and truth be told I don't really like managing ADHD, ODD, etc. But I love my present job. It's the great job. I think I'm at the pinnacle of what is available to me in my state. I believe my boss (collaborator and company medical director) issued a dictum when I came on board, "Make him happy." I would like the VA. I'm sure of it, but I'm a really lucky guy to have my position as a first NP job. I know I'm where I'm supposed to be.