Why wouldn't this cost of living hack work for California?

Nurses General Nursing

Published

Right now we live in Florida (put aside that I'm in school to be a PMHNP and that my wife currently works from home as one). If we went back to "bedside" why couldn't we live in Vacaville and commute to San Francisco (we each have about 10 years ICU experience) or live in Carson City Nevada and commute to Sacramento (or at least I could my wife could keep her current home based PMHNP, telemedicine job). In this way we could benefit from the high California pay (currently I make $45,00 no benefits working nights in the ICU) while minimizing the higher cost of living. Actually, I think living in Nevada and commuting to Sacramento might be the better bet even with relatively less pay in Sacramento than San. Fran. Currently, although I only live 32 miles from work in Orlando it takes me about an hour going one direction, but two hours with traffic going home.

Specializes in Psych, Addictions, SOL (Student of Life).
9 hours ago, 2Ask said:

Myo,

Do you think your partner would be willing to read the thread and comment?

Unlike some others, I can see you two staying together- there's a long history with her, apparently she is very tolerant and very wise (keeping out of your debt, dealing with the lack of intimacy, etc.), and Aspies need love and relationship too. Can you see from some of the reactions how blessed you are to have such a tolerant partner? Apparently she likes Florida and does not want to move. Are you willing to make some adjustments and compromises in your goals to demonstrate love and commitment to her?

My suggestions have been along the line of "bloom where you are planted". Kauai is not the only enjoyable place to hike and snorkel on the planet (and TBH I think you have highly idealized it based on a long ago two week experience!)

  • Take your son hiking in the Smokys ASAP and let that be your first hiking adventure with him of many (I have a bucket list to hike in all the national parks- Yosemite and Sequoia with my teen son is next week). If he or your SO don't want to hike with you, go alone.
  • go snorkeling in the Keys and the Caribbean right nearby Florida. There are several Caribbean islands that are American- no passport needed and cheap flights from Florida
  • live on your SO's income exclusively and use every nickel of your income for the next three years- 80K/yr in Fl you said- to pay off the debt rapidly.

I also highly suggest a visit to California to hike the Pacific Crest Trail the West Coast Version of the Appalachian trail. It takes a couple of months to do the whole thong from beginning to end but small parts can be done as day or multi-day hikes with beautify camping spots

Hppy

Specializes in ED.
7 hours ago, myoglobin said:

I estimated that as a percentage of my estimated future income that having 165k in student loan debt wasn’t that bad. I figured worst case I would stay in school deferment till retirement and let them garnish the max $150.00 month allowed by law. However, I fully expect to pay the debt off within the next three years.

My point is made.

You want to mooch off of everyone---your SO and everyone who has been idiot enough to lend you money, a place to stay or even advice.

Listen. You are simply not going to get what you want here---unless, of course---it's a "rise" out of everyone and attention.

Which is precisely what I believe this is. You're saying whatever---ignoring anything of substance...but but but but but but but........and just yammering on and on about how everything is going to work out in your favor...

THEN GO AND DO IT. You have it all figured?

THEN WHY ARE YOU HERE YAMMERING ABOUT IT.

Go make your "million in the bank" and cheat the banks and your SO and everybody else---because this is what you've got planned anyway.

Specializes in ICU, trauma, neuro.
28 minutes ago, TitaniumPlates said:

My point is made.

You want to mooch off of everyone---your SO and everyone who has been idiot enough to lend you money, a place to stay or even advice.

Listen. You are simply not going to get what you want here---unless, of course---it's a "rise" out of everyone and attention.

Which is precisely what I believe this is. You're saying whatever---ignoring anything of substance...but but but but but but but........and just yammering on and on about how everything is going to work out in your favor...

THEN GO AND DO IT. You have it all figured?

THEN WHY ARE YOU HERE YAMMERING ABOUT IT.

Go make your "million in the bank" and cheat the banks and your SO and everybody else---because this is what you've got planned anyway.

I don’t plan to cheat anyone. All of my loans are federal student loans. Half the residents I work with at the hospital owe more than me. How am I mooching when I supported my SO during her Masters program including with some of the loans I owe? Your negativity towards me seems out of proportion to my desire to simply follow a dream and help people at the same time. Granted my money planning has been poor. If only I were more crude and Tweeted more I suppose I would be qualified to be President.

Specializes in NICU/Neonatal transport.
8 hours ago, myoglobin said:

I would not attempt to start a business until debt free plus at least 100k in bank. My goal for that is in 5 years or age 55. My plan incorporates much of the input here and frankly is pretty much the situation I planned to be in ( minus the location) when I went back to school to be an RN in my mid 30’s.

This is a very unrealistic goal. You are essentially saying you want to make over 300k *extra* in 5 years?

Again, you've never answered my question about what either of you are really getting from the relationship and why you want to stay with her. I understand wanting to be with someone, but not everyone gets to do that. Sometimes things don't work out. You seem to stay out of obligation not out of wanting to be there.

I've been involved with someone like you, except his dream was children. For complicated reasons, he is the only person I can ever be involved with again. I can't have children anymore. But for him, naturally born children coming from his wife was the only way he could accept. He left because of that dream, which he is unlikely to achieve unfortunately for varied reasons. I'll never get to have a relationship again because of that, unless we get back together some day. But I also understand to some extent, because if he was going to resent me for my infertility, it wasn't going to end well anyway. He was either going to have to compromise on his dreams or leave. If he was willing to compromise, he would already be a father. But because of being on the spectrum, he couldn't see/accept other paths to happiness or his goal. It may well end with him also being alone and/or not having kids, because of his inability to see alternative paths.

Compromising on your dreams is not always a bad thing, because dreams can be unreasonable or unlikely. Sometimes you have to look at the big picture and what is most important to you. Sometimes the things you find along the way are in actuality more important than the goal.

Specializes in ICU, trauma, neuro.

I love my SO I love my son and I have a dream to live with in Kauai and have a business that would make money and help people. I’ve only dated two people in my entire adult life and the one I’m with now and I have been through a lot (she helped care for my dying mother, we raised five dogs who have died to old age, we purchased a duplex and lost it to foreclosure, had a mortgage business at age 30 making 250k per year only to lose it to name but a few things we faced). Plus, I really like her in addition to loving her. Maybe I’m a bit simple, but I believe all things are possible with God’s grace, hard work and perseverance. I realize the odds are against me, but many people said I would never last even a year in the ICU because the nurses would eat me ( they did and I got transferred to med:tele, PCU and finally 8 more years in neuro trauma ICU). For me “keeping hope alive” is important to accomplishing the difficult things I must do in the next years just to succeed as a new/older/ADHD/ somewhat autistic PMHNP. For you guys this might just be a silly thread, but for me it is my life.

Specializes in NICU/Neonatal transport.
18 minutes ago, myoglobin said:

I love my SO I love my son and I have a dream to live with in Kauai and have a business that would make money and help people. I’ve only dated two people in my entire adult life and the one I’m with now and I have been through a lot (she helped care for my dying mother, we raised five dogs who have died to old age, we purchased a duplex and lost it to foreclosure, had a mortgage business at age 30 making 250k per year only to lose it to name but a few things we faced). Plus, I really like her in addition to loving her. Maybe I’m a bit simple, but I believe all things are possible with God’s grace, hard work and perseverance. I realize the odds are against me, but many people said I would never last even a year in the ICU because the nurses would eat me ( they did and I got transferred to med:tele, PCU and finally 8 more years in neuro trauma ICU). For me “keeping hope alive” is important to accomplishing the difficult things I must do in the next years just to succeed as a new/older/ADHD/ somewhat autistic PMHNP. For you guys this might just be a silly thread, but for me it is my life.

What I'm trying to communicate with you is that you need to look at other ways you can be happy and achieve a dream without needing to be in Hawaii full time. It doesn't matter what could be in Hawaii. It's not going to happen. She doesn't want it.

Hawaii and the woman you love are diametrically opposed. Your options are: stay with the woman you say you like and love and have been through many difficult times with, or hang onto this dream and leave her. You can find other ways to achieve the things that you are dreaming of that you feel you can only achieve in HI.

My best friend moved to Hawaii as an NP four years ago and loved it. She died in a hiking accident two years ago in Hawaii. Hawaii does not give guarantees. Not of life, not of happiness.

You want to be able to dive and hike and snorkel. Look at moving closer to the coast in FL or another eastern coast state. Clear water is cool, but so is less than clear water. That won't stop you from diving or snorkeling and finding awesome things to see. Or from visiting HI.

You can either find a way to make most aspects of your dream happen and leave HI for after she dies/leaves (and don't mention it every day) or you can constantly be looking for what could be and not what you have.

Part of your diagnosis is a difficulty in flexibility. I get that, I'm on the spectrum too. But you are going to need to work very hard to try to be flexible. I think targeted therapy could help you find ways to do that.

If you want to stay with her, and she does not want Hawaii, no matter what you think she should want or could be happy with, you have to let go of it while she is with you. Find other dreams and options.

Specializes in ICU, trauma, neuro.
1 hour ago, LilPeanut said:

What I'm trying to communicate with you is that you need to look at other ways you can be happy and achieve a dream without needing to be in Hawaii full time. It doesn't matter what could be in Hawaii. It's not going to happen. She doesn't want it.

Hawaii and the woman you love are diametrically opposed. Your options are: stay with the woman you say you like and love and have been through many difficult times with, or hang onto this dream and leave her. You can find other ways to achieve the things that you are dreaming of that you feel you can only achieve in HI.

My best friend moved to Hawaii as an NP four years ago and loved it. She died in a hiking accident two years ago in Hawaii. Hawaii does not give guarantees. Not of life, not of happiness.

You want to be able to dive and hike and snorkel. Look at moving closer to the coast in FL or another eastern coast state. Clear water is cool, but so is less than clear water. That won't stop you from diving or snorkeling and finding awesome things to see. Or from visiting HI.

You can either find a way to make most aspects of your dream happen and leave HI for after she dies/leaves (and don't mention it every day) or you can constantly be looking for what could be and not what you have.

Part of your diagnosis is a difficulty in flexibility. I get that, I'm on the spectrum too. But you are going to need to work very hard to try to be flexible. I think targeted therapy could help you find ways to do that.

If you want to stay with her, and she does not want Hawaii, no matter what you think she should want or could be happy with, you have to let go of it while she is with you. Find other dreams and options.

The other part of the "dream" is business and that is only possible in an IP state. I've said it before, but here is why the business matters:

a. There is nothing else (or very few if any like it). That is to say a pscyh mental health practice open evenings, Saturdays, and which offers not state of the art pharmacotherapy, but also evidence based complementary and alternative medicines. For example there is good placebo controlled evidence for the use of SAMe in treatment resistant depression (especially in those who tend to genetically undermethylate something that can be determined by Genesite testing), but it is seldom utilized because no big pharmaceutical company is pushing an OTC product. Also, having specialized, hard to find counseling such as DBT (important for borderline personality) and EMDR (important for PTSD) along with CBT and other cutting edge therapies such as TMS and esketamine. In addition, to offering 30 minute medical management appointments rather than rushing people in and out the door in 15 or 20 minutes (some take longer, but the 30 minute paradigm with no shows allows more time to be spent with more intensive clients). This integrated concept alone could help many people "get off the benzo treadmill" and headed towards recovery.

b. In addition, this business approach could earn more (potentially much more) than the 180K (no benefits) max which is what my SO earns from telemedicine. Even a couple of years of earning a profit (combined) in the 500K range (say achieved by our mid early 60's) goes along way towards establishing a retirement fund. For example the clinic where I now do my clinical's earns several million per year after expenses and has waiting lists of over two months to be seen despite only offering 15 minute appointments and not implementing many of the above points.

c. Also, it is a "more resilient" model to competition and market over-saturation because we can build a customer base over time and while "getting a license" is one thing, establishing a clinic such as the one I propose is another. Also with my son going into nursing to become a PMHNP it could offer him something of a "legacy" to take over when we retire. Again, this will probably never be possible in Florida which is perhaps in the top five worst states for NP's (and I would argue RN's) in the nation. So while I'm willing to compromise on Hawaii (although Hawaii is one of the BEST states for IP), it would take a move to a state such as Nevada, Washington, Arizona, or Oregon to make this concept likely feasible. If we stay in Florida and telemedicine "goes bust" in three or four years with pay decreasing to $50 or so per hour (as many predict on these forums due to oversaturation of NP's) where will be then just from a practical standpoint? So yes while there is risk in action, there is also grave risk in the lack thereof. It's not just about Hawaii for me, and I am somewhat flexible. However, shouldn't flexibility work both ways? Even if I'm not able to execute this plan because of personal failings it is a good and needed approach. Perhaps, by presenting it here someone will read it and implement it themselves elsewhere. That too would be somewhat rewarding.

Specializes in NICU/Neonatal transport.
1 minute ago, myoglobin said:

However, shouldn't flexibility work both ways?

Ideally, yes, but sometimes it can't. That's why relationships end. That's why my partner left. I couldn't have a baby. He couldn't see any other path. He left. I will be alone for the rest of my life unless he comes back because I have something I am not willing to compromise on either. (mine is I have dyspareunia with every sexual partner except him. I'm not willing to give that up in a relationship or have pain again.) It was horrific for both of us.

You haven't offered much in the way of flexibility either. That's why I say look for other options. Find a state nearby that might offer what you think you want. This is not about business. Take business and money out of it.

This is about whether you want to stay with this woman. Hawaii is not going to happen with her. Can you find a way to have a dream that includes her? Hawaii does not include her. Get involved politically to help push full practice authority in FL.

But what you are doing right now will be horrific eventually for both of you.

Specializes in ICU, trauma, neuro.

Here's the thing my "dream talk" is pretty low intensity around the house. She buys a piece a furniture and ask's me what I think and I say "I don't care as long as it can be shipped to Kauai". She comments about a house she likes and I say "if it was in Hawaii, it would be fine". Then maybe it's not mentioned for a month or two. She has even mentioned going there for her birthday next Summer of her own accord. At the end of the day despite my big dream talk I'm a pretty laid back individual, and I won't easily be starting any businesses by myself (one of the biggest reasons that our mortgage company went bust was that when she had to take time off for our son when he was born, I could sell the loans, and figure out how to get them approved, but was helpless to copy, collate, and "process" them). I am simply to unorganized to execute a business by myself. Since I was 25 I've worked pretty much every job with my SO (collections for a non profit hospital, mortgage lead generation, mortgage loan officer, mortgage company owner, ICU nurse) I've never worked apart from her more than about three years (now is the longest stretch). In addition to my other issues I'm probably straight up dependent personality. It is probably not too much of a stretch to believe that if I succeed in getting a home based tele-medicine job like she has that I will go full blown agoraphobic, get all my stuff via Amazon, stop working out, regain the 100 pounds I've kept off for 10 years and end up washing myself with a rag on a stick (or as I used to say to my coworkers in the ICU when I wasn't ranting about Hawaii , "if I could get a tele-med job like my SO, I would get a foley, a rectal tube and start working on some stage four pressure sores").

Specializes in Critical Care; Cardiac; Professional Development.

Why is it that people on the spectrum always expect everyone else to be flexible but not themselves?

What you are requesting is not flexibility. It is abdication.

What you are reporting about yourself is diametrically opposed to what it takes to open, organize and manage a business. You tell yourself you want to help people but what this is really coming down to is an insane need to control everyone else. You love this conversation because it is all about you. Without the ability to build and maintain relationships with outside stakeholders your business has zero chance of ever making it off the ground, with or without your wife and/or son.

I am done reading this thread. You thrive off the attention and you absolutely get high talking about this idea. It isn't a constructive use of time.

Specializes in EMS, ED, Trauma, CEN, CPEN, TCRN.
6 hours ago, myoglobin said:

Half the residents I work with at the hospital owe more than me.

The difference is that their earnings will increase many, many times over immediately after residency. Heck, some residents can even make hundreds of dollars an hour moonlighting during residency. Comparing your debt (which should be your biggest concern right now, IMO) to theirs is not logical.

Specializes in NICU/Neonatal transport.
2 hours ago, Pixie.RN said:

The difference is that their earnings will increase many, many times over immediately after residency. Heck, some residents can even make hundreds of dollars an hour moonlighting during residency. Comparing your debt (which should be your biggest concern right now, IMO) to theirs is not logical.

And they were in school longer.

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