r/PMHNP

The hospital system where I've worked in a different role is probably going to make me an offer for a full-time inpatient PMHNP position. I like hospital work because I find it easy - tons of on-site support, kind of repetitive; you just show up and do the work and clock out and go home; no note writing at 11pm. Plus the stability and the benefits. It's a locked adult unit.

But I also got to like the 1099 format, too - you get to do more nuanced and elegant work, you build a relationship, and you get to see people get better and stay better. Plus, one of my 1099s offers group clinical supervision weekly and case consultation on demand. And, I get to see kids and adolescents in this role, which I like. However, it feels less stable - patients can cancel, stop seeing you, they can close the practice, etc.

If someone here has done both, which one do you prefer and why?

I’ve been seeing new positions pop up in the last few years for an in-office psych provider at PCP offices. Often they work in a team with a social worker. Has anyone worked a job like this? What is the daily patient load?

Have a private practice and up until now I was renting a shared office, now buying my own. Does anybody have any accessory/furniture must haves? Examples such as specific ambient lighting pieces, specific white noise machines, informative psychiatric posters/pictures to hang, or just overall tid-bit things that make your office more comfortable/welcoming/unique? Thanks!

I currently work at a small NP owned private practice, there are only 2 prescribes and a therapist. I am planning on leaving my job soon but am feeling really guilty about leaving because I know my boss is going to be blindsided. Ive quit jobs before but it was always a corporate organization and felt no allegiance to them.

My boss did give me an opportunity when there weren’t many in the area and I don’t want to burn any bridges, any advice on how to do this tactfully?

Update: yes I know to give advanced notice based on my contractual agreement, I guess I’m asking do I schedule a time to chat with them and have a conversation or just send the letter? What’s the best way to end your employment agreement?

Pmhnp here. Day 1 on Vyvanse and i want to cry.ive spent the last 5 years balancing hormones and making sure i addressed everything else before arriving at a stimulant.

I feel. Calm. Quiet. Slightly tearful. Like my tabs are closed and im able to open them one by one instead of 50 at time.

It wasn't the focus. It was the avoidance. Brain fog. Overstimulated and overwhelmed constantly. The procrastinating, being late to everything. The being MEAN and knowing you are being mean. Not smiling when random ppl are talking to you. Background static noise in my head.

It's been about 4 hrs and it's just quiet.

None of it manifested until peri. I saw signs when i was young but i could compensate and figured i still could. Well i can't anymore.

I seriously want to weep with joy.

Eta: i was wrong to think women were slightly exaggerating this. With my own providers convincing me to take the leap, I'm now a part of this population. And yes, I'm a pmhnp who understand what these women are trying to articulate.

I will be finishing my PMHNP program in August and am interested in working in the SUD setting. I have 13 years of experience as an AGNP, just as a little background, and I live in the Phoenix area.

1 - I would like to hear from anyone who has had any recent experiences working for Community Bridges in any of their settings.

2 - What other organizations might Phoenix providers recommend or suggest I avoid in the SUD arena?

3 - Does anyone have any advice at all for a new provider wanting to enter into SUD work?

I appreciate you all.

Ever since you have transitioned to NP, have you noticed a change in attitude in the workplace? Meaning you are not treated as disposable the way some RNs are treated, you are not fired over some stupid stuff, etc.

PMHNP career dilemma: leave my RN job or keep working both part-time?

I have been working part-time as a PMHNP in NJ for about 1.5 years: $135/hour, W-2 fee-for-service, averaging around 15 paid hours/week (in clinic 20hrs week). No benefits, PTO, malpractice, CEU/licensure reimbursement, or insurance.

I have also kept my part-time RN job two days/week. It pays $65/hour and is low stress, but more importantly has excellent health insurance for my family, PTO, bonuses, 401k with 3% match, cheap life insurance, certification reimbursement, and overall stability. The downside is every other weekend/holiday work causing me to miss out on a lot of things with my family.

My PMHNP employer wants me to go full-time this fall to take over a departing provider’s caseload. They know I am hesitant to leave the stability there and offered to bump pay to $150/hour with guaranteed pay for 32 hours/week until my caseload is full. The only benefit is 40% of my health premium; I would still pay about $2,200/month for family insurance, plus a $3,000 deductible and high out-of-pocket max. No PTO, malpractice, CEU, licensing, retirement, etc.

My ultimate goal is to work only as an NP and have more time with my family. But the hospital benefits and stability are hard to walk away from.

Would you leave the RN role and go all-in on the PMHNP position, or continue working both part-time for now?

Working full time, Midwest, very restricted state for NPs. I’m W2 getting probably 30% of what I bring in. Benefits are basic, nothing to rave about. I’m sick of this! I’m exhausted and seeing 30 pts a day sometimes. And it’s hard to take time off.

I feel secure with my salary and it is good when you look at average incomes but it’s the principle here. I’m making someone else rich and it makes me feel ill. How do I get out of this?! I’m ready to throw in the towel and sign up with some of these online agencies as a 1099 so at the very least, I have control of my schedule and vacations. Any solid FB groups to steer me in the right direction recommended? Any telehealth companies that you guys actually feel pay you fair?

Thanks in advance ❤️

Hi all,

I need ideas on how I could keep my license in my (restricted practice, horrendous job market) state from becoming inactive, if I take a full time remote job/license in neighboring state with better overall market? Is this even possible? And, if so, what is the minimum I can do/pay (I'll need a collaborating) to keep my state license active? Anybody doing this?

Thank you.

Do you use both? I graduate soon with FNP and considering doing a bridge program, because I want to have flexibility with my career options down the line, although I’m interested in a different specialty at the moment. Has anyone gotten dual certified and not used both, or regretted it?

Yeah so I'm thinking about using the site Talkiatry to see if they will prescribe me meds such as Klonopin. I have horrible anxiety and nothing else will work, right now I have been borrowing a few Klonopins from a family member when my anxiety gets so bad I can't stand it and the panic attacks are brutal.

But I'm just wondering is Talkiatry worth it? I would use Medvidi because I hear they will for sure prescribe meds like Xanax and Adderall but I can't afford that and I have pretty good insurance and Talkiatry does take my insurance so it wouldn't cost me anything to see them. I gave them a call and they emailed me a form to fill out and send back to them so I'm gonna do that. But I'm just wondering will I get prescribed the meds I want or what, who here has experience with Talkiatry and has seen them already, I'd love to only hear from those people. Thanks.

TLDR: Considering Talkiatry because it’s covered by my insurance, dealing with severe anxiety and panic attacks, wondering if they typically prescribe medications like Klonopin/Xanax or stimulants like Adderall/Vyvanse, and looking for real patient experiences before booking.

My wife (PMHNP-C) opened her own practice a couple of years ago. She'd used iCANotes at a previous job and stuck with it when she went solo. We also have a therapist and an office manager who handles scheduling and copays. I run the IT, banking/finances, and insurance-portal side and have little to do with the clinical work — so I'm hoping some actual PMHNPs can weigh in. Our biller has suggested that we switch to PracticeQ. And I can see how it would definitely help with front office stuff, but does it make sense from the clinical side of things.

A few specifics:

• Notes/AI: PracticeQ has a built-in AI scribe (Heidi). My wife uses JotPsych now and spent real time training it on psych nuance. How does Heidi's note quality compare, and is the in-EHR integration worth it? Can you keep an outside scribe instead?
• E-prescribing: how smooth is the controlled-substance (EPCS) workflow for stimulants/benzos day to day?
• Patient billing: how well does it handle saved credit cards, auto-charging copays, and invoicing patients who fall behind? (Our biggest iCANotes gripe.)
• Anything you wish you'd known before switching?

Honest takes welcome, good or bad. Thanks!

What are your best go to resources? Any advice would be greatly appreciated thanks so much!

Does anyone pay for UpToDate? Do you get $600 worth of value from it? I use Medscape emedicine (free) and StatPearls online (lower quality but free), but would like to have UpToDate at my fingertips. I am put off by the price.

Looking for advice or ideas on which way to consider for a job search with my situation. I graduate very soon and hoping to take my exam in early September. I currently live in MA (need a collaborator for first two years) but next summer I am moving to a southern state (not full authority).

This move is set in stone and would take a lot for us to change our plans to not move. I also have a job currently (Monday - Wednesday) that I prefer to keep, for now, as it’s needed experience for my other career path. Even after the move I will still have ties to MA and will come back often but not more than a few days each month.

Should I look for a PMHNP job in MA and quit in like 10 months (I feel like this is not a great professional option)? Look in MA for a full online job that I could keep after the move? Look for an online job (or rarely in office) in the other state now? Or wait and find a job in the southern state when I get closer to moving?

I appreciate any ideas/feedback/suggestions from all of yall with a lot more experience in the NP world.

I’m thinking of leaving headway but not sure what to tell patients and how much notice is recommended? Also, I’m not sure what I need to do to actually leave. Can I just stop accepting new patients and update my CAQH?