Exploring my options, what would be a good career choice?

[GOINGBALD42]

So I am a bit of an older guy in my late 20s. I have been on the fence about Physical Therapy and am considering nursing. I have been working as a PT aide for sometime now so this is a big decision.

My problem with PT is that the work may get boring, not a lot of room for growth, for the amount of schooling to income its not much, the amount of debt of the school to income ratio doesn't make that much sense. Also the future of the profession is a bit questionable, the job market where I live is pretty good, but other areas not in demand. Salary is on the fence for me and its a lot of fighting with insurance to get paid. I would need a steady 85k bare minimum to be comfortable. Average PT salary is probably gonna be around 60-75k as a new grad thats on top of 100k-150k of student loans. Capping out at 85k and possibly 100k in rare circumstances. I feel like this route would be a low stress lax lifestyle, but the stress would come insurance and making enough money.

Now someone has been talking to me about nursing and to me it makes lots of sense. I already have a bachelors in biology I can do 1 year accelerated and become a registered nurse. Start making money straight out of the gate, plenty of job options, lots of room for growth (I can go back to school and become a DNP), low debt, I can work 3 12 hour shifts and call it a day. To me it makes lots of sense however I would say the main thing holding me back is just ego and choosing this career would be a financial move it seems. I never had any desire to be a nurse as a kid. Working with a bunch of females not something I ever liked. I feel like I am taking a step back since I could have just went the community college route and done this. But ego aside I feel like its a good career decision with plenty of room for growth where I can work as a supervisor/manager or go to more schooling to be a DNP. If I choose this route would you recommend to do the 1 year accelerated bsn or the bsn to msn bridge program? I have a friend where they do accelerated program to get their bsn and then they go straight to getting their msn.

I want to hear your opinions, what do you think?

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[BlackWarrior]

I was in the same dilemma as you before. I have a BS in Biology and was in between PT and nursing. Long story short, I chose nursing. I absolutely enjoy the flexibility of nursing. If you want to pick up more shifts, it's possible. If you want to go back for more schooling, you can. If you want to switch to a different unit, probably not too difficult. Also, the pay in California is nice for Registered Nurses. My friend who graduated from an ADN program last December is now making $80k a year without overtime which is close to what a new grad DPT would start at (?). I was put off by the thought of selling myself short. I already had all the prereqs needed to apply to any health profession program. But nursing just made the most sense to me in terms of stability and financials.

 

[V781]

You're in the RN/NP/PA forum...would you consider becoming a PA in orthopedics? It's very relevant to Physical Therapy; you would often refer patients to a Physical Therapist and would communicate through notes about the recovery of this patient. You may also assist in Orthopedic surgery.

Doctors are often said to have a closer, more trusting, relationship with the PAs than with the nurses...sometimes discussing medical opinion with PAs as though on the same level (obviously would depend on the doctor). PAs see patients one on one and prescribe medicine, but with the signature of a supervising doctor.

The PA program would last just 2 years and requires a degree (so it wouldn't have all been for nothing as you suggest you feel nursing would be).

The title Physician Assistant may not impress your friends, who typically have never heard of it and confuse it with Med Assistant, but in the medical community, it's a respectable position.

 

[GOINGBALD42]

I was in the same dilemma as you before. I have a BS in Biology and was in between PT and nursing. Long story short, I chose nursing. I absolutely enjoy the flexibility of nursing. If you want to pick up more shifts, it's possible. If you want to go back for more schooling, you can. If you want to switch to a different unit, probably not too difficult. Also, the pay in California is nice for Registered Nurses. My friend who graduated from an ADN program last December is now making $80k a year without overtime which is close to what a new grad DPT would start at (?). I was put off by the thought of selling myself short. I already had all the prereqs needed to apply to any health profession program. But nursing just made the most sense to me in terms of stability and financials.

yes I agree with your sentiments. Did you end up going an accelerated bachelors of nursing or did you do an ADN like your friend? Also do you plan on pursuing higher education with nursing?

 

[GOINGBALD42]

You're in the RN/NP/PA forum...would you consider becoming a PA in orthopedics? It's very relevant to Physical Therapy; you would often refer patients to a Physical Therapist and would communicate through notes about the recovery of this patient. You may also assist in Orthopedic surgery.

Doctors are often said to have a closer, more trusting, relationship with the PAs than with the nurses...sometimes discussing medical opinion with PAs as though on the same level (obviously would depend on the doctor). PAs see patients one on one and prescribe medicine, but with the signature of a supervising doctor.

The PA program would last just 2 years.

The title Physician Assistant may not impress your friends, who typically have never heard of it and confuse it with Med Assistant, but in the medical community, it's a respectable position.

Yes I heard of PA and am considering it. But I realize it is incredibly difficult to get into. What are your thoughts on NP and a PA? I feel that nursing to NP is a very attainable goal.

 

[V781]

Yes I heard of PA and am considering it. But I realize it is incredibly difficult to get into. What are your thoughts on NP and a PA? I feel that nursing to NP is a very attainable goal.

I have not applied yet and am a non-traditional undergrad student. But I believe getting in is certainly possible so long as you are willing to consider a number of schools around the nation and are not afraid to try again the next year if you do not get accepted (work to improve for the next cycle). Work for some really amazing letters of recommendation and get help with writing a standout personal statement. Nothing else will allow you to stand out from the rest of the competitive applicants...Every applicant has similar numbers.

With your current thoughts about nursing, you just might not be happy (considering it a step back, working with mostly females, etc).

 

[BlackWarrior]

yes I agree with your sentiments. Did you end up going an accelerated bachelors of nursing or did you do an ADN like your friend? Also do you plan on pursuing higher education with nursing?

I'll be attending an accelerated program this Fall. I applied to multiple ADN programs and a couple ABSN programs. I was accepted into all the ADN programs, accepted into one ABSN program and still waiting to hear back from another. It was a difficult choice between the two, but I "just wanted to get it over with." I didn't want to get an ADN, worry about my job prospects, then go back and do an online BSN program. I dread over online courses. I like to keep busy so the accelerated program was the way to go for me. The ABSN program is more expensive, but you'll be earning sooner. Anyways, yes I'm thinking about pursuing either psych NP or CRNA. Maybe I'll even be a nurse educator.

 

[pamac]

An RN degree was the absolute best bang for my buck as far as education goes, (and I have a biology bachelors degree and a medical laboratory science bachelors degree, as well as my BSN). I went to a community college to get my RN for <$10,000. I hit the workforce with no debt, and my facility paid for my BSN (but if you can do an accelerated bachelors for a decent price, do that... not every facility pays you for your education like mine did). My first year I was making close to $80k per year (not in California).

My ego doesn't mind being a nurse because my ego is with me on my 4 days off each week when I'm enjoying the money I make from getting paid $90k per year in a job that I don't hate. When I want overtime, I can work as much of it as I want. Nurses at my facility also get to set their own schedules, and work the shifts they want to for the most part. I talked to a PA the other day who works 50 hours a week for $95,000, and takes call. If I worked 50 hours per week id be making over $100,000 per year easy. As it stands, I work 36 hours or so for around $80k, and a bit of overtime here and there. I wanted to buy a new bicycle and needed about a grand. Worked a shift and a half of overtime to cover it.

Get your BSN in a year... it will be the best investment you'll make in yourself. you'll have a job just about anywhere in the nation. If you want to go become a PA after you get your BSN, you will have your pick of where you want to go. Most likely, you'll opt to get your NP and save $70,000 by doing that instead of PA school, and you can work the whole time you are doing it, and come out even farther ahead. PA school= ~$100,000 give or take (and you won't be able to work). NP school= ~$30,000, but add in the fact that you will work and make ~$160,000.... so you are $130,000 ahead. I'd take the $130,000.... especially compared to the fact that PA school basically puts you $260,000 behind NP. So by doing PA school after getting a BSN puts you down $390,000 vs becoming an NP after getting your BSN. That's a very decent house where I live... nicer than the house I currently own.

My ego likes my paid off cars and debts, time off, and flexibility. My ego likes to golf and go on trips with my wife who also is in the medical field like me and makes that kind of money, along with the perks.

Downsides to being a nurse are plenty... the job sometimes sucks depending on the unit you work on. Coworkers usually are ok, but bosses can suck. Patients can be really tough to deal with at times. Nursing school educators often are insane.... most seem like they have something to prove by making your life complicated for no reason. The regulations and expectations of employers tend to favor your bosses needs over your own workload needs. But nobody pays you to sit and do nothing. And I'm working full time while going to school, and still seem to have plenty of time for my family and hobbies. Females aren't bad to work with, but I'm easy to get along with, so I don't know if that's why I don't have issues. Where I work its about 1/3 males anyway. Males are all over the place.

 

[DizzyJon]

resr

You're in the RN/NP/PA forum...would you consider becoming a PA in orthopedics? It's very relevant to Physical Therapy; you would often refer patients to a Physical Therapist and would communicate through notes about the recovery of this patient. You may also assist in Orthopedic surgery.

Doctors are often said to have a closer, more trusting, relationship with the PAs than with the nurses...sometimes discussing medical opinion with PAs as though on the same level (obviously would depend on the doctor). PAs see patients one on one and prescribe medicine, but with the signature of a supervising doctor.

The PA program would last just 2 years and requires a degree (so it wouldn't have all been for nothing as you suggest you feel nursing would be).

The title Physician Assistant may not impress your friends, who typically have never heard of it and confuse it with Med Assistant, but in the medical community, it's a respectable position.

Very awesome that you are suggesting RN/NP/PA and I second your recommendation about ortho PA as being "relevant" to PT. Just one minor correction to your statement "PAs see patients one on one and prescribe medicine, but with the signature of a supervising doctor". Said statement is not correct. A doctor does not sign a PAs prescription. A PA signs his/her own prescription.

 

[V781]

resr

Very awesome that you are suggesting RN/NP/PA and I second your recommendation about ortho PA as being "relevant" to PT. Just one minor correction to your statement "PAs see patients one on one and prescribe medicine, but with the signature of a supervising doctor". Said statement is not correct. A doctor does not sign a PAs prescription. A PA signs his/her own prescription.

Ok, you're probably right. Someone mentioned somewhere, in the forum, that both signatures were required.

I do see now that the printed name, address, license and telephone number of the supervising physician and surgeon is required on the drug order, but no signature.

Good. Even better.

 

[GOINGBALD42]

Whats your thoughts on NP vs PA? I hate the idea that I would be tied down and supervised by a physician. I know there is variances depending on the environment. I think for me freedom and flexibility is very important to me.

 

[NP 2 DPM]

Whats your thoughts on NP vs PA? I hate the idea that I would be tied down and supervised by a physician. I know there is variances depending on the environment. I think for me freedom and flexibility is very important to me.

It all comes down to what you want to do, what you know you are capable of, and your level of motivation to attain that said goal. If you are satisfied with making mid early six figures, great career maneuverability , opportunity for over time in outside clinics, then going the NP/PA route is great!

However,

If you have that deep burning passion to be the physician, to call the shots, the be the captain and master of the health care team, then go to medical school.

Its no ways an easy process, but then again, who ever said it was going to be easy?

 

[V781]

Whats your thoughts on NP vs PA? I hate the idea that I would be tied down and supervised by a physician. I know there is variances depending on the environment. I think for me freedom and flexibility is very important to me.

It's not necessarily terrible to be under the supervision of a physician. Keep in mind that physicians work beneath someone as well and are often more stressed by their bosses than the PAs are of their bosses (the physicians). And physicians deal with lawsuits or the possibility of them. PAs do not. This is obviously significant. Physicians have more responsibility but are under quite a bit more stress because of it.

It would depend where you work and on the physician that you were working with. Some PAs claim that their supervisor only stops by 2-3 times per month. Others work with the physician everyday and experience different degrees of autonomy. Some people claim that the physician they work with trusts them completely and lets them have their freedom.

 

[pamac]

Most people you know have a boss of some sort. Physicians have bosses too. They answer to partners, senior partners, insurance companies, regulators, Medicaid/Medicare regulators, patient satisfaction surveys, the board of medicine, administrators, spouses, banks, etc. I've heard patients say things to physicians that made my own blood boil. I watched a drug addict get a life changing surgery, have the surgeon patiently try to resolve their concerns and beg them to stay in the hospital instead of going to get high, and then the addict left anyway against medical advice... To go get meth. Once they left AMA, Medicaid no longer covered the work that was done, and the patient was then expected to pay the bill. Meth addicts aren't going to pay the bill. If they had money, they would smoke it. The surgeon was never going to get to collect on the surgery he performed. So meth addicts become bosses to physicians. Imagine how great that is.

Physicians have to go to school wherever they could get in, they do residencies where they are told to go, and spend at least a couple years or more being supervised closely and working 80 hour weeks. They miss out on a lot. My spouse would be absolutely miserable married to a med student/resident/on call physician. Money would not sway her. There are easier ways to make good money that don't involve huge debt, huge time commitment, and sacrifice. If med students put the time and effort they spent pursuing medicine into something else, they would do quite well, and probably be successful. Imagine opening a business like a janitorial company, putting in 80 hours a week for 8 years. That person would probably be a millionaire in short order.

Having a supervising/sponsoring physician might be a pain, but probably not because they want to be all up in your business. I'm sure most of them would prefer to not have to worry about an employee exposing them to liability. When something goes wrong, lawyers want to go after the docs, not the PAs. The downside to being a PA would probably pale in comparison to what physicians go through to get where they are.

I talked to a colonel in the Air Force one day and asked him what it was like to be a colonel. He said "it doesn't stink, but everyone wants to be me without doing what I had to do to get here, and if they knew what I was responsible for every day, they wouldn't want to be me either". I think it's a bit like that as a physician. Ever since my kids showed up, I've wanted to spend every moment with them. For me, it doesn't matter what kind of respect is headed my way by other healthcare professionals, to a degree. I obviously don't want to be treated like trash or paid poorly, but I also don't expect to be the king of the garbage pile.i want to be respected, but my ego isn't that hard to accomodate.

 

[DizzyJon]

Ok, you're probably right. Someone mentioned somewhere, in the forum, that both signatures were required.

I do see now that the printed name, address, license and telephone number of the supervising physician and surgeon is required on the drug order, but no signature.

Good. Even better.

This is state dependent what is required on a prescription pad. I work for a large healthcare system and no printed names are required on the prescription pad. However, we mostly do electronic RX's and rarely use the pads. In Ohio a PA is only required to have their CTP license number and DEA if for controlled. In California the preprinted name of the physician was required.

Whats your thoughts on NP vs PA? I hate the idea that I would be tied down and supervised by a physician. I know there is variances depending on the environment. I think for me freedom and flexibility is very important to me.

I've worked in 4 different specialties over 10 years and only during 1-2 of those years did I feel like I was being "tied down" or micromanaged and that was only with a few particular physicians who had control issues. It all depends on the specialty you are in. Practice environment is everything. If you're in a surgical/inpatient specialty you will often have more interactions with the physician. If you work outpatient you have less and sometimes none at all. The point is you can find the job with the amount of involvement that you want.

It's not necessarily terrible to be under the supervision of a physician. Keep in mind that physicians work beneath someone as well and are often more stressed by their bosses than the PAs are of their bosses (the physicians). And physicians deal with lawsuits or the possibility of them. PAs do not. This is obviously significant. Physicians have more responsibility but are under quite a bit more stress because of it.

It would depend where you work and on the physician that you were working with. Some PAs claim that their supervisor only stops by 2-3 times per month. Others work with the physician everyday and experience different degrees of autonomy. Some people claim that the physician they work with trusts them completely and lets them have their freedom.

PAs can and do get sued. To make a statement that PAs do not deal with lawsuits is 100% incorrect.

 

[V781]

PAs can and do get sued. To make a statement that PAs do not deal with lawsuits is 100% incorrect.

Well, everyone in this nation can be sued. It doesn't occur to nearly the same extent as for a physician.

From thepalife.com:
"There is one malpractice payment for every 32.5 PAs while there was one for every 2.7 physicians."

You might see how a physician could be significantly more stressed at any given moment.

I read from medscape.com that PAs are generally sued and held liable if they were "practicing out of their scope" - if they misdiagnosed and had never consulted with their physician...If a PA is sued, their physician is almost always sued as well and often held vicariously liable.


"Numerous studies have shown that midlevels are far less likely than physicians to be sued. When they are sued, the awards and settlements are much smaller than for cases involving physicians, according to Ellen Rathfon, senior director of professional advocacy for the AAPA."

Also, PAs spend greater time with the patient which leads to fewer misdiagnoses.

 

[DizzyJon]

Well, everyone in this nation can be sued. It doesn't occur to nearly the same extent as for a physician.

From thepalife.com:
"There is one malpractice payment for every 32.5 PAs while there was one for every 2.7 physicians."

You might see how a physician could be significantly more stressed at any given moment.

I read from medscape.com that PAs are generally sued and held liable if they were "practicing out of their scope" - if they misdiagnosed and had never consulted with their physician...If a PA is sued, their physician is almost always sued as well and often held vicariously liable.


"Numerous studies have shown that midlevels are far less likely than physicians to be sued. When they are sued, the awards and settlements are much smaller than for cases involving physicians, according to Ellen Rathfon, senior director of professional advocacy for the AAPA."

Also, PAs spend greater time with the patient which leads to fewer misdiagnoses.

But your statement was simply "PAs do not". As in you were stating we don't get sued. You didn't include this information where you are not saying that we do get sued, but just not nearly as often as physicians. Anything to do maybe with only there being only 115,000 PAs compared to like nearly 1 million physicians? Plus physicians taking the lead in specialty practice? Someone goes in for surgery and dies. You think they will sue the PA or the surgeon?

 

[V781]

But your statement was simply "PAs do not". As in you were stating we don't get sued. You didn't include this information where you are not saying that we do get sued, but just not nearly as often as physicians. Anything to do maybe with only there being only 115,000 PAs compared to like nearly 1 million physicians? Plus physicians taking the lead in specialty practice? Someone goes in for surgery and dies. You think they will sue the PA or the surgeon?

You're not thinking correctly about those numbers. If 1 out of every 32 PAs are sued, we would say that 3% of all PAs are sued in their career... and that if 1 out of every 3 Physicians are sued, 33% of all Physicians are sued at some point in career. You could view a smaller portion of the physician population to compare (115,000 Physicians to compare against 115,000 PAs) and you would likely see similar numbers - 3% and 33%. The total number of each group doesn't matter. The black population is small in comparison to the white population, but we are still able to say that the black population deals less with osteoporosis than the white population. We look at percentages.

Anyways, I feel you've spent more time in this thread trying to argue with me than to provide help. You're a PA - you could be giving OP some great advice.

 

[GOINGBALD42]

nursing sounds great to me and is something I would advise people to do. Only issue for me is am I okay with that type of work. Also does anyone know how difficult it is to get into a NP program? For PT I feel that I would get bored with it fairly quickly

 

[pamac]

Getting into NP school typically isn't a problem. There are plenty of programs, and the applicant pool is limited to nurses. Direct entry NP schools are another matter, and they are competetive. With direct entry, you are blazing through to get an RN, and then moving right into NP school. That's a lot of ground to cover. Nursing school for my RN wasn't hard neccessarily, but they seem to try to make a point to make life more complicated than it needs to be. That's RN school basically everywhere, but maybe direct entry NP schools are more supportive.

The work can suck, but my experience is limited to acute hospital settings. There literally are tons of jobs out there for RNs that don't involve running from room to room trying to keep people from dying. Most of the time in acute care it's not even as sexy as keeping people alive, it's more a matter of keeping them from falling, making sure they get their meds, cleaning them up, watching for infection or complications, and tons of paperwork and interruptions. But if that's not your thing, you could go work in case management, occupational health, quality improvement, school nursing, consulting, workers comp, wound care, public health, epidemiology, home health assessment.... I literally could name 50 different roles out there that require an RN that don't involve smelling feces or slipping in blood. Some roles aren't ones you can walk into without some experience behind you, but that's easy to get. If you want to go to Np school quickly, then the best place to work really is in a hospital job where you work 3 shifts a week and see people sick enough to need to be in a hospital setting. I've also found hospital nursing to be lucrative, flexible, and credibility building. I pretty much set my own schedule each semester for school according to what my class schedules are. In between terms I pick up massive overtime... Over Christmas break durring the month off school I worked straight through at least 5 days per week. Almost all of that was overtime, because I picked up shifts at the beginning of the week which were offered as time and a half, so by the time I started my scheduled shifts, I was already in overtime. So what I'm saying is that nursing has been good to me. It's easy to burn out though, so finding a way to cope with work is important, even for the folks who don't work like mad. If I expected to keep that pace up all the time, I would fold. For the most part I've dialed back on my work load, and limit my binge working to school breaks.

But I would do nursing again in a heartbeat. Even as an NP, you can always take on a nursing role again if being a provider burns you out (not everywhere allows that, but most places do). I don't see myself wanting that pay cut, but with nursing, you can typically put food on the table doing almost anything. I like the flexibility to fall back on if I need it. But I'm a personality that likes to settle in.

 

[NYCGuy86]

nursing sounds great to me and is something I would advise people to do. Only issue for me is am I okay with that type of work. Also does anyone know how difficult it is to get into a NP program? For PT I feel that I would get bored with it fairly quickly

I'm in my first year of practice as an RN, about 8 months or so in. Best decision I made. There are so many options available to you in nursing, not just NP. In relation to the work (what do you mean "type of work"?), I work on a neuro stepdown unit with a great team. Yes, we do wipe ass, and will help patients wash up, but that honestly is such a minuscule part of my shift (plus I worked as an assistant for many years prior so I'm used to that at this point). The rest of the time I'm performing physical and neuro assessments, inserting NG tubes, urinary catheters, peripheral IVs, interpreting vitals and lab values, hanging various types of IV drips and blood products, monitoring chemo and pt's response to chemo, wound care, all sorts of drains including spinal drains, patient and family education, etc. Perhaps when you speak of "ego" you're talking about taking orders? I've thought similarly, but it really isn't that serious (and many times you will be requesting orders from the providers). I'm also grateful that the residents, attendings, PAs, and NPs are overall great, never had a condescending experience. Once you get comfortable learning all the "skills" and the basics, you'll be able to pay more attention to the clinical presentation of patients, which is really, IMO, where the benefit of bedside RN experience is. As the bedside RN, you should be paying attention to why things are ordered for your patients, whether they're really indicated, the patient's response to treatments, medications, procedures, etc., and the presentation of disease processes. Plus, you'll be off 4 days a week. In addition, in my first year, there's 3 wks vacation, holiday time, sick time, personal days, continuing education days, etc. With night diff I make mid 90K (another job I considered in the area paid mid 70K). Once you have experience you can go for certification in your specialty, which also adds a differential, in addition to experience diffs, degree diffs, charge RN diff, preceptor diff, clinical ladder diffs, etc.

Many hospitals, including my own, also have various councils and committees you could get involved in if you desire. There are unit councils, pharmacy councils, research councils, quality councils, etc. All of these could lead to consideration and exposure for nursing leadership positions.

As for difficulty in getting into an NP program, it's pretty easy to get into an NP program. But you'll want to look for quality programs that don't have too many "fluff" courses, either sets up clinical rotations for you or helps you find preceptors, and allows you to increase the number of clinical hours you do if desired.

I don't think you can go wrong with nursing. Good luck!

 

[d2305]

Carpe diem. You're probably missing some prerequisites for both.

 

[GOINGBALD42]

that is great to hear about the bsn. Honestly my life is going nowhere fast. I just want to get into a program and get my life together.

 

[DizzyJon]

You're not thinking correctly about those numbers. If 1 out of every 32 PAs are sued, we would say that 3% of all PAs are sued in their career... and that if 1 out of every 3 Physicians are sued, 33% of all Physicians are sued at some point in career. You could view a smaller portion of the physician population to compare (115,000 Physicians to compare against 115,000 PAs) and you would likely see similar numbers - 3% and 33%. The total number of each group doesn't matter. The black population is small in comparison to the white population, but we are still able to say that the black population deals less with osteoporosis than the white population. We look at percentages.

Anyways, I feel you've spent more time in this thread trying to argue with me than to provide help. You're a PA - you could be giving OP some great advice.

I am helping by clarifying inaccurate information. Yes, I see your point about the numbers.

 

[AnnoyedByFreud]

I never had any desire to be a nurse as a kid.

Neither did I. Psych NP coming on 2 years of experience here. I was gunning to become a clinical psychologist but then decided to become a PMHNP instead and it was the best decision I’ve ever made. I just negotiated a job that will pay me 170k to work 14 days every 4 weeks, plus benefits/PTO/etc. The nursing upsides are very, very up. Very happy indeed. I did a direct entry program which was extremely competitive to get into, and somewhat pricey (graduated w/slightly less than 100k debt, despite having multiple scholarships). But I will have it paid off by Dec (in total 26 months) and get to spend the rest of my life (still relatively young here) out of student loan debt and enjoying a salary that I, frankly, never even dreamt of achieving. I had no idea how much bank you can make in nursing. Plus, if I ever get bored I can go into teaching, management, etc. Hell I can even go back to school and retrain in another specialty (I probably would never do that since most other NP specialties pay less).

 

[pamac]

I love hearing that about psyche NP....I'll finish up with mine in a little over a year.

Time off is a perk I'd love to have baked in to any career I have, and nursing and NP have always seemed to provide avenues for that. As a psyche RN, I've never been able to complain about the flexibility of the job. I accrue plenty of PTO, and we set up our own schedules for the most part (which also means I don't have to burn PTO), but I also have a group of other nurses that can fill in on short notice if something comes up. 3 days a week is hardly too taxing, even when I was a medical nurse.

After I get my psyche NP, I'm playing with the idea of adding on an FNP certification on top of that to be a double threat when it comes to employability if it gives me flexibility to do physical assessments along with the psyche assessments for any employers that it might appeal to for admissions to facilities. My NP program offers a second masters that can be obtained without as many hoops to jump through as the first masters you take from them, so it might be worth it.

New grads in psyche in my area are being offered around $140-150k per year. An experienced psyche NP I know was offered $90-$110 per hour for their current position with benefits which to me is mind boggling, but not at all unheard of now that I'm starting to ask around more as graduation approaches. I'm finding out that the psyche NP community here is vocal about wages because they don't want new people getting low balled and depressing wages and offers for everyone else. I didn't expect that, and it's wierd to me to have psyche NPs just throw out numbers like that at me when I'm talking to them, but I think it's fantastic. On the flipside, I'm hearing my FNP and PA friends throwing out depressing numbers where new grads are taking jobs that pay $75k for 5 day per week, 50 hour workweeks with call. I make that working 3 shifts per week with no call or overtime. But those folks aren't built for psyche. To them it's "icky". They ignore the fact that they see sick people with psyche issues every day in their medical practice.

Floor nursing can burn someone out, but I avoid that by pursuing education. Nursing is a great field for those continueing their schooling. If I were a career RN I think I'd go nuts, but as my spouse reminds me from time to time, I never intended to make floor nursing my career.

Indeed, nursing can make bank, and is probably the best return on investment I've come across given the amount of effort that goes into it. Physicians make a heck of a lot more, but the time that goes into that is tremendous as well. Nursing is a great fallback for friends of mine that have businesses and other careers like farming, realty, construction contracting, landlording, and other small businesses. I have a buddy that makes most of his money shipping out products through amazon for his small business, but he's been nursing at least one day a week for the benefits and for extra cash. If there's a downturn in his business, he just picks up more nursing shifts.

At some point after I get my psyche NP and some experience, I'll pick up licenses in some other states and jump into telepsyche. I'll work from my finished outbuilding in my pajamas.

My only regret (and it's not much of a regret because I look at things on the whole and appreciate where I am at) is that I would have liked to have become a nurse sooner. I could have done it 10 years earlier and been tartjer ahead, but I realize the benefits of the other paths I've taken. I think direct entry is a great option as well.

 

[GOINGBALD42]

I love hearing that about psyche NP....I'll finish up with mine in a little over a year.

Time off is a perk I'd love to have baked in to any career I have, and nursing and NP have always seemed to provide avenues for that. As a psyche RN, I've never been able to complain about the flexibility of the job. I accrue plenty of PTO, and we set up our own schedules for the most part (which also means I don't have to burn PTO), but I also have a group of other nurses that can fill in on short notice if something comes up. 3 days a week is hardly too taxing, even when I was a medical nurse.

After I get my psyche NP, I'm playing with the idea of adding on an FNP certification on top of that to be a double threat when it comes to employability if it gives me flexibility to do physical assessments along with the psyche assessments for any employers that it might appeal to for admissions to facilities. My NP program offers a second masters that can be obtained without as many hoops to jump through as the first masters you take from them, so it might be worth it.

New grads in psyche in my area are being offered around $140-150k per year. An experienced psyche NP I know was offered $90-$110 per hour for their current position with benefits which to me is mind boggling, but not at all unheard of now that I'm starting to ask around more as graduation approaches. I'm finding out that the psyche NP community here is vocal about wages because they don't want new people getting low balled and depressing wages and offers for everyone else. I didn't expect that, and it's wierd to me to have psyche NPs just throw out numbers like that at me when I'm talking to them, but I think it's fantastic. On the flipside, I'm hearing my FNP and PA friends throwing out depressing numbers where new grads are taking jobs that pay $75k for 5 day per week, 50 hour workweeks with call. I make that working 3 shifts per week with no call or overtime. But those folks aren't built for psyche. To them it's "icky". They ignore the fact that they see sick people with psyche issues every day in their medical practice.

Floor nursing can burn someone out, but I avoid that by pursuing education. Nursing is a great field for those continueing their schooling. If I were a career RN I think I'd go nuts, but as my spouse reminds me from time to time, I never intended to make floor nursing my career.

Indeed, nursing can make bank, and is probably the best return on investment I've come across given the amount of effort that goes into it. Physicians make a heck of a lot more, but the time that goes into that is tremendous as well. Nursing is a great fallback for friends of mine that have businesses and other careers like farming, realty, construction contracting, landlording, and other small businesses. I have a buddy that makes most of his money shipping out products through amazon for his small business, but he's been nursing at least one day a week for the benefits and for extra cash. If there's a downturn in his business, he just picks up more nursing shifts.

At some point after I get my psyche NP and some experience, I'll pick up licenses in some other states and jump into telepsyche. I'll work from my finished outbuilding in my pajamas.

My only regret (and it's not much of a regret because I look at things on the whole and appreciate where I am at) is that I would have liked to have become a nurse sooner. I could have done it 10 years earlier and been tartjer ahead, but I realize the benefits of the other paths I've taken. I think direct entry is a great option as well.

what are your thoughts on absn vs entry level masters? I have a friend who went to entry level masters and apparently you get your bsn and a masters of nursing in about 3 years. I figure I might go the NP route, but it is too early to tell. Just wanted to get your opinions

 

[pamac]

AnnoyedbyFreud did direct entry and seems to be successful. I did an ASN first, and then went to work. I've been in school getting my BSN, and then school to get my NP. It's not the shortest route by any means, but I am managing to work full time through school and am not accumulating mountains of debt. But on the flipside, I'm also not making fat psyche NP paychecks either. I can see the upside to doing direct entry if you feel like you will despise being an RN. Looking back, I don't think I could do it all over again (working as a medical RN), but at the time I did it, I didn't mind it that much. I love psyche nursing, though. The lifestyle is good. I'm not moving obese patients, or getting bled on, or worse. Being done with everything in 3 years has perks. The only real issues for me would be relocation for school, debt (those programs tend to be expensive...like PA school expensive), and lost income. Incidentally, those are 3 of the 4 reasons I didn't choose PA vs what I ended up doing. But if I had a time machine and could go back and start 10 years earlier on the nursing path, then I probably would just do direct entry NP and bite the bullet and make the sacrifices. I think direct entry makes a lot of sense for psyche NP's because the pay for psyche NPs can be quite high if you hustle. If I were a new grad family nurse practitioner coming back to my area with $120k of debt, I'd have a hard time paying that down at the rate that new grads are paid here, which usually starts around $80k. If my heart were set on FNP, I'd probably just do what I ended up doing.

 

[762513]

There are even opportunities as a psych NP with a FNP.

 

[AnnoyedByFreud]

There are even opportunities as a psych NP with a FNP.

An FNP is not a psych NP. Any FNP who is attempting to treat anything beyond basic depression/anxiety is opening themselves up to huge liability problems. The only reasons any employers would hire an FNP for psych is because they’re absolutely desperate to fill a position. Completely unethical.

 

[762513]

An FNP is not a psych NP. Any FNP who is attempting to treat anything beyond basic depression/anxiety is opening themselves up to huge liability problems. The only reasons any employers would hire an FNP for psych is because they’re absolutely desperate to fill a position. Completely unethical.

I know a number of FNPs who work in psych making 140,000 a year.

 

[AnnoyedByFreud]

I know a number of FNPs who work in psych making 140,000 a year.

Right and they are risking their license to do so. All they need is a bad outcome and they will get skewered in court for practicing in a field in which they do not have formal training or license to practice. This is being cracked down on left and right.

 

[pamac]

I've heard of FNP's openly doing that. They get the 3rd degree from psyche NP's when it comes up, but most of them are unapologetic about it and cite geographic need for providers. And right now there is a trend of FNP's taking the coursework to tack on PMHNP to improve income prospects due to tightening of the market for advanced practice folks in the face of competition. It seems like it would be a bit hard to really make the most of that situation and position yourself well against a PMHNP if you aren't in a severely "at need" locale, but some states let it happen, looking at it like a family practice physician prescribing across the slate of mental health medications.... which happens plenty, and often is appropriate based on the level of care. How many other areas don't get farmed out to specialties for any number of reasons? But I think the train goes off the track when an FNP shows up to a pure mental health setting to settle in and make bank unless there are just no other options. Its like parking a PA or NP running solo in a rural ED. Its dangerous and sub optimal for patients, but not as much as dying because there's no provider at all. Gotta be a cowboy to a certain degree to do it, but we live in a world with excesses and scarcity to deal with. I think my candid response to FNP's practicing as PMHNP's is that if you aren't in deep tundra with no providers working in psyche, then get a PMHNP or be working on one before you try to live large. I'm playing with the idea of getting an FNP after finishing PMHNP, but wouldn't dream of functioning as an FNP before I tacked on those letters backed up with clinicals, parchment, and license.

I was thinking about an inpatient setting where a psyche provider like a psychiatrist or PMHNP deals with some minor health issues for psyche patients, but overall, medical consults around me are almost always farmed out to the APN's and physician hospitalists, so that kind of dabbling in FNP stuff isn't typical in reverse on a broad basis... or at least its not something I hope to be presented with.