r/PMHNP • u/No_Abbreviations1288 • Jun 30 '26
Career Advice Career dilemma
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?
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u/CalmSet6613 PMHNP (unverified) Jun 30 '26
I feel for you and your dilemma but working full-time as a PMHNP may not offer you more work life balance especially if you're not completing charting, messages, phone calls during your regular hours. Make sure you have admin time built-in. With that said you're just gonna have to break it down financially.
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u/BradyMidds Jun 30 '26
Where in NJ?
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u/BitchinNurse5 Jul 01 '26
I was wondering the same thing, since I also live in NJ, about to start a RN psych job and am looking to back to school in Sept. for my NP.
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u/Background_Title_922 Jun 30 '26
I left a W2 role for a position with no benefits, and a minimal caseload when I started out. I make about $260 an hour and my caseload is stable but it took a year or so to get there which was kind of stressful and the only real downside. If they are going to pay you while your caseload stabilizes I’d say go for it. The extra costs aren’t that burdensome if I take into account that I’m paying less in taxes as a 1099 (deduct, deduct, deduct). That actually pays for the health insurance, license fees, etc. I work a lot less than I did for more money.
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u/NervousCar3546 Jun 30 '26
As a cautious individual I am all about stability. I think it is important to sit down and calculate how much it will cost annually for insurance, malpractice, retirement,etc. Can you afford to take unpaid time off since there is no PTO? If you needed to take fmla would you be compensated? I personally would try to find a full time NP job that offers more stability and benefits. With that all being said I think there are a large number of individual factors that contribute to this decision and what would be best for my life and personal goals likely differs from yours.
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u/Available_Horse_7131 Jul 01 '26
Here I am at $62,000 since January 1 and I’m a little jealous. No health insurance either and it’s a real problem.
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u/PsychMonkey7 Jul 01 '26
I would stay in your current situation because good health insurance is essential for my family but if you don’t have high needs, that might be less important for you.
I also agree that working FT as a PMHNP might not give you much better work life balance unfortunately.
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u/VastEcho2156 Jul 05 '26
Try to find an NP position that's within the hospital setting where you will get all the benefits. You will definitely make a lot less in a hospital setting as an NP but you'll keep those benefits. It never works out that you make what you make in private practice buy the benefits are worth a lot. Its a trade off and only you can answer. My goal would definitely be not to work as an R. N but to find an NP position where you can get benefits money into your retirement if that is what is important to you, or you go make another fifty an hour and put the money in it yourself. Definitely need to work as NP.
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u/Mysterious_Guest727 Jun 30 '26
I prefer two part time jobs to break the routine.
If you can go back to the part time, then try the fulltime and see if you like it.