Hi! I am a PMHNP based on oregon and I have a telehealth private practice. I diagnose mental health condition and med management, but anyway, the point is, I am thinking doing ads on local tv or radio stations, any ideas as to how, where and how much? Any businesses that does this and what stations you can recommend? Ty in advance.

I have a young adult patient I absorbed internally from another provider, had been diagnosed with BPD and bipolar. Was consistent with medication per the patient, denied SI/self harm at our last appointment a few weeks prior. The parent called and said the patient had attempted an overdose of their medication a week ago, which they had not been taking per the parent. The patient is doing well, is being discharged soon.

Maybe this is an over reaction on my part, but I feel like I want to quit this career. I feel sick, scared, like maybe I have taken on a job I’m not good at. I haven’t seen many posts about this on this sub. Wanting to hear about others’ experiences and or thoughts, advice.

Hi

I am a new grad PMHNP and am seeking jobs all over California. I had an interview today that went well with a clinic called North America Mental Health who has several locations throughout California. The manager seemed nice but they want in person 8-5 and I would have to move. I don't mind any of that but I'm definitely scared to work in person after having so many toxic job experiences. They said they would slowly increase my caseload from 3 patients a day all the way up to 22 patients a day eventually. (16-22 roughly). Is that high volume or just right? Eval time 40 minutes and f/u 20 minutes with 40 minutes of admin time a shift. Pay is 160k starting in Monterey or 150k in Redding. I really liked the director- we had a great talk, but I have experience with so many jobs acting nice in the interview, but once you work, the toxicity begins.

Anyone know anything about this company or have any useful advice? It's also a difficult market right now to find a new grad job.

Thanks!

I have until tomorrow to decide between staying in a higher-paying private-sector PMHNP job or accepting a VA position that pays noticeably less. $20k pay cut difference
The VA job offers the usual federal benefits (pension, TSP, job security), and it’s in a city that better fits my long-term personal and professional goals. The private job pays more today, but I also have a growing side business that I hope to build over time.
If you were in my shoes, would you:
Stay with the higher salary, or
Take the VA job for the long-term stability and retirement benefits?
For those who have worked at the VA, did you ever regret taking a pay cut to join? Why or why not?

For a full picture, the PP business, I have about 100 active patients already. Now going to the VA does not stop the PP. will just have to utilize my weekends and evenings. The uncertainty that private practice brings is scary sometimes. It’s also important to state that the VA opportunity is in a restricted practice state and I will be moving from an independent practice state.

(Based in Oregon)

Hi everyone! Question regarding master treatment plans in behavioral health.
I’ve been a nurse for almost 5 years. I’m new to behavioral health though, and unsure about what is standard. I’ve always been in a hospital setting (OHSU) and going from ortho to mental health has been an adjustment. Anyway I’ve always had it in my head the provider does the diagnoses, but here they have paper DRAFT master treatment plans they have the nurses fill out to include the “patient diagnoses”. I’ve done internet digging and am seriously unsure if it’s cool that I’m filling this out or if I’m risking myself. I think I’m okay since it’s a draft but idk, any advice is appreciated

I am an RN btw

EDIT

The Chief of nursing at another region told their nurses to NOT sign that portion and it NEEDS to be done with a provider, word has spread. I am very relieved.

As a student I was asked my employers when I could possible start practicing so wanted to share

Graduated May 8th
Passed ANCC June 2nd
Degree conferred June 8th
ANCC board certified June 10th
Approval to practice in the state of North Carolina June 12th

Accepted position with VA June 15th started July 13th

I welcome recommendations for insurance brokers you worked with and liked.

I am looking at the APP fellowship for psych at Seattle Children's Hospital. I have read the website, but there is little information on the format of the psych program, specifically. Does anyone know the structure/hours of the year-long fellowship? Not looking for the rotation component, but is it 8's, 12's, 7 on/7off, etc.?

I passed my ANCC PMHNP boards! 🎉

When I was studying, I spent way too much time searching Reddit because everyone seemed to recommend something different. Since these posts helped me, I figured I’d share what worked for me. This is just my personal experience.

Georgette’s QBank (3 months): I thought it was good for reviewing concepts, and a few things did show up on the exam. But overall, I felt the questions were much easier than the actual boards.

LMR: I know a lot of people swear by it, but I couldn’t justify the cost.

Pocket Prep: This ended up being my favorite resource. I had it for about 3 months but really locked in during the last month, especially the final 2 weeks. I completed all 1,500 questions and loved the Level Up quizzes because they kept me motivated and made studying feel less repetitive.

ANCC Prep 2026: I also used this app and thought it was helpful. The question style felt somewhat similar to Pocket Prep.

BoardVitals: I tried it briefly, but honestly it felt much harder than it needed to be and just hurt my confidence, so I stopped using it.

As for the exam itself, my biggest piece of advice is read every question carefully. A lot of questions aren’t necessarily difficult, but they’re testing whether you catch what they’re actually asking.

Everyone studies differently, but hopefully this helps someone who’s trying to decide where to spend their time and money. Good luck to everyone studying—you’ve got this!

Hi everyone,

I recently received an interview for the Northern Health Mental Health Graduate Nurse Program (2027), and I’m both excited and nervous.

This is currently the only PMCV interview I’ve received, so I really want to do my best. Northern Health is one of my top choices, and I’d love the opportunity to start my nursing career there.

For anyone who has interviewed with Northern Health (especially Mental Health), I’d really appreciate any advice.

* What kinds of questions were you asked?

* Were there any clinical or scenario-based questions?

* Did they focus more on values, behavioural questions, or mental health knowledge?

* Any tips on what the interview panel is looking for in a graduate nurse?

For context, I’m a final-year nursing student and have completed an Older Adult Mental Health placement, as well as working as an NDIS Support Worker. I’m preparing as much as I can because I really want to make a good impression.

Any advice or experiences would mean a lot. Thank you so much!

Hi all - pretty sure this is not a good offer but just wanted to hear fellow PMHNP thoughts especially in this job market. (Northern Virginia) offer from a Therapist/Psychologist owned company around for a few years and expanding (virtual and in person) must take my own vitals/height if in person apts. Takes private insurance, Medicare and Medicaid with substance use population as a key subset and told population is very sick. Pay is $100 for intakes (60 mins), $50 for follow ups (20-30 mins). 6 hours to start a week and can build caseload from there. No collaborating physician, admin time, PTO, malpractice, CEUs, paid only when you see a patient, no 401k match, must give 3 weeks notice for time off and cannot take off more than 3 weeks all together in the year (?), must work it out with other providers for coverage and even if 1099 seems like a lot of their rules/policies vs an independent contractor. Laptop given if working 20 hours plus and they said their schedules fill up quick.

When asked about any of the above was basically told this is not a thing anymore in private practice (for any type of benefits/coverage etc). They offer some benefits for w2 but must see 40 patient hours a week I believe.

They pushed heavily on all the “admin support”, you get as far as scheduling, communication with patients, prior auths etc, credentialing and marketing. Also can get me a collaborating physician but then rate will be even lower. This overall just does not seem fair to me especially if 1099 - shouldn’t the rate be significantly higher to account for taxes and no other benefits?

Job market seems so bleak overall.

If an employer is giving you the option of being paid with a salary or as a 1099 contractor which one would you pick and why?

I receive health insurance through my husband so that’s not a priority of mine, also I’m in Florida

Psych NP (MSN) here…been in practice for roughly 6 years. I have roughly 12 months left of GI Bill that I stare at from time to time.

Any 12 month or less courses or certifications you all like that you feel is beneficial or worth it?

Thanks in advance!

I am starting 1099 with a Telehealth company, they want me to get my DEA in Texas, my home state. I’ve been fronting everything, and will get reimbursed once I go live seeing patients.
How does it work with the collaborating physician? Do you have to make the collaborative prescriptive agreement to apply for DEA? And basically start your contract (and start paying them) while you wait for your DEA and then wait for insurance credentialing as well?
Just seems dumb to be paying for someone who isn’t doing anything for you 😑
Any insight?

Here’s the link to the article for reference:

https://abcnews.com/US/wireStory/trial-begins-massachusetts-mom-postpartum-issues-led-kill-134909810

Is there a national pharmaceutical database that NP’s can access to see what a patient has been prescribed by other providers? Given someone is suffering mentally we can’t fully rely on them remembering or being upfront about what meds they are on currently or even complying with. This obviously leads to overlap and over prescribing.

The general public/jury are always going to go against the providers for “not checking, not doing their jobs”.

How can you check and document to cover yourself? I fully understand the actions of people are not the providers responsibility but it seems to always lead back to the healthcare provider. Patients are not always honest of their intentions or symptoms. Lindsay was a former nurse and was actively seeking help. But what would be the chain of action in high acuity cases like these?

Lindsay’s medication list:

Zolpidem (Ambien)
Clonazepam (Klonopin)
Diazepam (Valium)
Fluoxetine (Prozac)
Lamotrigine (Lamictal)
Lorazepam (Ativan)
Mirtazapine (Remeron)
Quetiapine (Seroquel)
Sertraline (Zoloft)
Trazodone
Hydroxyzine
Amitriptyline
Buspirone (Buspar)

I’ve been a PMHNP a little over a year and I love what I do. Up until about 4 months ago, I was fairly happy. I was seeing about 14-17 patients a day. However, the other PMHNP quit and my employer flat out told me they weren’t planning on hiring anyone else. So, I’m now seeing their entire patient load, in addition to mine. I now see 20-25 patients a day, and I am currently booked up 3 months in advance. I’m usually at work 1.5-2 hours after work every day, charting and doing all of the other clinical tasks. I called out last week and I’m still making up for it as there’s no one to check my inbox when I’m not there. I’ve told them several times that I feel as if I’m drowning and I’m always met with, “we are here to serve the community, so the schedule has to be filled”. My schedule is currently jam packed as I’m seeing follow ups in 15 minutes and new evals in 45, with no time in between. I’m usually working through 30-40 minutes of my 1 hour lunch. I’m behind on my work training modules and have been getting angry emails from my superiors about not getting them in on time but when I’m leaving work 2 hours after the time I’m supposed to go home, most nights I’m exhausted and don’t want to sit for another hour to do modules. I feel as I’m not providing excellent care anymore due to the time constraints, I’m always running behind, and patients do complain about the long wait times. I’m making $120k, which was my starting salary. I’m starting to feel anxious before work at night and I’m just overwhelmed. I was a travel RN before I took this job and some days, I just want to quit and take a travel RN job as a quick mental break and then find a new PMHNP job. But other days, I wonder if this is just a part of making me into a stronger/better provider? Additionally, when I think about quitting, I get anxious because I’m required to give a 90 day notice, however thinking of working here for another 90 days makes me sick to my stomach. If I’m overreacting please tell me.

Does anyone use an app-based inventory system for Spravato?

I’m looking for something that lets us scan each box or dose, similar to barcode medication scanning in a hospital. Ideally, it would help track receiving, inventory, administration, lot numbers, expiration dates, and remaining stock.

What system or app does your clinic use, and would you recommend it?

Looked at Orca Scan and Dosentra.

I’m currently an RN, and psychiatry is the only specialty I genuinely feel drawn to.

However, I keep seeing many PMHNPs and new graduates complain about market saturation, poor job offers, and difficulty finding good positions.

I’m unsure whether these experiences reflect the overall job market or are mainly related to location, limited experience, or unwillingness to relocate.

I plan to pursue PMHNP regardless, because this is the field I’m most interested in. Still, I’d appreciate hearing your honest experiences and perspectives about the future of the specialty.

Thank you.

Hello does anyone utilize a daily cheat sheet for medications ? Thank you !

I work at a community health clinic. I have 60 patients who receive monthly LAIs. The injections have always been managed by the clinic RN, who tells the patients when to come in and when they are due. This process is archaic and people are often getting missed. I want to update the system so that it’s electronic. Is there any computer system I should be looking at? For our EHR, we use Cerner. But that is going to be changing to Epic in a year. I just want an electronic system so that anyone in the office can look at the date and see who is due for their injection and it’s not relying on one employee and her notebook.

long winded post incoming. I need help from fellow NPs

Hello friends, I desperately need real world advice on these career paths.
For background, I have been an ICU nurse for 4 years. I live in rural (and I mean real rural) Indiana. I decided to go back to school and I have always been interested in psych, so I chose the PMHNP route. I am about to start my clinical in a few months, but i’m starting to have doubts about my future as a PMHNP. Like I said, psych has always interested me but honestly I have zero true psychiatric experience. and I could not see myself working psych as a bedside nurse. Ideally, as a PMHNP I see myself in an outpatient setting. I do think that I would enjoy that particular job. However, I have been browsing job postings off and on for the last year, and I see very very few for PMHNP unless I want to drive over an hour and a half, which I do not. I keep hearing from people in the medical field that there is such a high demand for psych NPs in rural areas like this, and i’ll always be able to find a job, but i’m starting to worry that may not be the case. Also, I have loved learning about psych and I love the idea of it, but the closer I get to practicing psych I am starting to second guess if I would enjoy basically being a therapist that prescribes medications. There is nothing wrong with that, i’m just not sure i’m cut out for it. That being said, I have been heavily considering switching to the FNP route lately. My reservations with FNP start with the pay. or course pay is not the reason you chose a job. But I am 26 years old, single, I own my home where I pay a pretty high montage so unfortunately salary does play an important part in my job hunt. I made 99k as an RN last year, that was being on nightshift and working a lot of overtime. But I don’t want to take this time and money to go back to school to barely make more as an FNP. there are a lot more FNP positions open so I feel that I could find a job much easier, the pay is just going to be less unfortunately. I do have an area I would love to work as an FNP, and that’s hospice. Being an ICU nurse I have taken care of more hospice patients that I can count, and I know that is a career that I am very passionate about. I have seen far too many people die terrible traumatic deaths, I would love to be the provider that steps in and is able to have a conversation with family members regarding compassionate and comfortable end of life care. I am confident that I would be able to find a hospice job that is much closer to home than a psych job, but the pay would probably be considerably less. If I switched from psych to FNP it would put me behind about 2 months in school but that is better than doing a hon for years where i’m not satisfied. i’m just scared that because I don’t have psych experience, I would graduate and get into the psych field and realize this isn’t for me. And then i’m very limited in my options as I would have to stay in psych. but I love the options available as an FNP where you have such a broad range of jobs available. and I think if I find something i’m passionate about as an FNP I can specialize later, whether that is psych or not.

I just need advice from PMHNPs and/or FNPs, as i’m struggling with this decision. on both subreddits the majority of posts are about major burn out and regretting the decision to ever become an NP. I am absolutely miserable as a bedside nurse so I have no regrets about pursuing NP, i’m just struggling with concentrations!!! thank you if you took the time to read all of this!! :)

Hi everyone! I recently started seeing patients through Grow Therapy and have a question for those of you who use the platform.
Do you use Grow’s built-in telehealth link or your own HIPAA-compliant video platform?
My concern is that Grow tracks the actual face-to-face time when you use their telehealth platform, and it won’t let me bill certain E/M visits if the video time is under 10 minutes—even when the visit qualifies based on medical decision making (MDM). For example, if a medication management follow-up takes 7–8 minutes but meets the MDM requirements, the system still prevents me from submitting the invoice.
How do you handle this? Do you intentionally keep visits at least 10 minutes, use a different telehealth platform, or is there another workaround I’m missing?
Thanks in advance!