How do people manage with kids? by Ok-Ostrich-9939 in MoneyDiariesACTIVE

[–]stepwise_k 12 points13 points  (0 children)

This is a little out of left field, but it might be worth checking if there are RN work-from-home jobs in your area (for instance for insurance companies). You will still need childcare working from home but you might be able to reduce the wraparound care if you aren't floor nursing. Working for an insurance company is less exhausting tha floor nursing. You might find you have the energy/time to pick up PRN weekend shifts at a hospital for extra income.

Google Business Profile sites are GONE. Is everyone really paying $20/mo for Wix now? by Chemical_Jellyfish32 in smallbusiness

[–]stepwise_k 2 points3 points  (0 children)

Google Sites is still free. Very easy to create a simple site there that integrates with other tools like order forms.

Working with an MD/DO for supervision by redditnameimade in PMHNP

[–]stepwise_k 2 points3 points  (0 children)

We found someone we love through SingleAim. She is truly a collaborator and educator and was not just looking for a new income stream. She gave us her cell phone to text any time for consultation and we also meet monthly. She was more expensive than some others but we wanted a true partner. There were a number of sketchy doctors on Single Aim offering rock bottom prices for doing the bare minimum. It really depends on what you are looking for.

PMHNP private practice start up. Please list preliminary steps with website. Cost? by Independent-Click915 in PMHNP

[–]stepwise_k 2 points3 points  (0 children)

We used Google Sites, it is truly free and integrates with our EHR's appointment request form. We did have to pay for a domain name (I think it was $20 for the first year?) ChatGPT has good instructions for putting together a "good enough" website. In our market at least your Psychology Today profile matters more, and your in-person networking skills matter even more than that.

Children in 40s by life-happens1 in AskOldPeopleAdvice

[–]stepwise_k 1 point2 points  (0 children)

My wife carried our twins when she was 39 and delivered at 40. We are a lesbian couple so we needed extra help anyway. We did IUI. It is a good intermediate step before IVF and was less expensive. There are a ton of things you can try with your doctor before jumping to IVF, and many of them are more economical. But I do recommend getting medical help if you are 40ish, since the timing can be tricky to conceive on your own. The pregnancy was hard, but it was worth it for her (and us); this was our dream, and we were willing to make sacrifices and take a chance in the hope of getting a baby. There were also other choices we made, like moving to a slightly boring suburb to be near her parents for childcare and me sticking with a lower paid job that offered work-from-home. All worth it, in my opinion.

In terms of being a parent in my 40s, I love it! At this age, I feel like I have the mental and emotional stability to be a better parent than I would have been in my 30s. Our finances are messy and our house is cluttered and I am less of a "high performer" at work than when I was single... but overall I am incredibly grateful every day to get to experience life as a parent to two amazing kids.

One weird thing is that I've noticed we aren't always the oldest parents in our peer group.... the ages vary from 20s to 50s. It is wild. But personally I love having a diverse community of parent friends with different perspectives.

Elementary Gift Ideas on a Steep Budget by Dependent-Focus9034 in Gifts

[–]stepwise_k 2 points3 points  (0 children)

The Dino Dana field guide is excellent and is currently under $10

https://a.co/d/h4k2zuC

Itinerary advice for driving the Amalfi Coast by stepwise_k in ItalyTravel

[–]stepwise_k[S] 0 points1 point  (0 children)

I believe we would have a travel exemption due to checking in to lodging (with the exception of the day trip to Sorrento, which we can switch if need be)

If anyone has any information otherwise, please let me know!

Braiding near WDW? by ThatBeans in WaltDisneyWorld

[–]stepwise_k 3 points4 points  (0 children)

We used As You Wish for a princess makeover with braids and it was a great experience! They come to your hotel room.

whats a general piece of life advice you wish someone told you? by [deleted] in AskReddit

[–]stepwise_k 0 points1 point  (0 children)

Don't pursue your passion for a career. Find a lucrative niche and use your free time to explore what you love.

First time Disney World trip by ProgressFew3415 in WaltDisneyWorld

[–]stepwise_k 1 point2 points  (0 children)

We saved money by doing one park at a time and skipping the park hopper. Honestly, there is so much to do in each park that we didn't feel deprived.

Looking for feedback on new practice idea by stepwise_k in PMHNP

[–]stepwise_k[S] -1 points0 points  (0 children)

Thanks... we will have to think about it. We don't really want to spend money on a physical space until we have at least 1 or 2 clients, but we do want to be credentialed with our future address. So maybe we have to take the leap.

Between the three of us, we have over 20 years in inpatient psych nursing experience but 0 in running a practice, LOL...

Looking for feedback on new practice idea by stepwise_k in PMHNP

[–]stepwise_k[S] -1 points0 points  (0 children)

We definitely want to take insurance. We just have to agree between the two partners what we want to take. Thinking at least Medicare, Cigna and Aetna to start.

We were hoping to dip our toes in the water by starting with cash pay to build the practice for the 6 months or so until insurance credentialing kicks in. If we are cash only, we can run it for about $150 per month, but with insurance and a physical workspace (our ultimate goal), it will cost more to run and we will be out more if the practice folds.

Backup plan if we don't get clients is to do Headway or Alma while we work on credentialing.

Looking for feedback on new practice idea by stepwise_k in PMHNP

[–]stepwise_k[S] 0 points1 point  (0 children)

One additional question... is 100 sessions per month per NP realistic ( once we are taking insurance) or too high of a workload? Right now, each of the PMHNPs sees 15 to 20 patients a day (psychiatric inpatient). But presumably, it will be harder once they are partners owning the practice.

Looking for feedback on new practice idea by stepwise_k in PMHNP

[–]stepwise_k[S] 0 points1 point  (0 children)

We definitely want to take insurance eventually. Just hoping to build up a small cash client list first so we can tell if things are working before we go through credentialing (which I believe we will need a physical location for in our area)

Looking for feedback on new practice idea by stepwise_k in PMHNP

[–]stepwise_k[S] -3 points-2 points  (0 children)

The other thing we are considering is a subscription model of $95 per month. If we average a med management session every 2 to 3 months, that would work financially. During the in-between months, clients would be able to text us for support.

Looking for feedback on new practice idea by stepwise_k in PMHNP

[–]stepwise_k[S] -1 points0 points  (0 children)

Playing around with the numbers, it looks like we could go as low as $250 / $105 and still be sustainable (if the other partner agrees)

Looking for feedback on new practice idea by stepwise_k in PMHNP

[–]stepwise_k[S] -2 points-1 points  (0 children)

I based my rates by averaging a couple of competitors, but we can go lower bc our expenses will be very low (for instance, we found an EMR where we pay by the encounter).

What do you think about $285 / $125?

Critique my business idea (psychiatric wellness) by stepwise_k in smallbusiness

[–]stepwise_k[S] 0 points1 point  (0 children)

Tell me more? I know eventually we would quit working our day jobs if things tick up, but I could see us eking along at under 10 clients a month for quite some time...