The Sticky Note I Wrote One Month After Leaving My “Real” Job
On February 9, 2025, I posted on Facebook that Beyond the Stigma AZ was officially open. Two weeks later, on February 23, I completed my first psychiatric intake as a practice owner.
From the outside, that might sound like the beginning of a carefully planned entrepreneurial journey. It was not.
This Was Not the Original Plan
I had not planned to open my own practice before I had even gained experience working as a psychiatric mental health nurse practitioner. The plan had been for my employer to transition me from my nursing role into the PMHNP role they needed. I had trusted that plan and expected to begin this next chapter of my career with the structure, mentorship, consistent caseload, and dependable income of an established organization.
But the plans that had been discussed were not followed.
Suddenly, I had a decision to make much sooner than I expected: find a new employer or do it myself.
I interviewed with a couple of potential employers. Those conversations helped me recognize that their goals and models of care did not align with mine. I did not want to enter another position that would require me to compromise the way I believed psychiatric care should be provided simply so I could say I had experience working for someone else.
So I chose the path I had not expected to take yet. I began building the kind of practice I had hoped to work within.
Sixty Days After My First Patient
On April 24, exactly 60 days after my first intake, I left my reliable “real” job to focus on the practice.
Leaving meant walking away from a predictable paycheck and the security of employment. I believed in what I was building, but belief did not silence the fear. Once the safety net was gone, the “what ifs” became very loud.
What if the practice did not continue to grow?
What if I had left too soon?
What if choosing not to accept insurance made the practice unsustainable?
What if I could not replace my nursing income?
What if I had made the wrong decision?
By the end of May, five more people had found me. Five more people had chosen to trust me to guide them on their mental health journey. This doubled my caseload to 10 patients, and I ended the month with 13 total patient appointments.
Those numbers showed that people were finding me and trusting me with their care. Yet from where I stood, 13 appointments still felt frighteningly small compared with the dependable income I had left behind. I could look at five new admissions and feel hopeful, then look at the open spaces in my schedule and immediately begin questioning everything again.
The Sticky Note
On May 23, 29 days after leaving my job and 89 days after seeing my first patient, I needed something to interrupt the fear. I wrote this reminder on a sticky note:
The reminder I wrote on May 23, 2025, during the earliest and most uncertain stage of building my practice.
I did not write those words from a place of confidence. I wrote them because I was scared and needed to keep going.
The Growth I Could Not Count Yet
At the time, I was measuring the success of the practice primarily through the most visible numbers: how many appointments were on the calendar and how much income the practice was producing. Those numbers mattered, but they were not telling the entire story.
There was a quieter, less visible kind of growth happening within me. It happened every time a patient felt truly heard, every time a therapist trusted me with a new referral, and every time a patient chose to schedule a follow-up appointment. I did not know it then, but with every policy I wrote, every system I created, and every difficult clinical decision I had to make, the strength and confidence I would need as a practice owner were slowly being refined. I was growing without even realizing it.
I was developing my clinical voice while learning how to run a business. I was learning to make decisions without the structure of an employer, establish boundaries, tolerate uncertainty, and trust my own judgment. I was building a cash-pay private practice that allowed me to keep the focus centered on thoughtful, individualized care rather than the highest possible volume.
None of that growth appeared on a monthly revenue report, but it was becoming the foundation of everything the practice would later need.
Where I Am Now
As I write this in September 2026, it has been less than 19 months since my first patient. That perspective matters.
My practice now has a clearer identity, established systems, and a growing community of patients who value the care I provide. I have a much stronger understanding of the patients I am best equipped to help, the kind of provider I want to be, and what the practice needs in order to remain both personal and sustainable.
I am still building. I still have goals I have not reached, and uncertainty has not disappeared completely. But I am no longer standing one month outside of my reliable job, looking at 10 patients and wondering whether the practice is real.
I have evidence that it is.
What I Would Tell Her Now
If I could speak to the version of myself who wrote that sticky note, I would tell her to keep it.
I would tell her that fear after taking a risk does not mean the decision was wrong. Growth and uncertainty can exist at the same time. A quiet week is not a verdict on the future, and the beginning should not be expected to provide the same security as something that has existed for years.
Those five people mattered. Ten patients mattered. Thirteen appointments were not “only” 13 appointments. They were the beginning of something that had not existed until I found the courage to build it.
Most importantly, I would tell her that she did not have to know exactly how everything would unfold before taking the next step. The confidence she was waiting to feel would not arrive before the work. It would develop because she continued doing the work.
The sticky note was right. I was building something meaningful. Growth was happening, seen and unseen.
I was building the practice, and the process was also building me.
A Reflection for Your Mental Health Journey
Maybe your life does not look anything like opening a practice. But you may know what it feels like to be doing difficult work and still wonder whether anything is changing.
Mental health progress can feel especially slow because so much of it happens where other people cannot see it. It may look like pausing before reacting, asking for help, setting one boundary, taking your medication consistently, returning to therapy, or simply making it through a day that once would have overwhelmed you. These moments may not feel dramatic, but they still count.
If you feel behind, stuck, or discouraged right now in your mental health journey, try not to measure your healing or improvement by what is clear and visible to you today. You may still be in the part where the growth is quiet. Keep noticing the small evidence that something is shifting, and allow yourself to trust that meaningful change can be happening, seen and unseen.
On February 9, 2025, I posted on Facebook that Beyond the Stigma AZ was officially open. Two weeks later, on February 23, I completed my first psychiatric intake as a practice owner.
From the outside, that might sound like the beginning of a carefully planned entrepreneurial journey. It was not.
This Was Not the Original Plan
I had not planned to open my own practice before I had even gained experience working as a psychiatric mental health nurse practitioner. The plan had been for my employer to transition me from my nursing role into the PMHNP role they needed. I had trusted that plan and expected to begin this next chapter of my career with the structure, mentorship, consistent caseload, and dependable income of an established organization.
But the plans that had been discussed were not followed.
Suddenly, I had a decision to make much sooner than I expected: find a new employer or do it myself.
I interviewed with a couple of potential employers. Those conversations helped me recognize that their goals and models of care did not align with mine. I did not want to enter another position that would require me to compromise the way I believed psychiatric care should be provided simply so I could say I had experience working for someone else.
So I chose the path I had not expected to take yet. I began building the kind of practice I had hoped to work within.
Sixty Days After My First Patient
On April 24, exactly 60 days after my first intake, I left my reliable “real” job to focus on the practice.
Leaving meant walking away from a predictable paycheck and the security of employment. I believed in what I was building, but belief did not silence the fear. Once the safety net was gone, the “what ifs” became very loud.
By the end of May, five more people had found me. Five more people had chosen to trust me to guide them on their mental health journey. This doubled my caseload to 10 patients, and I ended the month with 13 total patient appointments.
Those numbers showed that people were finding me and trusting me with their care. Yet from where I stood, 13 appointments still felt frighteningly small compared with the dependable income I had left behind. I could look at five new admissions and feel hopeful, then look at the open spaces in my schedule and immediately begin questioning everything again.
The Sticky Note
On May 23, 29 days after leaving my job and 89 days after seeing my first patient, I needed something to interrupt the fear. I wrote this reminder on a sticky note:
I did not write those words from a place of confidence. I wrote them because I was scared and needed to keep going.
The Growth I Could Not Count Yet
At the time, I was measuring the success of the practice primarily through the most visible numbers: how many appointments were on the calendar and how much income the practice was producing. Those numbers mattered, but they were not telling the entire story.
There was a quieter, less visible kind of growth happening within me. It happened every time a patient felt truly heard, every time a therapist trusted me with a new referral, and every time a patient chose to schedule a follow-up appointment. I did not know it then, but with every policy I wrote, every system I created, and every difficult clinical decision I had to make, the strength and confidence I would need as a practice owner were slowly being refined. I was growing without even realizing it.
I was developing my clinical voice while learning how to run a business. I was learning to make decisions without the structure of an employer, establish boundaries, tolerate uncertainty, and trust my own judgment. I was building a cash-pay private practice that allowed me to keep the focus centered on thoughtful, individualized care rather than the highest possible volume.
None of that growth appeared on a monthly revenue report, but it was becoming the foundation of everything the practice would later need.
Where I Am Now
As I write this in September 2026, it has been less than 19 months since my first patient. That perspective matters.
My practice now has a clearer identity, established systems, and a growing community of patients who value the care I provide. I have a much stronger understanding of the patients I am best equipped to help, the kind of provider I want to be, and what the practice needs in order to remain both personal and sustainable.
I am still building. I still have goals I have not reached, and uncertainty has not disappeared completely. But I am no longer standing one month outside of my reliable job, looking at 10 patients and wondering whether the practice is real.
I have evidence that it is.
What I Would Tell Her Now
If I could speak to the version of myself who wrote that sticky note, I would tell her to keep it.
I would tell her that fear after taking a risk does not mean the decision was wrong. Growth and uncertainty can exist at the same time. A quiet week is not a verdict on the future, and the beginning should not be expected to provide the same security as something that has existed for years.
Those five people mattered. Ten patients mattered. Thirteen appointments were not “only” 13 appointments. They were the beginning of something that had not existed until I found the courage to build it.
Most importantly, I would tell her that she did not have to know exactly how everything would unfold before taking the next step. The confidence she was waiting to feel would not arrive before the work. It would develop because she continued doing the work.
The sticky note was right. I was building something meaningful. Growth was happening, seen and unseen.
I was building the practice, and the process was also building me.
A Reflection for Your Mental Health Journey
Maybe your life does not look anything like opening a practice. But you may know what it feels like to be doing difficult work and still wonder whether anything is changing.
Mental health progress can feel especially slow because so much of it happens where other people cannot see it. It may look like pausing before reacting, asking for help, setting one boundary, taking your medication consistently, returning to therapy, or simply making it through a day that once would have overwhelmed you. These moments may not feel dramatic, but they still count.
If you feel behind, stuck, or discouraged right now in your mental health journey, try not to measure your healing or improvement by what is clear and visible to you today. You may still be in the part where the growth is quiet. Keep noticing the small evidence that something is shifting, and allow yourself to trust that meaningful change can be happening, seen and unseen.