PA vs NP- need your advice!!

[Denatured]

Ive said it before and I'll say it again. PsychNP is probably by an NP and just some guy stirring the pot. Nobody is this oblivious to both reality and there own previous statements.

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[PSYCHNP]

PsychNP, if NPs actually had to have nursing experience to go to NP school, it might be different, but I doubt my opinion would change. Many NPs have no experience. Furthermore, many PAs were formerly medics in the military, paramedics, RRTs, and many even nurses.

I do feel that the education between PA and CRNA are very analogous. They both believe in prior HCE, with some schools putting more emphasis than others, and they both believe in full time hard science courses. They also both believe in substantial, full time clinical hours. The only difference is a CRNA focuses only on anesthesia and subjects in relation to it and PAs study all aspects of medicine.

BTW, PA was designed from it's inception based on accelerated physician training during WWII. They were never meant to be a "physician's assistant," (some ignorant people use the apostrophe) but a physician associate, which was there original name.

To minimize the role and training of the CRNA by even comparing it to that of a PA really is not doing are students any justice. The CRNA manages critical cases that is why he or she earns almost twice as much as the PA.

And as for the "unsafe" comment about PAs, get off your high horse. You think NPs don't switch specialties either? I've seen plenty of NPs go froth Ortho to cardiac, etc.

Good post, but the requirements for entry into any advanced practice nursing school (i.e. CRNA, NP, midwife) is to have a valid RN, BSN license and a minimum of 1-2 years of experience. Most have been practicing for several years.

The requirement of entry into PA school is prior "healthcare" experience. Which could be nurse's assistant, medical assistant, orderly ect. This means that for the first year the PA student probably would have minimal relevant experience and/or exposure to medications, treatments, manifestations of diseases ect.

That is the reason MDs/DOs who put in the time in residency are so opposed to the arrogance of the PAs. Let's face it, nothing beats actual experience.

Therefore, the NP student more often than not, enters his or her school at a much higher level than the PA student clinically. That is why in NP school the NP takes graduate level courses which build upon previous knowledge. Thus the title advanced practice nurse.

To compare CRNA education and job duties with that of a PA is not doing our students any justice. The CRNA manages critical patients that is why he or she earns almost twice as much as the PA and has a much more arduous educational path.

 

[Denatured]

Good post, but the requirements for entry into any advanced practice nursing school (i.e. CRNA, NP, midwife) is to have a valid RN, BSN license and a minimum of 1-2 years of experience. Most have been practicing for several years.

Wrong again. The only one that is right about is CRNA. Some NP schools require experience for specialty tracks, like the USA combined ACNP/FNP emergency care track, but 99% do not require any experience. Vanderbilt even has a pathway for you to go directly from no nursing degree to a NP without practicing a day as a nurse.

Check out vanderbilt's site here

Near the top you will see 3 prespecialty semesters and 3 specialty NP semesters for the nonBSN student.

CRNAs earn more because of it's specialty. It's high risk, low overhead, and high reimbursement. PA schools are of the same approximate difficulty (albeit in different ways) and CT surgery PAs can very well approach CRNA salaries.

I'm done speaking with you. I get the feeling your intention is to disparage nurses and I'm just doing the dirty work for you.

 

[PSYCHNP]

Wrong again. The only one that is right about is CRNA. Some NP schools require experience for specialty tracks, like the USA combined ACNP/FNP emergency care track, but 99% do not require any experience. Vanderbilt even has a pathway for you to go directly from no nursing degree to a NP without practicing a day as a nurse.

Check out vanderbilt's site here

Near the top you will see 3 prespecialty semesters and 3 specialty NP semesters for the nonBSN student.

I'm done speaking with you. I get the feeling your intention is to disparage nurses and I'm just doing the dirty work for you.

I believe you are wrong because in order to become an ARNP one must have a valid RN license. Notice that they mention that this is a "full-time" course and they take the time to give the different requirements for Diploma RNs, ASN and non BSNs.

Just because the program accepts nonBSNs does not mean that you are exempt from the credits required of a traditional BSN student.

Trust me, these institutions do not give away education for free get your LPN and try working your way up to be an ARNP. I can almost guarantee you take as many classes or more than a traditional ARNP student.

Nursing has already implemented bridge programs. Something PAs are trying to do with DO programs with little success.


"Program Length (full-time study)

Non-BSN 3 semesters pre-specialty + 3 semesters FNP coursesASN or diploma RNs2 semesters RN pre-specialty + 3 semesters FNP coursesBSN RNs3 semesters FNP coursesPost-master's Program length & courses determined by individual portfolio analysis"

 

[Denatured]

Crap. Becoming as bad as you with your "hiatus" bs.

I'll clarify my previous point. Of course you have to have a BSN. My point was they there is no experience requirement. They take you, do an accelerated BSN over a year, pass nclex, then you go into full time NP courses with NO experience. Be honest with me, do you have asperger?

No where did I say you didn't have an RN license, just no experience.
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[PSYCHNP]

Point well made denatured.

 

[Denatured]

What does the PA/DO bridge have to do with anything? It has nothing to do with nursing. Besides I'm talking about a lay person becoming a NP, not an ADN or LPN. And how would you know about it's success? It hasn't even been around for a year!
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[PrinceVersed]

psychnp makes me very tired.

Denatured, you seem to be very well informed and I generally agree with everything you say.

As I have stated previously in this thread, my state NP school doesn't even require an interview! You apply, you get in. It's like flipping community college or something. How you can compare between a NP program and a PA program is beyond me. The only saying grace for NP is that there are a lot of really good/smart nurses out there that have spent enough time (hopefully) in the unit to overcome at least some of the short comings of such a bad graduate education.

 

[Boston PreMed]

Thanks everybody for all of the relevant (some irrelevant) responses! I have a lot to think about. To answer some of your questions: yes, I do live in one of the states that NPs can practice independently. And yes, I do have HCE. The CRNA/AA idea that some of you brought up does sound interesting. I appreciate all of the input everyone has given me Still weighing out all of my options.

-Boston PreMed

 

[mafunk]

Someone said that AZ is an independent state for PAs.

I am just an aspiring med student, but in my research about DOs and PAs I've learned this.

PAs in AZ MUST have a supervising physician. They physician's malpractice insurance is responsible for the PA. The PA can have an office that is physically away from the Doctor, but must meet with the doctor once a week in person. The PA must get the doctor to sign off on certain levels of meds, but that can be done remotely through computer.

So, be careful about thinking you can have your own practice as a PA in certain states. I think it is more complicated than that.

Just my two cents... I don't know how correct or not, that I am

 

[deleted6669]

Someone said that AZ is an independent state for PAs.
PAs in AZ MUST have a supervising physician. They physician's malpractice insurance is responsible for the PA.

There are no "independent states for pa's".
pa's must have a supervising physician of record in all 50 states, guam, samoa, etc.
that is different than a pa owning a practice. pa's can own practices in many states but in all of them there must still be a supervising doc of record although they don't need to be physically present.
most places buy pa's their own malpractice policies.if the pa owns the practice they buy their own policy and a separate policy for the doc and all of their other staff providers.

 

[ReginaMove]

CNM's have independent practice in NY. They do not practice under physicians supervision (on or off site) and are completely independent practitioners. This includes admitting privileges at the hospital and prescribing rights.
At least in NY and NP is considered of higher level than a PA. But like you said you don't know what you want to be. And you want it quick. In NY there ism ore job security being an NP and more opportunities to increase your salary. DNP is not required of NP's already holding certification - and is promised not to change - even when DNP will be the standard for the profession in 2025.

Can I just say that PSYCH-guy is just insane! Pop a Ridalin man, jeez.

My understanding:

NP's have "independent practice" in the states above, but not really....independent practice means no prescription privilages, no hospital privilages and an even more limited scope of practice.


If you want independent practice...go to medical school

Otherwise, PA school.

 

[ReginaMove]

Your understanding is incorrect young grasshopper.

Mid-levels have a certain degree of prescriptive authority in every state. This goes for Advanced Nurse Practitioners, Doctor (that's a scream) of Nurse Practice, Midwives, CCRNAs and PAs.

What's wrong with DNP? Its a doctorate in nursing practice... is it not? Having a doctorate indicates the person being called a doctor, does it not? The word "doctor does not automatically indicate Medical Doctor... a chem professor is also a doctor... no?

 

[deleted6669]

At least in NY an NP is considered of higher level than a PA. :

ah, no.
in all 50 states pa's and np's are both midlevel providers.
pa's in ny state can staff an er solo with distant supervision. hard to be more independent than that.
politically some states allow np's to practice independently. that does not mean they are "above pa's" it means they can open their own primary care practices(so can pa's but they have to have an absentee physician supervisor of record who basically is a name on a form somewhere for which they collect a check every month).
if np's work for physicians in a hospital specialty group pa's and np's do the same things, are supervised in the same manner whether you call it "collaboration" or supervision, and are paid the same. some groups have a chief midlevel who is a pa, some have 1 who is an np. I used to run a group of 12 midlevels with several np's who all reported to me. I hired and fired pa's and np's.