Paramedic choosing PA or NP.

[LoadingMe]

Hello everyone,

Thank you for taking the time out of your busy day to read my post and possibly respond to it with your advice. Let me start this off by sharing a little about myself. I am a 26-year-old male who's been working as a paramedic for about a year up until this point with four years of experience as an Emergency Medical Technician. Prior to being getting on the ambulance I really had no direction in my life. Not sure what I wanted to go to college for or if I even wanted to go to college. To be completely honest I really had no thought about my future or what I wanted until I joined the fire department and worked on the ambulance for a few years. I grew to enjoy working on the medical side a lot compared to the fireside. I honestly can't even stand the fireside. I have no interest towards it and when the fire's come out over the tone, I'm the guy in the back praying its a false alarm so I do not have to fight any fire. I would much rather run a cardiac arrest over fire any day (not wishing for cardiac arrests lol). For the past couple of years, I have been constantly thinking about my situation of how I want to envision myself in my thirties and forties. I definitely do not want to be at the fire department for very long and I want to do something in the medical field but struggling to find where.

At first, I thought I had it all figured out, go to nursing school bridging from my paramedic to my RN and then completing the BSN program. After completing the program go do travel nursing and end up in the process working towards my Nurse Practitioner. This has always sounded "good" to me because I always wanted to travel and traveling nursing will give me the ability to do that while pursuing my master's degree but the issue is I am not sure if I want to be an NP for two reasons. The first reason is really stupid and I acknowledge it. The first reason is that I do not like the title "Nurse Practitioner." I hate that it makes me feel this way but its a girly title to me and it just bothers me when I know it shouldn't. I apologize if that offends anyone because I do not mean it too. The second reason why I am not a fan of the NP is due to lack of clinical hours and the lack of mobility. NP from my understanding and research do not have all concentration of specialties that PA's do. What I do like about NP is the ability to do it online while working. The salary is still pretty competitive. It's still a very highly respected career. You have the ability to practice independently which is huge for NPs.

The reason why I like Physician Assistant is one because of the title. I love how it sounds and I feel like it suits my personality better. The second reason why I love PA is due to the clinical hour requirements and the feeling of knowing that I will graduate with good clinical experience and knowledge. The third reason why I love PA is for the ability to be more mobile. If I get bored in one specialization I can move around compared to NP. One reason why I do not like PA is how hard it is to get into the program and missing the chance of having to wait to apply again. The second reason I do not like PA is the cost of the program compared to NP. PA can end up graduating easily with 80-120k of student loan debt.

My biggest problem with trying to choose which route to take is where I want to specialize. I love the sports medicine area. Working with sports team and athletes treating athletes with their injuries really attracts me. I know with Physician Assistant I "may" have the ability to get into this field but I am not sure if NP will give me the same opportunity or if I will need to take extra educational requirements just to get into the field I want to specialize in.

I am also struggling to try to figure out do I go through with the nursing program as a backup plan in case neither the NP or PA workout or do I go into another field like maybe RD or Exercise Physiologist for a bachelors degree to help get into PA school. These may seem easy and pathetic thoughts to some people other than myself but I really do not want to make a mistake I'll regret. Thank you for taking the time to read my post.

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[Caliguy88]

I can offer only this much advise, do as much research as you can, plan out every little detail - what I would have done/will do in the future.

Me in your situation rolling back the clock, I would do NP for sure

 

[pamac]

Many PAs like the “Physician” part of their name, and despise the “Assistant” part.

The reason I never minded the “Nurse” part of the NP moniker was because where I was an RN, there were tons of males in the field, so it didn’t suggest femininity to me. When the guys around you are burly looking dudes with beards and former careers as firemen, cops, military, construction, etc, the term nurse becomes more gender neutral. Another aspect is that when I got into nursing school, a lot of people, male or female, were gunning for that career because the economy was rough. People were like “dude you are so lucky, I’ve tried for three years to get into school”, or “Id love to get into nursing and work 3 days and make nursing wages”. It’s a job with TONs of options, mobility, and a certain degree of respect. Being an RN paid back for me big time. I finished up making as much after over 5 years as a nurse as many new NPs or PAs in my region, while working less and having better fringe benefits. And the work was cool. I spent time all over the hospital environment. So for me, when I hear the word “nurse”, I definitely get triggered in entirely positive ways, and that extends to the words “nurse practitioner”. I’d like to see PAs change their name to shed the anchor of “assistant” because it would probably start a good compelling conversation about expanding their scope. I do have lots of PA friends who do really cool things, and should essentially be practicing without a net. But that restriction is still there, and so when I hear PA, I actually think “restriction”, whereas when I hear “NP” I think “his own man.” Quite literally, the PA name was one of several things that turned me off to the career the entire time I considered it, even during interviews. For me it was less of a name they owned than a description of their relationship with physicians.
But, if you like elements of the PA career field, and gravitate towards it, then research it and become an expert at “pre” whatever. One thing to consider about NP is that the RN work in the run up to becoming one is a really fun aspect of the journey. I don’t feel like there is a set amount of time spent as an RN that is necessary, but it ends up helping in a lot of ways. For me it made it so I was able to take my time and be well off financially, while affording me freedom to spend time with my family, travel, and enjoy the process. I felt good the whole time I went to school, and being an RN and then going to school wasn’t something that I looked at with dread.

 

[FiremedicMike]

You are a medic, as am I. This means you have immediate access to doctors and nurses in the form of ER folks that you interact with and your medical director. I highly encourage you to talk at length with them about the difference between PA's and NP's where the rubber meets the road, out in the job market.

Perhaps they will tell you differently from what I have been hearing, but across the board I have been told that the job of a NP and the job of a PA are interchangeable at all levels, and that after a functional orientation phase, a PA is indistinguishable from an NP.

With that said, I am very likely going NP. While I would agree that at the surface, a PA program seems to be more structured, I find the barriers to entry to be absurd. In my neck of the woods, the pre-requisites for PA school are literally the same pre-reqs for medical school other than you can take 1 less semester of organic chemistry (although you have to replace it with a full year of anatomy and physiology) and you don't have to take the MCAT. All of this work to come out and do exactly. the. same. job. exactly.

I genuinely have the utmost respect for our PA brothers and sisters, but honestly if I'm going to put that much effort into the pre-reqs, I'm just going to take an additional semester of o-chem and apply to medical school. Anecdotally, I think this is why you'll see many more threads and youtube videos from PAs who say "wish I had just gone to med school" than you can find of NPs saying the same.

I recognize that the NP route may be slightly less structured and may require more effort on my part to be well rounded, but I'm content with trading that for 4 less years of undergraduate work..

 

[Gurby]

26 is not too old to start medical school pre-req's

 

[FiremedicMike]

26 is not too old to start medical school pre-req's

100% agree. If I was 26 and not tied to a pension number, I’d definitely go that route.

 

[LoadingMe]

26 is not too old to start medical school pre-req's

I agree that 26 is not too old but I also cannot see myself doing 13-15 years of schooling to become a physician. I enjoy the medical field but I am also realistic in the sense that I know I would not enjoy doing that amount of schooling and I felt the PA schooling fit me well in regards to knowing what I wanted to know and be content with it if that makes sense. Physicians have my utmost respect like any other medical professional. I just know for me personally I am not up for that amount of schooling and debt.

 

[LoadingMe]

I can offer only this much advise, do as much research as you can, plan out every little detail - what I would have done/will do in the future.

Me in your situation rolling back the clock, I would do NP for sure

Why would you choose the NP route?

 

[LoadingMe]

You are a medic, as am I. This means you have immediate access to doctors and nurses in the form of ER folks that you interact with and your medical director. I highly encourage you to talk at length with them about the difference between PA's and NP's where the rubber meets the road, out in the job market.

Perhaps they will tell you differently from what I have been hearing, but across the board I have been told that the job of a NP and the job of a PA are interchangeable at all levels, and that after a functional orientation phase, a PA is indistinguishable from an NP.

With that said, I am very likely going NP. While I would agree that at the surface, a PA program seems to be more structured, I find the barriers to entry to be absurd. In my neck of the woods, the pre-requisites for PA school are literally the same pre-reqs for medical school other than you can take 1 less semester of organic chemistry (although you have to replace it with a full year of anatomy and physiology) and you don't have to take the MCAT. All of this work to come out and do exactly. the. same. job. exactly.

I genuinely have the utmost respect for our PA brothers and sisters, but honestly if I'm going to put that much effort into the pre-reqs, I'm just going to take an additional semester of o-chem and apply to medical school. Anecdotally, I think this is why you'll see many more threads and youtube videos from PAs who say "wish I had just gone to med school" than you can find of NPs saying the same.

I recognize that the NP route may be slightly less structured and may require more effort on my part to be well rounded, but I'm content with trading that for 4 less years of undergraduate work..

From my short time of being a medic in the field I have had a few discussions with nurses only since I have yet to find any NP's or PA's that had a moment to speak. Some nurses have said pretty similar things in regards to them being interchangeable and not being able to tell the difference which I am not sure if that is a bad or good thing, to be honest.

And that's why I really like the PA choice over the NP is due to how well structured the PA school is and I do not want this to be taken out of context but the majority of the NP's I have met at an urgent care seemed rather lacking in confidence when it came to certain tasks. When I went for a routine checkup for my jobs physical I had an NP do it and she asked me if my patella has always looked dislocated when she was looking at my shoulder. It took everything out of me not to question her. Again these are just my experiences with some and if I was asked about the majority I would say most of well educated and are good at what they do.

While I agree that doing all that work makes more sense to just go to medical school but still its another 4-6 years if chosen.

 

[Caliguy88]

Why would you choose the NP route?

Strictly finances..I believe that regard it is the better choice and has the higher potential as well. Possibly subject to change in the next 10 years with everything else.

 

[pamac]

PAs are trained very well. A really good PA candidate also has some heavy sciences that take a while to obtain. I had a very heavy pre med background because I wanted to be situated to go to medical school, dental school, and later even PA school, although the latter was more of an afterthought that was appealing at the time because I already had tons of science credits (if I had originally wanted to be a PA I actually wouldn’t have pushed myself as hard because it hurt my GPA to take all that). The drawback to PA school is relocation and competition. 5 years before I applied, I would have just walked in to a program without much effort. But the economy tanked, and everyone fled to healthcare like a gold rush. Schools started not caring about health care experience, and it was far less appealing for me to relocate for two years to go to a good PA school.

 

[psychnurse]

If you don't know where you want to specialize or you want to work in sports medicine, and you don't care about having ability to practice independently, PA seems like a better fit. PAs seem to have a greater presence in sports medicine, but when I had my tendon repair surgery I did have an NP for post-op follow ups and she was training a PA.

At 26, you can pay off $80-120k debt with a PA salary quickly if you live frugally for a few years and/or pick up extra work. It's a good investment if you're not extravagant.

My SO had a terrible experience with a PA (also in sport med) recently. I wouldn't use any one anecdotal experience to generalize the entire profession. The only conclusion I would draw is that there are good and bad practitioners in every medical specialty.

 

[FiremedicMike]

My SO had a terrible experience with a PA (also in sport med) recently. I wouldn't use any one anecdotal experience to generalize the entire profession. The only conclusion I would draw is that there are good and bad practitioners in every medical specialty.

I wish this could be a banner on this site, pa-forum, and allnurses..

 

[MidwestPAC]

Many PAs like the “Physician” part of their name, and despise the “Assistant” part.

The reason I never minded the “Nurse” part of the NP moniker was because where I was an RN, there were tons of males in the field, so it didn’t suggest femininity to me. When the guys around you are burly looking dudes with beards and former careers as firemen, cops, military, construction, etc, the term nurse becomes more gender neutral. Another aspect is that when I got into nursing school, a lot of people, male or female, were gunning for that career because the economy was rough. People were like “dude you are so lucky, I’ve tried for three years to get into school”, or “Id love to get into nursing and work 3 days and make nursing wages”. It’s a job with TONs of options, mobility, and a certain degree of respect. Being an RN paid back for me big time. I finished up making as much after over 5 years as a nurse as many new NPs or PAs in my region, while working less and having better fringe benefits. And the work was cool. I spent time all over the hospital environment. So for me, when I hear the word “nurse”, I definitely get triggered in entirely positive ways, and that extends to the words “nurse practitioner”. I’d like to see PAs change their name to shed the anchor of “assistant” because it would probably start a good compelling conversation about expanding their scope. I do have lots of PA friends who do really cool things, and should essentially be practicing without a net. But that restriction is still there, and so when I hear PA, I actually think “restriction”, whereas when I hear “NP” I think “his own man.” Quite literally, the PA name was one of several things that turned me off to the career the entire time I considered it, even during interviews. For me it was less of a name they owned than a description of their relationship with physicians.
But, if you like elements of the PA career field, and gravitate towards it, then research it and become an expert at “pre” whatever. One thing to consider about NP is that the RN work in the run up to becoming one is a really fun aspect of the journey. I don’t feel like there is a set amount of time spent as an RN that is necessary, but it ends up helping in a lot of ways. For me it made it so I was able to take my time and be well off financially, while affording me freedom to spend time with my family, travel, and enjoy the process. I felt good the whole time I went to school, and being an RN and then going to school wasn’t something that I looked at with dread.

If your buddies cannot get into nursing school then they are not applying to various places. There are hundreds of programs around my area that have 100% acceptance with the minimum requirements. There are so many for-profit schools out there that anyone can get in if they want to move to a different area of the state or country.

PAs are NOT restricted in their daily practice. PAMAC needs to learn his role when making false claims. He does not know PAs nor has not spent the time looking into the laws. I will post a link so you can see that when PAs practice in a different location than their collaborating physician you have to have access to them via phone. Isn't that the exact same think NPs do in the states that have collaborating authority? So in our daily practice you are not limited by any means to have a physician "on site" and most states have laws in place changing this as we speak. For my state, the collaborating physician and the PA will decide everything at the practice site. For example, if the PA and physician decide that the physician never has to come on site then that is what it will be. Currently my collaborating physician comes to my clinic 8 hours per month for chart review. He works and lives over 60 miles away, not sure how this is restrictive? Also, PAs in my state have better laws than NPs. I would not let PAMAC scare you to go into NP just because it is easier to get into and NPs have "independent" rights in some states. This truly has not bearing on the way PAs practice in any states.

The reason it is harder to get into PA school is because the standard is much higher than NP schools. Yes, there are some good NP schools, but there are A LOT of the for profit, 100% acceptance rate NP schools also. Just listen to your words of should I go the easier route or the harder route. Which one do you think will pay off in the long run?

https://www.ama-assn.org/sites/ama-assn.org/files/corp/media-browser/public/arc-public/state-law-physician-assistant-scope-practice.pdf

 

[MidwestPAC]

PAs are trained very well. A really good PA candidate also has some heavy sciences that take a while to obtain. I had a very heavy pre med background because I wanted to be situated to go to medical school, dental school, and later even PA school, although the latter was more of an afterthought that was appealing at the time because I already had tons of science credits (if I had originally wanted to be a PA I actually wouldn’t have pushed myself as hard because it hurt my GPA to take all that). The drawback to PA school is relocation and competition. 5 years before I applied, I would have just walked in to a program without much effort. But the economy tanked, and everyone fled to healthcare like a gold rush. Schools started not caring about health care experience, and it was far less appealing for me to relocate for two years to go to a good PA school.

What? You could not just walk into PA school even 20 years ago. The standard has always been there except the HCE has been declining (which is sad and due to the number of schools and because PAs are trying to fight against all the NPs and NP schools out there). Please stop your lying man.

 

[pamac]

Sigh........... Just the fact that you have a physician have to come in for chart review (nobody comes in to review my charts like you have to have done for you) says it all. You have to do collaboration, and have to have someone come in for one day per month and have to have chart review. If you don’t have all that going on, it’s only because someone else (your physician) decided not to have that going requirement for you. So right there, you’ve highlighted the difference for me, lol. I have none of that requirement and never have. Thanks man! Maybe having that kind of thing foisted upon you doesn’t bug you at all, but it would me.

Hundreds of RN schools have 100% acceptance rates? If you are preaching that, you are going to quickly run into folks coming on here that won’t have experienced it, especially these medics. The only way that what you said might approach reality is if you throw in some places that are for profit programs that cost upwards of $100,000.

PA school hasn’t always been nearly as competitive as it is now. It used to be the fallback for folks that didn’t land medical school. I remember those times clearly. All you have to do to see that is look at different schools historical acceptance profiles from their stat sheets to see that they changed over time.

 

[Ho0v-man]

I think a good question would be the time frame your looking at. PA might be more debt, but if it gets you done a year faster then it’s worth it. Most NP programs require critical care experience that might cut into your time. This seems highly variable between programs. One program I know of requires X amount of hours in an icu with X amount of beds for a year. Another I know of allows you to work in a fast track in a low acuity ER part time while you do your BSN online. So this is also something to consider.

If you want to be a travel nurse then sure go to nursing school. But you’re really just dragging it out. You’re already thinking about what your thirties and forties will look like. It sounds like you don’t want to be doing either of these things in your late thirties or early forties so let’s get this going!

Feel free to call me out bc maybe I’m way off base here, but it sounds like you want PA more than NP, but going the nursing route is a lot safer. If so, this is a very common scenario. If you get burnt out or gun shy, you can just fall back on your BSN. But if you only have the RN to be a midlevel anyway than what are you doing?

On a personal note, I don’t think going for RN immediately to NP produces very good NPs. You really need that solid nursing experience to build off of. The ones I know who did that struggle a good bit initially.

 

[Boatswain2PA]

Nobody reviews my charts either. And last time I saw my boss was at breakfast, he has never come to the ED with me.
All this varies state by state

 

[pamac]

Nobody reviews my charts either. And last time I saw my boss was at breakfast, he has never come to the ED with me.
All this varies state by state

That’s nice of him or her to extend you that courtesy by their own accord. . But that’s their choice, not yours. What does not vary state by state is that you don’t practice without a collaboration/supervision agreement. There are no states where you may practice without one. You are fine with that, and that’s ok. I’m fine with you being fine with that. Many, many PAs are not fine with that.

 

[pamac]

I think a good question would be the time frame your looking at. PA might be more debt, but if it gets you done a year faster then it’s worth it. Most NP programs require critical care experience that might cut into your time. This seems highly variable between programs. One program I know of requires X amount of hours in an icu with X amount of beds for a year. Another I know of allows you to work in a fast track in a low acuity ER part time while you do your BSN online. So this is also something to consider.

I’m not trying to call you out, but there are significant financial burdens surrounding the high cost of PA school. There are exceptions, but usually you are looking at $100,000 of debt for tuition, and it’s really hard to work while in school. They are tough programs, and any work you do do means less time for studying, and you don’t want to flunk out. So then you have two years of living expenses to consider as well. NP programs can be really expensive if one is dumb enough to go to some place like Georgetown, which is way on the expensive side. But usually you are looking at around $25,000-$50,000. And you are working as a nurse making decent money while you hit school. So while I rarely meet many nurses with a high debt load (unless they paid a lot for their BSN), I almost never see PAs that aren’t paying down pretty significant debt. There are some that bite the bullet and get it paid down quickly, but I just rarely see that. Most of the time you have leftover debt from undergrad coupled to what they acquired in PA school, and then entering a market where they aren’t making the kind of money they had expected. I graduated with almost no debt. The smart folks cash flow their education if they can. There are tuition reimbursement schemes, but you shouldn’t count on them.

So everyone has been talking a lot in here about PA vs NP due to training. There’s merit to many aspects of that. The financial aspect of it is more compelling to me because when someone is asking about decisions that will affect them as deeply as debt, I don’t have the heart to say “go rack up massive debt to go to such and such school” especially if it’s not a sure thing (which for most folks, Pa school is literally years away). The path is littered with folks that fell off of it and have a ton of debt with nothing to show for it but a biology degree. There literally aren’t enough seats for even the good candidates who could do some great things if they had a chance.

With physicians, I don’t see how a medical student attending one of the expensive private programs could afford not to specialize in a high return specialty. I’ve talked to many doctors who are sitting on mountains of debt. Even though there is money flowing in, there are significant amounts of money flowing out as well. I see this with a few of my dentist friends as well.

There are also a lot of unrealistic expectations out there regarding what kind of money is to be made as a provider, as well as what it takes to negotiate a good wage. Most of my NP friends in primary care make around $110,000. That’s not that much compared to what a lot of RNs can make with a little extra overtime, and a lot less stress. It seems every PA and NP student knows a PA or NP that makes over $150,000 (I know those kinds of PAs and NPs too), but I know many more that top out at $120,000 after 10 years if they are lucky. People underestimate how much those top earners work to get the big wages. So while the money can be there, you’ll have to miss a lot of things to get it.

 

[Ho0v-man]

I’m not trying to call you out, but there are significant financial burdens surrounding the high cost of PA school. There are exceptions, but usually you are looking at $100,000 of debt for tuition, and it’s really hard to work while in school. They are tough programs, and any work you do do means less time for studying, and you don’t want to flunk out. So then you have two years of living expenses to consider as well. NP programs can be really expensive if one is dumb enough to go to some place like Georgetown, which is way on the expensive side. But usually you are looking at around $25,000-$50,000. And you are working as a nurse making decent money while you hit school. So while I rarely meet many nurses with a high debt load (unless they paid a lot for their BSN), I almost never see PAs that aren’t paying down pretty significant debt. There are some that bite the bullet and get it done, but I just rarely see that. Most of the time you have leftover debt from undergrad coupled to what they acquired in PA school, and then entering a market where they aren’t making the kind of money they had expected.

Absolutely agree. But if OP is wanting to say do ER, and gets a pay of about $125,000/year then even with that debt it makes sense to get that awesome pay sooner than later to reduce opportunity costs even if it is a bigger bill upfront. Makin’ dat paper 2 or even just 1 year sooner is better. Also this gives OP more time overall in his/her field increasing experience level for pay increases and marketability. If OP was already a nurse then it’d be a no brainer financially to go NP.

Again I’m going to make a statement that is my opinion here: if OP really wants to be a midlevel and just sees nursing as a means to an end, then I’d still recommend PA school bc you’d be miserable as a nurse.

 

[pamac]

That’s true. As an RN I worked with a handful of folks who just wanted to be NPs, and couldn’t figure out how to enjoy what they were doing in the way there. You can imagine how well they performed as RNs. But those folks can probably still be counted on to suck as NPs just based on their personalities. Most people rise to the occasion wherever they are. I didn’t love nursing most of the time, but it wasn’t going to stop me from working hard or finding a way to enjoy what I was doing.

 

[pamac]

I charted things out when I was deciding between PA and NP, and the thing that threw off the benefit of finishing sooner as a PA vs NP was the income as an RN. PAs where I’m at could safely expect to start at around $90,000. As a new RN I made $72,000 base. There wasn’t even a break even point to speak of because going to be a PA only ever kept me behind what I’d be if I did NP. Then I had to consider the quality of life I’d be giving up on due to relocation and missing time with my family.

 

[Ho0v-man]

I charted things out when I was deciding between PA and NP, and the thing that threw off the benefit of finishing sooner as a PA vs NP was the income as an RN. PAs where I’m at could safely expect to start at around $90,000. As a new RN I made $72,000 base. There wasn’t even a break even point to speak of because going to be a PA only ever kept me behind what I’d be if I did NP. Then I had to consider the quality of life I’d be giving up on due to relocation and missing time with my family.

Wow excellent point. RNs start off way lower where I’m from hence the disconnect between us on this.

 

[Splenda88]

If you don't know where you want to specialize or you want to work in sports medicine, and you don't care about having ability to practice independently, PA seems like a better fit. PAs seem to have a greater presence in sports medicine, but when I had my tendon repair surgery I did have an NP for post-op follow ups and she was training a PA.

At 26, you can pay off $80-120k debt with a PA salary quickly if you live frugally for a few years and/or pick up extra work. It's a good investment if you're not extravagant.

My SO had a terrible experience with a PA (also in sport med) recently. I wouldn't use any one anecdotal experience to generalize the entire profession. The only conclusion I would draw is that there are good and bad practitioners in every medical specialty.

But I don't think any PA or medical student would look at a shoulder and calling it patella. I hate when people say there are bad practitioners in every medical specialty as a way to equate PA/Physician/NP education.

NP education, for the most part, is a joke... But doing NP makes more sense financially

 

[psychnurse]

But I don't think any PA or medical student would look at a shoulder and calling it patella. I hate when people say there are bad practitioners in every medical specialty as a way to equate PA/Physician/NP education.

NP education, for the most part, is a joke... But doing NP makes more sense financially

I think you might be making too much out of what I said. I didn't compare NP/PA/MD education other than telling OP that, for what he wants, PA education might be a better fit. You could say that I believe education is important and partially responsible for making a good clinician, but not wholly responsible. If OP chooses NP, with hard work and experience, he can be a good clinician.

I agree that NP education has problems, especially programs with zero-to-low admission standards, lack of rigor in some areas, and paltry clinical hours. I agree that there is a lot more hard science in PA and MD education, and there's more overall clinical training. I can't comment on the outcomes because there's not enough information and I don't entirely buy the current research out there. Anecdotally, I have been a patient and caregiver of a number of NPs and MDs, and I have worked with Psychiatrists and Psyh NPs, and I had good and not-so-good experiences with both. I honestly have not met many PAs, so that's why I said I wouldn't put a blanket statement based on that recent terrible experience with the PA.

You should have questioned the NP who named your shoulder a patella. That's high school anatomy. Or at least clarify what she meant. There are many civil ways to do that. If she truly didn't know where the patella is, you should have made a complaint.

 

[MidwestPAC]

Sigh........... Just the fact that you have a physician have to come in for chart review (nobody comes in to review my charts like you have to have done for you) says it all. You have to do collaboration, and have to have someone come in for one day per month and have to have chart review. If you don’t have all that going on, it’s only because someone else (your physician) decided not to have that going requirement for you. So right there, you’ve highlighted the difference for me, lol. I have none of that requirement and never have. Thanks man! Maybe having that kind of thing foisted upon you doesn’t bug you at all, but it would me.

Hundreds of RN schools have 100% acceptance rates? If you are preaching that, you are going to quickly run into folks coming on here that won’t have experienced it, especially these medics. The only way that what you said might approach reality is if you throw in some places that are for profit programs that cost upwards of $100,000.

PA school hasn’t always been nearly as competitive as it is now. It used to be the fallback for folks that didn’t land medical school. I remember those times clearly. All you have to do to see that is look at different schools historical acceptance profiles from their stat sheets to see that they changed over time.

That is the scary part that you think your 600 clinical hours in psych are equal to a MD/DO and that you can practice independently. Very scary for your patients. It bugs you to have a second set of eyes in the practice of medicine? That is a scary thought that would bug you. Most of the laws for PAs are going to be collaboration only where it is set at the practice site.

Yes there are hundreds of nursing schools with 100% acceptance rates. You meet the minimum requirements and you are wait listed.

 

[MidwestPAC]

That’s nice of him or her to extend you that courtesy by their own accord. . But that’s their choice, not yours. What does not vary state by state is that you don’t practice without a collaboration/supervision agreement. There are no states where you may practice without one. You are fine with that, and that’s ok. I’m fine with you being fine with that. Many, many PAs are not fine with that.

That is not true. North Dakota just passed the law and there are several other states with this sitting to be passed as well.

 

[MidwestPAC]

Wow excellent point. RNs start off way lower where I’m from hence the disconnect between us on this.

Same with nursing around my area. Nurses start out at around $20/hr as a new grad and max out at around $40/hr for ceiling. NPs and PAs make about double what an RN makes around my area.

 

[LoadingMe]

Strictly finances..I believe that regard it is the better choice and has the higher potential as well. Possibly subject to change in the next 10 years with everything else.

I can understand that.

 

[LoadingMe]

PAs are trained very well. A really good PA candidate also has some heavy sciences that take a while to obtain. I had a very heavy pre med background because I wanted to be situated to go to medical school, dental school, and later even PA school, although the latter was more of an afterthought that was appealing at the time because I already had tons of science credits (if I had originally wanted to be a PA I actually wouldn’t have pushed myself as hard because it hurt my GPA to take all that). The drawback to PA school is relocation and competition. 5 years before I applied, I would have just walked in to a program without much effort. But the economy tanked, and everyone fled to healthcare like a gold rush. Schools started not caring about health care experience, and it was far less appealing for me to relocate for two years to go to a good PA school.

Yes, the drawback of PA school is the possibility of having to relocate and the competition but its not something I would avoid going to school for or having the chance too.

 

[LoadingMe]

If you don't know where you want to specialize or you want to work in sports medicine, and you don't care about having ability to practice independently, PA seems like a better fit. PAs seem to have a greater presence in sports medicine, but when I had my tendon repair surgery I did have an NP for post-op follow ups and she was training a PA.

At 26, you can pay off $80-120k debt with a PA salary quickly if you live frugally for a few years and/or pick up extra work. It's a good investment if you're not extravagant.

My SO had a terrible experience with a PA (also in sport med) recently. I wouldn't use any one anecdotal experience to generalize the entire profession. The only conclusion I would draw is that there are good and bad practitioners in every medical specialty.

That is actually why I was considering the PA over the NP or it being the major determining factor. To me, if I am going to end up putting a decent amount of time into my education and taking out a good bit of student loans that I want to have the ability to specialize when I can but also be mobile if I would like to be. NP just does not feel like I would have the opportunity in that regard and I just do not feel confident in the NP's education when I know you can take it online. Again I do not want to make it sound like I am saying all NP's are just dumb because that is not true. I personally just don't feel comfortable taking a mid-level provider online. Yes, I am 26 but I still need to figure out what I want to major in for my undergrad. I can't seem to make a decision. I want to choose something that if PA school fails or I end up never getting accepted, ill have my undergraduate to fall back on.

I am by no means trying to knock either a PA or NP. In both fields, you have your goods and bads. I was just sharing my experience is all. I would never label all NP's like that because that's arrogant and that is not me.

 

[LoadingMe]

If your buddies cannot get into nursing school then they are not applying to various places. There are hundreds of programs around my area that have 100% acceptance with the minimum requirements. There are so many for-profit schools out there that anyone can get in if they want to move to a different area of the state or country.

PAs are NOT restricted in their daily practice. PAMAC needs to learn his role when making false claims. He does not know PAs nor has not spent the time looking into the laws. I will post a link so you can see that when PAs practice in a different location than their collaborating physician you have to have access to them via phone. Isn't that the exact same think NPs do in the states that have collaborating authority? So in our daily practice you are not limited by any means to have a physician "on site" and most states have laws in place changing this as we speak. For my state, the collaborating physician and the PA will decide everything at the practice site. For example, if the PA and physician decide that the physician never has to come on site then that is what it will be. Currently my collaborating physician comes to my clinic 8 hours per month for chart review. He works and lives over 60 miles away, not sure how this is restrictive? Also, PAs in my state have better laws than NPs. I would not let PAMAC scare you to go into NP just because it is easier to get into and NPs have "independent" rights in some states. This truly has not bearing on the way PAs practice in any states.

The reason it is harder to get into PA school is because the standard is much higher than NP schools. Yes, there are some good NP schools, but there are A LOT of the for profit, 100% acceptance rate NP schools also. Just listen to your words of should I go the easier route or the harder route. Which one do you think will pay off in the long run?

https://www.ama-assn.org/sites/ama-assn.org/files/corp/media-browser/public/arc-public/state-law-physician-assistant-scope-practice.pdf

Thank you for the response.

While I did not intend this post to be disrespectful I am going to try my best to keep it that way. I would not say PAMAC is scaring me away from PA school. He is just giving me his honest opinion and I appreciate that from him and you as well. You both are giving your honest views on each side and that is all. I do agree with you that I personally would like to always go the "easier" route like anyone else but at the same time, I know me personally I would not be pleased with myself knowing I took the easy way and never really challenged myself fully. I also have been constantly thinking to myself over and over again that PA school will enable me to be a better mid-level provider.

I myself will most likely choose the PA route. My only dilemma right now is choosing what I want to major in for my undergrad. I am considering biology but I do not feel like it would be a wise choice in case PA school does not work out. I also work full-time as a firefighter/medic and need to take majority of my classes online for my undergrad and I am not sure how that will look for PA programs. I do however appreciate your advice sir.

 

[LoadingMe]

I think a good question would be the time frame your looking at. PA might be more debt, but if it gets you done a year faster then it’s worth it. Most NP programs require critical care experience that might cut into your time. This seems highly variable between programs. One program I know of requires X amount of hours in an icu with X amount of beds for a year. Another I know of allows you to work in a fast track in a low acuity ER part time while you do your BSN online. So this is also something to consider.

If you want to be a travel nurse then sure go to nursing school. But you’re really just dragging it out. You’re already thinking about what your thirties and forties will look like. It sounds like you don’t want to be doing either of these things in your late thirties or early forties so let’s get this going!

Feel free to call me out bc maybe I’m way off base here, but it sounds like you want PA more than NP, but going the nursing route is a lot safer. If so, this is a very common scenario. If you get burnt out or gun shy, you can just fall back on your BSN. But if you only have the RN to be a midlevel anyway than what are you doing?

On a personal note, I don’t think going for RN immediately to NP produces very good NPs. You really need that solid nursing experience to build off of. The ones I know who did that struggle a good bit initially.

Your absolute right sir. PA school may be the quicker choice because right now I am just a 26-year-old firefighter/medic who still needs to figure out what to major in for his undergrad degree. Once I have my bachelors degree all I will have to do is apply to PA school and taking all the necessary requirements for it.

I'm not going to call you out man. That's not my personality or who I am but you are definitely correct in saying that I prefer PA over NP because I do. If someone were to give me the choice right now to have the title of PA or NP. Ill choose PA every time. The only thing that is drawing me off is worrying about will I get accepted to PA school and am I smart enough for it because I did a free IQ test online and I scored a 103. It's not smart but is not dumb. I think it's considered below average and it drops my Intelectual confidence.

I agree completely with you that I do not like the idea of going straight to NP after completing your BSN is a good idea. I've never liked that and always felt like people who did that was doing it for the money rather than being a good provider or patient advocate.

 

[pamac]

That is not true. North Dakota just passed the law and there are several other states with this sitting to be passed as well.

Big News for OTP in North Dakota

NDAPA Members, The ND Academy of PAs Board of Directors is thrilled to pass on some important news from our meeting with ND Board of Medicine (NDBOM) last Friday. The NDAPA has been working with...

ndapa.mypanetwork.com

If that’s what you think full practice authority is, I’ve got a bridge to sell you.

For every state where OTP is being seriously considered, there are many more considering NP full practice authority. Although OTP is a step in the right direction, what that is doing is requiring PAs to be supervised at the practice level. If the docs don’t want to supervise, they don’t have to. But you have to be affiliated with a clinic or facility and have them deem you to qualify. They can rescind the arrangement at their leisure. You can’t go out and practice on your own without supervision. And in North Dakota, it’s not being independent like what NPs have. The one ray of light there is it sounds as if a PA might be able to open their own clinic upon approval if the board of medicine. It remains to be seen how likely that is to happen. It will be up to the BOM whether they have to find a physician partner to “not collaborate with” in that practice environment.

 

[pamac]

The only thing that is drawing me off is worrying about will I get accepted to PA school and am I smart enough for it because I did a free IQ test online and I scored a 103. It's not smart but is not dumb. I think it's considered below average and it drops my Intelectual confidence.

Lol... you are worried about your score in an ONLINE IQ test? Relax and chase your dreams. EVEN IF that test is correct, that would put someone with that score to be right in the middle of the pack. Work ethic will get you farther in life, but I’m not convinced you are even where that test says you are. You’ll be fine. Folks with high IQs need to work hard to keep up, there’s no way around that.

 

[pamac]

Same with nursing around my area. Nurses start out at around $20/hr as a new grad and max out at around $40/hr for ceiling. NPs and PAs make about double what an RN makes around my area.

Let’s use US news and world report’s average salary for PAs at $104,000. Average salary according to them for RNs is $73,000. About a $30,000 gap, but not double. There are market variables to account for, so maybe nurses in a few places are starting at $20 an hour. I’ve heard of that in really rural places, mostly in the Deep South. They start them at $35 where I’m at for 36 hour work weeks. The PA/NP market here is relatively saturated, because people want to live here. Nurses typically make $10,000 more than the average of $73,000, putting them at around $83,000 after a few years. PAs typically at least start out at $10,000 less, making about $93,000. Then there is overtime and differential for working nights for RNs. My RN program was also <$10,000, which my facility paid for, which made that a pretty good deal vs the $200,000 or more outlay that many PAs have to deal with.

 

[pamac]

That is the scary part that you think your 600 clinical hours in psych are equal to a MD/DO and that you can practice independently. Very scary for your patients. It bugs you to have a second set of eyes in the practice of medicine? That is a scary thought that would bug you. Most of the laws for PAs are going to be collaboration only where it is set at the practice site.

Yes there are hundreds of nursing schools with 100% acceptance rates. You meet the minimum requirements and you are wait listed.

LOL! I have considerably more than the minimum hours. My patients are in good hands.

Yes, it would bug me to have codified regulatory oversight, especially with even more time in practice. Nothing scary about that for patients. You’ll feel that way to with more time behind you. But here's the thing... I’ll have that choice myself. You won’t. In reality, I do have a second set of eyes on my practice, which is my state’s board of nursing. They investigate every complaint.

Most laws will be collaboration only? As decided by physicians in practice? Ok. If that floats your boat.

Waiting lists.... they may accept you (after years), but they also will flunk out a ton of those folks. My ADN/RN program had over 650 approved applicants with prereqs ready applying for 40 spots last year. No waiting list.

Don’t get me wrong about practice authority. I think you guys should have it too. With OTP, you guys have actually been given potential to screw up what NPs are working for in every state, because physician groups will look at that in the remaining NP dependent states and say “well, OTP is good enough.”

 

[Caliguy88]

Waiting lists.... they may accept you (after years), but they also will flunk out a ton of those folks. My ADN/RN program had over 650 approved applicants with prereqs ready applying for 40 spots last year. No waiting list.

Don’t get me wrong about practice authority. I think you guys should have it too. With OTP, you guys have actually been given potential to screw up what NPs are working for in every state, because physician groups will look at that in the remaining NP dependent states and say “well, OTP is good enough.”

Can you elaborate/clarify about the waiting list?

Pamac, you seem like an insightful person. In your opinion, what do you see as being the future for PAs primarily in CA in the next 5-10 years?

 

[Ho0v-man]

Let’s use US news and world report’s average salary for PAs at $104,000. Average salary according to them for RNs is $73,000. About a $30,000 gap, but not double. There are market variables to account for, so maybe nurses in a few places are starting at $20 an hour. I’ve heard of that in really rural places, mostly in the Deep South. They start them at $35 where I’m at for 36 hour work weeks. The PA/NP market here is relatively saturated, because people want to live here. Nurses typically make $10,000 more than the average of $73,000, putting them at around $83,000 after a few years. PAs typically at least start out at $10,000 less, making about $93,000. Then there is overtime and differential for working nights for RNs. My RN program was also <$10,000, which my facility paid for, which made that a pretty good deal vs the $200,000 or more outlay that many PAs have to deal with.

Wow! That’s freaking good $$$. I’m not sure about your market, but where I’m from those numbers don’t even kind of line up. Mines on par with MidwestPAC and the only RNs I’ve met that hit those numbers are getting nights/weekends/charge nurse diffs. Just goes to show you that the advice in these threads isn’t necessarily universal.

 

[Ho0v-man]

Your absolute right sir. PA school may be the quicker choice because right now I am just a 26-year-old firefighter/medic who still needs to figure out what to major in for his undergrad degree. Once I have my bachelors degree all I will have to do is apply to PA school and taking all the necessary requirements for it.

I'm not going to call you out man. That's not my personality or who I am but you are definitely correct in saying that I prefer PA over NP because I do. If someone were to give me the choice right now to have the title of PA or NP. Ill choose PA every time. The only thing that is drawing me off is worrying about will I get accepted to PA school and am I smart enough for it because I did a free IQ test online and I scored a 103. It's not smart but is not dumb. I think it's considered below average and it drops my Intelectual confidence.

I agree completely with you that I do not like the idea of going straight to NP after completing your BSN is a good idea. I've never liked that and always felt like people who did that was doing it for the money rather than being a good provider or patient advocate.

Hey just addressing your first paragraph, check the requirements of like the top 20 places you want to go for PA school. I was pre-PA before pulling the trigger for med school instead. I remember the prereqs mostly lining up with the generic premed prereqs but a lot of programs had really weird stuff. Like for one I had to take ochem 2 and biochem but another only gen chem 1&2. I had to take a medical terminology course for no reason for another. You get my drift. On this front, applying to med school was much more straightforward.

As far as the whole intellect thing; the absolute dumbest and most incompetent people you will ever work with are the ones who never doubt themselves or never entertain the idea of being wrong. Glad to see you don’t fall into that crowd. Good luck!

 

[pamac]

Wow! That’s freaking good $$$. I’m not sure about your market, but where I’m from those numbers don’t even kind of line up. Mines on par with MidwestPAC and the only RNs I’ve met that hit those numbers are getting nights/weekends/charge nurse diffs. Just goes to show you that the advice in these threads isn’t necessarily universal.

I’m not even in a high wage nursing market like California.

Charge nurse and weekend diffs aren’t nearly as much as night diffs. The only suckers in nursing (and I don’t mean that in a derogatory way) are folks who work day shift. Tons of problems and management, and low pay. I know nurses from all over the country, and the only places that offer $20 to new grads are either super rural places with a captive audience (and who usually can’t get nurses to work there anyway, and definitely not at that price), or places in the Deep South. But I’m just a nurse who talks with nurses, and on nursing boards too. What do I know. My advice might not be universal, but it’s probably pretty accurate. Saying that most nurses you know make $30,000 less than what the national average is would be consistent with the tendency of folks on here to race to the bottom to score points. Just because someone knows of an RN somewhere making $20 doesn’t imply that most nurses are closer to that than they are to what I made. Even nurses in the cheap places in my state haven’t made $20 as new grads since before 2007.

 

[pamac]

Can you elaborate/clarify about the waiting list?

Pamac, you seem like an insightful person. In your opinion, what do you see as being the future for PAs primarily in CA in the next 5-10 years?

I don’t know of any places that offer waiting lists, but I know they exist in a lot of places. California is one of those places that seems to have them. There are even for profit nursing programs that capitalize on people who either can’t make the cut for a merit based entry to an RN program, or folks who don’t want to wait on a waiting list for a long time. Those kinds of programs cost a ton of money... like in the over $100,000 range. I know nurses that have done that kind of program and are $175,000 in debt or more. That might work for someone wanting to work in California, where wages can be high. Unfortunately, there is also a lot of competition for jobs in the places that pay a lot.

The California environment for PAs sounds pretty good. There is still completion in the more appealing places. The nursing union dominates there, but they haven’t gained independence yet, so there’s rather close parity. It’s a pretty progressive place, so I can actually imagine that PAs could make a good case for them matching practice rights of NPs fairly closely if NPs do actually gain independence. The atmosphere there is actually more geared towards trying to accommodate patient access to care, which is the wave that NPs usually ride when lobbying for improved practice conditions. California also will face cost issues with all of the healthcare initiatives they are wishing to provide, and if they see non physician providers as being cost effective, that would be appealing to many politicians there. On the flip side of that, I don’t see the powers that be in that state wanting NP and PAs to be independent if it means that it bends the cost curve up rather than down. They wouldn’t be doing it for NPPs to be able to open their own practice and bill MediCal a bunch of money. So it’s a bit complicated.

In many places in California, RNs actually make more than many NPPs. You read on message boards about RNs who struggle with wanting to practice as an NP, but can’t take the pay cut. But the ones that do also speak about the working conditions as an NP being better than as an RN. Personally, I can say that my RN job that I liked best was way less stressful, worked less hours, and demanded less of me than my NP jobs. But the money for me is double as a psyche NP than my highest RN wage, and the hours are actually slightly less. There are other benefits of me being an NP are better than what I had as an RN. I got something like 280 hours of paid time off per year, which comes out to like 23 paid days off per year (that’s 12 hour shifts), which isn’t too shabby even for providers. But to get time off you had to schedule a couple months in advance unless you wanted to find your own coverage. I don’t currently take time off on a whim because I don’t want to leave my patients to be rescheduled at the last minute, but I have a bit more freedom to block out days and hours on my schedule. I’m scheduled out several weeks for even an open appointment, so it’s hard to fit folks in when they prefer to be seen.

 

[Ho0v-man]

I know nurses from all over the country, and the only places that offer $20 to new grads are either super rural places with a captive audience (and who usually can’t get nurses to work there anyway, and definitely not at that price), or places in the Deep South. But I’m just a nurse who talks with nurses, and on nursing boards too. What do I know. My advice might not be universal, but it’s probably pretty accurate. Saying that most nurses you know make $30,000 less than what the national average is would be consistent with the tendency of folks on here to race to the bottom to score points. Just because someone knows of an RN somewhere making $20 doesn’t imply that most nurses are closer to that than they are to what I made. Even nurses in the cheap places in my state haven’t made $20 as new grads since before 2007.

K. I wasn’t trying to discredit your post or anything. But it sounds as though you’re trying to discredit me. I’m not sure what you mean by race to the bottom to score points, either. Literally just acknowledging that mine and another poster have different experiences than yours so it’s useful to have more information. Your input and experience on the matter is valued and I’m sorry if my statement inadvertently offended you.

 

[Caliguy88]

I don’t know of any places that offer waiting lists, but I know they exist in a lot of places. California is one of those places that seems to have them. There are even for profit nursing programs that capitalize on people who either can’t make the cut for a merit based entry to an RN program, or folks who don’t want to wait on a waiting list for a long time. Those kinds of programs cost a ton of money... like in the over $100,000 range. I know nurses that have done that kind of program and are $175,000 in debt or more. That might work for someone wanting to work in California, where wages can be high. Unfortunately, there is also a lot of competition for jobs in the places that pay a lot.

Oh ok I was wondering because that coincides with a coworker who was wanting to become an ultrasound tech, apparently he had been on a waitlist here in SoCal for 2-3 years, I believe at a community college. Yes, the expensive nursing schools are over 100k...and starting to ring a bell with the DPT crowd.

Thanks for your projection, I definitely agree with everything said. I hope that PAs in the future will either have an (actual) bridge program to medicine, or at the very least some sort of provider independence, but in all honesty all I really care about is either consolidating my business opportunities in later life to correspond with my job in healthcare or managing the school debt in a way to pursue separate business opportunities outside of healthcare. Both of which, nursing seems to facilitate easier in either scenario.

 

[MidwestPAC]

Let’s use US news and world report’s average salary for PAs at $104,000. Average salary according to them for RNs is $73,000. About a $30,000 gap, but not double. There are market variables to account for, so maybe nurses in a few places are starting at $20 an hour. I’ve heard of that in really rural places, mostly in the Deep South. They start them at $35 where I’m at for 36 hour work weeks. The PA/NP market here is relatively saturated, because people want to live here. Nurses typically make $10,000 more than the average of $73,000, putting them at around $83,000 after a few years. PAs typically at least start out at $10,000 less, making about $93,000. Then there is overtime and differential for working nights for RNs. My RN program was also <$10,000, which my facility paid for, which made that a pretty good deal vs the $200,000 or more outlay that many PAs have to deal with.

Not in the deep south and this is in a town of 175,000 people. Again, most people live in bigger cities and areas, but the midwest varies a lot. I have a relative that works at a nursing home as a DON and their LPNs make more than the RNs in my area. We are only 5 hours away from them. Yes, it is double the pay in my area because my wife was making $22/hr as a floor nurse and now makes $45/hr as a FNP with 1 year experience.

 

[MidwestPAC]

LOL! I have considerably more than the minimum hours. My patients are in good hands.

Yes, it would bug me to have codified regulatory oversight, especially with even more time in practice. Nothing scary about that for patients. You’ll feel that way to with more time behind you. But here's the thing... I’ll have that choice myself. You won’t. In reality, I do have a second set of eyes on my practice, which is my state’s board of nursing. They investigate every complaint.

Most laws will be collaboration only? As decided by physicians in practice? Ok. If that floats your boat.

Waiting lists.... they may accept you (after years), but they also will flunk out a ton of those folks. My ADN/RN program had over 650 approved applicants with prereqs ready applying for 40 spots last year. No waiting list.

Don’t get me wrong about practice authority. I think you guys should have it too. With OTP, you guys have actually been given potential to screw up what NPs are working for in every state, because physician groups will look at that in the remaining NP dependent states and say “well, OTP is good enough.”

How many more hours? 500? Wow! You won't ever be where a MD/DO is and really a residency trained and/or psych CAQ PA but keep counting your numbers.

We had 2,200 applicants for 60 spots for my PA class....

 

[MidwestPAC]

I’m not even in a high wage nursing market like California.

Charge nurse and weekend diffs aren’t nearly as much as night diffs. The only suckers in nursing (and I don’t mean that in a derogatory way) are folks who work day shift. Tons of problems and management, and low pay. I know nurses from all over the country, and the only places that offer $20 to new grads are either super rural places with a captive audience (and who usually can’t get nurses to work there anyway, and definitely not at that price), or places in the Deep South. But I’m just a nurse who talks with nurses, and on nursing boards too. What do I know. My advice might not be universal, but it’s probably pretty accurate. Saying that most nurses you know make $30,000 less than what the national average is would be consistent with the tendency of folks on here to race to the bottom to score points. Just because someone knows of an RN somewhere making $20 doesn’t imply that most nurses are closer to that than they are to what I made. Even nurses in the cheap places in my state haven’t made $20 as new grads since before 2007.

Again you are wrong. I have worked with hundreds of RNs, have hired them and am married to one. We are not in a rural area, town of 175,000, with two level 1 trauma centers in the town. When I started in health care ~10+ years ago, RNs were starting at $15/hr in my area, now they are around $20-22 hrs for hospital, more for nursing homes ($24-26) and less for clinics ($16-$20). The RN that works at my wife's clinic makes $18/hr with 5 years experience.

 

[MidwestPAC]

Can you elaborate/clarify about the waiting list?

Pamac, you seem like an insightful person. In your opinion, what do you see as being the future for PAs primarily in CA in the next 5-10 years?

PAs are looking good everywhere same as NPs.

 

[FiremedicMike]

Again you are wrong. I have worked with hundreds of RNs, have hired them and am married to one. We are not in a rural area, town of 175,000, with two level 1 trauma centers in the town. When I started in health care ~10+ years ago, RNs were starting at $15/hr in my area, now they are around $20-22 hrs for hospital, more for nursing homes ($24-26) and less for clinics ($16-$20). The RN that works at my wife's clinic makes $18/hr with 5 years experience.

Deep south seems to be an enigma of horrible pay, seems to be true in public safety as well.

RN's in my neck of the woods are making $25-45/hr depending on experience and facility.