Paramedic choosing PA or NP.

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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.

So what you are saying flies in the face of the average numbers nationally for RNs. Again, this is consistent with your race to the bottom. I’d prefer to stick with the national average wages rather than hear you spin a tale of $20 an hour RNs while insisting that is the typical pay for most places. The average is around $30 and hour, and you want to argue otherwise? I know PAs that make under $85,000 (along with NPs), but I wouldn’t suggest that’s typical. Instead I used the national stats for BOTH PAs and RNs as a standard measure and you fire back with “well where I’m at RNs make almost nothing”. But nothing you are saying diminishes the fact that nurses make decent wages to live on.

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....

One thing I can say with confidence is that residency trained PAs in psyche are rare. Psyche NPs also have residencies/fellowships as well....so whatever. I have more psyche than the typical PA working in psyche. I also have much more pertinent pre NP experience than any psyche PA out there unless they were a psyche nurse. Again, it’s your intellectually dishonest approach of comparing the best that a PA can optionally obtain to the bare minimum of what an NP can obtain. It undermines you every time you do it, but it’s fine with me if you keep taking that approach. People see that and can draw their own conclusions.

If you have 2,200 applicants for 60 spots, that’s cool. But overall, that reflects the fact that PA applicants apply to quite a few schools to get into one or two. If you apply to one PA school, your odds of getting in are 1 in 4. If you apply to 12, the odds are 1 in 2. Overall 1 out of 3 applicants to PA school get in. It’s pretty competitive, I’ll agree to that, but your statistic doesn’t say much about the overall competitiveness. Just makes you feel good, I guess. To me it suggests that your school makes $220,000 if it charges $100 per supplemental application, so it’s in its best interest to encourage more applicants.

I’m onboard with the idea that the PA career is a good career to pursue, but not at any cost. I know quite a few folks getting hosed right now because of their undergrad loans coupled with their grad school loans. Even nurses I know are terrible with their money, and that includes what they are taking out for grad school. I throw my numbers out there and folks can decide for themselves whether they stack up. If someone wants to know what nurses make, the fastest way to do that is ask a nurse in your area and they will tell you. If nurses there make $45,000 per year, then you are only out $90k by forgoing work as a nurse while in PA school instead of above $140,000 ish like I would have. Choose your own adventure.

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PAs are looking good everywhere same as NPs.
PAs are looking good everywhere, but not necessarily the same as NPs are. NPs are working on adding more states to the fold of independent practice. PAs are making steps in the right direction, but don’t have anywhere near that. PAs have OTP in one state, which still doesn’t mean they are off the chain. It means their practice gets to decide their level of independence within that practice (in whatever Dakota they accomplished that in).

The intricacies if all that probably don’t matter to the vast majority of people who want to show up, take care of people, get a good wage, and go home. I think PAs should have something similar to what NPs have in most places so that there is much less red tape to what they do. Maybe it doesn’t matter in the day to day, but if it doesn’t matter in the day to day, then why not let them have it?go over to the Pa forums and read about how frustrated they are that they don’t have it.
 
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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.

Unless we are in the exact same neck of the woods, that’s what I’m seeing where I’m at too. But who do you believe, the one ranting with every breath, or your own lying eyes?
 
Unless we are in the exact same neck of the woods, that’s what I’m seeing where I’m at too. But who do you believe, the one ranting with every breath, or your own lying eyes?

I'm a guy who likes to look for the middle ground, to try and understand the other side of a debate, especially when it's extreme..

It's possible his worldview is narrow. I've heard tons of stories about horrid pay in the south for pretty much everyone.. Full-time cops/firemen making $35,000 a year.. Nurses making crap, NPs making crap.. The numbers he is quoting may be reality in his area..
 
I'm a guy who likes to look for the middle ground, to try and understand the other side of a debate, especially when it's extreme..

It's possible his worldview is narrow. I've heard tons of stories about horrid pay in the south for pretty much everyone.. Full-time cops/firemen making $35,000 a year.. Nurses making crap, NPs making crap.. The numbers he is quoting may be reality in his area..

PAs and NPs in those places get paid less accordingly.
 
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.
I am not even close to the deep south. I am in the midwest. Why do I have to repeat myself over and over.
 
I am not even close to the deep south. I am in the midwest. Why do I have to repeat myself over and over.

Ok, I'll admit I misread a previous post by you in this thread that mentioned the deep south and thought you were speaking for the deep south.

Perhaps you should type in full sentences, it makes it easier to understand the points that you're trying to make.

FYI, I'm in the midwest as well, the pay is well above what you state, at least in my area..
 
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So what you are saying flies in the face of the average numbers nationally for RNs. Again, this is consistent with your race to the bottom. I’d prefer to stick with the national average wages rather than hear you spin a tale of $20 an hour RNs while insisting that is the typical pay for most places. The average is around $30 and hour, and you want to argue otherwise? I know PAs that make under $85,000 (along with NPs), but I wouldn’t suggest that’s typical. Instead I used the national stats for BOTH PAs and RNs as a standard measure and you fire back with “well where I’m at RNs make almost nothing”. But nothing you are saying diminishes the fact that nurses make decent wages to live on.



One thing I can say with confidence is that residency trained PAs in psyche are rare. Psyche NPs also have residencies/fellowships as well....so whatever. I have more psyche than the typical PA working in psyche. I also have much more pertinent pre NP experience than any psyche PA out there unless they were a psyche nurse. Again, it’s your intellectually dishonest approach of comparing the best that a PA can optionally obtain to the bare minimum of what an NP can obtain. It undermines you every time you do it, but it’s fine with me if you keep taking that approach. People see that and can draw their own conclusions.

If you have 2,200 applicants for 60 spots, that’s cool. But overall, that reflects the fact that PA applicants apply to quite a few schools to get into one or two. If you apply to one PA school, your odds of getting in are 1 in 4. If you apply to 12, the odds are 1 in 2. Overall 1 out of 3 applicants to PA school get in. It’s pretty competitive, I’ll agree to that, but your statistic doesn’t say much about the overall competitiveness. Just makes you feel good, I guess. To me it suggests that your school makes $220,000 if it charges $100 per supplemental application, so it’s in its best interest to encourage more applicants.

I’m onboard with the idea that the PA career is a good career to pursue, but not at any cost. I know quite a few folks getting hosed right now because of their undergrad loans coupled with their grad school loans. Even nurses I know are terrible with their money, and that includes what they are taking out for grad school. I throw my numbers out there and folks can decide for themselves whether they stack up. If someone wants to know what nurses make, the fastest way to do that is ask a nurse in your area and they will tell you. If nurses there make $45,000 per year, then you are only out $90k by forgoing work as a nurse while in PA school instead of above $140,000 ish like I would have. Choose your own adventure.
Where did you get these odds from?

Nurses do not apply to multiple schools?
 
Ok, I'll admit I misread a previous post by you in this thread that mentioned the deep south and thought you were speaking for the deep south.

Perhaps you should type in full sentences, it makes it easier to understand the points that you're trying to make.

FYI, I'm in the midwest as well, the pay is well above what you state, at least in my area..
I have typed in full sentences on all my post. Please copy and paste what you are referencing.

The Midwest is a lot of states so that does not surprise me. My relatives live 5 hours from me in the midwest and the nurses make almost double what my wife was making. It all depends on where you live and the COL.
 
Not in the deep south and this is in a town of 175,000 people.

This sentence could mean "that's not how it is in the deep south, even in a town of 175,000" or it could also mean "I'm not talking about the deep south, I'm talking about a town of 175,000"

Whatever, once again we find ourselves off in in the weeds arguing irrelevant points.
 
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PAs and NPs in those places get paid less accordingly.
In the places with the low pay for RNs I mentioned in previous posts, the docs and mid levels were getting paid MUCH more than the averages posted online. I don’t know of any PAs making less than 6 figures, although this may be skewed as the were all surgical or EM PAs. The NPs who didn’t hit 6 figures were still close by just working outpatient clinic 4 days/week.

Edit: I recently moved to a new state for third year of med school and this thread got me checking RN salaries. ~69k/year. Much more in line with your previous posts than mine.
 
PAs are looking good everywhere same as NPs
I kinda disagree here. The explosive growth of PA and NP programs are starting to drive down pay. Adminiscritters would rather pay one of the 15 new grad NPs who applied only $45/hr instead of an experienced PA $85/hr.

The hospital closest to where I am going to semi-retire does this. But it just bit them in the arse with two malpractice suits, one of which was utterly indefensible. But that doesnt matter to the adminiscritter.
 
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I kinda disagree here. The explosive growth of PA and NP programs are starting to drive down pay. Adminiscritters would rather pay one of the 15 new grad NPs who applied only $45/hr instead of an experienced PA $85/hr.

The hospital closest to where I am going to semi-retire does this. But it just bit them in the arse with two malpractice suits, one of which was utterly indefensible. But that doesnt matter to the adminiscritter.

It think it’s anyone who hasn’t had any other healthcare experience that graduates and drives down the wages. More PAs are cranked out in my town thank NPs, and none of them know how to negotiate because it's their first real job. The NPs have all been nurses making decent wages, so they not only know what they are looking for, but they also don’t feel rushed to settle. One of the fluff classes everyone takes is a professional development course. The program I went to had one, as did my BSN program. But the market is getting flooded, and it’s to the benefit of administration. Same thing with the nursing shortage the hospitals always talk about. There’s not really a shortage like they want everyone to believe. What they want is lots of nurses to be churned out (mostly at the expense of the taxpayer funded schools), so that the hospital can then pay them less, and tell them to go to hell when they complain about things. Hospitals want a ready supply of replacements.
 
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It's not the direct/accelerated RN to NP graduates, or the no-HCE PA graduates running the wages down.

It's the sheer numbers of graduates. The programs, for different reasons, are lucrative so collages look to open more (and rake in the student loan money).

Furthermore, the adminiscritters dont care about anyone's competence, let alone prior HCE. They just want someone with a license.

And I believe there are 8 new NP grads for every new PA grad in my state.
 
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It's not the direct/accelerated RN to NP graduates, or the no-HCE PA graduates running the wages down.

It's the sheer numbers of graduates. The programs, for different reasons, are lucrative so collages look to open more (and rake in the student loan money).

And I believe there are 8 new NP grads for every new PA grad in my state.

NPs aren’t up to 8:1 graduation rate yet. Nationally it’s roughly 3:1, but I just saw a chart that showed that NP schools tend to churn out 3,000 more students EACH year more than the previous year. The spreadsheet showed that from 2010 to 2015, NPs increased from graduating 11,000 per year in 2010 to 20,000 in 2015. Over 28,000 NPs graduated in 2017, so with the average of 13% annual growth rate, (which it seems to roughly be increasing by), that means 2019 is looking like over 35,000 NP graduates if that trend is consistent. So yeah... there’s going to be saturation coming like what happened to lawyers if things don’t slow down.
 
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^ This is something I am worried about. However, government mandated/supplied healthcare should increase the needed number of providers tremendously. You should see how bad it is in California when healthcare is "free". People will schedule an appointment for a headache, while most middle class doesn't go in unless its serious like a compound fracture.
 
^ This is something I am worried about. However, government mandated/supplied healthcare should increase the needed number of providers tremendously. You should see how bad it is in California when healthcare is "free". People will schedule an appointment for a headache, while most middle class doesn't go in unless its serious like a compound fracture.

Yep. When things are free, they respect them as much as they respect other things that are free... by enjoying the novelty i the beginning, and then prioritizing it behind anything else they have going on, including naps and trips to the store.

Overall, I think things will be fine for quite some time.
 
NPs aren’t up to 8:1 graduation rate yet. Nationally it’s roughly 3:1, but I just saw a chart that showed that NP schools tend to churn out 3,000 more students EACH year more than the previous year. The spreadsheet showed that from 2010 to 2015, NPs increased from graduating 11,000 per year in 2010 to 20,000 in 2015. Over 28,000 NPs graduated in 2017, so with the average of 13% annual growth rate, (which it seems to roughly be increasing by), that means 2019 is looking like over 35,000 NP graduates if that trend is consistent. So yeah... there’s going to be saturation coming like what happened to lawyers if things don’t slow down.

Oversaturation only occurs if they all stay in practice. Allnurses is littered with posts from NP's who want to know what they can do next, as they're tired of clinical practice after 3-6 years of being an NP..
 
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@FiremedicMike @pamac @Caliguy88 @MidwestPAC @Ho0v-man

I would like to apologize in advance for me missing in this thread since it was my original post. I’ve been extremely busy and just had time now to look at all my replies.

From what I can see this stirred away a little from my post which is not bad. I just don’t see a point of replying to each comment when it does not completely relate to me and my post.

Again I would still like to however thank everyone of you for replying Tom,y thread and giving me your advice.

My biggest dilemma right now is trying to figure out what I want to major in prior to Physician Assistant school. My biggest concern majoring in something I can fall back on in case PA school does not work out. I was fully into nursing until I started my rotations at the hospital and saw how rude nurses can be and how the work environment really just sucks.
 
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@FiremedicMike @pamac @Caliguy88 @MidwestPAC @Ho0v-man

I would like to apologize in advance for me missing in this thread since it was my original post. I’ve been extremely busy and just had time now to look at all my replies.

From what I can see this stirred away a little from my post which is not bad. I just don’t see a point of replying to each comment when it does not completely relate to me and my post.

Again I would still like to however thank everyone of you for replying Tom,y thread and giving me your advice.

My biggest dilemma right now is trying to figure out what I want to major in prior to Physician Assistant school. My biggest concern majoring in something I can fall back on in case PA school does not work out. I was fully into nursing until I started my rotations at the hospital and saw how rude nurses can be and how the work environment really just sucks.
With the HCE you’ll accumulate as a paramedic combined with your typical premed degree you’d be a very desirable applicant. Anything you do in allied health\nursing—> that version of a bachelors will take longer than just majoring in generic bio or psych. BSN with a minor in chemistry would cover what you need if you want to play it safe though.

But if you take more and more time to get an undergrad degree just to play it safe, you’ll look back and think “If I just had the balls to go for it right away, I’d be a freakin’ doctor by now!” Speaking from experience here.
 
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So I am not going to touch on this PA vs NP debate but something you may consider as a possible third option would be athletic trainer. Depending on the state it can be done at the bachelor level (so pre PA) and works with a kind of broad scope, very much like a PA. This link shows the common services they provide:


It does have the disadvantage of not being as flexible a career as either nursing or PA but thought it might interest you anyways...
 
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Anecdotally, the second most common form of “real” health care experience of people I personally come across that are PAs is athletic training. The first is your CNA. Also, from what I’ve seen, exercise science is a major that seems to be the most common major of the really successful applicants without much healthcare experience. From what I could tell, the core classes in exercise science often are biology courses that are prerequisite for Pa programs. Then applicants can take a few more biology prerequisites as your electives. Getting good grades on the way to obtaining your degree isn’t as onerous as being a biology major with some really tough courses to knock down just to graduate with a biology degree and something like a chemistry minor. If most people cracked that code, they would be far better off. Your marketability with a biology degree in hand is roughly as dismal as if you have an exercise science degree (also because your gpa is probably worse with the bio degree because you had your nose to the grindstone the whole time). Meanwhile, the exercise science folks prance through and take like one hard course per semester, while you take 3 or more. Hardly seems fair, but because GPA is so important, you don’t want to screw that up.
 
I was a ground/flight medic for five years, then got my associate RN and worked ED/CCU. Finished BSN a while later. 20 years down the road I am now an NP and I don't feel "girly" or like I have the wrong title. I have a flexible occupation with reasonable income and good job satisfaction. I'm a guy in a female dominated profession. Not a big deal, nobody cares.

I also did travel nursing twice for about three years each time, it's fun when you're young. Do it............you can then go be a PA/NP. If you then chose to be a PA/NP, you'll have some solid experience to build on. You can make really good money as a travel nurse, save up, and pay cash for NP/PA school. That would be my suggestion, as a 47 year old guy with no mortgage, no debt, and a good job.

Being an RN before becoming a NP/PA is a great foundation to build on. People like to bash NP's thinking our education is somehow inferior, but there are plenty of programs turning out very naive PA's who have almost zero credible previous healthcare experience. Same could be said for NP's. So take it for what it is.
 
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IMHO RN experience in the specialty is key to transition into the NP role. The best NPs have had around 3+years of experience in that specialty.
 
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