pro/cons of NP/PA/CRNA

[harpert]

HI. I'm a ICU RN with one year experience. I have been looking at graduate programs, but unsure which program to go into next. I don't know the differences between NP/PA besides maybe NP is more nursing focused, but their duties sound very similar? Can anyone tell me the pros/cons of each field of study. I understand/know what each program requires, but I'm curious how each job is like. I'm unsure which route to take, or worth taking. Any suggestions?

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[zenman]

Start by looking at the curriculum of each program.

 

[Themanatee]

In practice, the difference is functionally nothing. Where I work, PAs and NPs do the exact same job and our MDs rarely remember and certainly don't care about what we are. Technically NPs have their own licenses and PAs don't but it isn't a meaningful difference in practice.

One major difference is that PAs are generalists in the same sense that MDs are - they're supposed to be competent at everything. This gives PAs a lot of flexibility. They can bounce from peds to surgery to ED quite easily. Becoming a PA is a great choice for someone who wants that sort of flexibility or isn't sure what they want to do.

Nurse practitioners are not trained as generalists. We're all trained for specific populations like family medicine, pediatrics or adult/geriatrics. It can even get really specific - I'm an Adult Acute Care NP which basically means I'm trained as a Hospitalist/Intensivist. In my case, I can prescribe and treat acutely ill adults but I'm functionally a nurse if I run into a sick kid, primary care or women's health issue. It's a key difference between the professions that most folks don't really get.

NP is a great choice if you're certain about what you want to do and what population you want to work with.

Either choice is good though. I can't speak for CRNAs, but the NPs and PAs I know are all happy about the decision they made.

 

[deleted6669]

"Technically NPs have their own licenses and PAs don't but it isn't a meaningful difference in practice."

Actually PA's do have their own licenses and dea #s but in order to work we must have a delegation agreement with a physician or physician group. I have a license to practice medicine in my state with my name on it alone. I just can't work without an affiliation with a physician.

 

[Themanatee]

"Technically NPs have their own licenses and PAs don't but it isn't a meaningful difference in practice."

Actually PA's do have their own licenses and dea #s but in order to work we must have a delegation agreement with a physician or physician group. I have a license to practice medicine in my state with my name on it alone. I just can't work without an affiliation with a physician.

That's true - I was oversimplifying and didn't get across what I was trying to say. What I meant was that in many states NPs can technically practice independently without the sort of collaborative agreement that PAs always need. In practice though, it's rare to find NPs working without some sort of physician backup and almost all of us have practice agreements in place with MDs. It's one of those differences that sounded important to me when I made my choice but ended up being pretty meaningless.

 

[MedGrl@2022]

Just curious... after reading about CRNAs... Can/Do PAs specialize in anesthesiology? If so, would they get paid more than a CRNA because they are trained on the physician model? Is the CRNA a type of NP or completely different? I am just curious. This is the first time that I am learning about CRNAs.

Thank you for all your help.

Sincerely,

Verónica

In practice, the difference is functionally nothing. Where I work, PAs and NPs do the exact same job and our MDs rarely remember and certainly don't care about what we are. Technically NPs have their own licenses and PAs don't but it isn't a meaningful difference in practice.

One major difference is that PAs are generalists in the same sense that MDs are - they're supposed to be competent at everything. This gives PAs a lot of flexibility. They can bounce from peds to surgery to ED quite easily. Becoming a PA is a great choice for someone who wants that sort of flexibility or isn't sure what they want to do.

Nurse practitioners are not trained as generalists. We're all trained for specific populations like family medicine, pediatrics or adult/geriatrics. It can even get really specific - I'm an Adult Acute Care NP which basically means I'm trained as a Hospitalist/Intensivist. In my case, I can prescribe and treat acutely ill adults but I'm functionally a nurse if I run into a sick kid, primary care or women's health issue. It's a key difference between the professions that most folks don't really get.

NP is a great choice if you're certain about what you want to do and what population you want to work with.

Either choice is good though. I can't speak for CRNAs, but the NPs and PAs I know are all happy about the decision they made.

 

[Denatured]

PAs cannot work in anesthesia. There are anesthesiology assistants, but the laws that regulate them are more restrictive than any of the other major providers (NP, CRNA, or NP). They can also only work in about 18 states and must have a anesthesiologist on site at all times, not that it's necessary with their training but it is the law. They are paid the same when employed by a group that uses both CRNA and AA. CRNAs often make more on a national average because they are unique amongst other non physician providers in that they are independent practitioners in all states. They are not required to work with an anesthesiologist and can bill directly for their services. So many work in solo rural positions, or all CRNA practices, making excellent money or even own an anesthesia group.

 

[MedGrl@2022]

PAs cannot work in anesthesia. There are anesthesiology assistants, but the laws that regulate them are more restrictive than any of the other major providers (NP, CRNA, or NP). They can also only work in about 18 states and must have a anesthesiologist on site at all times, not that it's necessary with their training but it is the law. They are paid the same when employed by a group that uses both CRNA and AA. CRNAs often make more on a national average because they are unique amongst other non physician providers in that they are independent practitioners in all states. They are not required to work with an anesthesiologist and can bill directly for their services. So many work in solo rural positions, or all CRNA practices, making excellent money or even own an anesthesia group.

Sounds like an excellent position for someone who is in it for the money. I am curious if that is the only reason that CRNAs get in the business or are their other draws to become a CRNA.

Thank you once again for all this information.

Verónica

 

[Denatured]

Sounds like an excellent position for someone who is in it for the money. I am curious if that is the only reason that CRNAs get in the business or are their other draws to become a CRNA.

Thank you once again for all this information.

Verónica

It isnt a short road. You must have a BSN and work 1 year minimum in an ICU, then 2.5 years in grad school. It is great money, but the professional allure comes from the wealth of knowledge in physiology/pharmacology, as well as high procedure performance. All the best parts of critical care without the long term management. It would get boring and repetitive if you work in outpatient surgery only, IMO.