REPOST. How would you compare the Nurse Practitioner profession/role/career to that of the PA?

[Intel1122]

Hi all.. By the way this is a repost since a previous forum I posted turned into a debating in which a lot of ego was involved. So let us please be civil and give perspectives and not angry comments.

Just curious. As someone in NYC/NY or if you are not familiar with the Family NP/PA role in these areas you could address them wherever you are.
How would you compare the role of the Family NP to that of the PA...? I know NPs are RNs with some level of experience with Graduate School education in a MS or DNP in a Family NP. PAs on the other hand graduated from a 2 year BS/MS in a Physical Assistant field of study not requiring substantial "true" clinical experience besides volunteering or the premed low key level clinical experience. I guess its NPs function under a Nursing mind set when diagnosing and Prescribing and PAs are people trained in an abridged version of medicine.

I know PAs have licenses, but they function under a doctor's license, hence why their Rx pads always have MD/DO on top of the PA's name. But they could go into literally any specialty except anesthesia/doing surgery/and some exceptions.

But after reading about NPs, it seems they have some looser rights and privileges than PAs. Sure this isn't the case in every state and every state has its own rules regulating the NP practice, but in the North East: specifically NY, CT, NH, and RH, NPs have only needed a collaborative agreement where they do not need to have their work reviewed by a doctor every day/week or require cosignature, they make require a review every 3 months, but that doesn't quality true "supervision." Every doctor/independent health care professional has some level of "collaboration" and job performance appraisals q 3 - 6 months.

All I am asking is, why there isn't a role difference between NP and PA, similarly to that of NP vs MD/DO, is there a true difference in how they practice. Does this difference in independence and practice ? I read that NPs go mainly into family practice, psych, women's health, NICU since those are the fields that require limited supervision and someone that doesn't have to consult with a doc regularly. But PAs go into Emergency med/surgery assist? I know Family NPs could do nearly any specialty but they are MORE CENTERED into family practice/psych/outpatient areas but PAs are more inpatient.

What is the real difference...? Do NPs have better rights long term in terms of opening up their practice more salary potential more opportunities..? Just curious.

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[deleted480308]

Quality of training doesn't have anything to do with it, power of the professional lobby does...that's the only part that matters

 

[Intel1122]

Quality of training doesn't have anything to do with it, power of the professional lobby does...that's the only part that matters

I agree in a way. No amount of education will replace the fact that PAs will require supervision.
But let me ask something different, Does that mean NPs have it better or what. ?

 

[FCMike11]

Quality of training doesn't have anything to do with it, power of the professional lobby does...that's the only part that matters

http://www.forums.studentdoctor.net/index.php?threads/1113871/

Wanted to link you to this before you waste your time.

 

[deleted480308]

http://www.forums.studentdoctor.net/index.php?threads/1113871/

Wanted to link you to this before you waste your time.

Dangit, the troll got me

7/10 troll...kudos

 

[Intel1122]

Not a troll just wanting an answer .

 

[deleted6669]

I will give you the benefit of the doubt and present a few facts.
PAs do work in collaboration with physicins. the amount of oversight varies by state from no chart review and md sees no PA pts (WA and NC) to 100% chart review and doc always on site available for questions in a few southern states.
PA education includes > 2000 hrs of clinical rotations, essentially the third yr of medschool and in fact, interchangeable at schools that have both md and pa. most PAs in 2014 have 3 yrs of prior medical experience( I can link a source if you like from the aapa site). many PAs were previously nurses, paramedics, resp. therapists, er techs, etc. or you can be a navy seal (like this guy)
http://www.nxtbook.com/nxtbooks/aapa/paprofessional_201412/
PAs tend to get most of the hospital based jobs(surgery, em, etc) while NPs get many of the primary care, psych, nicu, women's health, etc type jobs.
There is a PA to physician(DO) bridge program which credits PAs for the entire 3rd yr of medschool. there are no similar programs for NPs.
PAs and NPs working at the same place tend to do the same things for the same pay and have the same interaction with physicians. There are 2 NPs in our group and 15 PAs. the docs review all of our charts within 1 month as required by the hospital(not the state).
if you want to do primary care and have your own office it is easier to do as an NP. If you want to do EM, surgery, or ortho it is easier to do as a PA. there are exceptions based on individual hospital or group preferences. There are PAs who own practices and pay docs to do min chart review. you can do anything from either the pa or np route, but there are easier ways to get to certain endpoints. good luck whatever you decide. both are good fields with a bright future.

 

[W19]

PA is legit; NP is a joke.

 

[W19]

@Mad Jack ... Basically NPs take 5-6 'advanced nursing' classes and they are allowed to practice back door medicine... Good lobbying can do a lot of sh .....!

Here is a typical NP program curriculum: http://nursing.msu.edu/msn programs/Nurse Practitioner Concentration/NP Curriculum.htm
Courses

NUR 802: Theoretical Foundations and Role Development for the Advanced Practice Nurse
NUR 804: Statistics for the Healthcare Professional
NUR 805: Pathophysiology for Advanced Practice Nurses
NUR 806: Research for Practice Nurses
NUR 807: Clinical Decision Making
NUR 809: Applied Pharmacology for Advanced Practice
NUR 814: Health Care Policy and Politics
NUR 820/835: Health Assessment
NUR 821/836: Primary Care Management I
NUR 822/832: Practicum I Primary Care
NUR 823/837: Primary Care Management II
NUR 824/834: Practicum II
NUR 838: Care for Aging Individuals


Here is a typical PA program curriculum: http://www.quinnipiac.edu/school-of...master-of-health-science-physician-assistant/

First Year
Summer Session
Course Title Credits
PY 501 Human Physiology 4
PY 503 Principles of Interviewing 3
PY 507 Principles of Electrocardiography 1
PY 508 Diagnostic Methods I 2
PY 515 Clinical Pathology 3
PY 517 Human Anatomy 4
Total 17
Fall Session
PY 502 Physical Diagnosis 4
PY 505 Clinical Pharmacology I 2
FY 506 Principles of Medicine 6
PY 514 Diagnostic Methods II 1
FY 572 Medical Microbiology & Infectious Diseases 4
Total 17
Spring Session
PY 504 History, Roles & Responsibilities of the Physician Assistant 1
FY 509 Principles of Obstetrics & Gynecology 3
FY 510 Principles of Pediatrics 3
PY 511 Principles of Surgical & Emergency Management 4
PY 512 Psychosocial Issues in Health Care 2
PY 512 Behavioral Medicine 3
PY 516 Clinical Pharmacology II 2
Total 18
Second Year
PY 611 Clinical Residency I 3
PY 612 Clinical Residency II 3
PY 613 Clinical Residency III 3
PY 614 Clinical Residency IV 3
PY 615 Clinical Residency V 3
PY 616 Clinical Residency VI 3
PY 617 Clinical Residency VII 3
PY 618 Clinical Residency VIII 3
PY 619 Clinical Residency IX 3
Total 27
Third Year
PY 526 Principles of Epidemiology 3
PY 536 Biostatistics 3
PY 546 Ethics in health Care Delivery 3
PY 608 Graduate Seminar 4
PY 676 Comprehensive Examination 2
Total 15

Credit to Mad Jack

 

[medethics]

@Mad Jack ... Basically NPs take 5-6 'advanced nursing' classes and they are allowed to practice back door medicine... Good lobbying can do a lot of sh .....!

Here is a typical NP program curriculum: http://nursing.msu.edu/msn programs/Nurse Practitioner Concentration/NP Curriculum.htm
Courses

NUR 802: Theoretical Foundations and Role Development for the Advanced Practice Nurse
NUR 804: Statistics for the Healthcare Professional
NUR 805: Pathophysiology for Advanced Practice Nurses
NUR 806: Research for Practice Nurses
NUR 807: Clinical Decision Making
NUR 809: Applied Pharmacology for Advanced Practice
NUR 814: Health Care Policy and Politics
NUR 820/835: Health Assessment
NUR 821/836: Primary Care Management I
NUR 822/832: Practicum I Primary Care
NUR 823/837: Primary Care Management II
NUR 824/834: Practicum II
NUR 838: Care for Aging Individuals


Here is a typical PA program curriculum: http://www.quinnipiac.edu/school-of...master-of-health-science-physician-assistant/

First Year
Summer Session
Course Title Credits
PY 501 Human Physiology 4
PY 503 Principles of Interviewing 3
PY 507 Principles of Electrocardiography 1
PY 508 Diagnostic Methods I 2
PY 515 Clinical Pathology 3
PY 517 Human Anatomy 4
Total 17
Fall Session
PY 502 Physical Diagnosis 4
PY 505 Clinical Pharmacology I 2
FY 506 Principles of Medicine 6
PY 514 Diagnostic Methods II 1
FY 572 Medical Microbiology & Infectious Diseases 4
Total 17
Spring Session
PY 504 History, Roles & Responsibilities of the Physician Assistant 1
FY 509 Principles of Obstetrics & Gynecology 3
FY 510 Principles of Pediatrics 3
PY 511 Principles of Surgical & Emergency Management 4
PY 512 Psychosocial Issues in Health Care 2
PY 512 Behavioral Medicine 3
PY 516 Clinical Pharmacology II 2
Total 18
Second Year
PY 611 Clinical Residency I 3
PY 612 Clinical Residency II 3
PY 613 Clinical Residency III 3
PY 614 Clinical Residency IV 3
PY 615 Clinical Residency V 3
PY 616 Clinical Residency VI 3
PY 617 Clinical Residency VII 3
PY 618 Clinical Residency VIII 3
PY 619 Clinical Residency IX 3
Total 27
Third Year
PY 526 Principles of Epidemiology 3
PY 536 Biostatistics 3
PY 546 Ethics in health Care Delivery 3
PY 608 Graduate Seminar 4
PY 676 Comprehensive Examination 2
Total 15

Credit to Mad Jack

As an educator of both NPs and PAs this is offensive and does nothing more to divide us. NPs are RNs with a four year degree in the sciences then return for 36 credits after practicing as a nurse because they have clinical experience they do not require basic clinical residencies in school as a PA would.

Having said that most PA programs require a basic baccalaureate degree without clinical experience and complete the courses you mention in one and a half years. At the start of clinical practice because NPs have a background as RNs their clinical competencies are at a different level but within five years of practice both professions are similar

The PA profession started as Vietnam Vets with medic experience returned in the 1970's and had expertise to be applied. The PA is an assistant to the physician and thus not independent. NPs arose from a nurse Loretta Ford working with Dr. H. Silver to deliver primary care in indigent areas. They are independent practitioners and collaborate with physicians. The scope of practice of an NP does not include surgery. There is a current move to a Doctorate level and thus an NP will go to school for 7-8 years now while a PA will go six.

To give good advice is you are not interested in surgery an NP may be an option as you have two careers a RN and an NP. If interested in surgery a PA is an option. But if you truly want to be a doctor go to medical school

 

[AlteredScale]

As an educator of both NPs and PAs this is offensive and does nothing more to divide us. NPs are RNs with a four year degree in the sciences then return for 36 credits after practicing as a nurse because they have clinical experience they do not require basic clinical residencies in school as a PA would.

Having said that most PA programs require a basic baccalaureate degree without clinical experience and complete the courses you mention in one and a half years. At the start of clinical practice because NPs have a background as RNs their clinical competencies are at a different level but within five years of practice both professions are similar

The PA profession started as Vietnam Vets with medic experience returned in the 1970's and had expertise to be applied. The PA is an assistant to the physician and thus not independent. NPs arose from a nurse Loretta Ford working with Dr. H. Silver to deliver primary care in indigent areas. They are independent practitioners and collaborate with physicians. The scope of practice of an NP does not include surgery. There is a current move to a Doctorate level and thus an NP will go to school for 7-8 years now while a PA will go six.

To give good advice is you are not interested in surgery an NP may be an option as you have two careers a RN and an NP. If interested in surgery a PA is an option. But if you truly want to be a doctor go to medical school

I thought most PA schools require a couple thousand bourse of pause HCE?

 

[deleted6669]

I thought most PA schools require a couple thousand bourse of pause HCE?

YUP, THE VAST MAJORITY OF PROGRAMS( AND ALL THE QUALITY ONES) DO.
The avg PA student last year had 3 years of prior HCE. the reason PA school has more clinicals (even for former nurses) is because practicing medicine is different than practicing as a nurse or paramedic or R.T., etc.
Ask yourself this- take 2 identical nurses with similar backgrounds and experience and send 1 to pa school and 1 to NP school. day 1 of practice who is better prepared to treat pts? Lots of nurses still opt for PA over NP because they know the difference.

 

[W19]

YUP, THE VAST MAJORITY OF PROGRAMS( AND ALL THE QUALITY ONES) DO.
The avg PA student last year had 3 years of prior HCE. the reason PA school has more clinicals (even for former nurses) is because practicing medicine is different than practicing as a nurse or paramedic or R.T., etc.
Ask yourself this- take 2 identical nurses with similar backgrounds and experience and send 1 to pa school and 1 to NP school. day 1 of practice who is better prepared to treat pts? Lots of nurses still opt for PA over NP because they know the difference.

The curricula say it all... It's amazing they even let NP practice medicine...

 

[Boatswain2PA]

Not a troll just wanting an answer .

No you don't. You are like Baghdad Bob who got hired to schill for Obamacare. You have an agenda, and you won't let facts stand in the way of you advertising your agenda.

YES, NP's have it better in some ways, but this is entirely due to their political power which has allowed them to gain independence.

but then again PAs have it better because PA education is far superior to NP education, and physicians (who mostly hire/fire us) know that, and they know that NPs (with their education that is a fraction of MDs) are after their jobs.

But you already know that, don't you.

 

[Boatswain2PA]

As an educator of both NPs and PAs this is offensive and does nothing more to divide us. NPs are RNs with a four year degree in the sciences then return for 36 credits after practicing as a nurse because they have clinical experience they do not require basic clinical residencies in school as a PA would.

Having said that most PA programs require a basic baccalaureate degree without clinical experience and complete the courses you mention in one and a half years. At the start of clinical practice because NPs have a background as RNs their clinical competencies are at a different level but within five years of practice both professions are similar

The PA profession started as Vietnam Vets with medic experience returned in the 1970's and had expertise to be applied. The PA is an assistant to the physician and thus not independent. NPs arose from a nurse Loretta Ford working with Dr. H. Silver to deliver primary care in indigent areas. They are independent practitioners and collaborate with physicians. The scope of practice of an NP does not include surgery. There is a current move to a Doctorate level and thus an NP will go to school for 7-8 years now while a PA will go six.

To give good advice is you are not interested in surgery an NP may be an option as you have two careers a RN and an NP. If interested in surgery a PA is an option. But if you truly want to be a doctor go to medical school

I challenge you to show me ONE PA program that "complete the courses....in one and a half years."

Why would want "two careers a RN and an NP" if the NP is so great? Could be because in many places NPs can't find jobs as NPs, so they have to revert to using their RN?

 

[W19]

I challenge you to show me ONE PA program that "complete the courses....in one and a half years."

Why would want "two careers a RN and an NP" if the NP is so great? Could be because in many places NPs can't find jobs as NPs, so they have to revert to using their RN?

I am seing that trend in FL, but I don't know if that is happening everywhere...

 

[deleted6669]

I am seing that trend in FL, but I don't if that is happening everywhere...

At one of my jobs 1/2 the ER nurses are also FNPs. they can make more as senior ER nurses than as entry level FNPs so they don't use their NP licenses except for occasional volunteering at free clinics, etc.

 

[joeDO2]

I have seen that trend as well. A few of the NPs I know just do one day a week as an NP and the rest as a regular RN because the pay ends up being better.