ChronicSG Posted July 21, 2015 Share Posted July 21, 2015 Hello everyone, I'm a BSN student that just graduated their program and is starting their first job in oncology/ hematology. I am posting this because over the past months of researching my options, I have a couple of questions. I wanted to do PA because I felt that many NP programs I looked into looked very weak in terms of medical sciences and contain much "fluff" i.e management and research. I also feel that although I understand basic physiological/ pathological concepts, it is not enough to then go into clinical medicine which entails diagnosing and treatment. Furthermore, I like the fact that PA programs covered a whole spectrum of medical specialties. Unlike NPs which focus on one specialty or pt population. I was leaning towards PA, but after much consideration, it would take me 2 years of pre-reqs on top of the added costs of post-grad per credit fees. Furthermore, PA looks like it's much more expensive in comparison. Although I admire their education, I can't help but wonder if PAs really have that much of a difference in practice when compared to NPs. Is the lateral mobility of PAs worth it in your opinion or should I just take my time and choose an NP specialty. If any of you PAs that are already working in the field have any input, please let me know. Also, although off topic, would a nursing background give me a leg up in admissions? Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted July 21, 2015 Moderator Share Posted July 21, 2015 it is important to decide before making this choice what fields you are interested in. If it is EM, Surgery, ortho, critical care, or most hospital based specialties, go PA. If it is psych, nicu, women's health, or if you ever want to own your own practice, go np. lateral mobility for PAs is becoming more restricted every year. folks can transfer between related fields, but have a lot more difficulty going into unrelated fields due to hospital and joint commission requirements for procedure logs, etc. don't let that be the basis for your decision. Link to comment Share on other sites More sharing options...
ChronicSG Posted July 21, 2015 Author Share Posted July 21, 2015 it is important to decide before making this choice what fields you are interested in. If it is EM, Surgery, ortho, critical care, or most hospital based specialties, go PA. If it is psych, nicu, women's health, or if you ever want to own your own practice, go np. lateral mobility for PAs is becoming more restricted every year. folks can transfer between related fields, but have a lot more difficulty going into unrelated fields due to hospital and joint commission requirements for procedure logs, etc. don't let that be the basis for your decision. All those specialties that you stated are honestly the ones that I hold more interest in. Although I like the idea of primary care, it is too slow paced for me at the moment. Perhaps later on in my life. Thanks alot for your response EMEDPA. And yes, emergency medicine has peaked my interest, however for an FNP to even work there, their scope of practice is somewhat stretched and an ACNP certificate is recommended. EMED, SICU, and urgent care sound like the place for me and NP isn't all that conducive to it. Except the ACNP, but I don't want to be a hospitalist forever. Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted July 21, 2015 Moderator Share Posted July 21, 2015 PAs own the EM market... Link to comment Share on other sites More sharing options...
ChronicSG Posted July 25, 2015 Author Share Posted July 25, 2015 I just asked the manager at my facility, they stated that FNP certification is accepted to the ED if they have RN ED background. Mostly fast track stuff though. Is this the case with you EMEDPA or do you handle STEMI alerts and the sort?? Link to comment Share on other sites More sharing options...
UpRegulated Posted July 26, 2015 Share Posted July 26, 2015 I just asked the manager at my facility, they stated that FNP certification is accepted to the ED if they have RN ED background. Mostly fast track stuff though. Is this the case with you EMEDPA or do you handle STEMI alerts and the sort?? It varies geographically. All the EM's in my area use NP's, no PA's, however they are limited to fast track. As far as the other specialties, FNP or ACNP works fine in my area (and in many others) and there are FNP and ACNP programs that focus in certain areas (e.g. EM, hospitalist, ICU). Going NP will allow you to continue to gain RN experience while in school and depending on what area you end up in, that experience can be valuable. As a general rule, if you want to do hospitalist, ICU, or specialty, go ACNP. If you want EM, do family preferably with an EM emphasis. If you want to do surgery or ortho, you need to get some OR experience, preferably as a first assist, which can be done as an RN while you complete your NP program. And if I remember correctly, there is an ACNP/surgery program out there. Link to comment Share on other sites More sharing options...
browndog Posted July 29, 2015 Share Posted July 29, 2015 50/50 NP vs PA in my area Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted July 29, 2015 Moderator Share Posted July 29, 2015 ChronicSG- I see all comers. 2 of my 3 jobs I work solo and run codes, cardiovert, intubate, etc. The third job I alternate charts with a doc. we have 24 PAs and 1 np in our group who we inherited from a prior group(we don't fill positions with NPs). the np is only allowed to work fast track/urgent care and can not see pts in the main ED. Link to comment Share on other sites More sharing options...
Febrifuge Posted July 29, 2015 Share Posted July 29, 2015 we have 24 PAs and 1 np in our group who we inherited from a prior group(we don't fill positions with NPs). the np is only allowed to work fast track/urgent care and can not see pts in the main ED. Interesting. Is that "can not," or more "can not, and doesn't want to anyway?" What if this person decided he/she wanted to ramp things up? Would there be a system for doing that, or is it a rule that your group has? Since you don't fill new positions with NPs I get a sense. Just being nosy and curious. Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted July 29, 2015 Moderator Share Posted July 29, 2015 she wants to. no one thinks she is up for it, so we won't credential her to work there. she is a great family NP, but she only has 1 speed, FP speed, and only 1 H+P, the complete H+P... Link to comment Share on other sites More sharing options...
ChronicSG Posted July 29, 2015 Author Share Posted July 29, 2015 Yes, that is one of the reasons I don't wish to do fnp. They're focused throughout the life span but only for primary care. Then there's PAs that learn menu aspects of Medici e. If I did do NP, it would have to be the ACNP or CRNA certification. We'll see what I do. For now, I still have PA in the back of my head. PS Are PAs or NPs utilized in cath lab? I got some exposure to it and it looked fascinating. Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted July 29, 2015 Moderator Share Posted July 29, 2015 I have seen both PA and NP in the cath lab. There are PAs in NC at Duke med ctr who do the diagnostic caths(no stents) themselves. that is pretty cool. In my part of the world most of the ER, ortho, surgical, and ICU type positions go to PAs and almost all of the psych and NICU positions go to NPs. Link to comment Share on other sites More sharing options...
fishbum Posted July 29, 2015 Share Posted July 29, 2015 she only has 1 speed, FP speed, and only 1 H+P, the complete H+P... Taking the "fast" out of fast track... Link to comment Share on other sites More sharing options...
ChronicSG Posted July 30, 2015 Author Share Posted July 30, 2015 Taking the "fast" out of fast track... Hahaha Thanks a lot for the advice EMEDPA and all of you guys as well! I'm gonna see what I end up doing. I had a change of heart and wanted to do NP because the hospital I work seems to only hire NPs as employees with benefits while PAs are hired through their supervising physician.however, during my orientation, I kept seeing these NPs being only utilized for management or anything aside from actual clinical care! What a waste I thought. Although I would want to be vested via the facility, it's not worth it if I don't love what I do. So I'm back with PA on my mind since they teach all the stuff I like. Not "leadership in advanced practice" or "nursing theory." Got enough of that in nursing school. I'm gonna try to learn what Florida likes more, "PA or NP." For now though, I guess I'll just get some experience under my belt and see where my niche is. Starting off in oncology/hematology as a new grad. Gonna try my best to get to the cath lab or SICU within 2 years I hope. Probably gonna be SICU more than likely. Heard cath lab wants the best of the best considering all the acls and vasoactive drips that are going on. I'm glad though that non-physicians can work here though! Link to comment Share on other sites More sharing options...
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