PA vs. NP--how to fill education gap for NP

[unicorns]

I know subjects around this issue has been beat to death a bit, and I've scoured the posts and read whatever comes up on my search list. That being said, I keep getting waitlisted for PA school and I'm prepared to not get in. However, I was accepted to an accelerated BSN program here. In Missouri, I've heard favorable things regarding NP vs PA here in my state. Missouri is *heavy* NP, particularly the St. Louis region, which is reflected in the job posts I scour. I don't plan on relocating when I graduate, either (husband's career is here, family...we have two young children, 2 and 4). I realize there are a lot of options with a BSN, and I would absolutely pursue a masters or doctorate. I have a BS in chemistry and a masters in engineering, so I have a strong science background and a penchant for picking stuff like that up. I have shadowed, worked in an ER, etc, though, so I know this isn't some whim of a decision.

 

The most common complaint I see here is that NP's lack the medical model education that PAs get, which I find appealing. How do you recommend going about filling that gap? I'm concerned my education will be a bit short if I go this route. Especially since I'm a career changer and I don't want to be an incompetent provider.

 

Curious what your thoughts are. Thanks

[CoastalPalm]

I know subjects around this issue has been beat to death a bit, and I've scoured the posts and read whatever comes up on my search list. That being said, I keep getting waitlisted for PA school and I'm prepared to not get in. However, I was accepted to an accelerated BSN program here. In Missouri, I've heard favorable things regarding NP vs PA here in my state. Missouri is *heavy* NP, particularly the St. Louis region, which is reflected in the job posts I scour. I don't plan on relocating when I graduate, either (husband's career is here, family...we have two young children, 2 and 4). I realize there are a lot of options with a BSN, and I would absolutely pursue a masters or doctorate. I have a BS in chemistry and a masters in engineering, so I have a strong science background and a penchant for picking stuff like that up. I have shadowed, worked in an ER, etc, though, so I know this isn't some whim of a decision.

 

The most common complaint I see here is that NP's lack the medical model education that PAs get, which I find appealing. How do you recommend going about filling that gap? I'm concerned my education will be a bit short if I go this route. Especially since I'm a career changer and I don't want to be an incompetent provider.

 

Curious what your thoughts are. Thanks

 

 

Definitely ask your question over at allnurses.com, there are NP/APN forums over there.

 

First and foremost, look for a reputable NP program that is light on non-clinical coursework (there are many out there).  

 

I also think that having RN experience is very helpful, especially if it is in the area you're interested in practicing in as an NP.  Studying for board certification in a nursing specialty also expands your knowledge base.  The goal is to increase your knowledge of physiology, pathophysiology, pharmacology, treatments, diagnostics, etc. before even starting the NP program.  Bedside clinical RNs, at least those that aren't mindlessly following orders, should be doing this at a basic level.    

[south]

If I read this right, you're getting waitlisted at the local PA school(s) because you are unable to attend outside the local area.  I humbly submit a few thoughts based on this assumption and what you have written.

 

Let's fast forward a few years.  You've spent a year at RN/BSN and a couple more years getting the DNP, all online.  Based on your background, again, an assumption and I hereby label it as such, it was easy for you, and at times bored you to tears, because you are more into the science of things, which is absent in that field.  (Your grades should be stellar however).

 

Now you can go where NPs can go, which is predominately family practice / primary care; you won't find PAs giving shots at the Walgreens because of our tie with physicians.  

 

Unlike PA students, you will not have had the opportunity to work in diverse fields such as surgery or trauma or really anything outside the Primary Care bubble.  

 

And you won't have had the science, as you would have liked.  My program's Pharm and Micro were multiple semesters taught by PhDs at a PhD level; they are quite obnoxiously proud of that.  I don't have a science background, and it was a stone bitch.  There were a few that did though, and they really liked it.  

 

PA school is ridiculously intense and incredibly time consuming even for the truly gifted, and the people who struggle the most are those with distractions such as family obligations.  Nothing against this - I am a single parent myself - but going local PA and then having to give time to the family is trying to fit a square peg in a round hole.  

 

With zero distractions, there were times I took exams cold because there are only 24 hours in a day and I have to sleep at some point.  But it's 28 - ish months out of your life, half of which are in-person clinical rotations you may be able to get closer to home.  

 

Having said all of that, if I'm in your shoes, I'm thinking you have a choice:  go to a more distant PA program which may be a better plan anyway, then open up more options to yourself, or settle for NP because of family obligations.  

 

I left the kids with their mother and went across the country; it was the best plan by a long shot.  It was tough but it went by quick and the kids were 100% fine with it.  

 

My .02

[EMEDPA]

another option....complete the bsn, work for a few years, and then apply to your local pa program as an RN. many nurses become PAs...

[south]

When I was typing this I was thinking of a friend of mine who had a masters in Chem or maybe Chem-E, I forget which.  A relative was NP and talked her into one of the better programs.  She said the "rote memorization of worthless details that are already written everywhere" and no science content "tried to kill her soul".  She was in a PA program the next year, gave me her Pharmacology text for a "good weekend read".  She is crazy

[unicorns]

Definitely ask your question over at allnurses.com, there are NP/APN forums over there.

 

First and foremost, look for a reputable NP program that is light on non-clinical coursework (there are many out there).  

 

I also think that having RN experience is very helpful, especially if it is in the area you're interested in practicing in as an NP.  Studying for board certification in a nursing specialty also expands your knowledge base.  The goal is to increase your knowledge of physiology, pathophysiology, pharmacology, treatments, diagnostics, etc. before even starting the NP program.  Bedside clinical RNs, at least those that aren't mindlessly following orders, should be doing this at a basic level.    

That's a good tip, thanks. I will for sure post this question at allnurses.com and see how the non-clinical vs clinical coursework fares. I've looked at some specialty certifications, too, and I suppose a lot of those are self studies. I know I won't be content just doing something because I am told to; I'm the kind of person who will want to know *why*. Thanks

[unicorns]

If I read this right, you're getting waitlisted at the local PA school(s) because you are unable to attend outside the local area.  I humbly submit a few thoughts based on this assumption and what you have written.

 

Let's fast forward a few years.  You've spent a year at RN/BSN and a couple more years getting the DNP, all online.  Based on your background, again, an assumption and I hereby label it as such, it was easy for you, and at times bored you to tears, because you are more into the science of things, which is absent in that field.  (Your grades should be stellar however).

 

Now you can go where NPs can go, which is predominately family practice / primary care; you won't find PAs giving shots at the Walgreens because of our tie with physicians.  

 

Unlike PA students, you will not have had the opportunity to work in diverse fields such as surgery or trauma or really anything outside the Primary Care bubble.  

 

And you won't have had the science, as you would have liked.  My program's Pharm and Micro were multiple semesters taught by PhDs at a PhD level; they are quite obnoxiously proud of that.  I don't have a science background, and it was a stone bitch.  There were a few that did though, and they really liked it.  

 

PA school is ridiculously intense and incredibly time consuming even for the truly gifted, and the people who struggle the most are those with distractions such as family obligations.  Nothing against this - I am a single parent myself - but going local PA and then having to give time to the family is trying to fit a square peg in a round hole.  

 

With zero distractions, there were times I took exams cold because there are only 24 hours in a day and I have to sleep at some point.  But it's 28 - ish months out of your life, half of which are in-person clinical rotations you may be able to get closer to home.  

 

Having said all of that, if I'm in your shoes, I'm thinking you have a choice:  go to a more distant PA program which may be a better plan anyway, then open up more options to yourself, or settle for NP because of family obligations.  

 

I left the kids with their mother and went across the country; it was the best plan by a long shot.  It was tough but it went by quick and the kids were 100% fine with it.  

 

My .02

Yep I'm pretty much an all eggs in one basket thing. But no, I will not be leaving my husband to raise two young children alone for over 2 years. We did a 5 year long distance relationship when he was in the military, including an 18 month deployment, and have no desire to do it again. With a PA program here, the chances of obtaining nearby clinicals would be slim to none. There are other parents in the program here, so I'm not concerned with balancing family vs school obligations. A lot of the NPs here practice critical care nursing, though, and are not relegated solely to family practice stuff (I've done some shadowing in this field and I don't think I'm well suited for it).

 

If I read this right, you're getting waitlisted at the local PA school(s) because you are unable to attend outside the local area.  I humbly submit a few thoughts based on this assumption and what you have written.

 

Let's fast forward a few years.  You've spent a year at RN/BSN and a couple more years getting the DNP, all online.  Based on your background, again, an assumption and I hereby label it as such, it was easy for you, and at times bored you to tears, because you are more into the science of things, which is absent in that field.  (Your grades should be stellar however).

 

Now you can go where NPs can go, which is predominately family practice / primary care; you won't find PAs giving shots at the Walgreens because of our tie with physicians.  

 

Unlike PA students, you will not have had the opportunity to work in diverse fields such as surgery or trauma or really anything outside the Primary Care bubble.  

 

And you won't have had the science, as you would have liked.  My program's Pharm and Micro were multiple semesters taught by PhDs at a PhD level; they are quite obnoxiously proud of that.  I don't have a science background, and it was a stone bitch.  There were a few that did though, and they really liked it.  

 

PA school is ridiculously intense and incredibly time consuming even for the truly gifted, and the people who struggle the most are those with distractions such as family obligations.  Nothing against this - I am a single parent myself - but going local PA and then having to give time to the family is trying to fit a square peg in a round hole.  

 

With zero distractions, there were times I took exams cold because there are only 24 hours in a day and I have to sleep at some point.  But it's 28 - ish months out of your life, half of which are in-person clinical rotations you may be able to get closer to home.  

 

Having said all of that, if I'm in your shoes, I'm thinking you have a choice:  go to a more distant PA program which may be a better plan anyway, then open up more options to yourself, or settle for NP because of family obligations.  

 

I left the kids with their mother and went across the country; it was the best plan by a long shot.  It was tough but it went by quick and the kids were 100% fine with it.  

 

My .02

Yep I'm pretty much an all eggs in one basket thing. But no, I will not be leaving my husband to raise two young children alone for over 2 years. We did a 5 year long distance relationship when he was in the military, including an 18 month deployment, and have no desire to do it again. With a PA program here, the chances of obtaining nearby clinicals would be slim to none. There are other parents in the program here, so I'm not concerned with balancing family vs school obligations. A lot of the NPs here practice critical care nursing, though, and are not relegated solely to family practice stuff (I've done some shadowing in this field and I don't think I'm well suited for it). And of the PAs and NPs i've spoken to here, they comment that they are 'equal' in terms of autonomy, etc.

 

 

another option....complete the bsn, work for a few years, and then apply to your local pa program as an RN. many nurses become PAs...

This is certainly an option. A far more expensive one, though. It takes me out of the workforce for 3 years, versus 1 or 2, instead of working on the degree concurrently. I think I'll have to see how the landscape is an an RN to see how that plays out. But it's definitely an option. I just think it would be hard to be working, and then take myself out of the workforce for 28 months, when I had the option to work on a degree while working. Additionally, I'd like to have 2 more kids, and I don't want to be almost 40 when I do. So there are some other family issues going on, too.

 

 

When I was typing this I was thinking of a friend of mine who had a masters in Chem or maybe Chem-E, I forget which.  A relative was NP and talked her into one of the better programs.  She said the "rote memorization of worthless details that are already written everywhere" and no science content "tried to kill her soul".  She was in a PA program the next year, gave me her Pharmacology text for a "good weekend read".  She is crazy

That is a concern of mine....i have a penchant for hard sciences. That's my wheelhouse. When I look at the coursework for this BSN, I can't tell what it'll be because the courses are titled "pediatric nursing"....versus, say, pediatric disorders.

[CoastalPalm]

A lot of the NPs here practice critical care nursing, though, and are not relegated solely to family practice stuff (I've done some shadowing in this field and I don't think I'm well suited for it).

 

A lot of the NPs here practice critical care nursing, though, and are not relegated solely to family practice stuff (I've done some shadowing in this field and I don't think I'm well suited for it). And of the PAs and NPs i've spoken to here, they comment that they are 'equal' in terms of autonomy, etc.

 

 

Yes, same.  I have absolutely no interest in primary care, and there are plenty of NPs in my area in the specialties.  Sounds like you would be geared towards the acute care NP programs instead of the adult/peds primary care or family NP programs.  We have ACNPs in the various ICUs (we even have two MICUs, one of which is NP managed, CCU has its own NP service, CTICU has NPs and PAs, etc), cardiac units, etc.  I'm on a neuro unit as an RN and we have neurohospitalist ACNPs (we have a resident team as well, and the NPs and residents are separate services with their own patients), as well as epilepsy NPs and neuro-oncology NPs that round on their patients in addition to their outpatient and research endeavors.  All of this ultimately depends on your area and facility.  My area has NPs and PAs in all specialties, and NPs most definitely are not relegated to primary care here.

[unicorns]

Yes, same.  I have absolutely no interest in primary care, and there are plenty of NPs in my area in the specialties.  Sounds like you would be geared towards the acute care NP programs instead of the adult/peds primary care or family NP programs.  We have ACNPs in the various ICUs (we even have two MICUs, one of which is NP managed, CCU has its own NP service, CTICU has NPs and PAs, etc), cardiac units, etc.  I'm on a neuro unit as an RN and we have neurohospitalist ACNPs (we have a resident team as well, and the NPs and residents are separate services with their own patients), as well as epilepsy NPs and neuro-oncology NPs that round on their patients in addition to their outpatient and research endeavors.  All of this ultimately depends on your area and facility.  My area has NPs and PAs in all specialties, and NPs most definitely are not relegated to primary care here.

Yes, i think my interests lie in acute care or hands-on specialties, such as IR, procedural work, etc. I like to physically do things. I know our L1 trauma center hires NPs in their pediatric ER, and he does plenty of suturing and airway support. I just don't want to limit myself somehow in unforseen ways, but PA seems preferred for ER/surg specialties. I have no idea what the landscape here will look like in 15 years, either.

[MusicalPA]

Too bad you feel you have to stay local. If you were able to cast a wider net you would have a better chance of getting into a program. We moved from CO to PA for PA school. My husband goes to PA school and I stay at home with our kids. I've always stayed at home with the kids, so I didn't have to worry about leaving a career. We live off student loans, so we will have a nice shiny penny to pay off when he gets done. It will be worth it in the long run. 

[Kaepora]

You won't be relegated to primary care as an NP.  I am in an ACNP program and I literally am not able to practice in primary care unless I get a post-masters FNP (not that I want to even one iota).  Further, many FNPs still practice in ED, ICU and specialties - even though many states are beginning to limit this ability.  If you are smart and driven it won't be difficult to supplement the NP didactic education.  I added on an anatomy class and a physiology class through the medical school of my program and I'm doing extra reading.  It's not a huge deal.  And once clinicals start I will do those full-time.  In all honesty if you just accumulate as many clinical hours as possible (as opposed to the ~800 required) during your program you will do great.  You should have the opportunity to get 2000-3000 if you devote the time.  And DO NOT go to one of those for-profit, online schools.  I'm not saying part of the program can't be online (because why do I have to sit through a lecture on campus when I can sit through it at home) but the program must require time on campus.  Also, if you do one of the surgical NP programs, or complete one of the separate surgical programs offered (there are quite a few), you are able to practice in the OR.

[unicorns]

Too bad you feel you have to stay local. If you were able to cast a wider net you would have a better chance of getting into a program. We moved from CO to PA for PA school. My husband goes to PA school and I stay at home with our kids. I've always stayed at home with the kids, so I didn't have to worry about leaving a career. We live off student loans, so we will have a nice shiny penny to pay off when he gets done. It will be worth it in the long run. 

Yes, I fully realize that. This post wouldn't even be necessary if I could apply to more schools. I did meet a few students who had only applied to this program, so I do think it happens. Just hoping that I end up in that group.

 

You won't be relegated to primary care as an NP.  I am in an ACNP program and I literally am not able to practice in primary care unless I get a post-masters FNP (not that I want to even one iota).  Further, many FNPs still practice in ED, ICU and specialties - even though many states are beginning to limit this ability.  If you are smart and driven it won't be difficult to supplement the NP didactic education.  I added on an anatomy class and a physiology class through the medical school of my program and I'm doing extra reading.  It's not a huge deal.  And once clinicals start I will do those full-time.  In all honesty if you just accumulate as many clinical hours as possible (as opposed to the ~800 required) during your program you will do great.  You should have the opportunity to get 2000-3000 if you devote the time.  And DO NOT go to one of those for-profit, online schools.  I'm not saying part of the program can't be online (because why do I have to sit through a lecture on campus when I can sit through it at home) but the program must require time on campus.  Also, if you do one of the surgical NP programs, or complete one of the separate surgical programs offered (there are quite a few), you are able to practice in the OR.

Thank you for this response. I've been looking at some programs at UMKC and they do require some on-campus visits. I'll have to check out some of those programs in the surgical specialties. I am comfortable with online education, though (my masters was online) and it's definitely a "get out of it what you put into it" sort of situation, but I learn the material just fine when it's a lecture in video or in person *shrug*

[south]

So you are unwilling to do what is needed for PA, and don't want to do the schools and work required for NP.  

 

While all of that would be theoretically going on, you want to have 2 more kids.  Meanwhile, support at home won't change to adapt to your situation. 

 

You want to work in a very narrow (I assume highly competitive) field in your hometown only.  Commonly shift work, by the way.

 

You don't think that the universally most difficult part of attending these programs is actually a problem, at least for you because "people do it".

 

Simple summary but can't comment, because I made the choices, did everything you're unable or unwilling to, and it worked great, including kids at maternal age 39 and almost 42. 

 

Let us know what you decide to do. 

[unicorns]

Never said I was unwilling to do the work needed for NP...? I have no idea where you got that assumption. I have support here-that is the importance of staying for PA school. It is difficult. It is not impossible as a parent. I am unwilling to move and it is what it is. I refuse to leave behind ny husband and a 2 and 4 year old. Hell no.

 

I commonly see a lack of medical model education discussed here, and if that is to be a valid concern, I was looking for recommendations on that. So far, I'm not seeing a lot to convince me that one is a superior education, though, or that I will greatly regret the alternative path.

[Febrifuge]

This reminds me of the period when I was an ER tech, trying to decide what to do. At the time, I was worried about not getting in to MD school, so I was thinking about DO school, and I was starting to wake up to the fact that PA exists as a profession. This would be about 15 years ago, now. 

 

I was standing in the team center with a couple of ER nurses, both guys, both ex-military, and it somehow I came up with the idea that maybe I could do nursing school first, gain some experience, and think about next steps from there. 

They both said, "dude, no. The 'Nursing Theory' courses would make you want to kill yourself." They were part of the group that gave me so much respect for nurses and nursing, and they themselves had zero respect for a significant proportion of their own education. 

 

And I'm not even someone with a science background. Generally my attitude is that everything is temporary, and if you have a clear goal and a solid reason for pursuing it, you can weather anything. But the "this educational model tried to kill my soul" factor is something worth considering and learning a lot about, beforehand. I suggest lots of shadowing and informal informational interviews. Make some contacts, bring them some soup and bread from Panera over a lunch break, and get them talking. 

[unicorns]

This reminds me of the period when I was an ER tech, trying to decide what to do. At the time, I was worried about not getting in to MD school, so I was thinking about DO school, and I was starting to wake up to the fact that PA exists as a profession. This would be about 15 years ago, now. 

 

I was standing in the team center with a couple of ER nurses, both guys, both ex-military, and it somehow I came up with the idea that maybe I could do nursing school first, gain some experience, and think about next steps from there. 

They both said, "dude, no. The 'Nursing Theory' courses would make you want to kill yourself." They were part of the group that gave me so much respect for nurses and nursing, and they themselves had zero respect for a significant proportion of their own education. 

 

And I'm not even someone with a science background. Generally my attitude is that everything is temporary, and if you have a clear goal and a solid reason for pursuing it, you can weather anything. But the "this educational model tried to kill my soul" factor is something worth considering and learning a lot about, beforehand. I suggest lots of shadowing and informal informational interviews. Make some contacts, bring them some soup and bread from Panera over a lunch break, and get them talking. 

 

Funny that you say that, because I've been talking to lots of nurses lately, and I haven't gotten that impression at all from them. They note the pathophysiology and pharmacology classes they take are brutal, but that everything is evidence based. I imagine nursing theory is in the same vein as the "engineering leadership theory' courses I've had. You get those in every field, though. I certainly wouldn't want it to be a bulk of the coursework. It looks like the ABSN is slim on that (only one class that looks ambiguous--"leadership development") but that may be because they've stripped the fluffy classes out in order to streamline the program. If I go this route, though, I will definitely keep this in mind, though, thank you.

[LT_Oneal_PAC]

Funny that you say that, because I've been talking to lots of nurses lately, and I haven't gotten that impression at all from them. They note the pathophysiology and pharmacology classes they take are brutal, but that everything is evidence based. I imagine nursing theory is in the same vein as the "engineering leadership theory' courses I've had. You get those in every field, though. I certainly wouldn't want it to be a bulk of the coursework. It looks like the ABSN is slim on that (only one class that looks ambiguous--"leadership development") but that may be because they've stripped the fluffy classes out in order to streamline the program. If I go this route, though, I will definitely keep this in mind, though, thank you.

As a ICU nurse that did 3 semesters of NP school before PA school, I can tell you that a significant portion of nursing education can be a joke. While I can only speak for the places I attended, though I went to NP school at the biggest medical center in the southeast, the physiology was rushed and superficial, I got an A in pharm without cracking a book, and my physical assessment class gave so little input (online) i actuallly learned a few things wrong.

 

This may be limited to my experience and may not be yours. I've certainly met some good NPs, but the education received in PA school is universally better. I simetimes wish I had the legal benefits that NPs enjoy, but I never regret choosing PA school because of what I learned. Do whatever is right for you. Good luck.

[unicorns]

As a ICU nurse that did 3 semesters of NP school before PA school, I can tell you that a significant portion of nursing education can be a joke. While I can only speak for the places I attended, though I went to NP school at the biggest medical center in the southeast, the physiology was rushed and superficial, I got an A in pharm without cracking a book, and my physical assessment class gave so little input (online) i actuallly learned a few things wrong.

 

This may be limited to my experience and may not be yours. I've certainly met some good NPs, but the education received in PA school is universally better. I simetimes wish I had the legal benefits that NPs enjoy, but I never regret choosing PA school because of what I learned. Do whatever is right for you. Good luck.

 

This is so disheartening. Thank you

[Boatswain2PA]

They note the pathophysiology and pharmacology classes they take are brutal, but that everything is evidence based..

These classes are not "brutal" in nursing programs.  They are a cake-walk compared to PA programs, which are not as in depth as what is found in medical school.

 

Bottom line is it sounds like if you want to practice medicine (and if you want to be a competent provider, you will want to practice MEDICINE, not "advanced nursing" as the nursing mafia calls it) then you are limiting yourself (due to family) to going the NP route.

 

You can be an outstanding provider AND an NP, but the first step toward that goal is understanding that your NP education will not prepare you to practice medicine.  You'll have to jump through the hoops of NP school.  You will write papers about how great NPs are, how NP led teams are the future of medicine not only throughout America, but also throughout the world.  You will write papers referencing other NPs who wrote papers which referenced other NPs who wrote papers which referenced other NPs.  You will learn that what nurses call "research" looks nothing at all to what actual scientific research looks like.

 

And you will learn less science than you already know.

 

If you make it through the soul-sucking self-conflating educational farce that is most NP programs (and are able to shelter your id/ego from the constant battering of the social scientists who run NP programs), then you will have a license, and you'll be able to see patients.

 

At THAT point you throw yourself into learning the wonderful field of MEDICINE by self-study via conferences, podcasts, web-sites, or even youtube.  With your strong background in actual science you won't have a problem doing that.

 

One of the best EM providers I know is a NP, and this is how he describes how he got to where he is.  

 

Oh, and I would avoid AllNurses like you would avoid contracting syphilis. They are some of the most militant opinions around.

 

Lastly, please don't think I dislike nurses.  I LOVE nurses, and I'm married to one.  

 

 

[MedicinePower]

ACNP≠FNP. I think when people use the term NP they are referring to FNPs, not ACNP. I know several ACNPs and I am extremely impressed with their knowledge and skill-set. I also know one ACNP who started with a class of 20 and by the end there were 8 left. Even fewer passed the ACNP boards on their first try. The 12 who failed out all transferred to the FNP program.

 

I think the only real way for a FNP to bridge the gap in knowledge between FNP and PA is to apply to and attend PA school. I don't think this gap is something a person can fill on their own without a formal and systematic approach.

[steve.bannon]

One of the best EM providers I know is a NP, and this is how he describes how he got to where he is.  

 

OP, you can teach yourself to be this example of a great NP with the added prospects of independence and a stronger license.  Or you can resign yourself to be spoon fed information (a~la death by powerpoint) and be a dependent provider for life.  Your choice.

[Kaepora]

It all comes down to choosing an appropriate BSN/NP program as well.  I got my BSN through an accelerated, second degree program and thank goodness we skipped the fluff courses the traditional BSN students had to take because I don't think I could have done it.  And I chose an NP program with the least amount of fluff I could find.  In fact, the 2 best PA programs in my area have the same "fluff" courses my NP program does - medical ethics and health care policy.  Honestly, the one PA  program has an "education and counseling" class where you learn to "understand how patients present, learn and change based on the research on theories, models and techniques of: personality and learning styles; how to assess patient knowledge, attitude and readiness to change; and the effects of literacy, health literacy, individual coping mechanisms, ecological barriers and culture on patient comprehension and adherence."  That honestly sounds exactly like a nursing fluff course to me.  Haha.  And all the master's programs, both PA and NP, have research built in - although nursing research is LAME.  My first job before going to nursing school was in cancer genetics research so it was a struggle switching over to nursing "research".

 

​There are some absolutely horrific NP programs out there.  Do your research and DO NOT GO TO THEM.  There are some less than stellar PA programs as well.  Is PA education generally better.  Yeah.  Duh.  But if you put in the time you can graduate a great NP on par with any PA.  Like I said, generally FNP programs are the easiest to get in by far and provide the lowest caliber training.  The other more specific program tracks (ACNP, WHNP, NNP) have higher requirements and better training.  

 

Further, the hours requirements are the bare, bare, bare minimum.  You can and should do far more than the 500-1000 required.  For example, my ACNP program has 2 surgical, 1 ICU, 1 hospitalist, 1 specialty and 1 elective rotation - each 10 weeks.  I should easily be able to get 2000-3000 hours out of that, while only 1000 are required.

 

Really, if you have any specific questions PM me and we can discuss it.  I looked into a looooot of medical, PA, and NP schools.  I obviously chose NP for a few different reasons.  Also, have you looked into CRNA?

[unicorns]

I'll drop you a PM, definitely curious to hear your thoughts. I've long considered CRNA and am giving it another look. I'm hoping I can do some shadowing soon (I've seen glimpses while in an OR but never shadowed a full shift), but regulations are tough in an OR. A friend of mine is an OB and got me in contact with her CRNA friend, though, so I can speak to her. One of the fathers at my kids daycare is one and loves his job. My background would work well for it and they have loads of autonomy here

[Kaepora]

If you choose to do the ABSN then you will have time in the OR (as well as most other areas of the hospital).  And then when you start working as a nurse (in the ICU of course) you can much more easily shadow in the OR as an employee of the hospital.  

 

CRNAs love their jobs and love being CRNAs.  Usually, though, if you ask them why they chose that career they say, "because I loved being a bedside critical care nurse and wanted to keep doing that at a higher level..."  Well, I am not a huge fan of being a bedside critical care nurse.  Haha.  I do love the unit and the OR d/t the higher acuity and advanced treatment modalities, etc.  But I wanted to move on to a decision making role rather than being the one to execute given orders.  CRNAs really are, for all intents and purposes, still bedside nurses.  It's just not what I was looking for in an advanced role.  So make sure you truly understand the difference between these roles (PA/NP vs CRNA) before you choose which program you want to attend.  And as always the state you plan to practice in should be a rather larger factor in the decision as your practice is impacted by the laws.