What is the differences between PA and RN/NP?

[Boatswain2PA]

Though NA and PA and RN profile seems to be similar but the difference really lies in their training and background. An RN performs great range of duties such as recording medical histories, examining patients, providing treatment, and assisting in the administration of diagnostic tests whereas an NP can do all of the things that are an RN known for but additionally they can also order diagnostic tests and interpret test results. And physician assistant performs many of the task of an RN or NP, but he or she must work under the supervision of a physician or surgeon and cannot operate an independent practice.

 

Either another troll, or another ignoramus. The PA profession recognizes that physicians should be ultimately in charge of all patient care, therefore we work for/with physicians to practice medicine. Unfortunately lesser-trained NPs have the political strength to change state laws to allow them to practice unsupervised, a dangerous practice for their patients. Fortunately hospital systems recognize the importance of physician-led teams so they require NPs to work the same as PAs....with physician oversight.

[UpRegulated]

clinical hours:

typical pa program 1500-3000 hrs over 1 year full time.

typical np program 500-800 hrs over 1 year part time.

prerqs:

pa school heavy sciences

np school not so much

didacics:

pa school basically 2nd yr of medschool with some of ms1 thrown in

np school much of the same but more "soft" courses

 

don't get me wrong. I know of and have worked with some great nps but there is a big difference between an er or icu nurse of many years who goes to a solid np program and many of the direct entry folks today doing it mostly online.

 

I very much respect the PA model, but don't you think you are oversimplifying it a bit?

 

-On didactics, much of the material PA training covers is covered during RN-NP training too. The content may be "hidden" under course titles, but it is largely there. Nursing tends to integrate training, e.g. an NP "Health Assessment" course may cover physical diagnosis, laboratory diagnosis, imaging, EKG, differential development, etc. all in one single course under a simple title. I personally hate the integrated approach (I much prefer "front loading" and/or distinct stand alone courses), but the content is there.

-On prereqs, they are largely the same on average.

-On clinical hours, NP's tend have as much training in their specialty area as PA's do on average (e.g. FM).

 

 

don't get me wrong. I know of and have worked with some great nps but there is a big difference between an er or icu nurse of many years who goes to a solid np program and many of the direct entry folks today doing it mostly online.

 

DE should not be allowed for PA or NP, IMO. Both produce providers who just aren't ready.

[EMEDPA]

DE should not be allowed for PA or NP, IMO. Both produce providers who just aren't ready.

totally agree. not a big fan of direct entry/no hce pa programs at all. their grads make the rest of us look bad. it only takes one idiot pa to tarnish our image at a particular facility and change hiring practices to "we don't hire pas".

[EMEDPA]

-On clinical hours, NP's tend have as much training in their specialty area as PA's do on average (e.g. FM).

I have to disagree with this, at least in regards to my personal clinical year which I designed with an em focus.

I did 12 weeks 480-500 hrs of fp (basically a full fnp programs worth) and it wasn't even my clinical focus. in addition to that I got the following:

trauma surgery 600 hrs

peds em 250 hrs

psych(inpt) 200 hrs

inpt I.M. 200 hrs

obgyn (clinic, L+D, O.R.) 250 hrs

em required 300 hrs

em elective 500 hrs

 

the extra psych, peds, IM, ob, etc are certainly relevant to the practice of fp, even if you disreagrd trauma surgery and em rotations.

so, who would make the better fp provider right out of school, me or someone with only 500 hrs of outpt clinic fp training?

what about me vs an np who attended one of the few emergency np programs that boasts 800-1200 hrs of total clinical time vs my 2800 hrs?

typical pa program 117 credits, 50 weeks of clinicals:

http://www.drexel.edu/physAsst/programs/physicianAssistant/curriculum/

compare this to two high end np programs( I looked for top programs, not 500 hr programs)

this program is 60 credits with 990 hrs total of clinicals:

http://sn.rutgers.edu/academics/masters/FHNPEmergency/courses.html

this program for em nps gets you two certs, both fnp and acnp and is still only 1200 hrs of clinicals total:

http://www.nursing.vanderbilt.edu/msn/enp.html

 

 

 

[UpRegulated]

totally agree. not a big fan of direct entry/no hce pa programs at all. their grads make the rest of us look bad. it only takes one idiot pa to tarnish our image at a particular facility and change hiring practices to "we don't hire pas".

 

I almost went the DE NP route and I can't tell you how glad I am that I didn't. Several years ago I shadowed a cards NP who had just graduated from a DE program. She was like a fish out of water, and I could tell that even though I hadn't even started nursing school yet. She seemed very intelligent, but very lost. While shadowing her, she actually had the gall to complain that her SP wouldn't let her have her own patients. :) Anyway, not long ago, I ran into her while she was admitting one of my patients and her history, physical, and admit orders all seemed solid and she seemed to speak the cards "language" fluently. She seems like a decent NP now, but how much pain and struggle did she (and her patients) have to suffer through in the process and how much better could she have been had she had some experience under her belt?

 

With the higher number of generalized clinical hours PA's get in training, I'd be more comfortable with a DE PA than NP. But neither are a good idea.

[EMEDPA]

my question to rn folks is this:

if two identical rn's look at pa vs np school and one enters each, who will end up the more proficient provider day 1 out of school? compare the worst pa program to the best np program.

there are certainly reasons to do np( independence, dominance in psych, etc). better clinical training is not one of those reasons.

[LT_Oneal_PAC]

my question to rn folks is this:

if two identical rn's look at pa vs np school and one enters each, who will end up the more proficient provider day 1 out of school? compare the worst pa program to the best np program.

there are certainly reasons to do np( independence, dominance in psych, etc). better clinical training is not one of those reasons.

 

As an RN who is doing PA and has 20 semester credit hours of NP under my belt when my hospital was paying for it: PA no doubt wins.

 

 

Sent from my iPhone using Tapatalk 2

[EMEDPA]

As an RN who is doing PA and has 20 semester credit hours of NP under my belt when my hospital was paying for it: PA no doubt wins.

 

 

Sent from my iPhone using Tapatalk 2

 

thank you. I quoted you in this thread on sdn on a similar topic: http://forums.studentdoctor.net/showthread.php?p=14333334#post14333334

[edwinjvazquez]

PAs are certainly better trained out of school. I personally would support post graduate training for NPs. There are some currently available:

 

http://www.cumc.columbia.edu/pulmonary/clinical-centers/critical-care-np-pa-program

 

http://www.npresidency.com/

 

http://nursing.ucsf.edu/nurse-practitioner-residency-introduction

 

http://umm.edu/professionals/nurse-practitioners/residency

 

http://www.mayo.edu/mshs/careers/nurse-practitioner/cardiology-nurse-practitioner-fellowship-arizona

[EMEDPA]

I think postgrad training for both pas and nps is a good idea and will likely become a requirement at some point.

here are some pa postgrad programs http://www.appap.org

and here are the 19 specific to the field of emergency medicine(there are also separate ones for critical care and trauma):

http://www.physicianassistantforum.com/forums/showthread.php/2159-Emergency-Medicine-Links-Residencies

[ventana]

I very much respect the PA model, but don't you think you are oversimplifying it a bit?

 

-On didactics, much of the material PA training covers is covered during RN-NP training too. The content may be "hidden" under course titles, but it is largely there. Nursing tends to integrate training, e.g. an NP "Health Assessment" course may cover physical diagnosis, laboratory diagnosis, imaging, EKG, differential development, etc. all in one single course under a simple title. I personally hate the integrated approach (I much prefer "front loading" and/or distinct stand alone courses), but the content is there.

-On prereqs, they are largely the same on average.

-On clinical hours, NP's tend have as much training in their specialty area as PA's do on average (e.g. FM).

 

 

 

 

DE should not be allowed for PA or NP, IMO. Both produce providers who just aren't ready.

 

 

 

Wow, sorry if I rant....

 

PA versus NP schooling is nothig close - in fact we had two people FAIL out (get kicked out) of my PA program for grades.... they signed up for a DE NP program and tada 3 years latter they are NP's - NP school is FAR easier - BUT if built on 5+ years ER/ICU/CCU experience it can be great - BUT not as a DE

 

Pre-Req's = not even close

 

Hours of training, again not even close - I have known NP's who have graduated with a huge 400 hours of clinical experience!!! PA's have 2000+ as a bare min - I worked about 60+ hours a week for year two and therefor had > 3000 hours...... that is something like 8 times the hours of an NP new grad......

 

 

Just to be clear - I enjoy and appreciate NP's and there is some truly great ones out there. But to say that NP education = PA education is simply not true.

Easy way to answer the question is to allow new grad NP's to take the PANCE (not for certification but just to see how they do....) I suspect (and I have worked with NP students) they would not pass.....

 

 

More then once (many times actually) while working with NP students I would ask the famous "name the top three bugs for AOM" >90% of the PA-s can answer < 30 seconds, for NP-s usually < 20% could get even two of the bugs after thinking about it for a few minutes..... They simply are not the same.....

 

 

BUT 5 years out - I don't care about your degree - I care rather you have made the effort to educate yourself to better care for the patients...... then we are interchangeable....

[UpRegulated]

Wow, sorry if I rant....

 

PA versus NP schooling is nothig close - in fact we had two people FAIL out (get kicked out) of my PA program for grades.... they signed up for a DE NP program and tada 3 years latter they are NP's - NP school is FAR easier - BUT if built on 5+ years ER/ICU/CCU experience it can be great - BUT not as a DE

 

Pre-Req's = not even close

 

Hours of training, again not even close - I have known NP's who have graduated with a huge 400 hours of clinical experience!!! PA's have 2000+ as a bare min - I worked about 60+ hours a week for year two and therefor had > 3000 hours...... that is something like 8 times the hours of an NP new grad......

 

 

Just to be clear - I enjoy and appreciate NP's and there is some truly great ones out there. But to say that NP education = PA education is simply not true.

Easy way to answer the question is to allow new grad NP's to take the PANCE (not for certification but just to see how they do....) I suspect (and I have worked with NP students) they would not pass.....

 

 

More then once (many times actually) while working with NP students I would ask the famous "name the top three bugs for AOM" >90% of the PA-s can answer < 30 seconds, for NP-s usually < 20% could get even two of the bugs after thinking about it for a few minutes..... They simply are not the same.....

 

 

BUT 5 years out - I don't care about your degree - I care rather you have made the effort to educate yourself to better care for the patients...... then we are interchangeable....

 

OK, brotha. It's a PA message board. I'm just living in it. ;)