What do YOU think the PA profession will be like in the future?

[LT_Oneal_PAC]

U. Of WA and UCSF seem to turn out solid NP grads as well.

I don't know too much about them, but since you know that area I'll take your word for it. I should've said "Vandy is the best I know of."

[tunafish]

They showcase a current student who is a nutritionist with zero clinical experience and will be a clinician after THIS. Just great!

[Mainer]

 

 

This is correct for some programs, but not all of them. I was discouraged when I looked into the DNP curriculum - I was hoping it would increase clinical knowledge but it turned out to be, as others have said, nothing but fluff. As I continued researching, though, I realized that that isn't entirely true. For one thing, a DNP program does increase the minimum clinical hours of an NP program, which is great. Beyond on that, though, some schools have really increased clinical education in the DNP portion. Take Columbia for example:

 

Their DNP programs is two years, to be completed AFTER a Master's, and contains the following classes listed below. In addition, there is a FULL YEAR supervised "residency" in the students field. This STRONGLY increases clinical hours/knowledge of students that complete the program and I imagine other programs will follow suit eventually. The DNP minimum clinical hours + the full year residency would actually surpass the hours of a PA program. Obviously, this is not the case at all schools, but if the "Columbia Model" spreads, it would be a major boon to NP education.

 

N9300 Comparative Quantitative Research Design and Methodology I 3 N9400 Practice Management 2 N9412 Informatics for Advanced Practice 3 N9538 Advanced Seminar in Clinical Genomics 2 N9600 Legal and Ethical Issues 3 N9672 Principles of Epidemiology and Environmental Health 3 N9910 Translation and Synthesis of Evidence for Optimal Outcomes 3   Total Support Core 19 Clinical Core Courses     N9480 Chronic Illness Management 2 N9700 Residency for Doctor of Nursing Practice 5-10 N9700 Residency for Doctor of Nursing Practice 5-10 N9710 Doctor of Nursing Practice I 2 N9711 Doctor of Nursing Practice II 2 N9714 Field Experience: Doctor of Nursing Practice I 1 N9715 Field Experience: Doctor of Nursing Practice II 1 N9717 Seminar: Doctor of Nursing Practice 1 N9718 Seminar: Doctor of Nursing Practice I 1 N9719 Seminar: Doctor of Nursing Practice II 1

 

Your facts seem a little misinforming.  This still does not come close to PA didactic or clinical education requirements. NP education is soft no matter how you slice it......

Disappointing!

[MedicalRN]

NP Education is soft, for sure, but still creates capable providers that are working right alongside PAs in the same positions.

[Mainer]

NP Education is soft, for sure, but still creates capable providers that are working right alongside PAs in the same positions.

Working "alongside" doesn't mean equal.   And they do not work in the same positions, they work as nurse practitioners/APRNs, not physician assistants.  They are not licensed, regulated, or disciplined by the state medical boards.   They are indeed held to a "softer" standard.  We all work "alongside" physicians, but we are not equal.  Education and training to become a physician will always be the standard that all others are measured.   PA's train much like physicians.   It doesn't matter how the nursing industry markets their programs or degrees.  Word-smithing their titles doesn't change the actual content of NP training.  They want to provide primary care services without physician oversight and backup, yet lack complete training and education to provide primary care.  

 

I work with an NP who has never done an ER rotation, psych rotation, surgery rotation, spend a total of 2 wks in pediatrics, 2 weeks in women's health, had no inpatient training.   I don't remember if she ever did any internal medicine/subspecialty training.  Her didactic education was similarly structured.  She is 2 yrs out of school.  She struggles with every patient unless it's something routine... because her primary care education is incomplete.  Eventually, she'll figure out the patterns and protocols, but she'll never understand the fundamentals the way she should... because her primary care education is incomplete.  

 

You just can't skip fundamental didactic and structured clinical education in EM, inpatient/internal medicine, women's health/obstetrics, pediatrics, psych, and surgery, and somehow function as a primary care provider.  

[MedicalRN]

Working "alongside" doesn't mean equal. And they do not work in the same positions, they work as nurse practitioners/APRNs, not physician assistants. They are not licensed, regulated, or disciplined by the state medical boards. They are indeed held to a "softer" standard. We all work "alongside" physicians, but we are not equal. Education and training to become a physician will always be the standard that all others are measured. PA's train much like physicians. It doesn't matter how the nursing industry markets their programs or degrees. Word-smithing their titles doesn't change the actual content of NP training. They want to provide primary care services without physician oversight and backup, yet lack complete training and education to provide primary care.

 

I work with an NP who has never done an ER rotation, psych rotation, surgery rotation, spend a total of 2 wks in pediatrics, 2 weeks in women's health, had no inpatient training. I don't remember if she ever did any internal medicine/subspecialty training. Her didactic education was similarly structured. She is 2 yrs out of school. She struggles with every patient unless it's something routine... because her primary care education is incomplete. Eventually, she'll figure out the patterns and protocols, but she'll never understand the fundamentals the way she should... because her primary care education is incomplete.

 

You just can't skip fundamental didactic and structured clinical education in EM, inpatient/internal medicine, women's health/obstetrics, pediatrics, psych, and surgery, and somehow function as a primary care provider.

 

Your sample size of one does not speak to the quality of every nurse practitioner. Yes, NP education could do with some drastic standardization - it is far too easy for a school to become accredited and offer NP education, including for profit programs with nothing but their bottom line in mind. In addition, lax admission standards make it easy for even those of subpar intelligence to enter the field - people who don't have the critical thinking skills or logic to function as a provider regardless of the quality of their education. Despite that, nurse practitioners do function as physician extenders right alongside PAs and in a similar role, hence why many positions say "NP or PA". In addition, there are many highly qualified, intelligent, capable nurse practitioners who DO understand the fundamentals and pathophysiology behind what they're doing because they went to a good program, were taught by good preceptors, and have a desire to understand why something is happening vs just following a protocol. I'm sorry that has not been your experience, but the only reason I am considering NP over PA is because some of the best providers I have ever come in contact with have been Nurse Practitioners. If I based my view of NPs on the ignorant, jaded opinions of some people on this board, I would never give the career a second glance.

[rn2pa]

Your sample size of one does not speak to the quality of every nurse practitioner. Yes, NP education could do with some drastic standardization - it is far too easy for a school to become accredited and offer NP education, including for profit programs with nothing but their bottom line in mind. In addition, lax admission standards make it easy for even those of subpar intelligence to enter the field - people who don't have the critical thinking skills or logic to function as a provider regardless of the quality of their education. Despite that, nurse practitioners do function as physician extenders right alongside PAs and in a similar role, hence why many positions say "NP or PA". In addition, there are many highly qualified, intelligent, capable nurse practitioners who DO understand the fundamentals and pathophysiology behind what they're doing because they went to a good program, were taught by good preceptors, and have a desire to understand why something is happening vs just following a protocol. I'm sorry that has not been your experience, but the only reason I am considering NP over PA is because some of the best providers I have ever come in contact with have been Nurse Practitioners. If I based my view of NPs on the ignorant, jaded opinions of some people on this board, I would never give the career a second glance.

I totally agree with you...I am in fact a little surprised there is such animosity towards NPs.  Yes, the education is a bit different, but different doesn't mean better.  I wonder if MDs feel the same way about DO's?  I mean, the average MCATS, GPAs, etc to get into DO school are much lower than MD school...I digress.

 Either way, NPs are and will always be a PAs colleagues...why not accept the differences and move on?  There are horrible NPs just as there are horrible PAs, people need to stop generalizing based on one or two encounters.  

[Mainer]

Your sample size of one does not speak to the quality of every nurse practitioner. Yes, NP education could do with some drastic standardization - it is far too easy for a school to become accredited and offer NP education, including for profit programs with nothing but their bottom line in mind. In addition, lax admission standards make it easy for even those of subpar intelligence to enter the field - people who don't have the critical thinking skills or logic to function as a provider regardless of the quality of their education. Despite that, nurse practitioners do function as physician extenders right alongside PAs and in a similar role, hence why many positions say "NP or PA". In addition, there are many highly qualified, intelligent, capable nurse practitioners who DO understand the fundamentals and pathophysiology behind what they're doing because they went to a good program, were taught by good preceptors, and have a desire to understand why something is happening vs just following a protocol. I'm sorry that has not been your experience, but the only reason I am considering NP over PA is because some of the best providers I have ever come in contact with have been Nurse Practitioners. If I based my view of NPs on the ignorant, jaded opinions of some people on this board, I would never give the career a second glance.

Are you even a PA or NP student.....yet you are able to provide insight into "some of the best providers I have ever come in contact with".  I'll provide you with some insight, NP profession is truly the bastardization of medicine.  

 

Love the sample size comment. A brilliant touch, but clearly hindered by nothing so mundane as rational thinking.  Please note, these forums are simply a social medium in cyberspace, nothing more.   No need to bore me with your complex analytical thinking.  

 

Back to the basics now, NP's simply lack fundamental training and education.  The profession is flawed and the product as a whole mirrors their education shortcomings.   You seem to admit to it on some level, but don't seem to appreciate the task of overcoming the educational deficiencies.  The same NP who "was the best you ever met", would have been even better if s/he had gone to PA, or even better, medical school.  That's the point.

[Guest JMPA]

Are you even a PA or NP student.....yet you are able to provide insight into "some of the best providers I have ever come in contact with".  I'll provide you with some insight, NP profession is truly the bastardization of medicine.  

 

Love the sample size comment. A brilliant touch, but clearly hindered by nothing so mundane as rational thinking.  Please note, these forums are simply a social medium in cyberspace, nothing more.   No need to bore me with your complex analytical thinking.  

 

Back to the basics now, NP's simply lack fundamental training and education.  The profession is flawed and the product as a whole mirrors their education shortcomings.   You seem to admit to it on some level, but don't seem to appreciate the task of overcoming the educational deficiencies.  The same NP who "was the best you ever met", would have been even better if s/he had gone to PA, or even better, medical school.  That's the point.

lol true on, but lets let the nurses practice nursing and the PAs practice medicine as our schooling prepares us. i would not feed the troll

[generalfluff]

I just find it ironic that these "DOCTOR" NPs who go to school part-time, and who have a minimum of 500 clinical hours to sit for boards push for independent practice, while us PAs who complete 4 times the amount at minimum (my own program actually has about 2500+) do not do so. Just where is the logic of a less trained midlevel asking for autonomy?

 

While some may mention that a lot of NPs have several years of RN experience, it is not at all comparable that you spent 6 years following orders and providing care, to someone who actually considers DDx, plans what tests to order, and understands the pathophysiology of the disease, to determine what treatment to give. If you ever want to realize what exactly the difference is between a medical and nursing model, you've got the answer right there.

 

It gets even worse when you consider no HCE, direct entry NP programs. You can at least be confident that the newly minted PA can be competent, whether they had a lot of previous HCE or not. I wouldn't be so sure of the former, especially when this "DOCTOR" hangs a shingle on her door.

 

Somehow, the so-called Assistant is more trustworthy to entrust your care to than the so-called Doctor . The idea of autonomous NP practice becomes even more silly when you see that it's not really independent. Sure, they call it "collaboration." I'll apparently be "supervised" but I don't see an MD signing off every chart I make.

 

It's quite clear which profession has a better job future.

[mandyt]

I see a lot of back and forth between doctors and what they call "noctors" where I work.  

 

This post describes how many feel.    

 

http://medicinesux.wordpress.com/2009/12/23/noctors-aka-nurse-doctors/

 

"Yes, you too can enter the Texas Woman’s University (just make sure you were able to crack a whopping 960 on the GRE to qualify) and a mere 46 credits later (don’t worry you will never have to take more than 9 credits a semester) and you too can call yourself DOCTOR. If you fear that 46 credits maybe too much of an academic burden, then you can always apply to the Frontier School of Midwifery and Family Nursing as they only require 33 credits to achieve the doctorate! Or maybe you hate having to sit in class. Well thanks to the the University of Cincinnati you can do your entire doctorate online (plus no GRE needed)!"