Are PAs and NPs "interchangeable"?

[andersenpa]

Don't drink the coolaide. nps do NOT practice medicine. nps are NOT licensed to practice medicine. nps do NOT provide an equal level of competent care. I'm insulted because of your ignorance of the PA profession and your attempt to belittle my profession with such careless disregard for the earned title. I do not have any issues with a nurse practicing nursing. I do have issue with nursing claiming to practice medicine in equivalence with Physician Assistants or MDs at that. If you are so quick to support such notions then i would assume that you are pro "assistant physician" in missouri. You have shown your colors. PS. the PA profession should never allow nursing nor its own associations to erode our lateralization capabilities. It is on of the greatest attributes to being a PA.

Well as it was said above, call it what you want. A person using subjective and objective data to evaluate/examine a patient, and then using (almost exclusively) allopathic methods of treatment, is practicing what we all preceive as medical practice.

 

They are not licensed to practice "Capital M Medicine" but they are practicing "lowercase m medicine". I could blind you and anyone else to the credentials of 100 providers and by observation you could not discern MD/PA/NP as easily as you suggest. I have said for a long time that the "advanced nursing practice" is a successful ruse which allows them to practice medicine outside the Organized Medicine structure. They won that battle. But it's naive to think that they are playing a different ballgame.

 

Regarding equivalence they have the data to support that so you don't have to argue with an opinion just look at the literature. It's getting more robust as their numbers grow.

 

And regarding belittling "your" title.....well at this point in my life I am mostly amused at self righteousness.

 

You can read the MO thread to see my thoughts on that.

[andersenpa]

Just a quick biased opinion.

 

NP And PA are not equals, neither in practice nor education.

 

But the line in the sand, for me as a hire-fire guy, is the political philosophy the NP organization has, which is, succinctly, to put the PAs out of business, and eventually become the nation's sole advance practice providers.. CRNA and Nurse midwives exceptions.

 

NPs are NOT our friends.. There is NO parity between the two professions.

 

Do you see any movement or efforts on the NPs part to include PAs in their practice models?

 

Do you see any NP organization promoting the PAs as fellow advance practice clinicians???

 

North Carolina PAs were on the receiving end of nurse practitioner politics in 1994... At that time the state legislature authorized the PAs narcotic privileges.. Next year, the NPS came to us, asked us to endorse them in an effort to be included into that legislation.. Which we did ...

 

The next year ( having achieved parity with the PAs in prescriptive practice), the NPs and nursing organization instituted the " we are nurses, practicing nursing, we do not heed supervisory agreements, we will accept only a collaborative agreement", in recognizing the differences between those "dependent practitioners"( read: PAs ) and those not dependent by virtual of an independent license( NP).

 

We laid down with dogs and were surprised when we got fleas.

 

Assisting NPs into " our" realm is akin to selling a hangman the rope he will use to tie around our neck.

 

I can think of no time when the NP organization has helped us... Or even given us cursory lip service.

 

While I have influence in the region ( and I admit that I do have a little), no NP WILL BE HIRED IN THE ED.

 

and my patients will do just fine, thank you.

 

I will support your efforts. Mike, when I do not see them as a suicide pact.

 

Rc

Davis-

 

I'll agree that there's no parity (a shame given our superior training)

I don't agree that there is an unequivocal difference in practice

 

I KNOW that this is all colored by experience and my experience with NP colleagues has been VERY good. Strong providers who know what they're doing. Others have different experiences.

 

The animosity should be directed towards organized nursing (who have the agenda and $$$) and not the working NPs (who, like us, want to know their stuff, practice good care, and for the most pasrt be collegial).

 

I acknowkledge that PAs have more to gain from seeking NP parity than  vice versa, but there's nothing wrong with working on that goal if it serves patients and our profession.

 

Regardin nursing practice- even though they did beat the system, the fact is >90% of them are working in physician collaborative groups.

 

-Matt

[EMEDPA]

The animosity should be directed towards organized nursing (who have the agenda and $$$) and not the working NPs (who, like us, want to know their stuff, practice good care, and for the most pasrt be collegial).

 

I acknowkledge that PAs have more to gain from seeking NP parity than  vice versa, but there's nothing wrong with working on that goal if it serves patients and our profession.

 

Regardin nursing practice- even though they did beat the system, the fact is >90% of them are working in physician collaborative groups.

 

-Matt

I can agree with this. nursing boards are anti-pa, individual nps may not be.

[rcdavis]

I can agree with this. nursing boards are anti-pa, individual nps may not be.

Do not disagree, but don't you see the self perpetuation that occurs?

 

Individual NPs enjoy any effort we have towards eliminating degree discrimination or prejudice, but continue to promote and benefit from both nursing board and national nursing professional pathway pllicies, to our detriment.

 

(To be really politically incorrect) ... This argument is sorta like excusing Islam devotees who are not responsible for Sharia law or atrocities as a group I should tolerate and not judge, when I have yet to hear ANY Muslim leader or teacher make a statement decrying the blowing up of children, the beheading innocents, the sentencing a pregnant woman to death by hanging because she is an apposite, 9/11, Boston, London, etc... And until I do hear these disclaimers, I will consider that religion as a particularly violent and xenophobic one, mired in jihad and caliphate.

 

The NPs may be individually nice enough, and clearly are competent in most cases.. But they are pawns and Trojan horses to a system which has our profession's demise as a central tenet to its philosophy.

 

They are part of the system which is our sworn enemy.. And until I meet one that decries that national philosophy, and who actively supports the PAs by protesting the nursing boards and professional development sections to help get PAs included.. One. Who goes to the hospital administration and gives a PA a hand up by getting a door opened for that PA TO GET into the neonatal ICU, I will remain open eyed and defiant against them.

 

I see no advantage to the NP profession to help us, to give us any quarter... I accept that. And until they do that.. There is no advantage to us helping them.

 

I mention this as my basis for my "tit for tat" attitude.

[EMEDPA]

fair enough RC. I don't disagree with you. The NPs are the competition and until PAs realize that we will keep coming in last place in a race many don't even realize we are running.

[Guest JMPA]

As a PA,  don't you just love being equated to a nurse? might as well just equate us to janitors and allow medical school graduates whom have no residency training to take our jobs.

[andersenpa]

I mention this as my basis for my "tit for tat" attitude.

I would say then "don't hate the player, hate the game"

 

My take on this has always been to exploit the advances they make in any way possible. If we have an effective legislative presence (a big "If" there), we can take advantage of the inroads we have made. It involves staying involved at the state level which is a challenge to our numbers and $$$.

 

I don't disagree with your enmity towards their organization, but (in the spirit of this thread) institutiionalized hiring bias is not supported by measures of PA/NP clinical competence.

[rcdavis]

I would say then "don't hate the player, hate the game"

 

 

I don't disagree with your enmity towards their organization, but (in the spirit of this thread) institutiionalized hiring bias is not supported by measures of PA/NP clinical competence.

Agree. However, we live in a very political time, and actions we individually make inevitably will generate and influence politics.

 

I can MAKE a C level PA into a B level or even - given time and interest on their part- an A level one... Which would be sought after and hirable anywhere.

 

I choose to do this with preferential PA hiring..

INSTITUTIONAL HIRING BIAS ON MY PART IS THE ONLY WAY I KNOW TO PROTECT MY PROFESSION. ( oops, cap lock)

[EMEDPA]

gotta admit, RC, I do the same thing. we just had to replace several folks in the last year(retirement, move for family member illness, joined state dept, etc) and didn't even consider posting pa/np. we currently have 1 np who the group inherited from the prior group and when she is gone it is likely we won't ever have another np.

[Guest JMPA]

I would say then "don't hate the player, hate the game"

 

My take on this has always been to exploit the advances they make in any way possible. If we have an effective legislative presence (a big "If" there), we can take advantage of the inroads we have made. It involves staying involved at the state level which is a challenge to our numbers and $$$.

 

I don't disagree with your enmity towards their organization, but (in the spirit of this thread) institutiionalized hiring bias is not supported by measures of PA/NP clinical competence.

we have been exploited by the nursing profession towards their advancement because of people like you whom have the audacity to group (equalize) them with us. That being said, they get advanced and we get grouped (equalized) to their inadequacies. So yes, hate the player and the game.

[matchb0x]

we have been exploited by the nursing profession towards their advancement because of people like you whom have the audacity to group (equalize) them with us. That being said, they get advanced and we get grouped (equalized) to their inadequacies. So yes, hate the player and the game.

Ok I have witnessed a lot of this sentiment on here.  "DAMN NURSES!!"  What is weird to me is I have never seen, heard, or read this from any nursing lobby/group.  I do not believe the nurse powers that be have it out for PAs specifically, that is silly.  I believe they are out for their profession and if there's a collateral effect than oh well, that's it.  I can understand why YOU 'might' glean this idea from some very few regulations that have attempted to pass or have passed, but i wonder how much of your bias colors the move?  Perhaps you should be mad at AAPA or AMA.  

 

As was mentioned earlier, PAs lost in the 90s.  If the AAPA had any forsight at all, they would've been looking to the future and seeing where healthcare is headed and adjusted accordingly, like nursing.   right or wrong, they made the right moves in the most successful way.  Had the AAPA removed the "assistant" shackle ten/fifteen years ago, PAs wouldn't be where they are now, playing catch up. 

 

I truly don't get all the ire directed at nursing, they seriously don't care very much about anyone else, to their detriment, and yet nobody seems to capitalize on it.  I will say, these studies come out, one after another, supporting NPs in practice and showng that a properly educated and trained NP is effective and can deliver safe cost effective care to patients. 

 

I've said this before- I really admire the depth of education/training that a PA receives but going PA is becoming some sort of altruistic fight to "keep things the way the were" instead of innovation and moving forward while capitlizing on what makes a PA so great.  Perhaps it is my ignorance, but alot of the negative anti-np comments from here come from real ego driven places instead of research and data, difficult to change heart and minds that way.

[rcdavis]

Ok I have witnessed a lot of this sentiment on here. "DAMN NURSES!!" What is weird to me is I have never seen, heard, or read this from any nursing lobby/group. I do not believe the nurse powers that be have it out for PAs specifically, that is silly. I believe they are out for their profession and if there's a collateral effect than oh well, that's it. I can understand why YOU 'might' glean this idea from some very few regulations that have attempted to pass or have passed, but i wonder how much of your bias colors the move? Perhaps you should be mad at AAPA or AMA.

 

As was mentioned earlier, PAs lost in the 90s. If the AAPA had any forsight at all, they would've been looking to the future and seeing where healthcare is headed and adjusted accordingly, like nursing. right or wrong, they made the right moves in the most successful way. Had the AAPA removed the "assistant" shackle ten/fifteen years ago, PAs wouldn't be where they are now, playing catch up.

 

I truly don't get all the ire directed at nursing, they seriously don't care very much about anyone else, to their detriment, and yet nobody seems to capitalize on it. I will say, these studies come out, one after another, supporting NPs in practice and showng that a properly educated and trained NP is effective and can deliver safe cost effective care to patients.

 

I've said this before- I really admire the depth of education/training that a PA receives but going PA is becoming some sort of altruistic fight to "keep things the way the were" instead of innovation and moving forward while capitlizing on what makes a PA so great. Perhaps it is my ignorance, but alot of the negative anti-np comments from here come from real ego driven places instead of research and data, difficult to change heart and minds that way.

Exactly.

 

No arguments from me.

 

I agree with just about everything you say.

 

So, having conceded your main points, remind me again as to why, while i have hire authority, I should consider an NP rather than preferentially hiring PAs, and trying to slow down the NP juggernaut?

 

Short of endorsing professional suicide, I can think of not one reason.

 

But, do not worry ( not that you would), I am dying and soon will no longer be a professional impediment to the NP profession's success.

 

NPs sorta remind me of the Borg.

[matchb0x]

Exactly.

 

No arguments from me.

 

I agree with just about everything you say.

 

So, having conceded your main points, remind me again as to why, while i have hire authority, I should consider an NP rather than preferentially hiring PAs, and trying to slow down the NP juggernaut?

 

Short of endorsing professional suicide, I can think of not one reason.

 

But, do not worry ( not that you would), I am dying and soon will no longer be a professional impediment to the NP profession's success.

 

NPs sorta remind me of the Borg.

Don't let me misrepresent myself.  Having hire authority for your faciliy/group, YOU are best positioned to serve your patient population and your profession.  I don't begrudge that.  And if you think that only hiring PAs meets the needs of said population/profession than do it and dont look back (as you already are).  I just think that far too many people direct their negative feelings towards the "nursing powers" and far too little at the AAPA.   

 

 

And I am concerned that PAs might go away.  I think they are very valuable and would be the premier profession (vs NP), filling the needs of our country.  As a profession, they are supremely educated and highly capable.  It is a true shame that the profession might be undone by the very group that was formed to guide it (aapa).  It is too late to rail against NPs, that horse has left the barn, the farm, and the county.  It should all be about getting the "assistant" out of your title, getting collaboration rights, and magnifying your presence to the country at large.  All that being said, it is my personal belief this country is best served by a combo of MD/DO/PA/NP. 

 

 

 

I apologize for the length,  I was not blessed with the gift of brevity, so my wife says. 

 

 

Just so you know where I am coming from on all this:

Also, I always wanted to be a MD/DO.  But coming from a poor family situation I could not see myself devoting that amount of time to studying knowing that when I had kids (soon hopefully) at home I'd have to be studying 10 hours a day, or working 6 12's during residency.  So than naturally PA was the next option.  It made sense and I was starting to plan out my options, and than I learned about the AAPA.  I will not tether my future to a group such as the aapa nor to a random SP that "owns" my employability, i just don't trust either scenario.  I also cannot afford to not work for 2 years during school.  I have a BSN as it was the best healthcare related job that could be had with my GI Bill and still support my family, not because "I am nurse, hear me roar."  I am no shill.  So NP it is for me, which will be easier and better suits my life and family, and I have learned to be ok with that.  I will have to do a lot of work finding quality schools, quality preceptors, and study a ton to make sure I am ready for such a challenge and priviledge to provide care to the sick and injured.  Do I wish I could attend PA school? Yes I do.  It just not the way the cards were dealt.

[Lexapro]

As another NP student who frequents this forum, I do find the ire thrown at nursing (and NPs specifically), off-putting. I am very supportive of PAs and the ones I have met and worked with have been great clinicians. The reality is that the clinician is more than the letter behind their names, whether it is MD/DO/PA/NP. I am all for PAs and NPs getting together and supporting our mutual interests. I see this is quite unlikely, though. All I can say is that it is easy to throw mud at another profession and blame them for your perceived professional injustices. I should add that I am not some nursing fangirl and I frequently am highly critical of nursing and NP education (I want to clarify that I'm not a nursing shill). If PAs had more autonomy and better psych education, I would have gone that route.

[Guest Paula]

The AAPA HOD is just about ready to adopt collaboration in place of supervision, final vote on monday. PAs are moving forward. Send the hod good vibes for passage. There are a few psych residencies for PAs one in Iowa and one in Minneapolis.

[matchb0x]

The AAPA HOD is just about ready to adopt collaboration in place of supervision, final vote on monday. PAs are moving forward. Send the hod good vibes for passage. There are a few psych residencies for PAs one in Iowa and one in Minneapolis.

Good luck!

[andersenpa]

As another NP student who frequents this forum, I do find the ire thrown at nursing (and NPs specifically), off-putting. I am very supportive of PAs and the ones I have met and worked with have been great clinicians. The reality is that the clinician is more than the letter behind their names, whether it is MD/DO/PA/NP. I am all for PAs and NPs getting together and supporting our mutual interests. I see this is quite unlikely, though. All I can say is that it is easy to throw mud at another profession and blame them for your perceived professional injustices. I should add that I am not some nursing fangirl and I frequently am highly critical of nursing and NP education (I want to clarify that I'm not a nursing shill). If PAs had more autonomy and better psych education, I would have gone that route.

The differences on each side of the rift seem to be that organized nursing has (for a while) held and anti-medical stance, and been blatantly dismissive of the medical model as narrow and  lacking comprehensiveness. Unfortunately a vocal minority of nursing leadership and some NPs echo this, coming straight out of training with (IMO) and unwarranted feeling of superiority.

 

The animosity from PAs is all about resentment. Hard to swallow the fact that PAs have more hrs of clinical training than NPs, yet NPs have further and further expansion of independent practice.

 

Also- PAs and NPs have the same autonomy; they difference is the legal allowance for independence. Autonomy is granted at the level of the practice.

[db_pavnp]

The differences on each side of the rift seem to be that organized nursing has (for a while) held and anti-medical stance, and been blatantly dismissive of the medical model as narrow and  lacking comprehensiveness.

 

Thank-you for this explanation.  Like Lexapro, I have been pretty shocked by the last page or so here.

[andersenpa]

Yeah most PAs have issues with the lack of NP-PA parity rather than thinking NPs are incompetent or anything like that.

[Guest JMPA]

once again, there is no pa/np parity. we are two different animals. stop trying to blurr different professions

[Guest Paula]

Perhaps we should define parity.  Dictionary definition is:

 

1. Equality, as in amount, status, or value.  This definition is one most PA/NPs think parity applies. 

 

2. A level of farm product prices, maintained by governmental support and intended to give farmers the same purchasing power they had during a chosen base period.  This definition is one  NPs ascribe to.....they have achieved governmental support and are gaining purchasing power in the medical marketplace.  PAs have not attained that status. 

 

OR.

 

3. The comparative odd-even relationship between two integers. If both are odd, or even, they are said to have the same parity.  This is the definition we are arguing about on the forum.  PAs are seen as even, NPs as odd. 

[LIPPER]

I'm a working PA so that shoe doesn't fit.

 

Your comment falls in the same bucket as when organized nursing says PAs (and docs) are inferior because they lack a holistic approach, or that they are patient focused and not disease/diagnosis/procedure focused, etc.

 

Someone else may fall for it but I've been around long enough to know that

1. NPs practice the same medicine that we do, only under different license and boarding

2. Training gets you in the club but talent/drive/skill are what makes a clinician- NPs and PAs share that same opportunity

 

You or I or anyone else is not the final arbiter of who has "worthy" experience. Each profession has had the chance to prove its mettle, and due to that and PAs and NPs are both legitimate players in the patient care workforce.

 

You can be insulted that NPs provide an equal level of competent care as you, but being insulted doesn't make it any less so.

very nicely said.

 

 

Sent from my iPhone using Tapatalk

[Guest JMPA]

Perhaps we should define parity.  Dictionary definition is:

 

1. Equality, as in amount, status, or value.  This definition is one most PA/NPs think parity applies. 

 

2. A level of farm product prices, maintained by governmental support and intended to give farmers the same purchasing power they had during a chosen base period.  This definition is one  NPs ascribe to.....they have achieved governmental support and are gaining purchasing power in the medical marketplace.  PAs have not attained that status. 

 

OR.

 

3. The comparative odd-even relationship between two integers. If both are odd, or even, they are said to have the same parity.  This is the definition we are arguing about on the forum.  PAs are seen as even, NPs as odd. 

if you drink enough coolaide you may start to like the taste. #1 obviously from this very poll most PAs do not think parity applies. #2 i would agree #3 I would agree I suppose 2 out of 3 aint bad. maybee the coolaide needs more spike.

[Joelseff]

if you drink enough coolaide you may start to like the taste. #1 obviously from this very poll most PAs do not think parity applies. #2 i would agree #3 I would agree I suppose 2 out of 3 aint bad. maybee the coolaide needs more spike.

I like apple drink

 

Sent from my Galaxy S4 Active using Tapatalk.

 

 

[andersenpa]

I like apple drink

 

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It's green.....