Infamous PA vs NP question

[dndandrea]

I struggle with this because the NP and the PA on one of the floors I work at the hospital do the exact same thing. They even admit they both do the exact same thing, and split the floor (PA gets front half of patients, NP gets back half of patients). I want to become competent to be able to explain the general differences between the two, especially for the upcoming school interviews.

 

• The nursing model vs medical model influences the philosophy of their practice... Is it wrong to say that PAs are directed more toward diagnosing while NPs are directed more toward treating/caring? It's certainly not the case where I work.
• NPs can practice independently without any direct supervision of a MD.
• NPs specialize their training in 1 field of medicine.
• PAs have more flexibility meaning they can practice in practically any field of medicine.
• Every NP was once a nurse, whereas PA students have a much more diverse background (EMT, Respiratory, PTA, etc...) (should I not bother mentioning this?)

What else? Also, what other questions are likely to arise after I use answers similar to these?

 

Yes I searched the forum, yes I searched google, yes I did some personal research. I'm having a lot of difficulty putting the differences between the nursing/medical model into words.

[GreatChecko]

• The nursing model vs medical model influences the philosophy of their practice... Is it wrong to say that PAs are directed more toward diagnosing while NPs are directed more toward treating/caring? It's certainly not the case where I work.

I would look at this as studying medicine, i.e. differential diagnosis, pathology, physiology, vs studying advanced nursing theory, and other than writing essays about cultural sensitivity, I don't know what advanced nursing theory entails and am not one to intelligently comment on it. Many smarter people than I have posted about it on this site.

• NPs can practice independently without any direct supervision of a MD.

Yes, but no practitioner is an island and anyone who says differently is a fool.

• NPs specialize their training in 1 field of medicine.

PA's can do this, they can do a residency, but they still aren't pigeon holed to one field. While the flexibility isn't unlimited, a PA could definitely do ED, Inpatient medicine, and then primary care with some study and support during each transition. 

• PAs have more flexibility meaning they can practice in practically any field of medicine.

Yes, to a point. See above.

• Every NP was once a nurse, whereas PA students have a much more diverse background (EMT, Respiratory, PTA, etc...) (should I not bother mentioning this?)

Sure, it is a difference, it does answer the question. 

 

Really, at the end of the day, I believe the answer to this question has to come back to you and why you want to be a PA vs an NP. What attracted YOU to the profession? Why do YOU want to be a PA? Anyone can read the interview guides and regurgitate an answer. It's those that can then take the next step and say why they see themselves as a PA and not an NP/MD/AA, etc. etc. are the ones that will set themselves apart from the regurgitators. In other words, ending with a few sentences that begin with, "...and that's why I like the PA profession...."

 

Honestly, I hate the question because people stress over it, study the difference, and it does nothing to tell the interviewer if that person really sees themselves as a PA and if the PA title fits them. Call me cynical, but to me it just shows they are able to read and probably looked this up right after they saw the fifteen thousand other articles calling PA the best master's degree.

[EMEDPA]

in only about 1/2 of states are NPs independent(23 I believe). in the others they have to "collaborate" with a physician like we do.

PAs are trained as generalists but can specialize to some extent in school. I had > 1500 hrs of emergency med, peds em, and trauma surgery. this is more than any NP gets in the field of emergency medicine. so who specialized in school?

Every Np was a nurse at some point in their educational process. there are many direct entry np programs where one can go from no medical background and a BS in anything to an np in 3 yrs with the rn granted after yr #1.  Keep in mind RNs can also go to pa school.

[Joelseff]

The point about "no one practices on an island" is really worthless.. Sorry... Yes we all practice in collaboration with someone else, docs, other PAs, NPs etc but it's still a big ADVANTAGE that the NPs have over us, maybe not in clinical acumen etc but definitely in the eyes of the public and powers that be. By the same thinking, can we then say "So what if legally Docs can practice on their own, no one really practices alone..."

[JohnnyM2]

in only about 1/2 of states are NPs independent(23 I believe). in the others they have to "collaborate" with a physician like we do.

I learn something new everyday. Good to know.

 

 

[EMEDPA]

I learn something new everyday. Good to know.

it's even fewer where they can be in independent practice and rx independently(something like 18 states I think).

[dndandrea]

Really, at the end of the day, I believe the answer to this question has to come back to you and why you want to be a PA vs an NP. What attracted YOU to the profession? Why do YOU want to be a PA? Anyone can read the interview guides and regurgitate an answer. It's those that can then take the next step and say why they see themselves as a PA and not an NP/MD/AA, etc. etc. are the ones that will set themselves apart from the regurgitators. In other words, ending with a few sentences that begin with, "...and that's why I like the PA profession...."

 

Honestly, I hate the question because people stress over it, study the difference, and it does nothing to tell the interviewer if that person really sees themselves as a PA and if the PA title fits them. Call me cynical, but to me it just shows they are able to read and probably looked this up right after they saw the fifteen thousand other articles calling PA the best master's degree.

That makes a lot of sense, I appreciate what you made me aware of. However, the main reason I wanted to become a PA over a NP is flexibility to work in multiple different fields of medicine and because I was not already a RN. I feel like the flexibility answer is overused (even though it's true for most people) and that the not being a RN beforehand is just inappropriate to bring up since it makes me look less devoted/sincere to becoming a PA. They're both highly trained mid-level health care providers that I have a lot of respect for. I just don't like that they really want us to be able to differentiate between the two to the point where they bring it up in a stressful interview... Every PA and NP i've spoken to at my hospital struggles answering the question as well.

 

Thanks everyone for all the replies and information, it really helps!

[db_pavnp]

If I went the PA route, I would definitely emphasis that I strongly desire the diversity in clinical rotations.  This is a HUGE difference.

 

 

Here's a joke I heard:  What do you call a PA program that adds a nursing theory class?  An NP program.

[EMEDPA]

Here's a joke I heard:  What do you call a PA program that adds a nursing theory class?  An NP program.

no, what do you call a pa program that adds a nursing theory class and only goes to 1/3 of their rotations? an NP class.

[db_pavnp]

Good point.  I like it.