mistyPA Posted August 14, 2011 Share Posted August 14, 2011 I was wondering what the reasons were for most students in choosing between NP vs PA? Link to comment Share on other sites More sharing options...
Michigander Posted August 14, 2011 Share Posted August 14, 2011 Initially, I chose PA school because I don't have a nursing degree, so I would have had to go back for a second bachelors, then my third masters (MSN) then the DNP because I could not possibly get all that done by 2015 when the rumored switch to DNP for entry to practice starts. The more I talked to PAs, the more attracted I was for other reasons: the heavier science and medical model to counterbalance my two social science masters degrees, the career latitude to switch between primary care, pediatrics, psychiatry, surgery rather then picking "adult primary", "pediatrics", "psychiatry" as the nurse practitioner programs require, and the width of clinical year rotations. I think that for the most part, NPs and PAs are treated the same in my area in terms of practice and pay but I want to learn to practice medicine right away, instead of writing care plans and learning about the role of the nurse and other "fluffy" classes. Link to comment Share on other sites More sharing options...
Michigander Posted August 14, 2011 Share Posted August 14, 2011 I did leave out FNP amongst the NP options (CNM and CRNA are waaaaaaay outside my interests). But I really like hospital-based care and my understanding is that FNPs have a hard time getting jobs in acute care settings. On the other hand, I don't want to limit myself to acute care so would not want to do ACNP. The masters degrees that I have (MSW and MPH), IMHO, will complement the PA but there would been lots of overlap with BSN/MSN/DNP training. PAMAC: have you started nursing school yet? If so, are you enjoying it? Learning? I agree that nursing school is more flexible. The schools around here have part-time, evening classes, online classes, at all levels. Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted August 14, 2011 Moderator Share Posted August 14, 2011 or you could choose FNP and treat all ages. and never work in surgery or in a hospital in many states which require anp or acnp for inpt work....fnp is an outpt certification..... to have the same scope as a pa an np would need fnp(outpt)+acnp(inpt)+rnfa(surg). Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted August 14, 2011 Moderator Share Posted August 14, 2011 You didn't read what I said about what I wanted to do... Be an np sans surgery.. sans surgery or any inpt specialty or subspecialty. fnp= fp, peds, urgent care. if that's what you want, all well and good. if you ever want to work in a hospital in any capacity you might have a problem doing that in some places. that was my point. Link to comment Share on other sites More sharing options...
Planteater Posted August 14, 2011 Share Posted August 14, 2011 I really appreciate this discussion (thanks OP). I know exactly what school I want to go to and I want to be a PA. I have some personal stuff going on in my family right now that made me start wondering if I can make it through PA school and still give my kids what they need. I started searching for other possible options and found a direct entry NP program at the same school that would allow me a lot more flexibility for my family. I would have an intensive 1st year (though not as intensive as PA school for sure) and then work as an RN for 2 years while completing the rest of the NP coursework and clinicals. I am having a hard time deciding what to do because I believe in the PA education, but I am not sure it is the best thing. I want to work in primary care (in a rural area once I have plenty of closely supervised experience). My other big goal is to participate in medical mission trips. But, will I be terribly unprepared for both of these if I choose FNP? That is my biggest concern. Right now my plan is to apply for both and see what happens. But, I am the type to analyze everything like crazy so I feel the need to know exactly what I want before getting to interviews in January. Anyway, I'd love to hear more thoughts on PA vs. NP from you all. Link to comment Share on other sites More sharing options...
Planteater Posted August 15, 2011 Share Posted August 15, 2011 PAMAC- thanks for the reply. I appreciate it. I live in a very PA friendly state (NC), so that might be why I see things the way I do. You make some great points! Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted August 15, 2011 Moderator Share Posted August 15, 2011 FNP's in are in ERs in many places. hospital... no? sure, you can say that in lots of places certain things happen, but in lots of places PAs cant percribe what NPs can, cant to this or that... etc. I think pa's can rx equivalent to np's in every state except ohio. may be wrong about that but I know we have almost universal rx rights now. Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted August 15, 2011 Moderator Share Posted August 15, 2011 you've spent "24 years in emergency medicine" for a reason... could be because you love it, could be that you hate it but know you are good at it, or maybe the money is good and because you love it and are good at it.... i dont know what pushes you. I also do a decent amt of primary care at free clinics and overseas so could step into an fp position no problem. pa's also staff our obs unit and do treadmills so I could do hospitalist, cardiology, trauma team, icu, etc without extra schooling. one of our pa's just took a job in interventional radiology. we just got another from an ortho/neurosurg background(guy was also a national guard em pa). there are definite advantages to both routes(pa and np). np gets you independence and the ability to do part time school. pa gets you flexibility and better clinical training. Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted August 15, 2011 Moderator Share Posted August 15, 2011 if you want to work for Doctors Without Borders/Médecins Sans Frontières, being and NP would be the only way to get onboard as a midlevel, as they dont take PAs. . there are MANY other organizations that take pa's to do international and disaster work; just a small sample- nyc medics, team rubicon, medical teams international, every states dmat, all national imsurt's, etc I have a book that lists all the openings for pa's to do this kind of work. there are well over 100 organizations that use us in every nation on earth.. Link to comment Share on other sites More sharing options...
Contrarian Posted August 15, 2011 Share Posted August 15, 2011 the latitude issue seems to be exciting to many pre PA's, but the reality is that aside from the occasional switch that takes place, the likelyhood of spending a few years in one specialty then changing to another seems to be more of an academic endeavor. you've spent "24 years in emergency medicine" for a reason... could be because you love it, could be that you hate it but know you are good at it, or maybe the money is good and because you love it and are good at it.... i dont know what pushes you. Nope...!!! It allows you to live in a one hospital town and work in any area of medicine with a job opening. Personally... I have spent a MINIMUM of 2 yrs practicing in each of the following Internal Medicine Sub-specialties: Straight Internal Medicine Cardiology Rheumatology Addiction Urgent Care Psychiatry Some of the above was consecutive and some of it concurrent. I have also interviewed for Interventional Radiology, Allergy & Immunology, Sleep Medicine, Inpatient medicine positions but for one reason or another didn't get hired or declined the job offer. So no... not just "academic"... the lattitude is real and allows you to switch up... change up when you need to or simply get bored. Link to comment Share on other sites More sharing options...
andersenpa Posted August 15, 2011 Share Posted August 15, 2011 i deal with patients visiting clinics that have all sorts of specialty focus, and see the name of every provider treating them when results come through. i notice NP's in most every specialty out there that i also see PA's in.... but obviously i dont see much from surgery. i turned myself from my original point that FNPs do have a presence in many areas. but im not the one that said that FNPs didnt get to work outside of primary care, emedpa did. im sure that there is less latitude for an FNP, but they arent universally relegated to primary care. I think the point was they are often restricted from impatient settings. Link to comment Share on other sites More sharing options...
Contrarian Posted August 15, 2011 Share Posted August 15, 2011 im sure that there is less latitude for an FNP, but they arent universally relegated to primary care. Very True... Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted August 15, 2011 Moderator Share Posted August 15, 2011 im sure that there is less latitude for an fnp, but they arent universally relegated to primary care. but they probably should be....If they take almost any type of inpt job they are working in a field in which they have zero training,background or exposure....(of course there are exceptions, an oncology nurse who becomes an fnp and works oncology would run circles around most pa's). Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted August 15, 2011 Moderator Share Posted August 15, 2011 if an fnp desires to work in an icu there are avenues to get a second np cert like acnp fairly quickly. not trying to slam on you just make you aware that some states( TX most notably) don't let fnp's work in hospital settings at all. Link to comment Share on other sites More sharing options...
Contrarian Posted August 15, 2011 Share Posted August 15, 2011 if an fnp desires to work in an icu there are avenues to get a second np cert like acnp fairly quickly. Yep... Online classes, some $ca$h$... and some clinical hrs, then a multiple guess test. 500 clinical hrs ain't really that hard to get (~13 wks) as evidenced by the gaggle of ARNPs with the alphabet soup following their names. Link to comment Share on other sites More sharing options...
Contrarian Posted August 15, 2011 Share Posted August 15, 2011 heres a question maybe you guys could answer. say i wanted more clinical than just what the program requires or provides... could i obtain it on my own accord? Sure... After you got certified and a license: You could work for free (?free clinic?) for a few months. You could take a job with a physician who likes to teach. Link to comment Share on other sites More sharing options...
andersenpa Posted August 15, 2011 Share Posted August 15, 2011 basically, im asking what an NP can do to approach bad A status close to parity with what an newly minted PA would have. Go to PA school.... Link to comment Share on other sites More sharing options...
Contrarian Posted August 15, 2011 Share Posted August 15, 2011 Go to PA school.... Specifically Get yor BSN then go to the UC Davis Dual FNP/PA program. ____________________________________________________________________________________________________________ Depends on what type of NP and where they were trained... A new grad FNP with 2500hrs of clinicals will be as good as a new grad PA with 2500hrs of clinicals in a outpatient clinical setting. As soon as their employers ask them to go over to the hospital and round on a few patients... work in the ED, assist at surgery... the PA will shine. The PA will also be better equipped at explaining pre-op issues, or prehospital procedures due to their training pipeline. Again... this is based upon where the NP was trained. I say this because the program I attended was a Dual FNP/PA program. Everyone graduated with a PA credential RNs graduated with both FNP and PA credentials. There was NO difference in curriculum except that the RNs had to sit in a few (~2-3) more lectures. It was basically a full blooded PA program that happened to award a additional FNP certificate to RNs. As a matter of fact, the RNs were required to sign a form that stated that we would sit for the PANCE upon completion of the program. We all took it... but several of us didn't maintain NCCPA certification. Thing is, they can always retake it if they want to. So these new grad FNPs were/are equal to new grad PAs day one after graduation (because they attended PA programs), whereas normally it takes a FNP about 3-4 yrs before they catch up to the PAs. Link to comment Share on other sites More sharing options...
andersenpa Posted August 15, 2011 Share Posted August 15, 2011 yeah............ so that was insightful (contrarian that is, not anderson). Yeah Anderson doesn't make very good points. It's Andersen that you should listen to. Link to comment Share on other sites More sharing options...
andersenpa Posted August 15, 2011 Share Posted August 15, 2011 C'mon guys take a joke Link to comment Share on other sites More sharing options...
andersenpa Posted August 15, 2011 Share Posted August 15, 2011 so in the meantime, how would the NP not be shortchanging thier patients until they caught up to where the PA's are? 1. Keep reading 2. Work your a$$ off 3. Don't believe the hype Link to comment Share on other sites More sharing options...
Contrarian Posted August 15, 2011 Share Posted August 15, 2011 so your program was unique though. i wont be attending a program that will train me as a PA, and then call me an NP. Get yor BSN then go to the UC Davis Dual FNP/PA program... They DO accept out of state students Link to comment Share on other sites More sharing options...
Contrarian Posted August 15, 2011 Share Posted August 15, 2011 Umm.... PAYING ATTENTION TO DETAIL... is one way to not "shortchange" your patients. You can start by taking the hint that his name is Andersen NOT Anderson... :;;D: Link to comment Share on other sites More sharing options...
Contrarian Posted August 15, 2011 Share Posted August 15, 2011 hahah, if you are looking at my spelling an puncuation. Nope... That's disingenuous. I have NOT pointed out any spelling or punctuation errors as this is not a spelling error. As with most... you actually assumed that his name was Anderson because you really didn't pay attention. Fess up... Link to comment Share on other sites More sharing options...
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