psychonaut Posted January 25, 2012 Share Posted January 25, 2012 ...how would you want them to answer? I am in my final semester of my NP program. I was (and still am) a huge PA fanboy (I used to post here as "NeoRN," can't get my old account to work so I started this one). One of our classes (on-line, of course) has as it's first assignment to discuss the question, "What is the difference between NPs and PAs?" As you can imagine, the answers all involve the frequent use of the term "holistic" (well, except mine). I did my best (my answer took 6 pages, about 5.5 more pages than anybody else), and my fellow students seem to appreciate the answer, but their own answer was still very much in the tired old "medical model vs. nursing model" and "they are physician extenders and we are a separate profession" lines. Two points in fairness to my classmates: 1) the vast majority emphasized the need for mutual respect and professional cooperation, and 2) they may just be saying what they know our (DNP) instructor wants to hear (I may be the only one cocky/stupid enough to be sick of the BS) I will post quotes (without identifying info as to State or program, and of course identity) if you like. But I would really like some answers that I can likewise post in the discussion. While it would be foolish of me to not acknowledge that this is a good topic to stir folks up, believe it or not I am more interested in making my own profession better, and abandoning our false dogma about PAs (among a zillion other topics) seems a good place to start. I've been reading SDN, allnurses, and of course this forum for several years, before I was a nurse even. I came up reading emedpa, LESH, core0, COntrarian, et al. here and elsewhere. My fellow students apparently had lives and didn't spend all their time on internet discussion forums like me. Help me educate those who are willing to learn, please. Link to comment Share on other sites More sharing options...
psychonaut Posted January 25, 2012 Author Share Posted January 25, 2012 ...how would you want them to answer? I am in my final semester of my NP program. I was (and still am) a huge PA fanboy (I used to post here as "NeoRN," can't get my old account to work so I started this one). One of our classes (on-line, of course) has as it's first assignment to discuss the question, "What is the difference between NPs and PAs?" As you can imagine, the answers all involve the frequent use of the term "holistic" (well, except mine). I did my best (my answer took 6 pages, about 5.5 more pages than anybody else), and my fellow students seem to appreciate the answer, but their own answer was still very much in the tired old "medical model vs. nursing model" and "they are physician extenders and we are a separate profession" lines. Two points in fairness to my classmates: 1) the vast majority emphasized the need for mutual respect and professional cooperation, and 2) they may just be saying what they know our (DNP) instructor wants to hear (I may be the only one cocky/stupid enough to be sick of the BS) I will post quotes (without identifying info as to State or program, and of course identity) if you like. But I would really like some answers that I can likewise post in the discussion. While it would be foolish of me to not acknowledge that this is a good topic to stir folks up, believe it or not I am more interested in making my own profession better, and abandoning our false dogma about PAs (among a zillion other topics) seems a good place to start. I've been reading SDN, allnurses, and of course this forum for several years, before I was a nurse even. I came up reading emedpa, LESH, core0, COntrarian, et al. here and elsewhere. My fellow students apparently had lives and didn't spend all their time on internet discussion forums like me. Help me educate those who are willing to learn, please. Link to comment Share on other sites More sharing options...
Administrator rev ronin Posted January 25, 2012 Administrator Share Posted January 25, 2012 ... and what sort of purpose will a "dialogue" between participants here and nursing students' quotes, taken perhaps out of context and perhaps without permission, serve? Link to comment Share on other sites More sharing options...
Administrator rev ronin Posted January 25, 2012 Administrator Share Posted January 25, 2012 ... and what sort of purpose will a "dialogue" between participants here and nursing students' quotes, taken perhaps out of context and perhaps without permission, serve? Link to comment Share on other sites More sharing options...
psychonaut Posted January 25, 2012 Author Share Posted January 25, 2012 ... and what sort of purpose will a "dialogue" between participants here and nursing students' quotes, taken perhaps out of context and perhaps without permission, serve? A very fair question. Maybe no good purpose whatsoever. I just wanted to see if the way I defined your profession would vary in any way from how you all would like to be viewed by NPs, especially new grad NPs who don't seem to have a full grasp on your profession. My plan was definitely to c&p without permission, but with all effort to not reveal personal details. Maybe that is out of line...if so, I won't do that part. I will point my colleagues to this forum to learn more about PAs if they care to. I like your (PAs) educational and professional model. I love being an RN, and I'm sure I will enjoy being an NP. I am involved in the education side of my profession, and I have no problem looking outward for ways to improve our profession. Link to comment Share on other sites More sharing options...
psychonaut Posted January 25, 2012 Author Share Posted January 25, 2012 ... and what sort of purpose will a "dialogue" between participants here and nursing students' quotes, taken perhaps out of context and perhaps without permission, serve? A very fair question. Maybe no good purpose whatsoever. I just wanted to see if the way I defined your profession would vary in any way from how you all would like to be viewed by NPs, especially new grad NPs who don't seem to have a full grasp on your profession. My plan was definitely to c&p without permission, but with all effort to not reveal personal details. Maybe that is out of line...if so, I won't do that part. I will point my colleagues to this forum to learn more about PAs if they care to. I like your (PAs) educational and professional model. I love being an RN, and I'm sure I will enjoy being an NP. I am involved in the education side of my profession, and I have no problem looking outward for ways to improve our profession. Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted January 25, 2012 Moderator Share Posted January 25, 2012 I think in all fairness pa programs focus more on the clinical aspects of medicine with > 2000 hrs of clinicals vs <1000 for an np program(and many at 500 hrs) and the np programs, especially the dnp programs, focus more on running a practice, cultural sensitivity, research and publication, etc there are some great np programs out there and some not so great pa programs but I think the pa programs produce a more consistent product as the requirements vary less than among np programs. many np programs allow or require you to set up many or all of your own rotations. this can lead to variable quality rotations. it used to be that both pa and np programs required significant prior experience but now there are direct entry programs for both np and pa education and I am not a fan of either of these models. I think the best np's are former nurses with significant experience as nurses and the best pa's are folks with significant prior hce before their programs as well. Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted January 25, 2012 Moderator Share Posted January 25, 2012 I think in all fairness pa programs focus more on the clinical aspects of medicine with > 2000 hrs of clinicals vs <1000 for an np program(and many at 500 hrs) and the np programs, especially the dnp programs, focus more on running a practice, cultural sensitivity, research and publication, etc there are some great np programs out there and some not so great pa programs but I think the pa programs produce a more consistent product as the requirements vary less than among np programs. many np programs allow or require you to set up many or all of your own rotations. this can lead to variable quality rotations. it used to be that both pa and np programs required significant prior experience but now there are direct entry programs for both np and pa education and I am not a fan of either of these models. I think the best np's are former nurses with significant experience as nurses and the best pa's are folks with significant prior hce before their programs as well. Link to comment Share on other sites More sharing options...
psychonaut Posted January 26, 2012 Author Share Posted January 26, 2012 Excellent, thank you. Those are the very same points I have gleaned over several years of researching the two professions. Link to comment Share on other sites More sharing options...
psychonaut Posted January 26, 2012 Author Share Posted January 26, 2012 Excellent, thank you. Those are the very same points I have gleaned over several years of researching the two professions. Link to comment Share on other sites More sharing options...
Moderator ventana Posted January 26, 2012 Moderator Share Posted January 26, 2012 briefly PA school much more intense, much harder, much more information is taught and learned PA school much more expensive PA school much better at 'preparing' a practitioner NP school easier, cheaper (usually), less hard science BUT after 1-2 years out it is all about HOW HARD YOU CONTINUE to study, learn, hit the books and try to care for your patients to the best of your ability. The DNP creates an interesting quandry with the term Doctor - and the supposed respect it should demand..... I am a PA and hoping that PA's can ride th coat tails of the NP advocating for independent practice. 10+ years out and my doc's and I share a similiar (although mine is less) knowledge base and practice pattern. Day to day issues can be handled equally by myself or the doc's. BUT as a whole I feel PA's are slightly better off in the clinical realm....... why I say this - I think PA schools are starting to skim the top of the applicant pool and are producing a slightly (maybe trival) better long term product. This certainly might be just my local bias or my local hospital system but I only see a few NP's and they are sort of 'stuck' in the end of the career whereas I see a bunch of young smart aggressive PA's that are really making inroads into the essentially physician dominated local market. I honestly would love to see more local NP's opening their own business and really advancing the whole NP/PA practice stance to help drag us out of the 'Assistant' mentality that some of the local doc's have. It seems NP's have a more politically connected and active (likely due to pure #'s and $$$) but hopefully with the increasing #'s of PA programs we can have more and more #'s and more advocacy. I think the name change to Associate will help and then getting ALL states and ALL government agencies to HAVE to cover services provided by PA/NP. Their is a North West State where the NP's just got their reimbursement cut to 85% (they used to get 100%) and they are actively fighting it saying that they have the exact same overhead as a doc doing internal medicine and an office visit is an office visit.... IF they are successful in this arguement it would be a BOOM for NP/PA private practice in the primary care fields. If their is a name change, insurance companies are forced to credential PA/NP for all services, and we are recogonized by ALL public and private payers and paid equal rates to physicians we (in the internal medicine outpatient fields) will be off and running and expanding all over the place.... Link to comment Share on other sites More sharing options...
Moderator ventana Posted January 26, 2012 Moderator Share Posted January 26, 2012 briefly PA school much more intense, much harder, much more information is taught and learned PA school much more expensive PA school much better at 'preparing' a practitioner NP school easier, cheaper (usually), less hard science BUT after 1-2 years out it is all about HOW HARD YOU CONTINUE to study, learn, hit the books and try to care for your patients to the best of your ability. The DNP creates an interesting quandry with the term Doctor - and the supposed respect it should demand..... I am a PA and hoping that PA's can ride th coat tails of the NP advocating for independent practice. 10+ years out and my doc's and I share a similiar (although mine is less) knowledge base and practice pattern. Day to day issues can be handled equally by myself or the doc's. BUT as a whole I feel PA's are slightly better off in the clinical realm....... why I say this - I think PA schools are starting to skim the top of the applicant pool and are producing a slightly (maybe trival) better long term product. This certainly might be just my local bias or my local hospital system but I only see a few NP's and they are sort of 'stuck' in the end of the career whereas I see a bunch of young smart aggressive PA's that are really making inroads into the essentially physician dominated local market. I honestly would love to see more local NP's opening their own business and really advancing the whole NP/PA practice stance to help drag us out of the 'Assistant' mentality that some of the local doc's have. It seems NP's have a more politically connected and active (likely due to pure #'s and $$$) but hopefully with the increasing #'s of PA programs we can have more and more #'s and more advocacy. I think the name change to Associate will help and then getting ALL states and ALL government agencies to HAVE to cover services provided by PA/NP. Their is a North West State where the NP's just got their reimbursement cut to 85% (they used to get 100%) and they are actively fighting it saying that they have the exact same overhead as a doc doing internal medicine and an office visit is an office visit.... IF they are successful in this arguement it would be a BOOM for NP/PA private practice in the primary care fields. If their is a name change, insurance companies are forced to credential PA/NP for all services, and we are recogonized by ALL public and private payers and paid equal rates to physicians we (in the internal medicine outpatient fields) will be off and running and expanding all over the place.... Link to comment Share on other sites More sharing options...
purplecats07 Posted February 1, 2012 Share Posted February 1, 2012 This is actually a question I get a lot from patients. What the difference is between a PA and a NP. As I am not very familiar with NPs and their education process, I usually tell them that we are very similar. We are both midlevel practitioners but follow the different models. Our school is shorter and more intense, med model vs nursing ect. But what I like to tell them also is that the PA is very flexible, that we can switch specialties if we wanted easier then an NP. Of course you would have to work and study if you are making a big jump but it is easier then it is for NPs. I say that as I am under the assumption that nurses have to take special boards for the field they go into like psych, family med, or peds. While our certification covers all specialties, negating the need to take a certification exam for each different specialty. While the NPs have a certification exam for each different field, which I would imagine makes it harder for them to switch. If I am wrong about that please correct me as I would like to learn more about NPs as well. Link to comment Share on other sites More sharing options...
purplecats07 Posted February 1, 2012 Share Posted February 1, 2012 This is actually a question I get a lot from patients. What the difference is between a PA and a NP. As I am not very familiar with NPs and their education process, I usually tell them that we are very similar. We are both midlevel practitioners but follow the different models. Our school is shorter and more intense, med model vs nursing ect. But what I like to tell them also is that the PA is very flexible, that we can switch specialties if we wanted easier then an NP. Of course you would have to work and study if you are making a big jump but it is easier then it is for NPs. I say that as I am under the assumption that nurses have to take special boards for the field they go into like psych, family med, or peds. While our certification covers all specialties, negating the need to take a certification exam for each different specialty. While the NPs have a certification exam for each different field, which I would imagine makes it harder for them to switch. If I am wrong about that please correct me as I would like to learn more about NPs as well. Link to comment Share on other sites More sharing options...
user1234556 Posted February 2, 2012 Share Posted February 2, 2012 briefly PA school much more intense, much harder, much more information is taught and learned PA school much more expensive PA school much better at 'preparing' a practitioner NP school easier, cheaper (usually), less hard science As a soon-to-be PA student, I wouldn't say these facts are discouraging, but it's hard sometimes not to have thoughts like "hmm.. I could've gotten a BSN instead of a more difficult 4-yr degree, just gone to NP school, had an easier time, come out with a lot less debt and do the exact same job for the same money" While I realize that - in some scenarios - PAs do make more money, the stats show it to be almost a negligible amount and, considering the expense of PA programs, I'm not sure it even offsets. Link to comment Share on other sites More sharing options...
user1234556 Posted February 2, 2012 Share Posted February 2, 2012 briefly PA school much more intense, much harder, much more information is taught and learned PA school much more expensive PA school much better at 'preparing' a practitioner NP school easier, cheaper (usually), less hard science As a soon-to-be PA student, I wouldn't say these facts are discouraging, but it's hard sometimes not to have thoughts like "hmm.. I could've gotten a BSN instead of a more difficult 4-yr degree, just gone to NP school, had an easier time, come out with a lot less debt and do the exact same job for the same money" While I realize that - in some scenarios - PAs do make more money, the stats show it to be almost a negligible amount and, considering the expense of PA programs, I'm not sure it even offsets. Link to comment Share on other sites More sharing options...
user1234556 Posted February 2, 2012 Share Posted February 2, 2012 Our school is shorter and more intense, med model vs nursing ect. How do you figure? Link to comment Share on other sites More sharing options...
user1234556 Posted February 2, 2012 Share Posted February 2, 2012 Our school is shorter and more intense, med model vs nursing ect. How do you figure? Link to comment Share on other sites More sharing options...
user1234556 Posted February 2, 2012 Share Posted February 2, 2012 i came to that conclusion about the debt the moment i got into nursing school. i backed out of an interview at a PA program in the bay region and didnt send out any more supplementals and checks. the choice was between potentially relocating to an expensive private school in an expensive place and not working for the duration of school vs stay where i am with a good job, get my RN where my facility reimburses me my education costs in full, then work while i get my NP and have that reimbursed as well. no debt or lost income the NP route vs debt at the level of the price of a very nice house where i am. it makes sense to at least consider it, especially the folks who are asking for input on their weak stats and have little or no HCE. nursing is great, and im loving it so far. if i wanted to go to PA school, thats an option after i get my RN. i scratch my head when i read the plans of folks who have 105 credits and need to retake all thier sciences to barely break 3.0. that can cost a ton and keep you in limbo. just shop around for a nursing program that will look at your latest prereq gpa attempts and go that route. even get an LPN then do a bridge to asn or bsn and then go from there. to me, that makes more sense than retaking a boatload of prereqs and applying to 12 schools through caspa only to compete with a stronger applicant pool every year. I've already been accepted to a program and have paid a fairly hefty fee, so it's a moot point for me personally, but just throwing those thoughts out there. Definitely something for others to think about. Good luck to you! Link to comment Share on other sites More sharing options...
user1234556 Posted February 2, 2012 Share Posted February 2, 2012 i came to that conclusion about the debt the moment i got into nursing school. i backed out of an interview at a PA program in the bay region and didnt send out any more supplementals and checks. the choice was between potentially relocating to an expensive private school in an expensive place and not working for the duration of school vs stay where i am with a good job, get my RN where my facility reimburses me my education costs in full, then work while i get my NP and have that reimbursed as well. no debt or lost income the NP route vs debt at the level of the price of a very nice house where i am. it makes sense to at least consider it, especially the folks who are asking for input on their weak stats and have little or no HCE. nursing is great, and im loving it so far. if i wanted to go to PA school, thats an option after i get my RN. i scratch my head when i read the plans of folks who have 105 credits and need to retake all thier sciences to barely break 3.0. that can cost a ton and keep you in limbo. just shop around for a nursing program that will look at your latest prereq gpa attempts and go that route. even get an LPN then do a bridge to asn or bsn and then go from there. to me, that makes more sense than retaking a boatload of prereqs and applying to 12 schools through caspa only to compete with a stronger applicant pool every year. I've already been accepted to a program and have paid a fairly hefty fee, so it's a moot point for me personally, but just throwing those thoughts out there. Definitely something for others to think about. Good luck to you! Link to comment Share on other sites More sharing options...
NoClinic4Me Posted February 2, 2012 Share Posted February 2, 2012 PA school is better in all aspects (IMO) in terms of taking care of patients EXCEPT: 1. cost 2. time commitment 3. independence (pseudo though, IMO) I do agree with some of the above posts though, that a PA new grad is better off but as the years go on IF the NP puts in the time and effort into learning all of the stuff they didn't in NP school, they can become very competent providers. In terms of research in general, NP programs tend to provide more instruction in these areas. Pat, PA-C, MPAS, RN Link to comment Share on other sites More sharing options...
courtney.luoma Posted February 2, 2012 Share Posted February 2, 2012 OK, I have to comment on this post. I'm going to be a grad of a BSN program in May and have been accepted into PA school to start this Summer. However, I am most likely going to decline my acceptance and continue on to become an NP after I have experience as an RN. I work with NP's, PA's and RN's everyday and trust me I always ask people the question "PA vs NP". I can tell you, if you talk to a PA they tout their degree and talk to an NP they will do the same. Each think they are "better". Truth is, 95% of the jobs they have when they graduate are the same! So let's talk about why PA's have a slightly higher salary (and this is also based on your resource). Well, PA's are much more involved in surgical specialties than NPs... So that creates a large number of outliers. Of course a surgical PA is going to make more money than a FNP. That's just obvious, so you have to compare a PA and an NP in the same capacity (i.e.: Internal med, etc). Can you compare a cardiothoracic surgeon to a Family Practice doctor???? Or an Orthopedic doc to a Family practice doc? It's like comparing apples and oranges!!! But you know, a RN with a first assist license can make as much as a PA... and they don't even have to be an NP... Ok, second point, I laugh every time I see a PA fan boy say: "Well, PA's have better training because they have more clinical hours." Let's do the numbers here people... How many clinical hours did that PA get BEFORE beginning the program? (and yes I know some PA's are nurses and some are paramedics, but there are also a HUGE number of PA's who have no to limited actual experience before they start PA school... and some of the "experience" Pre-PA's have are funny...) Nurses go through school and have about 1000 clinical hours in their undergrad. (I also want to add, you have to be accepted into nursing school, which in itself is very competitive.) They then, on average work a few years, (which is about 1800-2000 hours a year as an RN) and when they begin their NP program, they don't have to learn all the things a nurse already KNOWS, but PA's start from scratch because they have people with all types of backgrounds and degrees. Then once in a NP program, they may do 500-1000 clinical hours for the NP degree. Well, why do PA's do 2000 hours of clinical and NP's do 500-1000? NP's have specialized training, so that means an NP has 500-1000 hours in ONE PARTICULAR AREA: Family Practice, Pediatrics, Women's health, Psych etc. PA's have a broad clinical experience in many areas: IM, ER, Psych, etc. So when you break down the number of hours in each area and compare them to an NP, then PA's actually have LESS clinical hours in any given area. If a NP wants the same scope of practice as a PA (Peds, IM, Family med, Surgery etc) they would have to go back to school and get a POST MASTERS certificate, which would require an additional 500-1000 hours. You would have to combine all of the NP specialties to have the most comparable scope of practice to a PA. If you did combine all the NP specialties, you would have double the hours that a PA receives in training to be a "broad" practitioner. If you compared a FNP and a PA in family practice; they will have about identical training in Family practice! PA's and NP's really can't be compared just because they work in similar capacities, because they are in fact not the "same". An NP is a NURSE who is advanced in NURSING. They are not "mini-doctors"; they are Advanced nurses. Both professions are a valuable asset to reduce healthcare costs and improve patent care. NP's and PA's should band together as "mid levels"; support one another, and promote whatever path is "right" for a particular future applicant. There are GOOD PA's and bad PA's. There are GOOD NP's and bad NP's. Both professions would benefit from a "united" vision... Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted February 2, 2012 Moderator Share Posted February 2, 2012 NP's have specialized training, so that means an NP has 500-1000 hours in ONE PARTICULAR AREA: Family Practice, Pediatrics, Women's health, Psych etc. PA's have a broad clinical experience in many areas: IM, ER, Psych, etc. So when you break down the number of hours in each area and compare them to an NP, then PA's actually have LESS clinical hours in any given area. . really depends on the pa program. I ended up with more fp hours than an fnp due to several required primary care rotations. I also had FAR more er/critical care/trauma surg hrs than an ENP or ACNP. I had more surgery hours than an rnfa. the "extra" hours pa's have in specialties in which they do not end up working serve to make them a well rounded provider. for example a psych np might lack skills and training regarding a comorbidity that one of their pts has that a pa would not due to a more extensive clinical training. a few other issues: training before pa or np school does not train you for the role of a midlevel provider so you can't add rn school(or medic or rt school) etc hrs to provider training hours. they are a different creature. helpful, yes but different. there are now many direct entry np programs which I would compare to the direct entry pa programs taking folks with minimal experience. I am not a fan of either. I agree that there are good and bad pa's and np's out there with varying levels of skill and experience. I have several good friends who are np's who I would not hesitate to see for my care or the care of my family. there are also pa's out there I don't trust to run a minute clinic. Link to comment Share on other sites More sharing options...
Kaepora Posted February 3, 2012 Share Posted February 3, 2012 ...im trying to get a handle on care plans and the nurse education community and their quirks. You definitely should have picked a school that doesn't focus on "nursing diagnosis". My instructors/program have openly told us they think it's bunk. Love that. Otherwise I don't know what I would do... Link to comment Share on other sites More sharing options...
Planteater Posted February 3, 2012 Share Posted February 3, 2012 tothc2- my husband is in nursing school right now. He saw your post and said "where do they go to school"? :;-D: Link to comment Share on other sites More sharing options...
Recommended Posts
Archived
This topic is now archived and is closed to further replies.