Nurses that became PAs..Why?

[Endeavor]

In a psychology class we had to talk about our future career plans and when I told my professor that I was going to PA school this was her response (she's also an undergad advisor)

"I don't understand why many people choose PA over NP. PA is ridiculously competitive to get into, whereas a BSN-->NP is much more doable. I've had couple friends who tried multiple times to get into PA school and couldn't get in, they then went on to do accelerated BSN then NP and now work as NPs which basically have the same job function as a PA with some minor differences. Just something to think about." 

So I'm curious to as why some Nurses choose the PA route instead of NP? Is the better "medical model " education worth the sacrifice? (The competitive nature of getting into PA schools, 2 years of basically no work, social sacrifices etc.). 

Thank you. 

[ProSpectre]

I have nurses in my class who chose PA school for exactly that reason; they believed the PA model of education to be more rigorous and standardized, more grounded in the hard sciences, and without the "fluff" courses that don't deal with clinical medicine, so overall they felt they would get a better education as a PA. One of the PAs I shadowed was also a former RN, and he chose it for the same reason. 

Just a thought, but the fact that PA schools are quite competitive to get into and that (most) NP schools aren't shouldn't be seen as a negative of the PA profession; it should be seen for what it is, that PA programs have high standards of entry because they want students that can reason and think critically at a higher level. The goal is to train medical practitioners, and there should be some sacrifice on the part of students to ensure they are adequately prepared for the high level of responsibility they are handed upon graduation and certification. I think NP schools having low standards of entry will ultimately be to the detriment of their profession, and many of the NPs I have talked to (and preceptors for NP students that I have talked to) tend to agree with me.

Remember, it takes physicians an average of 7-9 years of post-undergrad study to be able to practice medicine. PAs and NPs have much shorter training, but are held to the same standards of care; it isn't supposed to be easy or without sacrifice, and not everyone can (or should be able to) do it. 

[Joelseff]

I have nurses in my class who chose PA school for exactly that reason; they believed the PA model of education to be more rigorous and standardized, more grounded in the hard sciences, and without the "fluff" courses that don't deal with clinical medicine, so overall they felt they would get a better education as a PA. One of the PAs I shadowed was also a former RN, and he chose it for the same reason. 

Just a thought, but the fact that PA schools are quite competitive to get into and that (most) NP schools aren't shouldn't be seen as a negative of the PA profession; it should be seen for what it is, that PA programs have high standards of entry because they want students that can reason and think critically at a higher level. The goal is to train medical practitioners, and there should be some sacrifice on the part of students to ensure they are adequately prepared for the high level of responsibility they are handed upon graduation and certification. I think NP schools having low standards of entry will ultimately be to the detriment of their profession, and many of the NPs I have talked to (and preceptors for NP students that I have talked to) tend to agree with me.

Remember, it takes physicians an average of 7-9 years of post-undergrad study to be able to practice medicine. PAs and NPs have much shorter training, but are held to the same standards of care; it isn't supposed to be easy or without sacrifice, and not everyone can (or should be able to) do it. 

I applied FIVE times to 2 PA schools (wife and kids limited my choices to location near home) over a span of 7 years (took a break from applying between attempt 4 and 5 because if said wife and kids) I could have easily done a BSN part time online program whole working then attend a MSN FNP or heck a direct entry program during that time. Thought about med school too but again wife and kids mean more to me)

 

I chose PA because although I sacrificed 2 years almost entirely away from my family I could not see myself learn medicine in such a short time any other way. I'm glad I did it though thinking I was insane had been suggested by certain mentors and coworkers lol.

 

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[marktheshark89]

I know several NPs who never practiced as NPs and went back to work ad RNs after because they felt so inadequately prepared to practice. One who actually went to PA school after. 

[ventana]

Above is VERY common.  I read about 10 years ago that only about 30% of NP actually work as NP.  Seems like many collect the degree(easy to get) and then leverage it for admin jobs.   

 

Unsure what current  stats are.  

[Endeavor]

On 2/12/2018 at 2:31 PM, ProSpectre said:

I have nurses in my class who chose PA school for exactly that reason; they believed the PA model of education to be more rigorous and standardized, more grounded in the hard sciences, and without the "fluff" courses that don't deal with clinical medicine, so overall they felt they would get a better education as a PA. One of the PAs I shadowed was also a former RN, and he chose it for the same reason. 

Just a thought, but the fact that PA schools are quite competitive to get into and that (most) NP schools aren't shouldn't be seen as a negative of the PA profession; it should be seen for what it is, that PA programs have high standards of entry because they want students that can reason and think critically at a higher level. The goal is to train medical practitioners, and there should be some sacrifice on the part of students to ensure they are adequately prepared for the high level of responsibility they are handed upon graduation and certification. I think NP schools having low standards of entry will ultimately be to the detriment of their profession, and many of the NPs I have talked to (and preceptors for NP students that I have talked to) tend to agree with me.

Remember, it takes physicians an average of 7-9 years of post-undergrad study to be able to practice medicine. PAs and NPs have much shorter training, but are held to the same standards of care; it isn't supposed to be easy or without sacrifice, and not everyone can (or should be able to) do it. 

Thats the train of thought I was having. I guess in a perfect world they would standardize the education for APPs, but of course politics....but then again they pretty much standardized DO along the same lines as MD? Who knows? 

[Acebecker]

Good nurses make great PAs.  Excellent nurses make good NPs.

 

Their training is very good - we know what the "RN" means.  Those who are experienced will build on that to be great PAs.  The PA education model provides them a broad framework pushed to the corners of medicine.

However, a good RN who doesn't have a TON of self-drive to push their training into the corners of their lives and the medicine that is out there - those RNs who only learn what the NP curriculum teaches - make NPs that are less than well prepared.  I recall as a 2nd year PA student sitting down and teaching one of my senior NP colleagues how to read an EKG.  She was very receptive, very collegial, and I enjoyed having her as a colleague but she had never been taught to read EKGs and hadn't really read any books or done any self learning on the issue.  A second NP who was precepting me at the time only knew how to read differences in EKGs.  If she didn't have a previous one to compare to, she didn't have a handle on what the EKG actually told us.

Anecdotes, admittedly.

But my point is that PA school is without a doubt more rigorous, teaches us more, exposes us to more systems and gets us more well rounded.  A good RN who goes to PA school will emerge among the better new grad PAs in a vast majority of the cases.  NP school is less thorough, less rigorous, and you only get exposed to the people and systems you can wrangle 800hrs of clinical time with (most often they are your friends or systems you have worked in before, so there is very little new information).  A good RN who goes to NP school will emerge with a basic knowledge that has gaps that cannot be identified by anyone until they are in practice.  A great nurse who goes to NP shool will emerge probably on par with the PA students.

[Boatswain2PA]

Absolutely everything Ace just said.  PA program is good choice for RNs who want to dive deep into medicine instead of a glossed over NP program.

However, one of best NPs (and overall providers) i've ever worked with admitted he went to a crappy, online, part-time NP program and did 500 hours observing with a friend.  He did that because he couldn't afford (financially and family costs) to go to med school or PA school.  But he understood that his NP education sucked, so he threw himself into learning medicine on his own.  

10 years out from school the biggest driving factor of competence is personal attributes.

So, an RN dropping their $45K/year job for 3 years to knock out PA pre-reqs and then program, plus $100K for the program = $235K loss to become a PA.  Same RN can work a little harder, take part-time online NP program for $40K and become a NP.

Doesn't make much sense when you look at it that way.

[MidwesternTexan]

In my PA class of '94- there were several RN's that made it in.

When working as an ER PA, one of my colleagues, also a PA, stated she was a retired flight RN, who went back to Pa school.  I asked why not NP- she stated she wanted the better education, instead of 'writing a few papers' for her degree!  This was an actual response  from one person, nearly 20 years ago.  My 2 cents

[Boatswain2PA]

2 hours ago, MidwesternTexan said:

In my PA class of '94- there were several RN's that made it in.

When working as an ER PA, one of my colleagues, also a PA, stated she was a retired flight RN, who went back to Pa school.  I asked why not NP- she stated she wanted the better education, instead of 'writing a few papers' for her degree!  This was an actual response  from one person, nearly 20 years ago.  My 2 cents

Made more financial sense 20 years ago when PA was a certificate/AA/BS program and might have cost a few grand.  Many PA programs today cost >$100K.  Ridiculous.

[Endeavor]

Good point @Boatswain2PA I see people argue that the PA profession is suppose to be or traditionally for licensed professionals such as Medics, RT's, RN's etc.. But doesn't make sense these days to give up your 40-70k yearly income for two years, make social sacrifices and be in 100k in debt. 

That's why we see the trend of younger college graduates with lower tier PCE who can easily let go of their 10k income to go to school for two years and graduate at the age of ~25 without giving up much social sacrifices either...