hockey833 Posted July 18, 2012 Share Posted July 18, 2012 18 yr old male starting college this fall. ------------------------------- I am thinking about becoming a nurse before PA school for medical experience. I am going to attempt to become an EMT also, however I've heard there is a hiring freeze due to the economy. I dont want to get caught up in that and have heard many nurses get jobs right out of college. I figure this experience would help me a lot in PA school, more than just the "semi-basics" EMT's learn. Is that correct? Does nursing give you an advantage over EMT's, CNA's, etc? I researched being a nurse practitioner. I prefer the idea of going to PA school for only 2 vs. 4 for your DNP (they both make the same salary, so why go to school 2 more years?). A PA can switch specialties a lot easier (which HIGHLY interests me) and I've even heard of some working multiple specialties at once. I've read that PA's follow a "clinician" model versus a "advanced nursing" model like np's, which I'd rather do. ---------------------------------------------------- Do both get the same amount of respect from doctors, patients, etc? What is an advantage of being a NP over PA? I mean why go to school for 2 extra years if you're going to be learning/doing about the same and making the same? ---------------------------------------------------- Sure a NP can start their own practice, but I've heard that's stressful as is and being a NP makes it even more difficult/expensive. If I want to open a practice as a PA I can do it, but just with a physician(s). Wouldn't that help decrease the overall stress for both (or all) of us? Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted July 18, 2012 Moderator Share Posted July 18, 2012 np's are all nurses. most pa's have prior health care experience so you can't really say 1 is 2 years and the other is 4. lots of pa's were paramedics, resp. therapists, etc first. some were nurses. my personal path to pa was emt-b in high school, er tech during college, paramedic school(1 yr) after college then 5 yrs as a medic before becoming a pa. nursing school to np would have been faster than the route I took. all depends on your background. Link to comment Share on other sites More sharing options...
Moderator LT_Oneal_PAC Posted July 18, 2012 Moderator Share Posted July 18, 2012 Also, the DNP is not everywhere yet, likely will not be mandatory for decades, and it certainly isn't 4 years full time. Vandy's program is 1 year with no nursing experience for the msn fnp. A DNP at that rate would add 6 months. Most are 3 years "full time" which is really part time as most are able to work in school. As a RN myself, it is great training for PA. Link to comment Share on other sites More sharing options...
hockey833 Posted July 18, 2012 Author Share Posted July 18, 2012 Well I am saying four years for NP because I've read " The current proposal is that all advanced practice registered nurse programs will require a Doctor of Nursing Practice (DNP) degree by 2015, thus effectively eliminating the MN or the MSN as an entry to practice degree." And I will be graduating in 4 years, or 2016. One year too late, right? I am still having difficulty finding clear differences between being a Pa and being a NP? I am now thinking of just going straight from my BSN to get my MSN, if those programs exist. And the fact that I can work during school is definitely a plus. However what if I want to change specialties? How long would I have to go back to school as a nurse practitioner? Is it a 1-2 yr residency type thing or do you have to go back to a school that specifically trains in that specialty? I am wondering because I want to explore which specialties I enjoy most (part of the reason I dont want to be a doctor). I am thinking of Emergency Medicine, ICU, Surgery, and possibly OB/GYN Link to comment Share on other sites More sharing options...
Moderator LT_Oneal_PAC Posted July 18, 2012 Moderator Share Posted July 18, 2012 The key word in the "mandate" you have there is "proposal." they cannot dictate anything. State law has to change, they have to say they will not accredit msn programs (they haven't), and the NLN (the other accrediting body) has said it is against a DNP. It ain't gonna happen anytime soon. That said, your program of choice may be one of the many that are transitioning to DNP only. You don't have to go back to school to change specialties. With an FNP you can do whatever, except you need an RNFA cert to first assist in the OR. The problem is you will not rotate through all the specialties like a PA and would require significant on the job training, especially if you do direct entry and have no experience. Link to comment Share on other sites More sharing options...
browndog Posted July 18, 2012 Share Posted July 18, 2012 I am thinking of Emergency Medicine, ICU, Surgery, and possibly OB/GYN Hmmmm.....for EM you need the FNP due to the Peds component (unless you find a dedicated adult ED)..... for ICU and Surgery the ACNP is required (at least where I live), and for OB/GYN I would think that the WHNP would be the ticket. So if you, like most folks, are not sure where you want to practice (specialty wise), either go PA or get the FNP (broadest acceptance) and simply add a post grad cert in ACNP or another specialty. Good luck with your decision. Link to comment Share on other sites More sharing options...
Joelseff Posted July 18, 2012 Share Posted July 18, 2012 Can a NP moonlight at another specialty? As a PA I used to work PC, HIV, and GI/Hepatology on different days. Sure the learning curve was steep but I had experience in all those fields and I did a GI/Hep/Liver tx rotation in PA school. That may be the beauty of "being able to switch specialties" for PAs as many of my colleagues do this. Now I only do FP/HIV ay one site but i don't automatically refer my HCV, HBV coinfected pts. And my SP comes to me for hep and GI stuff. Kinda cool.... Sent from my myTouch_4G_Slide using Tapatalk Link to comment Share on other sites More sharing options...
Moderator True Anomaly Posted July 18, 2012 Moderator Share Posted July 18, 2012 I am going to attempt to become an EMT also, however I've heard there is a hiring freeze due to the economy. This is quite possibly the most vague and generalized statement I've read on these forums. There are thousands of independent organizations that hire EMT's, whether for 911 EMS, transport EMS, ER technician or niche fields that having an EMT certificate can get you into. There's not one monolithic organization that suddenly decided to put on a "hiring freeze due to the economy". This statement makes no sense. The answers to your other questions, particularly the difference between PA's and NP's, has been discussed and debated ad nauseam in every possible way for the past decade on this forum- we have a treasure trove of archived data to search through, so I suggest being proactive about it and find those threads. Link to comment Share on other sites More sharing options...
Guest hubbardtim48 Posted July 18, 2012 Share Posted July 18, 2012 You think that every question is the most vague and generalized statement you have ever read on these forums. I precept tons of EMT students every year and where I live there are NO jobs out there for EMTs. I have several (>10) friends that work as a volunteer EMT because they cannot find jobs. This is not from my mouth, but from their mouths. Just because "your" area is OK does not mean every where else is not doing well. You might be the rudest person I have meet on this forum because you belittle everyone for stating facts that are true to their are, but if it is not true to your area then God forbid it is occurring somewhere else and you get pissed at everyone for stating that fact. You need to get over your issues and treat people better or at least word your sentences better so you don't come off so rude and ignorant. God bless... Link to comment Share on other sites More sharing options...
Moderator True Anomaly Posted July 18, 2012 Moderator Share Posted July 18, 2012 You think that every question is the most vague and generalized statement you have ever read on these forums. I precept tons of EMT students every year and where I live there are NO jobs out there for EMTs. I have several (>10) friends that work as a volunteer EMT because they cannot find jobs. This is not from my mouth, but from their mouths. Just because "your" area is OK does not mean every where else is not doing well. You might be the rudest person I have meet on this forum because you belittle everyone for stating facts that are true to their are, but if it is not true to your area then God forbid it is occurring somewhere else and you get pissed at everyone for stating that fact. You need to get over your issues and treat people better or at least word your sentences better so you don't come off so rude and ignorant. God bless... I highlighted for you the part of your rant that actually has application in this thread, because it pertains directly to the discussion we're having. The rest of your statement goes off the rails into a personal attack, which I do not feel is warranted. You need to educate yourself on the difference between an impassioned opinion on a topic and a personal attack. What I wrote in my post was my opinion on a topic. What you wrote was a personal attack out of left field. Never have I written before on this forum that "this statement is vague and generalized", or something to that effect. And even if I had, how do you get drawn into the discussion by launching a personal attack on me? It's not an angry statement on my part; however, yours is. Either you have clearly mistaken me for another poster you seem to have a huge personal problem with, or your reading comprehension is a bit off. I suggest you take your own advice, and re-read things before you go off on a rail and come off looking "rude and ignorant"...which is what you look like now. Link to comment Share on other sites More sharing options...
Guest hubbardtim48 Posted July 18, 2012 Share Posted July 18, 2012 Sounds like a personal attack to me. Good one though...just be nice and you will be blessed. Link to comment Share on other sites More sharing options...
hockey833 Posted July 19, 2012 Author Share Posted July 19, 2012 This is quite possibly the most vague and generalized statement I've read on these forums. There are thousands of independent organizations that hire EMT's, whether for 911 EMS, transport EMS, ER technician or niche fields that having an EMT certificate can get you into. There's not one monolithic organization that suddenly decided to put on a "hiring freeze due to the economy". This statement makes no sense. The answers to your other questions, particularly the difference between PA's and NP's, has been discussed and debated ad nauseam in every possible way for the past decade on this forum- we have a treasure trove of archived data to search through, so I suggest being proactive about it and find those threads. You're a douche. I am surprised you made it through PA school not being able to put together what I was trying to say. In case you haven't noticed, our economy is not doing so good. When the economy is hurting, most businesses lay off workers or have to cut their budget. A recession doesn't only affect one business. Of course there are going to be EMT companies hiring, I'm not that stupid, but I was making a general statement. But there is only one ambulance company in Reno, so competition is fierce and space is VERY limited..... Does that clear that up for you? Link to comment Share on other sites More sharing options...
Moderator LT_Oneal_PAC Posted July 19, 2012 Moderator Share Posted July 19, 2012 Whoa buddy, you and Tim (what I've seen in quotes since I have blocked his crap) need to dial it back. TA has earned his place and, no offense, you are the FNG. I understand your questions, fustrations, and I even understand not using the sorry device they call a search function here. But keep your cool. Link to comment Share on other sites More sharing options...
hockey833 Posted July 19, 2012 Author Share Posted July 19, 2012 The key word in the "mandate" you have there is "proposal." they cannot dictate anything. State law has to change, they have to say they will not accredit msn programs (they haven't), and the NLN (the other accrediting body) has said it is against a DNP. It ain't gonna happen anytime soon. That said, your program of choice may be one of the many that are transitioning to DNP only. You don't have to go back to school to change specialties. With an FNP you can do whatever, except you need an RNFA cert to first assist in the OR. The problem is you will not rotate through all the specialties like a PA and would require significant on the job training, especially if you do direct entry and have no experience. Ok thanks for clearing that up for me. That actually was one of the reasons I was thinking of being a PA over a NP. So you are suggesting to go to school to be a FNP? I'm still confused as to the details of the specific certifications like the RNFA and how you switch specialties. You just be a FNP and send out a resume to doctors that specialize in what you want and they will train you on pretty much EVERYTHING in that specialty? Im confused as to the distinct differences between NP and PA besides being able to start your own practice Link to comment Share on other sites More sharing options...
hockey833 Posted July 19, 2012 Author Share Posted July 19, 2012 Whoa buddy, you and Tim (what I've seen in quotes since I have blocked his crap) need to dial it back. TA has earned his place and, no offense, you are the FNG. I understand your questions, fustrations, and I even understand not using the sorry device they call a search function here. But keep your cool. He doesnt have to have a condescending tone Link to comment Share on other sites More sharing options...
Moderator LT_Oneal_PAC Posted July 19, 2012 Moderator Share Posted July 19, 2012 Ok thanks for clearing that up for me. That actually was one of the reasons I was thinking of being a PA over a NP. So you are suggesting to go to school to be a FNP? I'm still confused as to the details of the specific certifications like the RNFA and how you switch specialties. You just be a FNP and send out a resume to doctors that specialize in what you want and they will train you on pretty much EVERYTHING in that specialty? Im confused as to the distinct differences between NP and PA besides being able to start your own practice With an fnp, you can work with any age group. Some states or hospitals may not let you work in critical care or surgery, but my local one does. You can definitely work in any outpatient setting. The problem is an FNP will rotate ONLY through family practice, mostly in-clinic ob stuff and gyn, outpatient peds, and maybe IM or ER if you asked nicely to your clinical advisor, but likely more FP clinic. Clinic hours usually average around 700 for msn level, compared to 1600-2000 for PA. So a doc may hire you and train you to work with him, but you will be at a severe disadvantage anything outside of primary care. An RNFA is a first assist cert that allows you to bill for those services in surgery. Otherwise, you're not pulling in money. With PA, you'll have rotated through all the core specialties and will not need as much hand holding. Also, PAs have tons of residencies that will propel you light years ahead of everyone if you go that route. Though you won't have as much freedom as an NP as PAs are more regulated. 95% of the time you won't see a difference. I went to ACNP for two semesters. Hated every second and didnt felt like I was learning much. PA has more of the hard science (gross anatomy, more physiology/patho, pharm, and clinical medicine) I was looking for and rotated through more specialties. Also, a PA can work in surgery without any other certs. I didn't feel like NP was preparing me to be competent. NOW that may have just been my program. I've seen other schools do a better job and there are plenty of great NPs. That was just my experience. So, take from that what you will. Google the curricula and make a decision for yourself. Link to comment Share on other sites More sharing options...
Guest hubbardtim48 Posted July 19, 2012 Share Posted July 19, 2012 Agree and I don't care if he has been on this forum since day one, I could even go as far as I don't care if he was my OWN DAD, NO ONE deserves to be talked to like that. Give me a break, quit sticking up for someone that is being so rude. TA can treat you like that oneal if you like him so much, but to other people TA needs to BACK down and learn how to communicate to people. Link to comment Share on other sites More sharing options...
Moderator LT_Oneal_PAC Posted July 19, 2012 Moderator Share Posted July 19, 2012 He doesnt have to have a condescending tone Understand you feel that way, but try to stay above the fray my friend. Practice now will serve you well, especially as a nurse or PA. Let stuff like that roll off you like water off a duck's back. Link to comment Share on other sites More sharing options...
hockey833 Posted July 19, 2012 Author Share Posted July 19, 2012 See I am interested in being a PA because the curriculum and schooling feels more professional and educational than the nursing model used by NP's. "With PA, you'll have rotated through all the core specialties and will not need as much hand holding." "Though you won't have as much freedom as an NP as PAs are more regulated."...I feel as if PA's are better trained in all specialties when they graduate versus NP's. Am I being biased or making a false statement? What if I am not sure what specialties I want to go into? Should I go to school for nursing and just choose PA or NP in 4 years? Link to comment Share on other sites More sharing options...
hockey833 Posted July 19, 2012 Author Share Posted July 19, 2012 Understand you feel that way, but try to stay above the fray my friend. Practice now will serve you well, especially as a nurse or PA. Let stuff like that roll off you like water off a duck's back. You have taught me a valuable lesson, thank you Link to comment Share on other sites More sharing options...
Moderator LT_Oneal_PAC Posted July 19, 2012 Moderator Share Posted July 19, 2012 See I am interested in being a PA because the curriculum and schooling feels more professional and educational than the nursing model used by NP's. "With PA, you'll have rotated through all the core specialties and will not need as much hand holding." "Though you won't have as much freedom as an NP as PAs are more regulated."...I feel as if PA's are better trained in all specialties when they graduate versus NP's. Am I being biased or making a false statement? What if I am not sure what specialties I want to go into? Should I go to school for nursing and just choose PA or NP in 4 years? I'd prefer not to get too negative on NP education so I'll try to talk about PA positives. PAs are definitely uniform in their education. PA has more hard sciences, such as gross anatomy which is not in any NP school. Then there is the fact you rotate through all the core specialties and you also have electives. This does not mean you'll master all of them, but you'll have a much broader base to draw from and many more clinical hours. Better trained? I would say yes, but that is my opinion. I feel it is a no brained if the PA also did a residency in their field. Are they always better practitioners? I feel that is more a factor of the individual. I would the hardest worker and most eager learner working on me more than I care about their degree. Going to nursing school is a great option. You'll have a somewhat lucrative back up job, you'll get great healthcare experience to make you a better applicant for PA, you'll learn about specialties you may want to do, and you can change you mind and have other options. You could be a NP, a CRNA, or PA, even administration if that is your fancy later. Link to comment Share on other sites More sharing options...
Moderator LT_Oneal_PAC Posted July 19, 2012 Moderator Share Posted July 19, 2012 You have taught me a valuable lesson, thank you Well, I don't know if I've taught you anything. I appreciate the sentiment. I certainly didn't "learn it" the first time someone told me. Once I tried it though, years later, I realized I was a lot happier just smiling at them like I could care less rather than get angry. Plus, it's a lot easier to make the other guy look like a jerk when you just blow it off and at like you don't have a care in the world. Link to comment Share on other sites More sharing options...
Moderator True Anomaly Posted July 19, 2012 Moderator Share Posted July 19, 2012 You're a douche. I am surprised you made it through PA school not being able to put together what I was trying to say. In case you haven't noticed, our economy is not doing so good. When the economy is hurting, most businesses lay off workers or have to cut their budget. A recession doesn't only affect one business. Of course there are going to be EMT companies hiring, I'm not that stupid, but I was making a general statement. But there is only one ambulance company in Reno, so competition is fierce and space is VERY limited..... Does that clear that up for you? My apologies if you were offended. That being said...as Oneal has alluded to, as you will start to see in approaching a professional level, you will come across MANY different varying opinions and ideas...NONE of which necessitate calling someone a "douche" and making assumptions about how "surprised that I made it through PA school". Might I remind you that I was merely responding to your statement, without attacking YOU as a person. I didn't attack your age, your education or your specific situation, but I will comment all day about any statements that are off to me that you or others make. That's the point of a discussion forum. You can comment about a particular post without it being a personal attack. And my post was not a personal attack. Learn to separate your attachment of your own personal feelings to statements made on a forum, particularly a professional forum such as this, or it's gonna bite you in the rear when you start getting into more professional settings in the real world. With all THAT being said, on the whole the "economy" has been stabilizing and is moving in the right direction. While I acknowledge that it may play a role in a particular organization putting a hiring freeze, I would have no doubt that it's way down the list of why one particular organization isnt hiring, but if a person who is doing hiring gives you the reason of "we're not hiring because of the economy", it's an extreme generalization and potentially covering up the actual reason they aren't hiring. Link to comment Share on other sites More sharing options...
hockey833 Posted July 19, 2012 Author Share Posted July 19, 2012 Going to nursing school is a great option. You'll have a somewhat lucrative back up job, you'll get great healthcare experience to make you a better applicant for PA, you'll learn about specialties you may want to do, and you can change you mind and have other options. You could be a NP, a CRNA, or PA, even administration if that is your fancy later. That is the reason I am asking this question. If I become a nurse I have a lot of options to choose from. I was attempting to see if being a nurse has helped them get to where they are. If it gave them an advantage in some way, whether it be having many options or being a more well rounded applicant to school. But I'm still trying to figure out the difference between NP's and PA's. I've heard NP's have stronger unions, so they have been granted more 'privileges'. What can a NP do that a PA cant? and vice versa? I have no idea what to choose because honestly it just feels like the same job, just two different ways of getting there. Link to comment Share on other sites More sharing options...
Moderator LT_Oneal_PAC Posted July 20, 2012 Moderator Share Posted July 20, 2012 That is the reason I am asking this question. If I become a nurse I have a lot of options to choose from. I was attempting to see if being a nurse has helped them get to where they are. If it gave them an advantage in some way, whether it be having many options or being a more well rounded applicant to school. But I'm still trying to figure out the difference between NP's and PA's. I've heard NP's have stronger unions, so they have been granted more 'privileges'. What can a NP do that a PA cant? and vice versa? I have no idea what to choose because honestly it just feels like the same job, just two different ways of getting there. For the most part, it is the same job. It gets difficult to describe the little differences in the practice setting because it varies by state. Some states an NP can be completely independent and is allowed to do whatever she has been trained in, though you will likely never find a completely independent NP in a inpatient specialty. Other states let NPs be independent after certain time in supervised practice, like in Maine. Yet in few others, you may find them just as restricted (maybe slightly more) than PAs. PAs have supervision in all but a handful of states, where they have a sponsoring physician. This never means it has to be direct oversight. In some states supervision is a meeting every few months, just have dinner with your SP and your done, like in North Carolina. Most states probably have a 10% chart review. You may go months without seeing the person who does your chart reviews, like emedpa does, or they may be your boss in a FP clinic. In some places, you could essentially be independent. Open you own urgent care clinic in NC, give a physician 5% ownership to meet with you do often, and boom. Not much difference than an independent NP. You should note that the same percentage of NPs and PAs own their own business. As for the future, which at your stage is the concern, NPs are likely to get more and more states where they are given independent status and I see the DNP becoming the norm. For PA, I first see a change in title from assistant to associate (really its a revert back to associate) and I see mandatory residencies for anything other than primary care. Also know that these are minimums. Any facility can impose greater restrictions if they want. So your practice could be different from the guy across the street. So, it really is a futile question unless you ask about a specific place. But if you need an answer, they are the technically the same. Send me a PM if you have more questions. Link to comment Share on other sites More sharing options...
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