[tiredfeetED]

Originally Posted by joffus

In eigIn eight states, including Oregon, Washington DC, Washington state, New Hampshire, and many Mountain/Pacific Time Zone states NPs work totally autonomously, and many choose to open their own clinical practice. PA's CAN NOT.

I work in air medical transport as a BSN and a NURSE/NURSE configuration is considered a higher level of care than a NURSE/MEDIC configuration for transport. Also as a transport RN, mind you not even an advanced practice nurse,use medical diagnosis when communicating to our medical control, and not nursing diagnosis. The PA profession was initially developed to use combat medics from the Vietnam war as healthcare providers under a physicians guidence, and they do an invaluble service, but like I said nurse/nurse is a higher level of care.

Just enroll in an FNP/PA program at Stanford University or UCDavis. They have combined both into one program. That is how similar their roles are so don't let some nit picker confuse you. Choose the program that you believe will give you the greatest advantage in being a health care provider in the future, and I wish you the best of luck in your future.

Nurses use medical dx when communicating with other nurses not just transport RNs.



tiredfeetED FNP-S/PA-S

[patrick1rn]

I am in school to be a FNP. I just wan to learn as much as can in school and continue when I graduate to learn and work as a FNP.

[CraigB-RN]

Originally Posted by core0

Unfortunately the Stanford program is no longer available:
http://pcap.stanford.edu/program/FNP...n%20Change.pdf
The Davis program now has a separate FNP program as well as an option for RNs in the PA program to get their FNP with additional classwork (due to the requirement for an MSN to be licensed as an FNP.

Welcome to allnurses.com

David Carpenter, PA-C

David do you ever sleep? I have a hard enough time keeping up on the reading I need just to stay current, much less read everything that you do. Again thanks for all your input. If everyone (including me) put as much time and effort into their postings here, things would be better for everyong.

[core0]

Originally Posted by CraigB-RN

David do you ever sleep? I have a hard enough time keeping up on the reading I need just to stay current, much less read everything that you do. Again thanks for all your input. If everyone (including me) put as much time and effort into their postings here, things would be better for everyong.

One of the joys of working in surgery is the odd hours. That and the ability to work on little sleep.

David Carpenter, PA-C

[MSADN]

David, I want to add my thanks for the info you give and the passion you show in your posts. I follow your posts here and in the PA forum, so I feel I've grown to "know" your online persona.

Everywhere I've lurked, most PAs and NPs agree that with 2-3 years of experience both professions are on the same footing in what they do and their competence when they do it. Online, some in both professions become a bit territorial, and they say things they would not say in person. The didatic and clinical training may be different, but in the "real world" PAs and NPs seem to function quite well together.

[core0]

Originally Posted by MSADN

David, I want to add my thanks for the info you give and the passion you show in your posts. I follow your posts here and in the PA forum, so I feel I've grown to "know" your online persona.

Everywhere I've lurked, most PAs and NPs agree that with 2-3 years of experience both professions are on the same footing in what they do and their competence when they do it. Online, some in both professions become a bit territorial, and they say things they would not say in person. The didatic and clinical training may be different, but in the "real world" PAs and NPs seem to function quite well together.

I would tend to agree. There are some institutional issues that can be involved but generally on a personal level PAs and NPs get along.

David Carpenter, PA-C

[prairienp]

Originally Posted by core0

I would tend to agree. There are some institutional issues that can be involved but generally on a personal level PAs and NPs get along.

David Carpenter, PA-C

I would add MDs to the mix. Generally, if a NP, PA or MD isn't getting along with the other providers they don't really get along with a whole of lot of other people.

[star77]

I applied to both PA and NP programs. I work with both in a family planning clinic.
I can honestly say that the PAs and FNPs that I work with are highly intelligent, personable people whom I respect greatly.

At this juncture in my life, I'm working on entering a MEPN program, mostly because I want to be an ACNP, but also because I think earning an RN will give me greater flexibility in my career path. If I want to also be a PA, I can do so at a later date. Right now, I'm working on getting knee-deep into trauma (love the ED).

From my understanding and from my discussions with some fabulous representatives of both PA and NP folk...
PAs are trained very well, but must work under a licensed physician. NPs are able to work under their own license. That kind of autonomy is important to me.
Both are able to diagnose patients. Scope of practice seems very similar, although regulated differently. It seems like underlying philosophies might be different (ie Nursing philosophy vs physician philosophy?).
Correct me if I'm wrong, and apologies if this is redundant, as I haven't spent the past 3 hours reading all of the posts here.

[core0]

Originally Posted by star77

I applied to both PA and NP programs. I work with both in a family planning clinic.
I can honestly say that the PAs and FNPs that I work with are highly intelligent, personable people whom I respect greatly.

At this juncture in my life, I'm working on entering a MEPN program, mostly because I want to be an ACNP, but also because I think earning an RN will give me greater flexibility in my career path. If I want to also be a PA, I can do so at a later date. Right now, I'm working on getting knee-deep into trauma (love the ED).

The opportunity cost for PA after you have an NP certificate is too high in my opinion. Outside of the one remaining dual cert program I am not aware of anybody who has gone back and gotten a PA after getting their NP or vice versa. Realistically you have to pick one career path or the other (unless you choose the UCDavis route).

From my understanding and from my discussions with some fabulous representatives of both PA and NP folk...
PAs are trained very well, but must work under a licensed physician. NPs are able to work under their own license. That kind of autonomy is important to me.
Both are able to diagnose patients. Scope of practice seems very similar, although regulated differently. It seems like underlying philosophies might be different (ie Nursing philosophy vs physician philosophy?).
Correct me if I'm wrong, and apologies if this is redundant, as I haven't spent the past 3 hours reading all of the posts here.

PA work under their own license but have a supervising physician. NPs also work under their own license but in most states do not have a supervisory physician (and in some states do not have collaborating physicians).

As far as scope, I think that this is now becoming the biggest difference clinically between the two professions. As noted multiple times the PA scope of practice is defined by the supervising physician. In pretty much all states the NP scope of practice is defined by the certification, training as an NP and BON direction. If you had asked the question a when this thread started I would have stated that an FNP and PA scope of practice were essentially identical. In the last year I have seen the FNP scope dramatically narrowed in a number of states. The ACNP seems to be the preferred certification for inpatient (and increasingly specialty) work. How the NP profession will deal with the pediatric component of many specialties remains to be seen.

David Carpenter, PA-C

[CraigB-RN]

Originally Posted by star77

IThat kind of autonomy is important to me.

My question is why is that autonomy important to you? I've found over the years that a lot of people really don't understand what they mean by autonomy. I've worked in places as a staff nurse were I had enough autonomy to get my self in a lot of trouble if I wasn't careful.

Even Doc's don't have as much autonomy as people think they do. They are governed by "standards of Care", There are clinical pathways that direct how a given disease process is handled,The pharmacy committee dictates what antibiotics will be available in any given facility, insurance companies have more control over things than people think they do sometimes, and the economics of the the patient limits what a doc can and can not do. And I bet if you looked at the numbers, a large percentage of Docs actually work for someone.

Is it the opportunity to open your own practice? Dave help me on this, but from what I know about practice management, it's a LOT of work and not as much patient care as you would like. Plus it's expensive, salaries, equipment, rent. Just way to much like work for me.

I admit that part of my opinion is based on what is rapidly approaching 32 years in this business and I'm pretty cynical about a lot of things.