Nurse Practitioner or Physician's Assistant? - pg.9 | allnurses

Nurse Practitioner or Physician's Assistant? - page 12

Well, I graduated with an associate's degree, and passed my NCLEX in January. I've been working in an LTC since Feburary. I have an opportunity to return to school, and I've already been accepted... Read More

  1. Visit  nurseman78 profile page
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    That would be hard. I wish you the best of luck. You're always welcome here in Utah!
  2. Visit  zaga09 profile page
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    I saw this was orginally posted back in 2009. I am in a similiar situation. I love to go to PA school but I heard they don't like RNs. Also the ones where I live are super competitive ( accepting only 19 percent of applicants!) Going for my nurse practioner would be ideal because I heard most school offer classes online and you can work while going to school. I am interested in working an in ER however and I think ERS are more likely to hire PAs. If someone could enlighten me why pa school don't like nurses that might sway me one way or another.
  3. Visit  nurseprnRN profile page
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    "realistically within a practice nps and pas will do the same job. the pay is very similar and the opportunities for practice ownership are basically the same."

    not true. or, should i say, only true if you think that a pa without a nursing license can practice to an aprn standard of care, which s/he cannot.
    an aprn can hang out a shingle in many states without being under the md's license. a pa cannot.
    an aprn can legally diagnose human response to illness and injury (as well as have prescriptive authority under the aprn license)and make a plan of care without md sign-off. a pa cannot.

    many nurses are familiar with the "i can do anything a nurse can do, i just don't have the credential" mindset that pervades the lpn and cna ranks (until they get better educated). so too do many pas believe about aprns.

    you're a nurse. be a nurse.
  4. Visit  core0 profile page
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    Quote from grntea
    "realistically within a practice nps and pas will do the same job. the pay is very similar and the opportunities for practice ownership are basically the same."

    not true. or, should i say, only true if you think that a pa without a nursing license can practice to an aprn standard of care, which s/he cannot.
    an aprn can hang out a shingle in many states without being under the md's license. a pa cannot.
    an aprn can legally diagnose human response to illness and injury (as well as have prescriptive authority under the aprn license)and make a plan of care without md sign-off. a pa cannot.

    many nurses are familiar with the "i can do anything a nurse can do, i just don't have the credential" mindset that pervades the lpn and cna ranks (until they get better educated). so too do many pas believe about aprns.

    you're a nurse. be a nurse.
    this was answered two pages back (although without green text). functionally everywhere i've worked nps and pas doing the same job do the same work. i can diagnose medical conditions, formulate a plan and enact it without anyone signing off. the only thing that is the physician is required to sign is my discharge summaries (just like the nps). technically you are correct i do not practice to an aprn standard of care. i practice to a physician standard of care for the specialty that i am working in. i really don't know or care what the aprn standard of care for my specialty is (although if my fellow aprns practice to less than the physician standard of care they would certainly hear about it). functionally and legally in my organization, the only difference between what i do and the aprns that work with me do is that i can see patients under 18 and they can't. ymmv.

    for the poster above you and for others if you want to go to pa school take a look. its not for everyone and there are real advantages to np school for an rn that i elucidated several pages back. nationwide around 5% of pa students are rns, if you include nps and lpns that number goes up. anectodally it seems to be growing for a number of reasons. the medical experience that an rn has is valued and while pa school remains competitive, depending on the program an rn might give someone an advantage.
  5. Visit  nurseprnRN profile page
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    "technically you are correct i do not practice to an aprn standard of care. i practice to a physician standard of care for the specialty that i am working in."

    "practicing to standard of care" has a very specific legal meaning. if you are not a licensed physician, you are not, in fact, practicing to a physician standard of care, and in a court of law you would not be held to one. let us not redefine "i can do tasks as well as a physician" into "i am practicing to md standard of care."

    likewise, aprn standard of care exceeds pa standard of care in autonomy, which is my major point. again, this isn't saying that you can't do what you do. it does say that you can't do it without md backup, and aprns can.
  6. Visit  core0 profile page
    0
    Quote from grntea
    "technically you are correct i do not practice to an aprn standard of care. i practice to a physician standard of care for the specialty that i am working in."

    "practicing to standard of care" has a very specific legal meaning. if you are not a licensed physician, you are not, in fact, practicing to a physician standard of care, and in a court of law you would not be held to one. let us not redefine "i can do tasks as well as a physician" into "i am practicing to md standard of care."

    likewise, aprn standard of care exceeds pa standard of care in autonomy, which is my major point. again, this isn't saying that you can't do what you do. it does say that you can't do it without md backup, and aprns can.
    the community standard of care does have a specific meaning. as someone who does expert testimony as a pa i can also tell you that with one very limited exception that i can think of, the community standard of care that a pa practices is that of the physician in that specialty. since the pa scope of practice is defined by the supervising physician, the standard of care is also that of the supervising physician.

    as far as autonomy, i have never seen autonomy defined in any state practice act for either np or pa. indeed standard of care is the act toward a patient. i have a hard time seeing how autonomy and standard of care go in the same sentence. instead autonomy is earned within an organization or practice.

    the details of practice vary by state and institution. in my state, pas have a supervising physician, nps have a collaborating physician with similar regulatory requirement (actually prescriptive authority is much easier for pas). in my institution both pas and nps must have a sponsoring physician and priveleges for both are done by the credentialing committee. both pas and nps must have "physician backup".

    basically for the 2% of pas and nps that own their own business there are state based advantages either way. for everyone else you work with as much autonomy as you earn. its not defined by the scope of practice or any other document. both physicians and organizations have considerable liability in all the providers in the practice, that's where earning autonomy comes in.
  7. Visit  ange09RN profile page
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    I have been browsing PA and NP programs. Since I am a RN, it looks to be more convenient to go to NP school, but I just wish there were more face to face programs near by. My good friend is graduating from NP school in May. we were discusssing the clinical hour requirements. The requirement is around 750hrs and Im sure that varies. We both agreed the required hours should be more. According to her, you cannot compare being a staff RN to advanced practice and working as a mid-level provider. The way of thinking is completely different. I think instead of the BON contiplating on making it a requirement to obatin a DNP, they should require a residency or more clinical hours. The PA programs I have been looking at require way more sciences and offer more clinical time in different areas. My friend attends George Washington University & she has only completed clinical hours in a clinic setting. In fact, I have another friend in NP school at UAB and it is the same. PA students go through several rotations and receive OR expierence. The MDs I speak with about this respect both professions and hire either or. I do not feel one is better than the other, they are both essential to healthcare. I think it all depends on what works for you. Personally, I would want the feedback of a MD, esp. as a new grad. If a person wants to be completely independent and make more money, than go to medical school and become a medical doctor.
  8. Visit  Guttercat profile page
    1
    Great thread. Just wanted to say thanks to Coreo0 and others for taking the time to add your experience and insight.


    I'm currently researching paths between MBA, NP/DNP or PA.


    Threads like this help immensely.
    kalevra likes this.

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