Nurse Practitioner or Physician's Assistant?

[arelle68]

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 to a local college to complete a bachelor's in Nursing. This is the quandry I am in. I'm realizing that nurses are not respected or well treated, and I don't like it. I don't know how long I'll be able to put up with it. I have been headed toward Nurse Practitioner. Is physician's assistant a better goal? What are the differences? Is the same amount of schooling from associate degree RN?

[nurseprnRN, BSN, RN]

"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.

[core0]

"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.

[ange09, ADN, RN]

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.

[Guttercat, ASN, RN]

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.