PA NP movability

  1. Hello, I was wondering about a specific difference about NP vs PA's.

    I was talking to an NP last night and he said that NP's can go into any field they want to, regardless of their past. He said he could go into geri's, peds, surgery, ortho....whatever he wanted to. I realize a PA had the ability to do that as long as they had a supervising physician to allow them to do that...but I thought an NP had to declare their 'major' or specialty pretty much in the beginning of NP school. So...I'm now confused, as an NP, regardless of the concentration one picks in the beginning of NP school, you can choose any field and you don't have to go back to NP school (for the speciality)?
    •  
  2. 14 Comments

  3. by   fergus51
    I think he's oversimplifying it. You can not go into ANY area. Neonatal NPs for instance need to have experience in neonatology as nurses, then take their NP program focused in neonatology, then write their certifying exam as neonatal NPs. General NPs do have a wide variety of areas to choose from, but it isn't unlimited.
  4. by   Pinoy2.0
    ...more thoughts?
  5. by   JACKMAC
    I am a recent NP grad and he is actually right depending on your area of concentration. If you chose to be a Family NP, you can work in a wide, wide variety of areas. If you choose a more narrow focus then, yes, you will only be employable in that area such as pediatrics, women's health, neonatal, acute care, and psych. But I have seen FNPs in family practice, internal medicine, dermatology, cardiology, ENT, acute care, ER, pediatrics, endocrinology and on and on. Lots of people are finding that they need to expand their scope of practice and most are going back for the FNP because it is much more marketable. I hope this helps you.
    I should clarify, no concentration is unlimited in scope.
  6. by   Pinoy2.0
    so who would have more or less an opportunity to change fields w/o more education, a pa or np?

    or are they the same?
  7. by   jeepgirl
    Where I live, we have two (at least) FNP programs. It has gotten so bad that some of them cannot find jobs and are having to relocate. However... the ones that are specializing (WHNP, PNP, MHNP) are being snapped up like hotcakes. I worried about this as well (I am in a PNP/Nurse educator program) but after asking around for a LONG time and going out of my way to look at how things are going in my area (I really don't want to move) I decided to go ahead and just specialize in my specialty instead of doing FNP. Just my observations. However, every market is DIFFERENT and every region has a different mix of who tends to hire what.
    Thanks!
  8. by   JACKMAC
    I think that the FNP and PA are equal in scope of practice and mobility. Both have lots of flexibility. In both cases if you find a physician to work with, you can do whatever he/she needs, within your scope. Neither will be performing surgery alone (both can be first assist), delievering babies (only CNMs), but you don't really want them doing that either, IMHO.
    One difference is that is some states a FNP can open his/her own practice and to my knowledge PA cannot. That is not a goal of most FNPs but I think as NPs get more and more experience more will start opening their own pracitices.

    If you are already a RN, I would go the FNP route. You won't repeat as much as if you went to PA school. Also there is more flexibilty with NP school than with PA school if you need to work while going to school and go part-time. PA school is full-time no exceptions usually.

    Please realize my bias since I just finished NP school but there is also a PA school 15 miles down the road and I chose not to go that route.

    With either one, there is a learning curve when you finish, just like when you finish as a RN. Neither one is completely prepared for the new role.
    Hope this is helpful.
  9. by   Pinoy2.0
    Hmm, I'm wondering then...I was talking to the NP about RN/NP/PA/MD stuff and he said about becoming a PA, "Why would you want to pigenhole yourself like that?" - Does anyone know what he could of meant by that? I asked him and he just kept on saying, "Trust me...trust me."
  10. by   fergus51
    Quote from Pinoy2.0
    Hmm, I'm wondering then...I was talking to the NP about RN/NP/PA/MD stuff and he said about becoming a PA, "Why would you want to pigenhole yourself like that?" - Does anyone know what he could of meant by that? I asked him and he just kept on saying, "Trust me...trust me."
    Probably because they need to work under a doctor and NPs can work independently.
  11. by   JACKMAC
    He also may have meant that a PAs scope of practice is determined by his/her supervising MD whereas a NPs scope is determined by the state board of nursing/medicine (in theory). I see this difference as minimal, if a MD is going to hire you most (not all) are going to want you to be as independent as possible so you are not bothering them all day. There will be some that will want you to consult on every patient but that is not very cost-effective since you can't see as many patients.

    Be aware that some NPs have "issues" with PAs and I would ask what was meant by that statement. I am interested myself.

    In my primary care NP program, one of my best preceptors was a PA and I was with MDs, NPs, and a PA. In practice, there just isn't that big of a difference between the two IMO. I think each brings something different to the table because of their various backgrounds.
  12. by   Pinoy2.0
    Well, not all PA schools are full-time. Although, like 98% of them are.

    I tried to find the NP, but I think it is what was mentioned here, I think he hates PA's. The whole time I was talking to him he had great things to say about RN's, NP's and MD's. Then when it came to PA's he would say, "Why do you want to pigeonhole yourself like that? (<-- he said that 3 times in our conversation) Why do you even want to know about PA's? PA's just do things that the Dr.'s don't want to do. PA's get the work no one else will take. DR.'s like NP's more than they like PA's. It went on and on, so I kinda took the entire conversation with a grain of salt. Now that I think about it, he pulled me aside before all the PA stuff (all the nurses left the 'group meeting' we were having at this point) he said and mentioned, "Why would you even think about being a PA". I mean, to me, the guy really went out of his way to steer me against the profession. That was a little weird. I just wanted a job at the hospital job fair, lol.

    Question about the FNP and specialities. Why would someone choose a speciality if they could just be a family nurse practitioner (FNP)? Wouldn't specializing yourself in NP school be like 'pigenholeing' (using his word) yourself? I mean, if you're not 100% you want to be in a speciality or there's a 5% chance down the line you want to change your field, why not go FNP and have all the roads available?
  13. by   fergus51
    Quote from Pinoy2.0
    Question about the FNP and specialities. Why would someone choose a speciality if they could just be a family nurse practitioner (FNP)? Wouldn't specializing yourself in NP school be like 'pigenholeing' (using his word) yourself? I mean, if you're not 100% you want to be in a speciality or there's a 5% chance down the line you want to change your field, why not go FNP and have all the roads available?
    Because an FNP does not have ALL roads available. I work NICU and don't know a single nurse who would want to be an FNP because we could never work in NICU again since we only take NNPs. Our peds units also require PNPs, they don't take FNPs. Want to work in L&D and you need to be a CNM since they don't take FNPs. The list goes on. Also, pigeonholing doesn't mean that you won't be able to find work and be well compensated at that. There are more FNPs out there than NNPs, but there are a lot of well paying NNP jobs in my area. CRNAs are the best paid and arguably the most in demand of any type of advanced practice nurse. They are very specialized, but they do a lot better than FNPs in some ways. It all depends on what you want to do.
  14. by   Pinoy2.0
    Hmm, ok. So, for the most part, as a FNP you have most roads open, even in some specialties. It's up to the employer, for the most part, to determine if in their speciality requries that a specialist is needed or a FNP would be fine. However some specialites may be restricted by law and you won't be able to practice in them unless you have a speciality in them (i.e. NICU-NP's)?

    Sorry, but this is all confusing!

close