PA vs. RN

jjjoy, LPN · Aug 4, 2009

Scott, thanks for sharing your observations! A few points, though, seemed to oversimply and/or exaggerate an otherwise valid observation.

dnrscott said:
PA's are to have their charts CO-signed and present each case to the Lead MD of the day....

Some people make it sound like NPs always have A LOT more autonomy than PAs and that going to PA route is essentially unnecessarily restraining one's options. I have two points on that. 1) Becoming an NP or PA isn't just about earning a piece of paper, it's building a foundation for one's practice. NP and PA programs can vary alot, so it's important to consider what kind of training/curriculum would suit any particular person. 2) Outside of rural areas, most NPs that I've run across work as part of a medical group/HMO/hospital and their job is to make the MD's job easier (to take of care routine cases, do mundane follow-up, etc). I understand another hang up is that many insurances will only reimburse NPs if they have an MD "supervisor." So while an NP license may provide the *possibility* of "hanging out one's shingle", most NPs (at least in urban areas) do not practice completely independent.

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Never need to worry about having, finding or rapidly being hired.

While relatively more stable than many fields, I think it's an exaggeration to say "Never." Nurses at times DO face lay-offs and difficulty landing jobs (especially jobs in facilities that aren't horribly understaffed/poorly managed/etc).

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And you have the flexablity to go into any field of medicine.

If a person doesn't take to hospital nursing, though, they risk becoming pigeonholed in a non-acute area and may face great difficulty trying to get into a different area. It may take an investment of several years of progressive lateral moves to gain relevant experience to get into certain areas. And the flexibility to go into any area of medicine also depends upon one's comfort of learning-on-the-job. Most nursing jobs don't provide a whole lot of transitional support... it's sink-or-swim and learn-as-you-go. That works just fine for some. Each individual must think of their own learning style when considering options.

geekgolightly, BSN, RN · Aug 4, 2009

dnrscott said:
First, you have to ask yourself in what type of function would you like to be apart of the medical team. RN's(most AA programs are phased out, so a BSN is now required in many states)

Could you please provide proof that AA programs have been phased out and most states require a BSN?

strux · Nov 21, 2010

geekgolightly said:
Could you please provide proof that AA programs have been phased out and most states require a BSN?

In NY and NJ for example, you will HARDLY find a job as an RN-ADN if you are a new grad unless u r currently enroll in a BSN program. You can make a quick search for your self if not convinced.

PetiteOpRN · Nov 21, 2010

PAs are physician extenders. While there are many different specialties in which PAs are employed, the role is always that of the physician extender.

Nursing is a little broader. There are options ranging from clinics and hospitals to case management to administration to research. There are also different educational tracts in nursing from LVN/LPN to PhD.

I work with many PAs and I think they enjoy their job. Personally, I enjoy the freedom that nursing gives me. I have a regular job, a PRN position, and now am able to do chart reviews from home on my own time.

jjjoy, LPN · Nov 22, 2010

strux said:
In NY and NJ for example, you will HARDLY find a job as an RN-ADN if you are a new grad unless u r currently enroll in a BSN program. You can make a quick search for your self if not convinced.

I'll bet new grad BSNs are having a hard time landing jobs as well. ADNs hear "Don't bother applying without a BSN", BSNs probably hear "Don't bother applying without at least one year experience."

While there is much talk over time of if BSN should be entry to practice, I'm not aware of associate's programs being phased out.

jjjoy, LPN · Nov 22, 2010

If one isn't already a nurse, is interested in being a mid-level provider and isn't interested in other nursing roles, they may very well easily decide to aim for PA.

If one isn't already a nurse, is interested in being a mid-level provider and is interested in other nursing roles, aiming for NP might make the most sense.

If someone is already a nurse, aiming for NP makes a lot of sense for them.

Whatever a person's background, the choice of aiming for PA or NP can be informed by comparing curriculum, opportunities, the local job market, and if one has a strong preference for the "medical model" or the "nursing model" of health care.

mentalhealthRN · Nov 22, 2010

Here in Rochester NY I believe the PA programs are what they call a 5 year Bachelors degree. So it depends on what state you are in as far as if the PA is a Bachelors or Masters. The NP is always a masters--regardless of state.

It sounds like you need to clarify if you are talking RN or NP vs. PA.......as stated you can't really compare an RN and PA as only the NP and PA are considered mid-level providers. Check out the courses you take for the PA compared to the NP and you will see the differences. The focus is different in school and as well in the real world.

just3ofus · Dec 8, 2010

dnrscott said:
That is SO untrue. To be an NP in California, by law you now have to have a masters degree......read up on state laws. Certified PA have a masters degree, not all PA have one however. Whatever happens here and in the Northeast will eventually have an inpact on the rest of the states. Associate degree programs are being phased out, and many of hospitals are requiring RN's with AA to have or obtain an BSN upon hire. HOWEVER, if money is your sole idea, you might want to look at a different profession. That isnt or wasnt your objective on becoming any type of health care provider.

Umm, my ASN program is hot and on the move. Haven't heard to much of phasing them out. Sounds a bit like you are inserting your opinion on ASN graduates.