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) work under the ordering scope of PA, NP and MD's. However, the days of ALL liabilities falling to the doctor are gone. As an ER RN working at a major trauma hospital in California for many of years, my observations are the following:
1) PA's are to have their charts CO-signed and present each case to the Lead MD of the day. Does it happen always, NO. It depends upon the MD really. Some want each case presented and others are okay with signing the charts at the end of the day. Keep in mind, the PA must by law be functioning under the direct supervision of an MD. Not on call, but in the building and available. Does it happen always, NO. PA function as diagnosising providers but they are NOT independent of MD's. Liabilty falls back on the MD co-signing the chart as being appropriate and just care rendered.
2) NP's are completely indepenent providers of health care. They diagnose and treat illness at any level of care. But you often see them used in clinics. However, they work in all types of hospital settings and are liable for all that is done. No supervision is needed. The other consideration is this: NP's start making less money than seasoned RN's who have been RN's for years. Interesting, but true. But after a few years, they catch up and eventually make more in the end than remaining an RN.
3) Nursing shortage. Never need to worry about having, finding or rapidly being hired. There are jobs everywhere. And you have the flexablity to go into any field of medicine.
4) Completly different ideas of health care. Diagnois and treat are the function of MD/NP/PA. And as the RN, you are the person supplying the care. You work with the patients and know them. Thus, you find yourself guiding the MD/NP/PA to what needs to be done. Without your knowedge of the patients being inputed, how can anyone medically treat anyone.
5) RNs are the ones respsoble for this that and the other thing. Making sure that this that and the other thing are done, and done appropriately. And trust me, your the one that will hear about it.
6) RN's with a lot of experience tend to ignore the PA's at first, and will frequently questions orders given. Just as you have poor RN's you have poor quality PA's.
7) Responsibiltiy and liability: You give it, your responsible. So you have to know what your doing as an RN.
8) Because of the differences in thought is where, at times, conflict comes into play with all of the above. Does a nusre have to get up from the chair one was sitting in when the MD's make there rounds anymore? NO. Did they use to, yes. Did the hospital once always side with the MD's, YES. But things are changing and that is no longer the case. Nursing is becoming a more supported health care provider more now than ever before by hospital admin, MDs and the like. Now is this the case in Nebraska(sp????) , maybe not as pronouced as above.
So ask yourself???????
What type of role do you want to provide in the health care setting and it will lead you to what type of degree to achieve.
Hope it helped,