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reeya 5,336 Views

Joined: Jan 23, '11; Posts: 122 (24% Liked) ; Likes: 56
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  • Dec 20 '17

    I can tell you about WA state. I used to work as a telemetry RN in a hospital for 2 yrs & I often used to get floated to ER when overstaffed. We had both PA & NPs in ER. Basically, the collaborating MD/PA had same schedule as MD & MD had to sign off all PA orders w/i 24 hrs because they worked under MD license. If pt. was transferred to floors & PA orders were not signed off w/i 24 hrs, we used to call MDs & remind them to come and sign off. After 24 hrs all orders were automatically voided if it wasnt signed off by supervising MD. Whereas, orders from NPs were not voided because they worked as independent providers under their own license & no supervising MDs were needed. We had lots of hospitalist NPs (palliative/hospice in onco floors, GI, IM) & lots of PAs worked in trauma team. A lot of MDs were irritated by that 24 hr signing protocol and they preferred to work with NPs than PAs in ER. So, most of our PAs were slowly switching to trauma/surgery 1st assist team where as NPs worked as hospitalists. It really depends what you wanna do.

    I am in a NP school now. NP school really builds on RN skills. For eg. if they are teaching CV system, they totally skip EKG analysis, chest tube care etc because they expect you have mastered that skill as RN. They skip a lot of things like diagnostics tests/ reasoning because there's certain expectation that as a RN you've mastered them as well. Even in health assessment, they skip lot of things (heart/lung sounds--you must have mastered them--diff type of murmurs--for eg, diff. between murmur sound like mitral regurgtitation vs. aortic stenosis, systolic vs diastolic murmurs etc) and jump directly to adv diagnosing. If I hadnt worked as a RN for 2 yrs in a tele floor doing own EKG strips q shift for last 2 yrs & listening to diff heart/lung sounds etc, I would have been so LOST in assessment class in NP school. They assume, you have mastered most of the skills/assessment. The only new assessment for me was pelvic exam in women. Honestly, I think PA school teaches from scratch which is better for people w/o experience. When I worked as a nurse, I learned a lot from fellow nurses, charge nurses, NPs, MDs etc. & I believe my experience of 2 yrs (more than 2000 hrs) & 800 NP clinical hours easily compensated for the 2000 hrs of PA. Without experience though, I would have definitely felt deficient. I would say go to PA school since you dont have that skill/education to build on.

  • Sep 1 '17

    Quote from linearthinker
    And I just have to disagree. I found them extraordinarily helpful. I guess value is in the eye of the beholder.
    If you have the NP review book and read cover to cover...u dont need the CDs. Did you not read what I wrote? Sorry but at $$446...they better be good. Did I say they were not helpful? The CDs are almost exact verbatim of her book & I found it boring. She sounds like she read it line by line from a book with a voice that is not so pleasant to listen.

    I was letting other people know that if they have the fitzgerald NP review book...they dont need fitzgerald cds...they can invest in Hollier CDs or some other review CDs...something to add to review that is not almost same.

  • May 24 '17

    sorry to chime in...i am a female NP student.

    When this topic of education PA vs. NP comes....people become too offended quickly. I have realized it on both a offendee and defendee...LOL

    It wouldn't be too bad if NP school did not waste 2 semesters (= 1 yr) on roles, ethics, community health, research, policy classes. They could make 1 semester by combining several of those classes in one....I mean we spent "3 credits on Advance practice roles" thats 6 hrs/week X 4.5 months. So unnecessary...It could have been woven into research / policy. Likewise we spent "3 credits" on community health project. Now, if I wanted to pursue public health I would have gone that route...Again that community health class could have been woven into policy/roles/ethics/community health together. We had epidemiology 3 credits + community health 3 doesn't this seem like public health route to you.

    Besides, advanced research class (which is imp as a healthcare to do research and interpret research)...I felt like I was on a hybrid version of MPA/MPH program with healthcare concentration until the end of first year (of course we had patho,pharm,assessment during 1st year together with those classes I mentioned). our program is 2.5 yrs. NP education can definitely be improved and more clinical hours can be added to it. I thought MSN-FNP was bad enough..I just cant understand why DNP would be more paralled to longer version of FNP.

    In the end, we learn from work experience and learning mistakes. I had MD, NP, CNM as preceptor and now I have PA as a preceptor for this semester. They all tell me first couple of years after school is learning stage. They were all fab and knowledgeable. I see NP and CNM doing the MD/PA job + education. MD/PA leave out the patient education but in the end they all treat their patient. That makes me not regret the choice of NP school but we definitely need more clinical hours. Everytime, I see pt with derm problems ( besides common eczema, hives, acne etc)...I wish I could have spent 4-5 weeks in derm clinic (not cosmetic clinics)/ ER/ Jail instead of writing pages and pages of papers on what is the role of APRNs.