nurselyfe4115, BSN, MSN, RN 4,458 Views
Joined: Apr 18, '12;
Posts: 26 (12% Liked)
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5 year(s) of experience in Cardiothoracic Intensive Care
There is this myth that still seems to be circulating around that Physician Assistants (PAs) can do more than Nurse Practitioners (NPs). For example, if you want to have a role that involves more invasive procedures like central line or chest tube placement, you need to become a PA. This is not true and in fact is becoming more false each year as the NP role and profession keeps changing and adapting to hospital needs and patient populations.
Many times in the past I had the discussion with my fellow nurse colleagues about whether to go to PA school or NP school, when contemplating going back to school. I considered going to PA school on the basis that I wanted to be able to do invasive procedures and assist in the operating room. At the time, in my hospital, we only had PAs in this type of role and I really didn’t know how the NP role had evolved into invasive tracks such as the ACNP role.
Don’t get me wrong, I have absolutely nothing against PAs and work with some fabulous ones, I just want to provide a little “clarity” for those who are still unsure about which track they should take and what each role can actually do. The difference between the two roles is really just that one track requires a nursing license and one doesn’t. The NP track tends to have a foundation that involves more nurse theory and evidenced based practice, while the PA track tends to have more of a straightforward medical approach.
I’m not saying that you don't learn medical management in NP school, you're just relating that management to nurse theory and research, where as in some PA schools, they only have 1-2 classes on evidence based medicine. The prerequisites are different as well. Prerequisites for NP school are usually obtained in your undergraduate program so no extra classes are required, where as, some PA schools require organic chemistry and biochemistry. For somebody with a nursing degree, these classes would have to be taken post-nursing degree because most undergraduate nursing programs don’t tend to require these types of chemistries. This is just something to think about if you’re considering going to PA school.
Looking at programs people can argue that PA schools require a lot more clinical hours to complete in their programs, but you have to keep in mind the general PA student. The general PA student doesn’t have much hands-on patient experience, so the hospital is essentially a new environment for them and they will therefore require more hours. In NP School you still a lot of clinical hours to complete in the hospital (or clinic), but you've also probably worked a couple years prior to graduate school (and continue to work through school) so those extra hours at the PA students are getting, you've already had those in real world situations touching real patients.
With all of this being said there is NOTHING WRONG with a nurse going to PA school. Sometimes people don't want the “nursing foundation,” they want the straightforward medical foundation, which is totally fine, to each his own. Whether you go the NP or PA track, by the end of your program, you will still come out doing the same job, being just as good at your job, and eventually (hopefully) making the same salary. So, if you think that you want to become a PA because they can do invasive procedures, now you know that NPs can also do invasive procedures with the appropriate program and training. I have had an attending physician tell me that they would much rather hire an NP than a PA because NPs most likely already have nursing experience and know how to talk to patients. But, I also do realize I'm a little biased being that I’m an NP graduate.
Physician Assistant. They are qualified for everything you wish to do. You'll probably relate better to surgeons too.
Since the program I just finished was an Acute Care NP program, a majority of it was in class. We had class 1-2 times/wk and sometimes even clinical at the same time.
As I finish my ACNP program (in literally days) I'm reflecting back in my journey. I realized that although I got want I needed and much more from grad school, the process to obtaining this degree was not what I expected so I wanted to give a little insight in what you may actually go through furthering you education. It's not to deter you from going, I just want to give you an honest idea of what you may go through so you can realize, you're not the only one.
You Will Be Overwhelmed.
I know you probably already anticipate this because hey, your going back to school and you haven't written a paper or taken a test in how many years? This is already expected but I didn't realize just how overwhelmed I would get until I actually got into it. Class, clinical, papers, family work...shall I go on? Having to manage it all at once was rough. I considered myself an organized person before grad school but it took me awhile to get everything organized out. My advice to you would be to first, don’t panic, you will get everything done. Then, figure out a system that works for you and stick with it. For me, taking it one week/assignment at a time allowed me to focus on what was due and put all my effort into it. Towards that end I was able to focus on multiple items and even work ahead, but it took me awhile to figure out what my instructors wanted and what worked for me.
You Write, A Lot.
Going into grad school I knew that there would be writing but I just had no idea. The care plans in undergraduate nursing school are nothing compared to the progress notes, H&Ps, discussion boards, policy papers, synopses, and projects grad school has to offer. You feel like all you do is write. What I definitely realized was that the farther you take your education, the more you have to write and document. However this is for good reason. You're doing more, such as procedures, and therefore have more responsibility so you have to be able to provide proper and accurate documentation to cover yourself, should something go wrong.
You Will Second-Guess Your Decision to go Back.
Ok, so you didn't do well on a test, had a bad day in clinical, or just can't quite get a concept and you think, "why don't I just quit and stay a bedside nurse." While there is nothing wrong with staying a bedside nurse, it may not be what you want to do long-term. Everyone at some point in their program, no matter what kind of program, has had this thought come across their mind, possibly more than once. You want to go back to bedside nursing because you are good at it, its familiar and less stressful than what your doing, BUT, you wouldn't be doing grad school in the first place if that was truly what you would want to be doing, right? My advice to you would be to stick it out. You're a student, your going into depth about concepts you know, but only know the "surface" of. You're in unfamiliar environments assuming a role that you haven't done before, so you can't expect to feel confident at every point of your program. I will assure you that it gets better though, and by the end if your program you'll be glad that you continued.
You Will Cry.
Whether it be from sleep deprivation, stress, or the feeling of not knowing anything, there will be a time that you will break down and cry. Don’t worry, you won’t be the only one chances are, your classmates are too, they’re just letting you know. Grad school is tough. You’re put in situations where your supposed to learn, and you do, but you also feel like the least intelligent one in the room. If your doing inpatient, rounds can definitely make you feel this way. Don’t take it personally, the attending doesn’t hate you (usually), they’re just trying to teach you how to do it they way they want it done. They do it to everybody, residents, fellows, interns…everybody. I will never forget, one tough attending told me that rounds were there to “teach and put hair on your chest.” After surviving rounds in grad school, you feel like you’ve accomplished something and will be a better advanced practice nurse because of it
You Will Learn A Lot.
This one is pretty obvious but I don't think I realized just how much I needed to know to be a competent ACNP in the ICU. In my program we do a lot if simulation and I remember going home after the first day of the clinical year crying because I did so horrible telling my husband "they expect us to be doctors!" Don't get me wrong I knew my stuff (you need to, to get in) but I didn't know it to the depth that they are preparing us for. During simulation they would ask us what our differential diagnoses were, specific drugs used, doses, tests, why we were ordering a certain test, the contradictions for certain treatments or tests, gram positive vs. gram negative antibiotic coverage etc. They didn't expect us to know all of this at the beginning, but have prepared us to know it by now (the end). Remember, advanced practice nurses are there to offset the physician shortage and fill the gaps, so it would only make sense that we know just about the same depth of knowledge.
You'll Make Life-Long Friendships.
Going through a stressful time such as grad school allows you to bond and form life long friendships with those that are going through it with you. Your classmates know what you’re going through; they're experiencing it too. Lean on each other, encourage each other, and help each other. Believe it or not, those friendships can have an impact on your success in your program. They allow you to push each other to become even better advanced practice nurses.
I'm just curious if DNPs get paid more than masters level practitioners. I read somewhere that they didn't and then another article, that they did. I am currently in a masters program and contemplating going on to get my DNP once I graduate but am just curious if the extra time and money that I spend getting it will be worth it OR will I just end up spending extra money and time and still make the same salary...if that makes sense. Thanks in advance!
I was just wondering if there were any NPs who also hold a CRNA license out there? If so do you utilize both? How? What program/what kind of program did you attend to get your CRNA degree (post masters vs. full program)? Was it worth the EXTRA time and money spent? In what region do you work and are you compensated fairly? Any kind of feedback would be much appreciated, thanks!
Thanks so much for your responses! ghillbert, that sounds awesome and so like my dream job! My only concern (and fear) is that i'm in Missouri and we tend to "jump on the band wagon" a little later than other states. Where I work now, we have very little NPs that work in the hospital, and if they do, they're FNPs. So, I'm just hoping there will be a job available with Cardiology, in the hospital, when I graduate.
I just got accepted to an ACNP program so I'm already trying to plan out possible career options when I graduate. I work in a cardiac icu and would love to get a job in acute care cardiology when I graduate, but I'm just curious if anyone could give me some insight into what they think I would be doing (I have an idea of what I would be doing, but I'm not sure), hours, compensation (in the midwest area), and job outlook. Thanks in advance!
Does anybody know how many ACNP students they take??
murse89 are you from Cali?
Anybody hear anything yet???
mnmary mine also says no decision yet
mnmary, did you click on the Fall-2013 part under application term? I also thought my just said submitted until I actually clicked the term and then it had me type in my password to get to my "letter"
Type in you email, click the Fall-2013 button, type in your password, press continue, then it should tell you your status (so far it's just been telling people they've either been rejected or a decision has not been made yet, meaning your either on the waitlist or admitted). Sorry this is so long!
Hi mnmary! I too applied to UCLA's ACNP program! Have you checked your decision status online yet? I heard that they've already sent out some rejection letters and just sent out acceptance/wait list letters on March 1. Where are you from? I'm from Illinois so I'll have to wait awhile for any sort of letter, the waiting is unbearable!!
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