If you don't have to be (insert job) before becoming a PA, why become an RN before NP?

[nightingale4me]

So, I'm just curious, I've seen conflicting views on the RN -> NP route or just straight direct entry MSN NP route.

I already have a bachelor's degree and worked in healthcare for a few years (to get my patient contact hours and took pre-reqs for an MS in Physician Assistant program).

However, life circumstances changed that route and I have been debating whether I should go for a direct entry MSN (NP) program instead. There are many factors weighing in that decision, but overall, nursing suits me more.

Obviously, you get your BSN along the way when you enter these (direct entry MSN) programs, but you don't practice as a BSN, you just go straight through.

One of the things I've read in other posts is the argument for becoming an RN / BSN first and practicing in that area before becoming an NP (or that it helps your chances for employment in an NP role).

I'm not in the nursing world, so I guess I don't understand why the same concepts aren't applied as they are in a PA role.

Most people who go to PA school have the patient contact hours in some form (PT, OT, EMT, Aides etc.), but they aren't judged by that when they graduate to perform their mid-level practice of medicine (because it's not the same role or the same scope).

So, why do some nurses think you need to be an RN / BSN first in order to be a "good NP?"

If you're a competent individual and fully immerse yourself in the world of NP, why do you need to be an RN / BSN first when it's not the same thing?

I'm not so far left field that I don't understand how a role as RN / BSN could be helpful to draw from certain experiences or knowledge, but at the end of the day, they are two separate roles with two separate scopes, so why define someone's ability as an NP based on RN / BSN experiences / duties (or lack thereof)?

And, is it really going to be hard to find a job after doing a Direct Entry MSN / NP program vs. becoming a BSN then going the NP route?

Does this make sense? Or, am I just not understanding the dynamics of these roles?

I'm asking this from a place of trying to understand, not controversy for the record.

[aprnKate]

From my understanding, PA's have their license but they always have to have a supervising physician. NPs have their own license as well but do not necessarily have to be under a physician to practice depending on what state they practice. In TX both NP and PAs have to have a delegating physician to prescribe controlled substances and as well as their own DEA numbers and cannot own their own clinic practice (although there are loop holes around this)

NPs in AZ don't have to have a delegating physician to prescribe controlled substances. NPs in NM can own their own practice and not have to be under a physician from what I understand. I'm not sure if PAs are allowed in other states to own their own practice without being under a physician

This is something you should delve into when you are trying to decide which route to go.

[bnw6385]

Simply put, NP training relies on your basic health care exposure as an RN so the training can be shorter. By no means does being an RN mean you will make a decent NP, but NP school skips much of the basics. PAs train on a medical model and start from square one. Honestly, they get more standardized and better basic training even though we end up practicing virtually interchangeably. If you do not want to be an RN, go the PA route. It is that simple. There should not by any program out there that offers someone to just go straight to NP.

[BostonFNP, APRN]

Honestly, they get more standardized and better basic training even though we end up practicing virtually interchangeably. There should not by any program out there that offers someone to just go straight to NP.

A few important corrections:

NPs in many states do not simply practice interchangeably.

There are no (none, zero) NP programs that don't have a full RN program preceding the graduate NP work; you must be an RN to do your graduate work towards NP.

[Jules A, MSN]

There are no (none, zero) NP programs that don't have a full RN program preceding the graduate NP work; you must be an RN to do your graduate work towards NP.

Ahhh yes but there are many that only require the degree with zero requirements to ever have worked as a RN so although technically correct rather irrelevant with respect to the original intention of NP programs, allowing us diagnostic and prescribing rights with a brief education due to building on nursing experience. I know I'm in the minority of those who place any value on our RN experience but felt it was worth adding.

[BostonFNP, APRN]

Ahhh yes but there are many that only require the degree with zero requirements to ever have worked as a RN so although technically correct rather irrelevant with respect to the original intention of NP programs, allowing us diagnostic and prescribing rights with a brief education due to building on nursing experience. I know I'm in the minority of those who place any value on our RN experience but felt it was worth adding.

I don't think it is irrelevant to the comment that "NP school skips much of the basics"; it doesn't. Education and experience are fully independent and whether you have 0 RN experience or 30 years of it, the education component is the same (and in fact one could argue that the more contemporary the pre-licensure education the more applicable it is).

I think there is value in RN experience (especially relevant RN experience) , as I am sure everyone does. I don't consider it a requirement for all students.