Interesting Physician Perspective On NPs

Specialties NP

Published

  • Specializes in burn ICU, SICU, ER, Trauma Rapid Response.

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Specializes in Cardiac.
*** (sigh) No it won't be.

Alright, already, I stand corrected, sorry for being wrong. It is strongly recommended but has not been mandated. I researched this more and found I had misspoken, sorry to have been misinformed.

T-Bird78

1,007 Posts

PAs follow the physician model, NPs follow the nursing model. A PA needs a master's and PA school whereas the NP needs a MSN and NP schooling. NPs actually have more education than PAs do, yet in my state PAs could write scripts years before NPs could. NPs can operate independently where PAs can't. I worked with a MD who trusted his PA enough to let him see new pts, preop visits and postop followups, order testing and do CT reviews. Another MD I worked for would only let his NP see established followups and she couldn't order allergy testing or tests beyond CT sinus or CXR. A lot of it depends on the doc. Both the PA and NP I've worked with were great!!

PMFB-RN, RN

5,351 Posts

Specializes in burn ICU, SICU, ER, Trauma Rapid Response.
PAs follow the physician model, NPs follow the nursing model. A PA needs a master's and PA school

*** Actually not the case. A PA can be trained at any degree level, including the associates degree. There are a number of community colleges that offer associates degree RN and PA programs. A lot of PA programs are bachelors degree programs. So far as I can tell there doesn't seem to be the same angst among PAs over the different paths to entry as there is with nurses.

Here is an example of a junior college associates degree PA programs website:

Physician Assistant Program

purplerose3

12 Posts

NPs have a higher salary than PAs. Plus they can join faculty as a professor at a university. The background in nursing, and ability to branch out with their own clinic. I would like to earn my DNP then open an alternative complementary therapy womens clinic :-) This is one that I agree with the MDs on. Come on you nurses...Nurses Rule!!!!!

Lovanurse

113 Posts

Specializes in Community Health.
States differ on what PAs can/ cannot do; ditto for NPs. I believe all (or most) states require PAs to work under a physician, some have the same requirements for NPs; some states don't allow NPs prescriptive authority, but most do; some states don't allow PAs to prescribe.... different states, different rules and scopes of practice. But, generally, NPs have more autonomy and a broader scope of practice than the PAs.

NP's have achieved prescriptive authority in all 50 states.

"By 2006, NPs in all 50 states and the District of Columbia had achieved some degree of prescriptive authority.28 NPs in 11 states may now prescribe drugs independently without physician involvement. The remaining states allow NPs to prescribe drugs with ranging levels of physician oversight. In 34 states, for instance, prescribing NPs must first secure a written prescriptive protocol with a physician. In ten states, physician supervision or collaboration is required only where NPs seek to prescribe drugs.29 NPs in these states are otherwise authorized to practice independently."

http://futurehealth.ucsf.edu/Content/29/2007-12_Overview_of_Nurse_Practitioner_Scopes_of_Practice_In_the_United_States_Discussion.pdf

Specializes in Hospitalist Medicine.
*** Actually not the case. A PA can be trained at any degree level, including the associates degree. There are a number of community colleges that offer associates degree RN and PA programs. A lot of PA programs are bachelors degree programs. So far as I can tell there doesn't seem to be the same angst among PAs over the different paths to entry as there is with nurses.

Here is an example of a junior college associates degree PA programs website:

Physician Assistant Program

That is an exception, rather than the norm. If you check the majority of PA programs, a bachelor's degree is required for entry, along with a host of science pre-reqs as well as required Patient Care Experience hours. It's not like Joe Blow is jumping into a PA program on a whim.

The PA school I want to attend requires an extensive science background and even states that a science/health related degree is preferred. Numerous pre-reqs (Pharmacology, A&P, Organic Chem, Bio Chem, Stats, Calculus, Nutrition, Microbiology, etc.) & at least 2,500 PCE hours to be considered. (Requirement is 100 PCE hours, but students accepted into last cohort all had 2,500 or above). So, in order to get the PCE hours, you would need to be an RN, EMT/Paramedic, Phlebotomist, CNA, PCT, etc.

Also remember that many NP programs have an accelerated RN/MSN if you already have a bachelors in a non-related field. I don't see why people "bash" this with PAs and gloss over the same fact with NP school. (Not saying you are bashing, just in general...)

I would love to see more synergism between the NP & PA role. They fill a much-needed gap in medical care and both play an important role. I think the issue is that the lines of responsibility are so blurred between the two and what a PA/NP can or cannot do varies so much between states, it creates a lot of confusion & misconception with the public.

llg, PhD, RN

13,469 Posts

Specializes in Nursing Professional Development.
"PAs are at the bottom of the medical word. PMFB should become and NP, they are at the top of the nursing world".

The attending and other residents all readily agreed. I thought it was an interesting insight into physician thoughts about mid levels.

I am not an NP. I have a PhD in nursing. My father was a physician. When I was in high school, choosing a career, my father always expressed the same general philosophy as that expressed in the OP above. While other people were encouraging me to go to medical school and become a physician -- my father encouraged me to go into nursing with the expectation of going to graduate school. He pointed out that as a physician, I would be "just another 1 of many." But that as a nurse with an advanced education, I could be at/near the top of my profession (and have more flexibility in my career.)

That's a big reason for my choice of nursing over medicine. I'd rather be at the top of the nursing world, than at the bottom or in the middle of the medical world. With that perpective, it was a very easy choice for me.

I also think that way about some of my current choices: With a PhD in nursing, I can either be near the top of the hospital nursing food chain ... or the middle of the university food chain. (I work for a hospital doing staff development and teach one university course per year for fun and extra cash.)

PMFB-RN, RN

5,351 Posts

Specializes in burn ICU, SICU, ER, Trauma Rapid Response.
That is an exception, rather than the norm. If you check the majority of PA programs, a bachelor's degree is required for entry, along with a host of science pre-reqs as well as required Patient Care Experience hours. It's not like Joe Blow is jumping into a PA program on a whim.

The PA school I want to attend requires an extensive science background and even states that a science/health related degree is preferred. Numerous pre-reqs (Pharmacology, A&P, Organic Chem, Bio Chem, Stats, Calculus, Nutrition, Microbiology, etc.) & at least 2,500 PCE hours to be considered. (Requirement is 100 PCE hours, but students accepted into last cohort all had 2,500 or above). So, in order to get the PCE hours, you would need to be an RN, EMT/Paramedic, Phlebotomist, CNA, PCT, etc.

*** Actually it is the norm. Last time I looked, and its been a couple years, less than half of PA programs were masters programs. The rest were bachelors degree programs with a few associated dgrees thrown in. Also the amount the previousl health care experience required varies tremundously between zero and extensive. Most of the bachelors degree programs do not have science pre-reqs, though the science classes are taken as part of the program.

I wouldn't be suprised to learn that a majority of PA programs are now masters programs but the other degrees would be a large minority and that isn't an exception.

Dixiecup

659 Posts

I work at a federally funded rural clinic. There is one physician on site and me (I am a NP) The physician had a PA student doing clinical with her for 8 weeks. The student was at the end of her first year. I was so amazed at how knowledgable she was! She probably knew more about eval, dx and treatment right then than I do now after graduating, working two years with 20 years nursing experience. They start in with what you actually need to know to work in the real world right out of the starting gate in PA school. I was really impressed with this student. Even after I got my degree and went to work it was pretty much on the job training. I felt like I was not at all prepared after I graduated and had to learn everything by researching as it came up. Just my opinion!

Music in My Heart

1 Article; 4,109 Posts

Specializes in being a Credible Source.
It was definitely intended as a compliment, but the MD stated that an NP is as good as you can get in the nursing world, and PA is the worst in the medical world, but both roles are very similar, so he's insinuating that an NP is not so great after all lol.
Regardless, I think that the top of the nursing world is the CRNA...

Evidence? Look at the pay...

Specializes in Emergency Nursing.
Regardless, I think that the top of the nursing world is the CRNA...

Evidence? Look at the pay...

It's not really about the money, though. My quick guess is that the pay Anesthesia Nurses get is related to responsibility and liability.

Music in My Heart

1 Article; 4,109 Posts

Specializes in being a Credible Source.
It's not really about the money, though. My quick guess is that the pay Anesthesia Nurses get is related to responsibility and liability.

Sure...

not to mention scarcity.

Pretty much top of the scale through all categories, IMO.

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