Interesting Physician Perspective On NPs - page 4

by PMFB-RN 19,863 Views | 96 Comments

I am not an NP. I am a full time rapid response nurse at a teaching hospital. This morning I stopped in to residents office to update the night residents on what had happened with their patients and what I had done. They were in... Read More


  1. 6
    Quote from PMFB-RN
    "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.)
  2. 0
    Quote from SopranoKris
    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.
  3. 0
    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!
  4. 0
    Quote from Good Morning, Gil
    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...
  5. 1
    Quote from ♪♫ in my ♥
    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.
    cardiacrocks likes this.
  6. 0
    Quote from Anoetos
    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.
  7. 0
    Anecdotal indications are that CRNA pay may be getting reduced at some facilities...

    ANECDOTAL

    That said, CRNAs deserve our respect, but AFAIK, their educational requirements are fairly limited as compared with what an NP might choose to undergo, and again, unless I am mistaken, they don't really have prescriptive authority.

    Within the culture, CRNAs rank very highly among nurses, and yes, probably at the top in the opinion of many nurses, but it seems to be a little subjective. The field of practice is pretty narrow for a CRNA as compared with that of, say, an FNP or a GNP. So, who's on top becomes a bit of a matter of judgment.

    I'd be happy to just say they're both up there and leave it at that.

  8. 2
    I was talking with the wound nurse during one of my clinicals and she was actually a former PA who later became an RN and was at that time in school to become an NP. When I was talking to her about school and thinking about either ACNP or PA she said to just forget about being a PA. Her comments echo those of the Residents in the OP's post. Basically she said she was a nobody as a PA and not treated particularly well. As a nurse she has much greater input and commands greater respect.
    Cauliflower and InfirmiereJolie like this.
  9. 0
    Quote from PMFB-RN
    *** 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.
    very inaccurate. vast majority of PA programs are masters with many prereqs.
  10. 0
    Quote from ScottE
    I was talking with the wound nurse during one of my clinicals and she was actually a former PA who later became an RN and was at that time in school to become an NP. When I was talking to her about school and thinking about either ACNP or PA she said to just forget about being a PA. Her comments echo those of the Residents in the OP's post. Basically she said she was a nobody as a PA and not treated particularly well. As a nurse she has much greater input and commands greater respect.
    that sounds really strange, a PA becoming an RN?


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