Interesting Physician Perspective On NPs

Specialties NP

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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 the middel of sign out to the day team including several interns, residents, the chief resident and the attending. After I was done an intern speaks up and says "PMFB you should become a PA!". This was met with a rousing round of "NOooos" & "no way!" from the residents and attending. The intern looked confused. The chief resident leans over to her and says "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.

Specializes in Emergency Nursing.

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.

:)

Specializes in Cardiology and ER Nursing.

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.

*** 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.

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?
Specializes in burn ICU, SICU, ER, Trauma Rapid Response.
very inaccurate. vast majority of PA programs are masters with many prereqs.

*** What is the evidence for this large change?

*** What is the evidence for this large change?

Physician Assistant Programs

170 programs. Eight cert or associates. Another 15 or so Bachelors. The rest are Masters. Most of the Bachelors and Associates programs offer a distance learning masters degree in addition to the program degree.

I really don't think this bickering between PAs and NPs helps either of our fields. Most agree that a few years into practice, the differences between NPs and PAs is minute. I wish the fields were more supportive of eachother.

Specializes in burn ICU, SICU, ER, Trauma Rapid Response.
Physician Assistant Programs

170 programs. Eight cert or associates. Another 15 or so Bachelors. The rest are Masters. Most of the Bachelors and Associates programs offer a distance learning masters degree in addition to the program degree.

*** I believe you but don't see that information in the link you provied. I had already found that site as well but without goig to each school's website I didn't see how you could determine what kind of program they were. They used to list them by state with degree listed after. I notice they don't do that anymore.

What has been the motivation for more and more programs going to the masters degree? Were PAs prepared at other levels shows to inadiquatly prepared?

Specializes in FNP, ONP.

Sorry, all advance practice nurses are created equally. None of them is superior to any other, and I don't know anyone who thinks otherwise except students who don't know any better. We think of ourselves, along with our PA brethren, as well as MDs and DOs, as colleagues. We have different specialties and backgrounds, but we are all peers. This constant need to "rank" people is jejune, and only diffident people feel the need to play that game. Everyone brings something unique to the table. When you are working within a group, you quickly learn how to work together toward everyone's strengths and all that ego nonsense falls away.

Grown ups do not discuss their salaries, how gauche.

I've got news, the coding police, practice managers and risk mangers ultimately out "rank" us all. ;)

Sorry, all advance practice nurses are created equally. None of them is superior to any other, and I don't know anyone who thinks otherwise except students who don't know any better. We think of ourselves, along with our PA brethren, as well as MDs and DOs, as colleagues. We have different specialties and backgrounds, but we are all peers. This constant need to "rank" people is jejune, and only diffident people feel the need to play that game. Everyone brings something unique to the table. When you are working within a group, you quickly learn how to work together toward everyone's strengths and all that ego nonsense falls away.

Grown ups do not discuss their salaries, how gauche.

I've got news, the coding police, practice managers and risk mangers ultimately out "rank" us all. ;)

Very good!

Specializes in burn ICU, SICU, ER, Trauma Rapid Response.
Sorry, all advance practice nurses are created equally. None of them is superior to any other, and I don't know anyone who thinks otherwise except students who don't know any better.

*** If you mean CNM is equal to NP and NP is equal to CRNA then I agree. However they are not all created equally. Some are much better at their jobs than others on an individual level.

I really don't think this bickering between PAs and NPs helps either of our fields. Most agree that a few years into practice, the differences between NPs and PAs is minute. I wish the fields were more supportive of eachother.

agreed strongly. unfortunately, there is lots of misinformation that ought to be cleared up. but our fields more or less occupy the same niche in healthcare with subtle differences. Therefore uniting to meet common goals will almost always be in our best interest.

And on the contrary, those who would oppose our interests would rather have us divided. This would be true for any movement.

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