Medic --> ADN --> BSN/MSN

sandnnw, BSN, MSN, EMT-B, APRN · May 26, 2010

I even teach some medic classes and precept students. I am very good at my job and am proud of it. The job really promotes critical and independent thinking, treatment planning, and so on

I believe you have almost answered your own question. The answer may lie within how "independent" you wish to be. If you are use to working under a medical director and like the medical model, then by all means, stick to the MS/PA route. You'll definitely find the rigor, focused "hard" science about which you speak.

I work along side PAs almost everyday. Each of them (

I have military roots and the services tend to really exploit their broad "authority" to push the PA to their maximum benefit. This is true for the corpsman, IDT for the Airforce and combat medic in the Army. As a Paramedic, you can identify with this, esp if you have any peers who have come out of the services. EMTs who come of the military (Iraq/Afghastan) have certainly gotten far more t-shirts than the basic EMT, but they are a bit disappointed when they come out of the military and transition to a state EMT license. They hold BLS/ACLS/BTLS/PHTLS/PALS, but are mostly held back because of out-of-date and liability rules/law that, In my opinion, does not serve the public well.

Sorry to stray, back to your original question. Our faculty told us from day one, they had several missions/goals for us. We were NOT going to be spoon fed, we were going to be taught by TOP specialists in their field, education would be broadly->focused based where appropriate, adult/graduate level (think theory here) and would be expected to pass all national cert exams, plus *prepare* us for a doctorate transition. I attended a Southern Ivy, compliments of the US government, can't speak for others.

Your "teaching" and pride statements spark my curiosity. A lot of emotion/caring here, interesting... Occasionally at the clinic, someone asks the question, "what's the difference between a PA and a NP?" My answer is always the same, I hold out my hand and shaking theirs saying, "My hand is warmer." The PAs just shake their heads and smirk, rolling their eyes, knowing its true. My supervising MD fully agrees with my summation, whispering in my ear, "your right."

Curious of your choice of a Diploma program, why? I would advise caution with this choice. Either route, PA/NP is going to require Bachelors prep, so I assume your have some undergraduate hours (Paramedic work). Be sure you take the time to research all programs and pre-reqs. The PA program may squawk at the RN-Dipl and not recognize the hard work you are about to attempt. Even some NP grad programs may turn their nose up to it, instead offering to "bridge" or take all the equity out of your home to prepare you for the NP program. See where I'm going? It may cost a little more on the front end, to save on the back end. Add it all up before you leap into the RN-Dipl.

From what I have read here, the choice seems obvious...

greatone1210 · May 26, 2010

The best mid-level I have ever met was/is a ACNP and a current NREMT-P. He is a mix of what I aspire to in terms of professionalism and competence. And for the most part, the NPs I have met have all been equally, if not more, knowledgeable than the PAs I have met. But like anything you will have your good and your bad.

I am proud of my job and I will admit that I am very good at it BUT I call my command physician without hesitation if I have a question. I think being good at your job means knowing your limitations and understanding when to "pass the buck". I humbly admit I do not know everything and there is always room for improvement. I am in no way a "paragod". But I do have a strong desire to be excellent at my job for both myself and my patients.

I teach because I enjoy the material and helping others gain a grasp on topics in EMS. My favorite class to teach happens to be Pathophysiology. Granted it is not as in-depth as an undergrad or grad course but I really try to put things together for my students. And everytime I teach, I too learn something new.

My reason for diploma is the program fits my schedule as I cannot quit my job or even cut to part-time for financial reasons. I plan on getting my BSN/MSN from one of the colleges with affiliation agreements with my choice of the diploma program. The really cool thing is my diploma program is associated with Pitt (UPMC). Working in Pittsburgh I know how strong their program is.

DU

sandnnw, BSN, MSN, EMT-B, APRN · May 26, 2010

See, you already have it figured out. Stop with the silly questions, good grief, what are you waiting on???

Funny you should mention Patho. One of my first classes was from a PhD in Physiology from the Medical School next door. She teaches the lecture portion of their intro A&P, manages the lab rats, dry, dry, dry...etc. I was FLOORED when her first slide rolled up..."PhD, RN" a very modest woman in a room FULL of attitudes, ha!

You can do anything you want. Desire, sweat, and a scrap o'luck. I never thought I would make it this far, let alone out of the back of an ambulance.

celclt · May 27, 2010

ditto... medic, (then medical asst) and now RN (ADN) headed to said Southern Ivy (lol) for ACNP school in the fall--you are young = look at all of your options and rock it out!

ivanh3 · May 27, 2010

I am a paramedic who went from medic to ASN to BSN/MSN. I am now an FNP. So I have some insight here.

Don't get caught up in all of the "independent practice" nonsense. Independence and autonomy are two different things, and I believe that just about every state in the union allows for PAs to work at a site with no physical MD presence. Pretty much all states have requirement that PAs have the ability to contact an MD either by phone, radio, etc.

Everybody collaborates. This includes NPs, PAs, and MDs.

So if I am so pro "PA" then why am I an NP? I did not know for sure that I wanted to go into advance practice until after I was an RN. Tons of medics move on to become RNs. It is a very comfortable and natural progression.

So two things I would ask myself:

1) Time and money. The vast bulk of my PA friends did not work during school. There just simply wasn't enough time. It was all on school loans and scholarships. If this is an issue for you then I would consider going the NP route. You can continue to work, and maybe get some help in the way tuition reimbursement while you are an RN working on your HP degree.

2) If that is not a problem, and you really want to go into advance practice, then why waste the time of going through nursing school? Just go to PA school. You will have just as many opportunities (some would argue more opportunities). If you want to specialize then PAs are excellent choices for that. If you want to go into primary/family care then tons of opps there as well. And yes, if you want to practice without a physician on site. You can. If there is a state that says otherwise, please correct me.

greatone1210 · May 27, 2010

I am not concerned with independent practice. I do however care about autonomy, like many of you do as well.

I am very well informed on the roles of mid-level providers in numerous settings. Many of my friends are NPs and PAs. Really there seems to be little difference once you are in the field.

I have applied to a few PA programs, getting in to two of them. But I cannot afford it due to numerous financial obligations. Such is life. But I am not one to just give up on something. Thankfully I found a RN program I can complete while working full-time and I am aware of more than a couple BSN/MSN programs that I can complete while working full-time. That seems to be the ticket needed for me to get where I want to be.

Thanks for taking the time to post,

DU

sandnnw, BSN, MSN, EMT-B, APRN · May 29, 2010

When I refer to "independence" I do so in a far more global sense of the term. I've seen this myself. There is a submissive relationship between the two. Why do you think PAs are called, "assistants" and NPs are called "practitioners?" Remember, I work along side them everyday, and I cherish them and their work, they are my friends.

In "the" top 20 medical schools, I find it interesting, there are 18 associated Nursing graduate programs, only 5 PA programs, two that are new. Many of these Nursing graduate programs have been around since the early 1900s, before the PA/NP model creation. All of these graduate programs have distinguished Deans, tops in their specialities, etc. One of the PA schools are *allowed* an Assoc Deanship (Cornell), and only half has a one full PA Professor, Duke without a Doctorate, who happens to be...a nurse. Upon commencement procession, notice as the schools staffs are marched in...when Duke's Dean called for her candidates to stand, the PAs are included along with all the other mixed allied health. Never will there be a Duke PA Dean.

Yes, in some states, PAs are authorized to open their own practice. I applaud this move. I believe it will be the PA/NP model that will save healthcare tomorrow, and keep us from being a third-world provider.

I really think most folks don't give a flip about this. Both give great care and the pedigrees are very similar. But remember this one little perk, I can always walk and get a job as an RN...any day of the week.

foreverLaur · May 30, 2010

Occasionally at the clinic, someone asks the question, "what's the difference between a PA and a NP?" My answer is always the same, I hold out my hand and shaking theirs saying, "My hand is warmer." The PAs just shake their heads and smirk, rolling their eyes, knowing its true. My supervising MD fully agrees with my summation, whispering in my ear, "your right."

So, if I go the NP route I will be warm and friendly towards my patients and if I go the PA route, I will smirk at my patients and roll my eyes? Warm compassionate providers come from who the person is, not the education that was received. A rude individual is not going to become warm and compassionate from attending NP school and a warm compassionate person is not going to become rude and stone hearted from attending PA school. That's a ridiculous notion.

LoveANurse09 · May 30, 2010

I really think most folks don't give a flip about this. Both give great care and the pedigrees are very similar. But remember this one little perk, I can always walk and get a job as an RN...any day of the week.

touche..

LoveANurse09 · May 30, 2010

So, if I go the NP route I will be warm and friendly towards my patients and if I go the PA route, I will smirk at my patients and roll my eyes? Warm compassionate providers come from who the person is, not the education that was received. A rude individual is not going to become warm and compassionate from attending NP school and a warm compassionate person is not going to become rude and stone hearted from attending PA school. That's a ridiculous notion.

I don't think it was meant so literal..most nursing models include compassion.

foreverLaur · May 30, 2010

I don't think it was meant so literal..most nursing models include compassion.

and what... PA/MD models include the opposite? Being a compassionate person should be on the list of reasons why someone is going into the medical/nursing field. That can't be taught. If you aren't a compassionate person you should look for a line of work outside of providing patient care.