Quote from PMFB-RN
I am neither an NP or a PA. Just a regular RN who works in a very high acuity surgical trauma intensive care unit. Nurses on my unit are expected to (and are trained to) do everything from recover fresh open hearts with ECHMO, IABP, vent, many vaso active drips, PA catheters, ect to taking fresh traumas with every sort of injury, to neuro-surgical patients. We are also on the code and trauma teams and one of us carried the code and trauma beeper all the time. We are also expected to handle the vents on our own, the RTs only come around once a shift.
We have both a PA and an NP on all the time. the PA works days and the NP works nights as well as coverage by surgical residents. I can detect no difference between the job our PA on days does and the job the NP does on nights. We also work with PAs and NPs from the various services from CV surgery, nuero sugery, infectious disease, nephrology and several others. On my unit when an RN needs orders the PA is the first call, except on weekends when the surgical residents cover ( I dread calling for orders on weekends for this reason). I have learned that I can call the the PAs and NPs with problems and they will help me, but when I have to call the MD residents I need to know exactly what I want and in what dosage becuase the first thing the resident is going to ask is "what should we do about it?" or "what do you want?" and they seldom know the dosage needed.
I have decided I want to be one of these highly competent mid-level providers. I have been asking many questions about the schooling required for both. I had about written off PA school because of the pre-reqs required means I would have to go to college for 1-2 years before I could even apply to PA school. However the though of going to graduate nursing school makes me sick. I work with lots of RNs who are getting their masters to be educators or NPs. I see what they have to do. It seems it's (like my RN-BSN program) mostly paper writing and projects. I am under the impression, from talking to many PAs and looking at PA school web sites, that PA school is more competency based. More this is the material you need to learn and there will be an exam type learning. This is MUCH more my style. I have discovered a PA school that only accepts RNs and just about any ADN RN would already have the pre-reqs done (A&P, chem, pharm) for this particular school. I am leaning to PA vs NP for this reason.
If I have arrived at completely incorrect conclusions please enlighten me.
There are a lot of nurses that feel the way you do. We had four RN's in our class. One of the areas of medical experience that any PA school will accept is nursing. Ultimately the decision between NP and PA is multi factorial. There are certain areas that are dominated by on side or the other. For example there are many more PAs working in surgery than NPs. On the other hand there are more PNPs or NNPs covering pediatrics or neonatology than PAs. There are also regional variation. In my city two of the NICUs are PA only and the others are NNP only.
You also have to consider your environment. If I wanted to work at Vanderbilt I would not consider PA. If I wanted to work at Duke I would not consider NP. You have to assess the local market and see what that will support.
Another factor is lifestyle and learning style. Many NP programs can be done part time by working. Almost all PA programs prohibit working while in the program. I can't speak for the educational style of NP programs, but there was very little information that wasn't clinically relevant. Of the 1700 clock hours in my didactic program, about 50 were not directly related to clinical medicine. Even this was related to billing, coding, the history of the PA profession etc.
I can't speak for NP education but PA education is incredibly focused on clinical competency. The guidelines published are derived from surveys of what PAs actually do in practice. The testing done is based on that same data.
The only caveat I would warn you about the school that you are considering is that this is the only PA school that wants you to fine your own clinical sites. In theory they will provide sites, but because of this they are not well thought of in the community. On the other hand I have never worked with one of their graduates and they have a decent first time pass rate. I would urge you to look around at some of the other programs. If you have your BSN you should be within 2-3 classes of most programs.
David Carpenter, PA-C