PA-C or NP? What would you do? - page 2

I am an ADN, with many years under my belt in nephrology, ICU, ER, and M/S. In my current role, I function quite independently/autonomously and I'm quite good at it clinically. One thing this... Read More

  1. Visit  LagunaB} profile page
    2
    Hello and thanks for starting this thread. I am in a similar situation, as I was recently accepted into an entry level MSN-FNP program and also was accepted to PA school. I have done a lot of research on the whole NP/PA thing and really went back and forth for a while. It really seems like they are 2 different paths to a similar outcome.

    I chose PA because I am not an RN already, so PA school is 2 years versus 3 1/2 for NP. Also, I like the notion of learning under the medical model and PA school is said to be about 75% of Med School. Also, the clinical rotational hours are almost double for a PA vs NP. I wanted more hands on clinical training and thought that I would be better prepared as a diagnostician after attending a rigorous PA program. Also, it seems like ERs and Surgeons tend to hire more PAs, whereas NPs seem to work a lot in primary care (I could be wrong about this, it just seems to be the case in CA...correct me if I'm wrong!).

    I may end up in primary care (and actually that is where I feel most led), but wanted the option to specialize, which seems more viable for a PA vs. NP. This is just my opinion. I am sure there are many excellent and challenging NP programs, and I am sure that NPs do specialize, but it just seems that more is required of a Physician Assistant. Also, I was accepted in to FNP program and I am still not sure of the specializing options for Family Nurse Practitioners. I just thought that I would be mostly doing primary care.

    I understand that NPs do have more autonomy in California, yet it seems that most NPs work under a doctor anyways. I would be curious to know how many NPs actually do work independently. Supposedly the education requirements for NPs are changing in 2015. All new NPs will be required to get their DNP, which may add some clinical hours and obviously...more school!! I think that students who enter the program now or soon will be grandfathered in, which made me think that I should get the NP before they add more and more requirements. Also, I was leaning towards the NP because I though I might have better job prospects. Yet, nearly every job posting I've come across asks for either an NP or a PA. Not to mention that PA school is 50K cheaper in tuition alone. The notion that I could finish my education slightly faster and considerably cheaper, and to have the same job prospects, duties and responsibilities really appealed to me. So as of today, I will be attending PA school in the fall!
    BradS and Zaphod like this.
  2. Get the hottest topics every week!

    Subscribe to our free Nursing Insights: Student Edition newsletter.

  3. Visit  Tinabeanrn} profile page
    0
    Wow Laguna B. 50k less! That is amazing . Good luck with school in the fall. It will go by so quick
  4. Visit  TraceyMarino} profile page
    5
    Hi! Something to consider....I too looked at PA vs. NP, and as an RN already, it was a wash time and money wise.

    I do a lot of medical mission trips, and travel extensively. If you are interested in any international work, PA's are only recognized in the US and Canada, where NP's are recognized pretty much world wide. An NP can work in Mexico, Australia, Canada, and all over Europe. PA's are an American invention, where NP's and advanced practice nurses and midwives have been around forever in many other countries. In Australia, the lion's share of healthcare providers are NP's and midwives, not doctors.

    I think PA and nurse practitioner are both a great way to go. There will always be struggle for autonomy, as the AMA and doctors as a whole are lobbying very hard against all midlevels, midwives, NP's, PA's, and CRNA's. They are instrumental in creating the limitations outlined in the ACO language, and will continue to try and thwart the progress of PA's and nurse practitioners.

    Go where you will get a great education, in the least amount of time, for the least amount of money. Then, practice where they appreciate you and treat you well.
    SierraBravo, ICUman, Lisalis, and 2 others like this.
  5. Visit  ghillbert} profile page
    1
    The clinical education advantage of PA seems to be that they do more hours and more varied rotations, but I did extra clinical hours in my MSN (more than required) and was able to choose a variety of areas - I do not feel my clinical experience was limited. Just make sure you choose a program that gives you some flexibility. I do feel that your experience as an RN really makes a difference to potential NP employers - I am interviewing at the moment and my years of ICU experience as a CCRN mean a lot more to them than my 850 hours of clinical during my MSN.

    Edit to say: RE lobbying power, PAs and NPs need to work together and join forces!! The employment outlook is fantastic for advanced practice providers, and there are enough jobs for both types of APP. We are still being lowballed on pay though - many of my graduating class will start at just about the same or even less as a new grad NP than they were as experienced RNs in senior positions.

    At the end of the day, choose a program that suits your needs, and an education model NP/PA that is most marketable in your area, since that varies.
    Tinabeanrn likes this.
  6. Visit  juan de la cruz} profile page
    1
    Quote from LagunaB
    I understand that NPs do have more autonomy in California, yet it seems that most NPs work under a doctor anyways.
    Well, California isn't really known for NP autonomy. There are restrictive laws here...one, NP's need a Standardized Procedure laid out with a physician prior to starting a practice and two, NP's do not prescribe, we "furnish" and a Furnishing License is required prior to being able to furnish therapies and pharmacologic agents.


    In its true sense, the number of nurse practitioners who own a practice with no physician oversight are low compared to the overall number of NP's: http://www.aanp.org/NR/rdonlyres/F7E...tionSurvey.pdf


    The states where true NP independent practice exist are seen in this map in pink:
    http://championnursing.org/sites/def...11.branded.pdf
    LagunaB likes this.
  7. Visit  ProgressiveThinking} profile page
    0
    This is something I've been thinking about as well. Although there are a lot of factors that will come into play, I intend to apply to grad school, but leaving the VA would be difficult (we have the greatest benefits ever). The community college that I did my RN at offers a PA program with a price tag of $3000. If you have a bachelor's degree, they award you a master's degree from a university in Pennsylvania. Not too shabby. The only downside if you CANNOT work during the program. A cal-state about 2 hours away from where I currently live has an FNP program for about 20k, which is not too shabby either considering there are other local schools that run for 60k+. You can also go part-time if needed.
  8. Visit  Akewataru} profile page
    0
    Not to mention, if you go the PA-C route and you want to further your education and become an DO you can go to Lake Erie College of Medicine and do their PA to DO bridge program in three years. I don't know of any physician bridge program for NPs. Correct me if I'm wrong, cause' I learn more when I'm wrong!
  9. Visit  Tinabeanrn} profile page
    0
    Wow. .. that's amazing! I wish I could become a DO in 3 years. I would jump all over that!
  10. Visit  Conqueror+} profile page
    0
    I believe that as APN's gain more autonomy that physicians will start looking for ways to regain ground (read $$). Since they cannot control the wave of NP's their only option will be to focus on scaling back the PA's because they control PA practice. It may sound silly but it's what I would do and I'm a pretty good strategist. PA's will be at a disadvantage because their jobs are literally tied to the physician's. Ours is not.
  11. Visit  core0} profile page
    0
    Quote from Conqueror+
    I believe that as APN's gain more autonomy that physicians will start looking for ways to regain ground (read $$). Since they cannot control the wave of NP's their only option will be to focus on scaling back the PA's because they control PA practice. It may sound silly but it's what I would do and I'm a pretty good strategist. PA's will be at a disadvantage because their jobs are literally tied to the physician's. Ours is not.
    So how do physicians control PA practice if you are such a good strategist?
  12. Visit  Conqueror+} profile page
    0
    Well my being a good strategist has nothing to do with Physician's controlling PA practice they just do. My rationale is pretty basic. Let's say your family's drinking water was in a large container inside your home and one day you saw two holes in it. You couldn't reach one of the holes but you could reach the other. What would you do?
  13. Visit  core0} profile page
    0
    Quote from Conqueror+
    Well my being a good strategist has nothing to do with Physician's controlling PA practice they just do. My rationale is pretty basic. Let's say your family's drinking water was in a large container inside your home and one day you saw two holes in it. You couldn't reach one of the holes but you could reach the other. What would you do?
    What makes you think you can reach either hole?
  14. Visit  Conqueror+} profile page
    0
    It's a straightforward scenario but feel free to go far fetched. The bottom line is that a PA's ability to practice is tied to the Physician who can choose to hire them or not. They are governed by the medical board(physicians) AP nurses are not. To get back on topic I would pursue AP nursing for the reasons stated by myself and some other posters. Good luck with your decision
    Last edit by Conqueror+ on Nov 4, '13 : Reason: sp


Nursing Jobs in every specialty and state. Visit today and Create Job Alerts, Manage Your Resume, and Apply for Jobs.

Top