Anyone NOT have enough exp before NP school?

core0 · Dec 9, 2009

PAs - "Mid Level Practitioners"
NPs - "Primary Providers of Health Care"
Does a primary care PA deliver health care as a "primary" provider? What are the "levels" that the PA is in the "mid" of????
How is the "level of education" related to the level of physician involvement? You seem to be obfuscating two very different things- education and physician supervision/collaboration.
How many NPs are in true independent practice (zero physician involvement)? How many PAs? Do you know the real numbers?

The funnier part is that the person that wrote it lives in Florida.

David Carpenter, PA-C

ANDIELLISON · Dec 9, 2009

The funnier part is that the person that wrote it lives in Florida.
David Carpenter, PA-C

David, what is it about the fact that I live in Florida that you find so amusing. I thought that my post would anger some people and even stated so. If you are suggesting that the function of PA's in the state of Florida is any different than I stated in my post, you are incorrect. According to the State of Florida Dept. of Professional Regulation "A PA may be delegated tasks within his/her supervising physician's scope of practice". No PA in the state of Florida can practice independently. Every PA must be supervised by a licensed physician who assumes responsibilty for all medical services provided by said PA. In fact, in all 50 states, DC and the US territories. PA's can only work with physician supervision. Furthermore the AAPA's definition of the duty of PA's states " Physician Assistants are healthcare professionals licensed to practice medicine with physician supervision".

There is no confusion on my part regarding the education and responsibilities of NP's and PA's. While both are certainly refered to as MLP's, the scope of practice and responsibilities of each profession are vastly different.

I joined this forum to have intelligent discussions with other nurses who are respectful of each other. We are all entitled to our opinions. I certainly did not expect to be insulted by a PA on "allnurses.com".

www.doh.state.fl.us/mqa/PhysAsst/info_faq.doc

http://ssaapa.aapa.org/prepa/pafaq.htm

ANDIELLISON · Dec 9, 2009

PAs - "Mid Level Practitioners"
NPs - "Primary Providers of Health Care"
Does a primary care PA deliver health care as a "primary" provider? What are the "levels" that the PA is in the "mid" of????
How is the "level of education" related to the level of physician involvement? You seem to be obfuscating two very different things- education and physician supervision/collaboration.
How many NPs are in true independent practice (zero physician involvement)? How many PAs? Do you know the real numbers?

Takeback, I see that you are also a PA. What are you doing on a nursing forum?

Trauma Columnist · Dec 9, 2009

Let's be polite and respectful to all posters please.

David - my take on your post was the fact that it is well known that FL has a fairly restrictive practice when it comes to mid-levels. Is that how you meant it? Can you please clarify your post? Thanks.

Andiellison - AN is not restricted to just nurses. As mid-level providers we (NPs, PA, CNSs, CNMs, CRNAs) work together as a team to provide quality pt care. Our scopes of practice do vary greatly from state to state. Just as we have MDs, DOs, chiropractors and other health professionals on AN, we welcome other's opinions as well.

Sometimes it helps to consider other's outlooks and perspectives.

Thanks everyone.

ANDIELLISON · Dec 9, 2009

Let's be polite and respectful to all posters please.
David - my take on your post was the fact that it is well known that FL has a fairly restrictive practice when it comes to mid-levels. Is that how you meant it? Can you please clarify your post? Thanks.
Andiellison - AN is not restricted to just nurses. As mid-level providers we (NPs, PA, CNSs, CNMs, CRNAs) work together as a team to provide quality pt care. Our scopes of practice do vary greatly from state to state. Just as we have MDs, DOs, chiropractors and other health professionals on AN, we welcome other's opinions as well.
Sometimes it helps to consider other's outlooks and perspectives.
Thanks everyone.

All I did was repond to a post that questioned why the writer could advance more quickly as a PA vs a NP. As I stated, I thought a joined a forum for nurses. I will not post again. These two PA's did not like what I had to say and ganged up on me.

prairienp · Dec 9, 2009

takeback, i see that you are also a pa. what are you doing on a nursing forum?

please don't discourage pa or any other from participating in this forum. takeback was asking questions, although i suspect takeback already knows the answers to the questions posted. over the past few years allnurses has become more inclusive and tolerant (a good thing). i continue to read the pa forum, many posters there continue to bash nps, recently compared np to being the taliban and other noteworthy descriptions. with increased knowledge should come an increased understanding. bashing others almost always reflects ignorance and the inability to tolerate change. what type of health care provider do we want to be known as???

Mr I Care · Dec 9, 2009

I am a ADN nursing student and I have done a great deal of research on the requirements needed to bridge from RN-MN. LSU is one of the colleges that I am considering and their RN to MN program requires that a RN have atleast two years of experience before being admitted to the program. For those BSN nurses they require that the nurse have a few hundred hours of practice as a nurse. I hope this help in your decision.

Trauma Columnist · Dec 9, 2009

It is always better to be thought of as a respectful and valued member of the healthcare team. Those that bash or otherwise criticize an entire profession make themselves look small and may find they aren't taken seriously.

core0 · Dec 9, 2009

david, what is it about the fact that i live in florida that you find so amusing. i thought that my post would anger some people and even stated so. if you are suggesting that the function of pa's in the state of florida is any different than i stated in my post, you are incorrect. according to the state of florida dept. of professional regulation "a pa may be delegated tasks within his/her supervising physician's scope of practice". no pa in the state of florida can practice independently. every pa must be supervised by a licensed physician who assumes responsibilty for all medical services provided by said pa. in fact, in all 50 states, dc and the us territories. pa's can only work with physician supervision. furthermore the aapa's definition of the duty of pa's states " physician assistants are healthcare professionals licensed to practice medicine with physician supervision".
there is no confusion on my part regarding the education and responsibilities of np's and pa's. while both are certainly refered to as mlp's, the scope of practice and responsibilities of each profession are vastly different.
i joined this forum to have intelligent discussions with other nurses who are respectful of each other. we are all entitled to our opinions. i certainly did not expect to be insulted by a pa on "allnurses.com".
www.doh.state.fl.us/mqa/physasst/info_faq.doc
http://ssaapa.aapa.org/prepa/pafaq.htm

here is what you posted

crazypremed,
i do understand your frustration but i believe there is a vast difference between pa's and np's. pa's are mid level practitioners who can not practice without a method of contact with a supervising physician. np's serve as primary providers of healthcare. from my perspective, and i may make a few people angry, the difference in the levels of responsibility for each of these professions dictates both the education and experience required to safely deliver care.
i started np school with 20 years nursing experience.

here is the applicable florida practice act:

"64b9-4.010standards for protocols.

(1) an advanced registered nurse practitioner shall only perform medical acts of diagnosis, treatment, and operation pursuant to a protocol between the arnp and a florida-licensed medical doctor, osteopathic physician, or dentist. the degree and method of supervision, determined by the arnp and the physician or dentist, shall be specifically identified in the written protocol and shall be appropriate for prudent health care providers under similar circumstances. general supervision by the physician or dentist is required unless these rules set a different level of supervision for a particular act. the number of persons to be supervised shall be limited to insure that an acceptable standard of medical care is rendered in consideration of the following factors."

my amusement stems from the fact that you describe the "vast" differences between pa and np practice, however in florida, there is virtually no difference in practice. both types of providers are limited to non-scheduled medications, both types of providers have similar supervision requirements including limits on the ability to see dermatology patients. in florida you have a dependent license just like the pas. one advantage of this is that in florida, unlike other states, nps scope of practice is not tied to the specific nursing domain, but instead is tied to the practice agreement with the physician.

in general your post is simply incorrect. yes there are vast differences in the way that pa and np education is conducted. this is in response to the end product. pas are trained in general medicine within the total domain of medicine and surgery. nps are trained in a specific field of advanced practice nursing. in addition you seemed to have confused competency based education with academic degrees.

to respond to the ops original statement which dealt with the ability to move within various inpatient and outpatient medical specialties then depending on the state an np may have a more difficult time. the field of operative surgery is dominated by pas for mostly historical reasons. other areas may prefer one type of provider or another because of state law or local preference. there are states where an fnp certification will allow the np to practice in any area. there are other states where it will only allow the np to practice outpatient primary care medicine (+/- urgent care and nursing homes). ymmv.

david carpenter, pa-c

Editorial Team / Admin · Dec 9, 2009

Thank you, core0, for your breakdown regarding NPs and PAs in Florida. Greatly appreciate you and always value your input about PAs in general.

And, we greatly respect our fellow PA colleagues coming here to add their expert posts about the PA profession. Afterall, we are all here to professionally elevate the individual professions, work together, and deliver the best possible care to our patients.

_____________

Now...

Let's keep to the topic, "anyone not have enough experience before NP school?".

Thanks...

CSam5 · Dec 10, 2009

I realize this discussion is about experience related to NP school but I simply can not resist.

I do not see anywhere in ANDIELLISON's post where she limited her discussion to Florida.Yes, Florida is one in a handful of states that impose heavy regulation of NP's. It is only one of two states, Alabama being the other, who do not allow controlled substance prescriptive authority to NP's. The other 48 states have granted authority to NP's in varying degrees.

On December 09, 2009, the New York Times published an article about NP's. "Numbering roughly 125,000 nationwide, more than 3/4 of NP's train in primary care, making them the largest group of non-physician primary care providers, according to a study by the American College of Physicians". This same article lists the states that currently allow NP's to practice independently, without physician involvement, at 22.

To the person who originally posted, most PA schools will accept students with little or no healthcare experience whereas NP schools require all applicants to be currently licensed as an RN and have several years nursing experience. The education process is very different as are the roles of PAs and NPs. What role you choose to assume depends on how autonomous you want to be.

allnurses Guide · Dec 10, 2009

In the interest of accuracy, Csam5, there are NP schools that accept students without RN experience. Some are traditional programs that accept BSNs right out of school, and others are direct entry. I am a graduate of a direct entry program who works as an NP, but has never worked as an RN. No disrepect intended, but just making sure that the correct info is out there.