Are NPs and PAs "Interchangeable"

chillnurse, BSN, RN, NP · May 12, 2014

Probably depends on recruiter and personal experiences. That would be my guess and what I have seen in the past. HBU?

Also, if i was a recruiter and looking into hiring a new grad I would probably prefer a PA over an NP. Don't worry I have my body armor on. I am an np, I say this because of all of the lax np programs online for profit programs. I have also seen a lot of terrible NPs in my practice.

Plus PA education is more standardized.

I know who would have expected me to say that right?

PG2018 · May 12, 2014

As another said, you get a sort of standardized provider when you get a PA. They get a year of scientific education, which is actually very appealing, and a year of rotations in the various medical specialties; IM, Peds, Fam, EM, Surg, Psych, etc. A procedure heavy or surgical practice would seemingly demand a PA. A psychiatric practice would likely necessitate a Psych NP. This is notwithstanding the fact that there are PAs in psych and NPs in surg. It's likely a crapshoot based on the NP/PA's life experience and interview.

In hindsight, I think I would have liked PA school substantially more than my BSN/RN and MSN programs.

TakeBack · May 12, 2014

As another said, you get a sort of standardized provider when you get a PA. They get a year of scientific education, which is actually very appealing, and a year of rotations in the various medical specialties; IM, Peds, Fam, EM, Surg, Psych, etc. A procedure heavy or surgical practice would seemingly demand a PA. A psychiatric practice would likely necessitate a Psych NP. This is notwithstanding the fact that there are PAs in psych and NPs in surg. It's likely a crapshoot based on the NP/PA's life experience and interview.
In hindsight, I think I would have liked PA school substantially more than my BSN/RN and MSN programs.

The question for me is how to recruit. Is it appropriate to recruit for a position SOLELY to one or the other. Do you post the Surgical job ONLY to PAs, the Family Practice SOLELY to an FNP, etc.

allnurses Guide · May 13, 2014

I would not. I post them as NP/PA and then take the applicants on individual experience and training. I have had great NPs and PAs and not so great NPs and PAs. It entirely depended on the individual. Probably overall, I've seen NPs better at dealing with patients initially due to more experience as nurses/in healthcare before becoming an NP. But with experience, I think either is competent. I would probably prefer PA if I was hiring for a surgical position involving OR, simply because NPs just don't get trained in that.

PG2018 · May 13, 2014

I'm sorry. I guess I didn't completely follow. I concur with ghillbert. I think you should recruit both and screen them based on their total package. As ghillbert also said, I would likely prefer a PA for surgery as well. In those instances, you might really limit yourself to PAs.

What I would do is look at your population base. Where are your recruits likely to come from? What schools are they likely to come from? Contact those institutions to see what they're trained in bearing in mind the program administrators at those schools will likely tout their programs as producing "more useful" new grads than they really do.

Riburn3, BSN, MSN, APRN, NP · May 13, 2014

Love this topic.

Most jobs seem to post NP/PA positions interchangably, and the reality of our systems demand for care providers means that probably isn't going to change, especially if you live in an area where their respective scope of practices are along a gray line with each other. If I were you I would actively recruit both and base your choice on who you think would fit in better with you and has the experience you desire. Although in my area PA's tend to stick to the surgical arena or ER, more and more ACNP's are jumping into that field, especially if their RN experience was in OR/ER. Similarly, primary care and family practice seems to be more the arena of NP's, however, there are a couple of PA's I know in the area, and they do fine.

Post the positions together and hire the individual that you think will serve you best regardless of whether or not they're an NP or a PA.

babyNP., APRN · May 16, 2014

Neonatology is one field where I imagine most people would hire a NP over a PA because a PA is a generalist and have very little neonatal focused content, whereas a NNP is required to have at least a year's experience as a RN in a NICU and their graduate program is solely focused on neonates.

There are a few neonatal PA programs poppping up now, but they are a "third" year of school, doing a fellowship after PA school. PAs are successful in the NICU; we have some great ones in our NICU, but comparing a new grad NNP and a new grad PA (with no fellowship) is no comparison, IMHO.

Trauma Columnist · May 16, 2014

Our practice uses the terminology: APN/PA and hires them equally. Again, it depends on the individual. Great topic.

zmansc, ASN, RN · May 16, 2014

I would assume this would be dependent on the scope of practice for each in the state and the job opening. I know one local urgent care likes to have an equal mix of PA/NP/MD. I'm not exactly sure why they feel the need for keeping that balance, but I do know they hire specifically to keep that mix. One large FP group in town considers NPs & PAs interchangable as far as I can tell. In fact I could probably throw in MDs in that group, anyone who is alive, has a script pad and is willing to work for cheap!

TakeBack · May 16, 2014

Neonatology is one field where I imagine most people would hire a NP over a PA because a PA is a generalist and have very little neonatal focused content, whereas a NNP is required to have at least a year's experience as a RN in a NICU and their graduate program is solely focused on neonates.
There are a few neonatal PA programs poppping up now, but they are a "third" year of school, doing a fellowship after PA school. PAs are successful in the NICU; we have some great ones in our NICU, but comparing a new grad NNP and a new grad PA (with no fellowship) is no comparison, IMHO.

This is a great example. I agree that out of the box an NP with this specialty focus in training and RN experience wins hands down.

I still feel that I wouldn't NOT recruit a position excluding one group because, as you said, there are experienced PAs doing it.

I just got an email job listing yesterday for a cardiac surgery position that was "PA or NP"; not many NPs in CTS but still best to keep it as open as possible.

TakeBack · May 16, 2014

Thanks for all your feedback. I'm eager to hear more examples if you have them.