I've been wavering back and forth between three different options for graduate school. The are NP, PA, or MD. Though the MD would be a very inspiring course of study, since I love the science of the human body, the time commitment is a little too much. The NP option may be a good match, since I'm doing a second degree BSN and will have an RN license in 6 months. I think I've been getting valuable exposure to physical assessment, pathophysiology, and pharmacology, though very basic in comparison to graduate study, I'm sure. The PA option seems good also, but it seems like there would have to be much more dependence on the collaborating physician. I'm in CA so laws are slightly different here. A few questions are as follows.
do PAs get more respect and trust in the community and among patients? do PAs generally get paid more? Are physicians more respectful and trusting of PAs? Is PA school more fun? I think I'd probably like a more med school like experience, because I'd really like to tie in my previous science background, which includes molecular understanding of physiological processes. I haven't gotten that deep in nursing school so far. And I'm kind of turned off by certain aspects of nursing, like nursing diagnoses and verbose taxonomy. I do like the premise of treating the whole person and their response to illness. Thanks much!
In my undergrad, as well as my current grad program, we did go deep into microbiology, vesicular transport, the lactate-pyruvate pathway, bio-organic chemistry, the clotting cascade, etc....
I can't remember if you are a nurse yet, but when you graduate and have anywhere from 1-12 patients to be responsible to care for, the important points of micro and biochem come to mind, but the finer points which you're speaking of are left out. When you're compressing your pt's chest so hard you can feel ribs crack, but have a good compression pulse while pushing drugs and fluids in order to get them back, you're not running through the conversion of the pt's metabolism from aerobic to anaerobic in your head. I'm not a physician, but I'm pretty confident that most docs are not House, MD. Unless a researcher or diagnostician, I would venture to guess that with the array of diagnostic equipment and tests available, most physicians do not sit around and try to diagnose on a molecular/chemical level. Say a physician sees an acute brain infarct on CT. He's probably thinking about the inflammatory process and cerebral edema that's headed his way. Not the individual cell and molecular responses that cause those results. It's kind of like "skipping ahead" to the "good part." Today's highly acute medical arena doesn't really allow for it, which is why it isn't focused on in a lot of programs. That's why most nursing schools require prereqs before entry to NS. Too much to study in too little time. If nurses had 8 years of education before practicing, there would be plenty of time for all that. I'm not saying it isn't important, I'm just being the devil's advocate for the practical aspect of healthcare.
JMHO
My ADN program and the prerequisite sciences also focused on breaking things down to the cellular level to understand the human body and its response to illness. Hearing that others are not getting a similar education makes me appreciate it more. Even though we knew a lot more was required of us than across the river at a few other schools. To the OP. The time is going to pass regardless of what you do with it. If you have even an inkling that after another 4 years when you have an NP or PA license you will still de dissatisfied, you really should just bite the bullet and start the MD/DO process. How awful would it be to incur more student loan debt for a grad program/career only to feel that you want to go back for a different degree. Good luck in making your choice.
I certainly learned about bioscience at a cellular level in my bachelor degree. In addition, working and doing postgraduate study in critical care has enabled me to attain more specialized A&P and patho knowledge.
Your basic nursing education, be it BSN or ADN, enables you to act as a BEGINNING practitioner. What you learn from there is up to you.
I'm not a nurse yet, 5 months to go in my accelerated BSN program. I feel that in my program we are not going into depth and maybe it's because it's accelerated. Still I think they could go into more depth with the patho, like the why and how, rather than just memorize this and these lab values are used to diagnose it. Well, what are these values used to diagnose it and how does it have to do with the patho, I often wonder. When someone asks something about it, sometimes the professor will say I don't know, you have to look it up. I had one professor say to us, you don't have to know as much as a physician, blah blah. Well we have to interact with physicians and if we don't know enough as students we get criticized by some physicians and nurses too. In order for me to feel comfortable I need to know why certain lab values correspond to the disease process, etc. I don't like just memorizing things and not understanding them b/c when someone asks me why I don't want to say I don't know, go look it up. And I think it's even worse for students in my program that don't have a biology background b/c they are left memorizing more stuff that they don't understand. When something is understood there is less memorizing and more reasoning and I think it makes a better clinician. For example if a practitioner gives the RN a bad order, the RN should know it and refuse, if they don't know they put their patients at risk. I'm glad to hear your programs were good. And it makes me hopeful for grad school, that these topics will be explored more thoroughly. Thanks much.
Izzy, I felt the exact same way as you. Since I already had a BS in Biology & minor in Chemistry, I knew how shallow the nursing classes truly were. In my case, I've chosen the most rigorously scientific nursing graduate program in my geographical area. I am supplementing the required coursework w/ a few extra science courses. All are taught by PhD's w/in their respective scientific fields & engaged in research, which is important to me. Point is, you can make grad school as rigorous & science focused as you choose in the MN/NP route.
That said, if you have a choice (ie. if you're still young & have the time, finances, and personal freedom), Med School would probably be your best option. If I could do it all over again, it would have been my choice. Since I now have a child, the NP program made more sense. In my region the PA did not make sense (ie. only one program to choose from), since the coursework is actually less difficult than that offered by the nursing program. Also, NPs in my area are completely independent of MDs, unlike PAs. So I felt that becoming a PA would send me back a step. Your area may be different.
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smk1, LPN
2,195 Posts
My ADN program and the prerequisite sciences also focused on breaking things down to the cellular level to understand the human body and its response to illness. Hearing that others are not getting a similar education makes me appreciate it more. Even though we knew a lot more was required of us than across the river at a few other schools. To the OP. The time is going to pass regardless of what you do with it. If you have even an inkling that after another 4 years when you have an NP or PA license you will still de dissatisfied, you really should just bite the bullet and start the MD/DO process. How awful would it be to incur more student loan debt for a grad program/career only to feel that you want to go back for a different degree. Good luck in making your choice.