Best route to NP?

zoidberg, BSN, RN · Jan 29, 2012

go to PA school if you know you want to function as a mid level and you have a Bio degree.

MIRN923 · Jan 29, 2012

The reasons PA school does not appeal to me are twofold...

First, a PA must work under the supervision of a doctor--I would like the option to have a bit more autonomy in a practice.

Second, a PA is a terminal degree. It seems like there are more advancement opportunities as a NP than as a PA.

I'd love it if you elaborated on your thought though or if anyone could share info with me regarding this.

zoidberg, BSN, RN · Jan 29, 2012

in many states PA's and NP's have very similar scopes of practice and autonomy. When you say "autonomy" I am assuming you do not want to own your own practice, but want to be able to see patients, diagnose, prescribe meds, etc. without an MD watching your every move. As a PA, you can do this. A PA can operate without an MD in the room or building, they must be in the same practice, available for help if needed(phone call works), and the MD is ultimately responsible for the PA's actions.

Unless you are in a state that allows NP autonomy in its most complete form like Arizona and you plan on opening your own practice... a PA can do what you want to do.

Now your mention of the PA as a terminal degree, i will explain. A PA is a national certification, which requires education, in most cases a Masters degree. An NP is a plethora of certifications that is hard to keep up with and ever changing, and, in most cases requires a masters degree. Being an NP and having the new Doctor of Nurse Practice degree will not provide you with any advancement opportunities that you could not have as a PA, unless you get more education in nursing to shift roles. As a practicing clinician, for the most part a PA and an NP is equivalent. The DNP does not make NP's better than PA's... all it does is make NP education take longer, cost more, and adds some research, ethics, law, and theory courses, rarely if ever adding to the NP's ability to treat patients.

As far as scope of practice, a PA is more flexible. You can work in any field you wish if you find a hospital, practice, or physician who is willing to train you and give you a job. As an NP, if you get your FNP certification, you cannot leave family practice and decide to do work in the ICU. If you are a Psych NP, you cannot decide to go work in L & D. A PA can do this. As an Example, if an NP wants to work in the ER, they must get the right NP education to do this. With all the types of patients that come in the door, not all NP's can see every patient due to each type of NP's scope of practice being limited to a certain population. A PA is trained as a generalist and is exposed to many areas before completing the degree.

And also, in many parts of the country, PA's are more desirable to hire than NP's. It sucks, but thats the way it is. In your position, as well, going from a non nurse directly to an NP defeats the entire purpose NP's were created: build on years of nursing experience and take the next step to diagnose and treat. NP education is IMO not adequate to produce a clinician out of someone who has never interacted with patients save their BSN clinical time. However, the PA education is designed to do this. Go talk to a PA about their education-I bet they will tell you that it prepared them very well for their role. NP education is not as reliable, and while there are many great programs, a PA is going to get the job over a NP from a direct entry program or an NP with very little experience.

sorry its so long! ill stop now...

MIRN923 · Jan 29, 2012

i really appreciate all that wonderful information you wrote! i do still think that np is a profession that i am more drawn towards. for my background, it makes the most sense... after graduating with a ba in biology, i went on to do teach for america, teaching chemistry to high schoolers. i therefore don't have any volunteering or shadowing experience under my belt yet--and most pa schools that i looked at required anywhere from 500-2000 hours of that type of experience.

does this make me underqualified for either profession? possibly... i'll refer back to my original post:

"

1) will getting a masters through a mep make me overqualified with too little experience to be hired into a private practice or a hospital right out of school?"

i would definitely consider just getting a bsn (rn) and working in that role for a couple of years before going back to school for a masters to become an np. the problem is that i would much rather only apply to one school right now... get the whole thing done in three or four years and be a practicing np. plus, with those mep's, most peoples' biggest gripe seems to be the lack of clinical experience mep students come out of their programs with. however, most mep programs allow the student to attend their masters classes part time while working part time as an rn, thus gaining the needed clinical experience.

so really... i do totally appreciate your reasons for going the pa route. thank you for helping me understand that a bit more... but i do think that my options at this point are between a mep program or an accelerated bsn program, working, and then going into a np program.

between those options... knowing what i want to do, are there any other opinions?

zoidberg, BSN, RN · Jan 29, 2012

your welcome! ha you would think i was going to PA school... but i am accelerated bsn student with plans to go to grad school... so to be honest that is a fine plan too. I went this route because my undergrad bio GPA was not that great i was in no mood to retake classes and be a CNA for a year, so this seemed like a good option. Since most NP programs allow for online courses and using a local preceptor, the accelerated bsn followed by an online NP degree is quite flexible. The flexibility is the main reason i chose nursing. Though my description seems anti NP, there are tons of options for APRN's and many NP's are very satisfied with their work. Don't worry about getting in to school. If you do an acc BSN and get a solid GPA you'll have no problem getting in to an NP program.

KCEG · Jan 29, 2012

Hi Sam,

it's nice to see your post. My brother-in-law is a PA, formerly a respiratory therapist, and he and I have been talking about the pros and cons of PA vs NP, as well.

As a PA, he was very well trained in the sciences in the medical school model, which makes sense, since his training was done in a school of medicine.

The main item that PA's push over NPs, from what I can see, is that they feel like they are better-trained out of the gate in medical science and patient assessment (which, undoubtably, they are). It appears that this doesn't translate into making a whole lot of difference when looking for work, however, or practicing clinically, from what he tells me.

There's a lot of talk about ease of movement from one area of practice to another as a PA, but if you go the FNP route, you can work in pretty much any environment you want to, whether that be primary care in an office setting, the ER, as a hospitalist, or in a free-standing doc-in-a-box "urgent" care. If you decide to move from family practice to neonates, it is true that you will need additional education, but I don't think this is likely for most people.

An added bonus of NP certification is that, in a lot of states, you can open your own practice if you choose to, referring more complex cases to a specialist, just as Family Practice Doc's do.

There seems to be a contentious relationship between physicians and NP's in the national media, especially between accrediting bodies, but I think this stems primarily from MD's being threatened by NP's gaining increasing autonomy in clincal practice, making some physicians worry about competing with NP's. In day to day practice, this tension isn't usually present and doesn't seem to be an issue, at least in the part of Texas that I currently reside in.

Good luck in your decision, and in your applications!

Kind Regards,

KCEG

KCEG · Mar 4, 2012

I don't know if anyone read my above post, but I learned today at Vanderbilt's Open House that FNP's who choose to work as a hospitalist in TN are working outside their scope of practice, which will be an issue if a situation arises in which that practitioner is involved in litigation.

I wanted to correct my post from 1/29 where I said that a Family Nurse Practitioner could practice as a hospitalist.

The FNP and ACNP Program Director's both spoke to the fact that NP's can find themselves operating outside their scope if they're not careful, which can result in unpleasant consequences from both a state BON and/or the legal system.

FNP's are sometimes hired into hospitalist positions where I live, and I have first-hand knowledge of FNP's who function in this capacity, but they may face the possibility of being at odds with the BON in relation to their training and subsequent scope of practice . As always, it's imperative to know the laws and regulations of the state BON where you choose to practice.

I'm just starting my voyage into the application cycle, and I'm trying to learn all I can about the pros and cons of each area of practice.

Good luck to everyone on this same journey.

Sincerely,

KCEG

MIRN923 · Mar 4, 2012

I'm in the same boat as you are. Would you consider comparing notes on variouis areas of practice?

Best route to NP?

In my situation, your advice would be: