Deciding Between RN vs PA.

BluegrassRN · Sep 30, 2010

RN will be faster and more marketable, even in this economy. You can always go for a nurse practitioner, if you wish. NPs and PAs are hired for the same positions (regardless of what PAs would tell you, they do seem to have a chip on their shoulders regarding NPs sometimes).

PA doesn't take much longer, and will give you significantly more earning power, initially.

I guess it's up to you.... I suspect you'd do well and be equally happy or unhappy with whichever choice you make. There are advantages and disadvantages to both, but they are both good careers.

Sorry, that's probably not terribly helpful!

nurseinprogress2010 · Sep 30, 2010

I am a nursing student about to graduate in December. I recently was on a clinical round in the CVICU. I was able to speak with a PA who was helping the cardiac surgeons. She was preparing patients, checking charts, opening, closing, and assisting during surgery. My impression was that a PA has vast opportunities. I would imagine that compensation would also match the level of responsibility she had achieved. If I had the time in life to become a PA, I would have considered that an excellent choice! However, I am very excited about graduating soon as well

nursynurseRN · Sep 30, 2010

I would be a RN NP. It has way more flexibility on jobs your can do as opposed to being a PA.

Nurse Joey · Sep 30, 2010

I have found that PAs have less of a chip on their shoulder, not to say they don't have one, but NPs always seem defensive about their role. As a LVN currently working on becoming a RN, I plan on getting my masters and becoming a PA after I get my BSN. I would like to have a foot in both worlds, doctor and nurse. If you do the research NP and PA are basically the same job with different titles. The best advice is to decide which one fits you the best, not the one that looks best on paper.

StangGang92 · Sep 30, 2010

I would be a RN NP. It has way more flexibility on jobs your can do as opposed to being a PA.

I would actually have to disagree with that, with a NP you need to choose a specialty before you start school (Adult, Family, Neo, ect), but when you are a PA thats it - you can jump from job to job since PA's don't "specialize".

BluegrassRN · Sep 30, 2010

I have found that PAs have less of a chip on their shoulder, not to say they don't have one, but NPs always seem defensive about their role. As a LVN currently working on becoming a RN, I plan on getting my masters and becoming a PA after I get my BSN. I would like to have a foot in both worlds, doctor and nurse. If you do the research NP and PA are basically the same job with different titles. The best advice is to decide which one fits you the best, not the one that looks best on paper.

Meh, I guess it depends on the forums you peruse. I should add I've never met an NP *or* a PA in real life who is persnickety one way or the other about their role. In my area of the country, both perform the same, receive the same pay, and when there is an opening for a midlevel practitioner, it's advertised as "NP or PA".

Joey, have you explored the curriculums closely? Which seems more clinically oriented? I've been recently very discouraged with my BSN coursework, and cannot fathom moving on to an NP tract and writing more theory papers. The PA path seems more and more appealing, particularly as the only area PA program seems more academically and clinically rigorous than the local NP programs. Unfortunately.

n87934 · Sep 30, 2010

Try to find both a PA and NP in your area who will meet with you and and discuss the ins and outs of their field. Offer to treat them to lunch. Also ask if it would be possible to shadow them for a day. I've worked around NP's and PA's and both fields have a lot to offer.

Sparrow23 · Sep 30, 2010

I talked to many RN's that I have worked with and they all tell me that it's better to go towards becoming a Nurse Practitioner. The PA's tell me that skip it all and become an MD. The MDs tell me just leave health care and find something better to do with my life

I am sorry but that just made me laugh!!! All their advice sounds pretty encouraging, huh? Oh the joys of healthcare. :lol2:

I would give you advice myself, but I don't know much about PAs and I'm afraid I would be quite biased as, despite being in a fairly awful workplace, I still love being a nurse. I say research research research, and then go with your gut (and heart). Don't let the burnt-outs and bitter ones discourage you from anything.

Nurse Joey · Sep 30, 2010

Joey, have you explored the curriculums closely? Which seems more clinically oriented? I've been recently very discouraged with my BSN coursework, and cannot fathom moving on to an NP tract and writing more theory papers. The PA path seems more and more appealing, particularly as the only area PA program seems more academically and clinically rigorous than the local NP programs. Unfortunately.

PAs do more clinical hours, and are taught using the medical model. NPs, I believe, receive more teaching in nursing theory. Both are well prepared upon graduation for clinical work. NPs do have to choose a specialty but if you choose to go into family medicine you are trained as more of a generalist like the PA. I personally like the medical model versus nursing diagnosis. Pain r/t recent amputation of left leg AEB pt. screaming "get me my morphine"... DUH! Food for thought; NPs have to do the continuing education like other nurses, but PAs have to do 300+ question exams every 6 years to recert.

ilnurse15 · Sep 30, 2010

I would ask myself, do I want to assist in surgery or act more like an adovcate for patients and then maybe one day become more like their primary care giver? If you like the first option go for the PA, they get to assist in surgery and do some more "Hands in" the patients stuff (Not for me). If you like the second option then become the RN and then maybe the FNP or PNP route. It's all about what you really want to do in the field of medicine. Once you decide that, the choice will become very clear. I am currently applying to GEM and ELMSN programs to become a NP, that's what I know in my heart is the right choice for me. I have a good friend that just became a PA and she is working with a surgeon right now. So think about that before you make any choice.

Remember each program has a pro and a con, but you can always change your mind if you start out as a RN, once you get your PA master's you have to go back for an entire new program. Same with the ELMSN for nursing. Maybe start out smaller with a 12 month RN or BSN and then see if that's really the road you want to take. After that you can always go back for more schooling and in some cases it may actually count as clinical hours or coursework.

I hope this helps!

KatieMI, BSN, MSN, RN · Sep 30, 2010

Just my:twocents::

NP/APN: takes more time, especially now with programs moving to universal doctorate and many of programs require at least some time spent doing bedside nursing as a prerequisite. Requires at least temporary commitment to a specialty, although one can get as many Masters' as he/she wishes or can afford. Most of the studying might be done while working at least part-time. NPs are expected to practice more holistic, person-oriented care with large dose of education and leaning more toward primary care/family care. NPs are able, under certain circumstances and places, to work clinically without supervision. There are numerous opportunities in non-clinical areas (insurance, research, business) with MSN degree, and I believe that we will see much more of them in a few years. Specialty residencies are available, but so far not enforced nor required.

PA: takes less time (about 2 years/program+ 1 or 1 1/2 years of pre-requisites); working while in program usually isn't possible. Curriculum is closer to medical school, and therefore PA's clinical thinking is expected to be more like a doctor's. Better starting opportunities for surgical specialties but the same as ones for NPs for everything else except Anesthesia (PAs cannot practice anesthesia; one has to be RN/CRNA or become AA, which is a completely different story), although PAs apparently can do pain. Officially not able to work without supervision (althoug that's happens practically). So far, a PA can change his/her specialty according to a whim, but it may not be so easy in real life, and there's an emerging and (quite understandibly) strong trend to require residency training in the specialties before employment. PAs have less options for non-clinical jobs.

NPs can become PAs, but PAs cannot become NPs unless they have BSN as undergraduate.

Both areas do not require life-long commitment to specialty or years of "additional training" (often under hellish conditions and for rather symbolic money). Liability, though, is almost as big a problem for mid-levels as it is for physicians.

For me, the main reason for choosing nursing route for becoming a mid-level provider was that it apparently offers more flexibility and options to go ahead/stay put at every moment. I was greatly impressed after meeting a nurse employed as a clinical coordinator while being totally blind - there's not many professional fields where such a disabled person can find satisfactory and well-paid job.