Hello. I am considering NP and PA school. I have a few years of experience as an ED Tech in a Level 3 Trauma Center in California (busy, but not too intense). Our ED is staffed with PA's no NP's.
I have a few questions about clinical differences between NP's and PA's. I know that PA's seem to have a great ability to work in surgery specialties like ortho, neuro, peds, and cardio surgery. They do pre and post surgery exams, order interprets tests, and prescribe meds (at least in 47-49 states). Are there any NP's on this forum who do this? Are there any in California who can comment?
Second. I know that most PA schools have a much longer clinical component than do NP schools. I have been told it is because NP's already have so much clinical experience as nurses. But can you really compare the two? In our ED, the nurses are not making differential diagnoses, determining etiology of disease, etc. etc., they are monitoring the pt's overall state and response to the treatment ordered by the Physician (or sometimes PA). Therefore, does this experience compare to the rigorous training PA's get in diagnosing?
Part of my interest in medicine is the actual procedures themselves. I want to do chest tubes, central lines, suturing, first assistant surgery, etc. etc. Are there any NP's out there who are doing this?
Finally, I know some people (including some nurses) who deride the "nursing diagnosis" concept. Can anyone offer up a brief rationale for how nursing diagnoses are of value to an NP in clinical practice?
Specializes in PACU, Critical Care, Primary Care, Derm.
Is the Stanford program mentioned earlier online or a typical in class type program? I am considering NP vs PA as well. I have a BS in Nursing and 9 yrs experience (varied, but mostly ICU and PACU). In Tennessee there is a critical shortage of professors to instruct in Nursing Schools. Could I teach with a PA or as a FNP if it is a masters level degree?
Also, let's talk about pay. Does FNP pay better than teaching? I would hate to incur the expense of higher education to find I made the same amount as an RN and now have to pay loans back.
Is the Stanford program mentioned earlier online or a typical in class type program? I am considering NP vs PA as well. I have a BS in Nursing and 9 yrs experience (varied, but mostly ICU and PACU). In Tennessee there is a critical shortage of professors to instruct in Nursing Schools. Could I teach with a PA or as a FNP if it is a masters level degree?
Also, let's talk about pay. Does FNP pay better than teaching? I would hate to incur the expense of higher education to find I made the same amount as an RN and now have to pay loans back.
If you are talking about this program it is in person:
I am not aware of any PA program that has a substantial online portion. As far as teaching the terminal degree for a PA is the Master's. If you want to be a program director many have a DHS or PhD. I believe you need a DNP or PhD to teach NP's but I would welcome correction on this. I am not sure if you could teach a BSN course with an FNP.
As far as pay it will depend on your area. In our market you will take a $10K pay cut to work as an FNP with primary care. Specialty practice will pay better. The primary care pay goes up some but tops out in the $70's. Your mileage may vary. If you are just going into this for the money you may be disappointed.
I agree billing is important once in practice. I just dont think the decision to not become a midlevel should be made on worries about billing.
No PA programs are online. Some have a few classes online but the meat and potatoes have to be in person. ECU, I think, tried an online program and it didnt work.
i am not aware of any pa program that has a substantial online portion. as far as teaching the terminal degree for a pa is the master's. if you want to be a program director many have a dhs or phd. i believe you need a dnp or phd to teach np's but i would welcome correction on this. i am not sure if you could teach a bsn course with an fnp.
as far as pay it will depend on your area. in our market you will take a $10k pay cut to work as an fnp with primary care. specialty practice will pay better. the primary care pay goes up some but tops out in the $70's. your mileage may vary. if you are just going into this for the money you may be disappointed.
david carpenter, pa-c
to teach in a fnp you need a master's degree or doctorate (dnsc, ed. phd). to be a program director you need the doctorate. the dnp is very new and very few actually have the degree today. some dnp were grandfathered in from their nd degrees.
you can teach bsn with a fnp, in fact many assessment courses are taught by fnps.
faculty salaries are almost always lower than a practicing np.
i agree, if you are seeking the fnp for the $$$ you will be disappointed. if you are seeking a stable income with a variety of opportunities the fnp is a great career.
to teach in a fnp you need a master's degree or doctorate (dnsc, ed. phd). to be a program director you need the doctorate. the dnp is very new and very few actually have the degree today. some dnp were grandfathered in from their nd degrees.
how did the nd get grandfathered in to a dnp? at least in colorado it was a three year degree off a non nursing bachelors. the students got a bsn after the first year and then nd after the next two. i have a hard time seeing how that is equivalent to the dnp. in reality from what i remember the state bon refused to recognize it as an apn degree. it still is not recognized here. if you are talking about the case nd then i can see that.
How did the ND get grandfathered in to a DNP? At least in Colorado it was a three year degree off a non nursing bachelors. The students got a BSN after the first year and then ND after the next two. I have a hard time seeing how that is equivalent to the DNP. In reality from what I remember the state BON refused to recognize it as an APN degree. It still is not recognized here. If you are talking about the Case ND then I can see that.
David Carpenter, PA-C
I am not sure about case, I know RUSH grandfathered their ND to DNP. Hard to believe the state BON wouldn't recognize the ND if they recognize the MS. The ND had everything a masters had with a bit more. Remember the DNP is new, degree requirements will vary during these early stages. The most recent suggestions are 3 years full time (36 months) or 4 years (with summers off).
All the NDs I know entered the ND program with a masters degree in nursing.
I am not sure about case, I know RUSH grandfathered their ND to DNP. Hard to believe the state BON wouldn't recognize the ND if they recognize the MS. The ND had everything a masters had with a bit more. Remember the DNP is new, degree requirements will vary during these early stages. The most recent suggestions are 3 years full time (36 months) or 4 years (with summers off).
All the NDs I know entered the ND program with a masters degree in nursing.
That was a far cry from the ND here. I was almost like it was a deliberate attempt by the nursing faculty to alienate every nurse in the state. The way the program worked was that you could only apply if you were not a nurse (ie had a bachelors in another field). It was full time for three years getting a BSN after the first year. They portrayed it as above a MSN. The problem was that you had nurses that supposedly were advance practice nurses who had no nursing experience and were expecting fairly largish salaries. This was also at the height of the last nursing glut so they could not even get jobs as BSN's. The defining moment was when two of the students got into a fistfight in the lobby of a local hospital.
On the other hand the Case program (I believe the rush program was similar) allowed multiple points of entry. You could start as a non RN and go four years. Or as a BSN and go for three years or with an MSN and go one or two years and get the ND. This concept was pretty interesting.
Specializes in ED, Cardiac-step down, tele, med surg.
The length of this thread interested me, and I thought I'd throw my two cents in.
I'm currently an ABSN student, former career Firefighter/Paramedic. Lotsa lame letters after my name.. boring..
To anyone considering a PA or NP, I would have to argue for the NP route solely based on the intense lobbying of the nursing community. I thought about PA school long and hard, it's a route many paramedics often take. The entire PA education was based on the knowledge and respect of former military Corpsman/Medics returning from Vietnam who did not have a comparable career to return home to. That's what is used to be..... Now one could easily argue that it has become the "med school drop-out" option, with many students entering with questionable prior medical experience... i.e. fresh out of school, lame volunteering experience, B.S. in Biology...yawn...
Yeah, some PA's/students will be angry at this post.. But believe me I know PA's/ PA students, came from a big PA state, (Michigan), and have examined the career thoughly... Regardless of what has been said about the growth of the PA profession... The AAPA is up against the battle hardenend, large in number, angry, academic nurse nazi's which are influencing government and health care policy. Best of luck to the AAPA and all my PA friends.. They really aren't very nice...
NP... it's the way to go... Why??? Numbers and lobbying.. Good or bad the nursing community is well organized, powerful, and the nursing schools are handing NP degrees out like they're candy... Rather disappointing, honestly... Most NP programs do not require or waive the GRE, have low GPA requirements
One only needs to look at the new DrNP program at Columbia to see (Columbia requires the GRE and decent grades/experience) where and how the plan to expand NP's and the entire field of nursing is progressing.... Like it or not the NP field is expanding rapidly and aggressively. As the saying goes... if you can't beat em, join em.
Of course if the DrNP is going to be the new standard... maybe MD or DO doesn't look so bad anymore...
PERSONALLY, I THINK THE GRE IS LAME, NOT A VALID MEASURE OF INTELLECTUAL POTENTIAL. NEITHER IS GOING SOLEY ON GPA. SOME UNIVERSITIES ARE MORE DIFFICULT TO GET HIGH GRADES IN. SOME MAJORS ARE MORE DIFFICULT THAN OTHERS, ETC...THERE ARE OTHER FACTORS THAT SHOULD BE REQUIRED OF A CANDIDATE FOR CONSIDERATION FOR GRAD SCHOOL. MED SCHOOL'S A LOT OF WORK, SOME OF IT I THINK IS VERY VALUABLE. SOME OF IT I THINK IS EXTRANEOUS. I HAVE A BACHELORS IN CELL BIOLOGY AND I USED TO WANT TO GO TO MED SCHOOL, TILL I REALIZED THAT THE STUDY OF MEDICINE HAS FLAWS IN ITS PHILOSOPHY AND ALSO IN ITS APPLICATIONS (ALSO WE NEED TO UPDATE THE PHYSICS USED IN BIOLOGICAL SCIENCES). IN MY OPINION IT'S TOO NARROWLY FOCUSED. I CAN UNDERSTAND YOURE FRUSTRATION IF YOU WOULD RATHER STUDY A MEDICAL MODEL PA AND NOT HAVE WORK WITH A PHYSICIAN. I AM GOING TO GO THE NP ROUTE, EVENTHOUGH I HAVE LOTS OF BIOSCIENCE CLASSES, MORE THAN ARE EVEN REQUIRED OF PRE MED STUDENTS. I'M GLAD THAT NURSES HAVE LOBBYED FOR NPS AND I HOPE THEY CONTINUE TO DO SO, BECAUSE IN MY EXPERIENCE I'VE GOTTEN BETTER CARE FROM AN NP. I'M NOT SAYING MDS ARE COMPLETELY USELESS BECAUSE IF YOU NEED A SPECIALIST OR SOMEONE THAT CAN TREAT AN UNCOMMON ILLNESS THEY ARE HIGHLY VALUABLE. THE THINK I LIKE ABOUT THE NP SCHOOL OF THOUGHT, SHORT OF THE SOLE RELIANCE ON ALLOPATHIC REMIDIES, IS THE HOALISTIC APPROACH TO PATIENT CARE. A LIVING BEING IS NOT A MACHINE, THE PSYCHE, SPIRIT, AND SOUL ARE INSEPARABLE FROM BIOLOGY AND DOCTORS SEEM TO FORGET THAT (OR MAYBE THEY DON'T IT).
I HAVE A BACHELORS IN CELL BIOLOGY AND I USED TO WANT TO GO TO MED SCHOOL, TILL I REALIZED THAT THE STUDY OF MEDICINE HAS FLAWS IN ITS PHILOSOPHY AND ALSO IN ITS APPLICATIONS (ALSO WE NEED TO UPDATE THE PHYSICS USED IN BIOLOGICAL SCIENCES).
When I bring this up with some physicians (out of date science), they go berserk. I like to tell them that they don't even believe in how some of the diagnostic machines they use work, lol!
I'M NOT SAYING MDS ARE COMPLETELY USELESS BECAUSE IF YOU NEED A SPECIALIST OR SOMEONE THAT CAN TREAT AN UNCOMMON ILLNESS THEY ARE HIGHLY VALUABLE. THE THINK I LIKE ABOUT THE NP SCHOOL OF THOUGHT, SHORT OF THE SOLE RELIANCE ON ALLOPATHIC REMIDIES, IS THE HOALISTIC APPROACH TO PATIENT CARE. A LIVING BEING IS NOT A MACHINE, THE PSYCHE, SPIRIT, AND SOUL ARE INSEPARABLE FROM BIOLOGY AND DOCTORS SEEM TO FORGET THAT (OR MAYBE THEY DON'T IT).
First of all ALL CAPS IS YELLING mmm bad OK.
Second you probably need to get a little experience before you make these profound statements. I would hang out in the ICU a little and see all the "holistic" healing going on. 99% of all NP's use a medical model and their treatment modalities are not different from the MD's. NP's spend more time with their patients on average, but this is the same kind of care that most physicians would like to give if they were not socked in with the overhead (radiologists or pathologists excepted). Please familarize yourself with such concepts as nursing and therapeutic touch before you go on about holistic medicine:
Specializes in ED, Cardiac-step down, tele, med surg.
First of all ALL CAPS IS YELLING mmm bad OK.
Second you probably need to get a little experience before you make these profound statements. I would hang out in the ICU a little and see all the "holistic" healing going on. 99% of all NP's use a medical model and their treatment modalities are not different from the MD's. NP's spend more time with their patients on average, but this is the same kind of care that most physicians would like to give if they were not socked in with the overhead (radiologists or pathologists excepted). Please familarize yourself with such concepts as nursing and therapeutic touch before you go on about holistic medicine:
Note this is not a bash on nursing, just an example of how fringe players can co-opt a valuable profession and bring disrepute.
David Carpenter, PA-C
i did not know that the all caps thing was taken as yelling, so apologies if you took it to mean that. with respect to hoalistic therapies, perhaps you should familiarize your self more with other non western therapies. some of them are very beneficial, like accupuncture and some herbal remidies for things instead of using mainly pharamacuticals. aryuvedic medicine is supposed to be very cool as well. some western practitioners are also trying to learn other healing arts as well, which is what i'd like to do after getting the NP. it's unfortunate that practitioners in the ICU would attribute all of the healing to chemicals, rather than recognizing that it may be that they care about other human beings and their well being (that thier hearts may have something to do with medicine). i read the quack watch website and I actually thought some of the therapies sounded cool (why not try them in addition to traditional therapies). it is also good to avoid name calling because it discredits the person who calls names, especially in science. science is supposed to be objective, not biased and rude. science should be a process of discovery. western medicine has it's place, but it is not a panacea and there are other healing methods that have been used successfully by other cultures that i think can be beneficial to us. if doctors respect science than they must keep an open mind, because that is what science is about. i truely believe that biology is more beautiful and complex that we think it is. it's bad to think that we know it all. thanks much for your response and no hard feelings.
Green turtle
11 Posts
Is the Stanford program mentioned earlier online or a typical in class type program? I am considering NP vs PA as well. I have a BS in Nursing and 9 yrs experience (varied, but mostly ICU and PACU). In Tennessee there is a critical shortage of professors to instruct in Nursing Schools. Could I teach with a PA or as a FNP if it is a masters level degree?
Also, let's talk about pay. Does FNP pay better than teaching? I would hate to incur the expense of higher education to find I made the same amount as an RN and now have to pay loans back.