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?
Okey so after reading all of these pages. I think I have an idea about what NP/PA's can do can't do compared to one another. But then again the posts went all over the place so I'm not quite sure. Just to make sure I have this right. Basically, there isn't anything a NP/PA can do that their counterpart can't do interms of procedure. Is that correct?
Generally they are the same. NPs are going to be limited by what their state nursing act says. PAs are going to be limited by what their supervising physician can do. Both may be limited by hospital credentialing.
For our readers it is important to correct at least a portion of some misinformation concerning admission into graduate nursing programs as stated, "A BSN is NOT always required to get into a NP program. Plenty of 2 yr RNs go on to NP school as well". This is absolutely not true. One must have a BSN to get into graduate nursing school. Period. ASN's have never and will never "leap" into any graduate nursing program without that BSN degree whether they had to 'bridge' it with another degree or not, they still HAD to earn a BSN before entering the graduate nursing program. Hope this clears up this misconception for others.
We are all working together to provide the highest quality, cost-effective healthcare we are able to for the healthcare consumer, i.e., your family and friends, my family and friends etc. Whether you're a physician with many years of training or a PA or NP, we all have the same goal and it's important to not lose sight of this fact.
Specializes in ED, Cardiac-step down, tele, med surg.
Actually for some MS in nursing programs like UCSF don't require a BSN in particular in order to get into the masters program. But a bachelors degree is always required for admission to the masters programs. There are also direct entry programs that require a bachelors degree with no prior nursing experience.
Specializes in Education, FP, LNC, Forensics, ED, OB.
This is absolutely not true. One must have a BSN to get into graduate nursing school. Period. ASN's have never and will never "leap" into any graduate nursing program without that BSN degree whether they had to 'bridge' it with another degree or not, they still HAD to earn a BSN before entering the graduate nursing program. Hope this clears up this misconception for others.
This is not exactly true.
As pointed out above, some students do not attain a baccalaureate degree in the course of their ADN-MSN studies in some programs. Graduates will earn an MSN in the graduate area of study they pursue.
And, not all programs bestow the BSN in their programs before conferring the MSN.
Specializes in Stepdown/IMU, full-time Night shift charge.
The University of Southern Mississippi does not require or award a BSN in their RN-MSN program. The following directly quoted from the site (http://www.usm.edu/nursing/ . Click on Masters of Science in Nursing, then scroll down) :
"The RN to MSN is an accelerated program which allows qualified registered nurses to take a specified number of upper division nursing courses and move directly to graduate courses in a chosen specialty. Students in this program do not receive a BSN."
I graduated from DUKE's acute care nurse practitioner program. My clinical rotations were as follows: Neurosurgical intensive care, trauma (critical care and floor), renal (intensive care), internal medicine, and heart failure. I did over 900 plus hours over clinical time. Physician assistants (licensure title, not degree conferrment title) require a physician's co-signature on almost ALL orders and require cosignature on prescriptions. Nurse practitioners require a collaborative not SUPERVISORY physician agreement. Nurse practitioners can definitely open independent clinics. In regards to practicing medicine vs nursing, I think thats a little assinine. If I can diagnose, prescribe, and treat, that's medicine.
Specializes in ED, Cardiac-step down, tele, med surg.
I think that NPs do have more independent practice where PAs are physician extenders and thus cannot function without the physician. And there is nothing wrong with that and collaboration with physicians as an NP is necessary also. Collaboration with other professionals on the part of physicians is necessary and beneficial also. Health care is about collaboration so that the patient gets the best care. Providers have somewhat different roles and it shouldn't be about power and ego so much.
I graduated from DUKE's acute care nurse practitioner program. My clinical rotations were as follows: Neurosurgical intensive care, trauma (critical care and floor), renal (intensive care), internal medicine, and heart failure. I did over 900 plus hours over clinical time. Physician assistants (licensure title, not degree conferrment title) require a physician's co-signature on almost ALL orders and require cosignature on prescriptions. Nurse practitioners require a collaborative not SUPERVISORY physician agreement. Nurse practitioners can definitely open independent clinics. In regards to practicing medicine vs nursing, I think thats a little assinine. If I can diagnose, prescribe, and treat, that's medicine.
Since you trained at the home of the Physician Assistant Profession I am sure you can provide citations for the claims that you made. Let me help you. From the NC regulations:
"Q: In what form may PAs make inpatient chart entries?
A: A supervising physician (primary or back-up) is not required to co-sign physician assistant charts. However, PA entries into inpatient charts (hospital, long-term care facilities) must comply with the institution's rules and regulations. This means that any given supervising physician, medical practice, hospital or medical facility is free to impose its own guidelines, including co-signing of patient charts, and the physician assistant is expected to comply with that physician's or institution's rules and regulations."
For prescriptions:
"(e) Any prescription written by a physician assistant or order given by a physician assistant for
medications, tests, or treatments shall be deemed to have been authorized by the physician approved by the Board
as the supervisor of the physician assistant and the supervising physician shall be responsible for authorizing the
prescription or order."
Hmm lets see what it says about NPs:
"The supervising physician has provided to the nurse practitioner written instructions about indications and contraindications for prescribing drugs and a written policy for periodic review by the physician of the drugs prescribed"
So it does seem that in NC (the state you trained in) NPs do have supervising physicians, PAs can write notes and prescribe without cosignature.
If you would look back on the 27 pages of this discussion you would find that the claims that you have made, have been made before and refuted before. For more authorative information than what you have been previously given I would invite you to look at the Duke PA web site:
Interestingly the number of PAs that practice independently is almost exactly the same as the number of NPs that practice independently at 2%. For those of you that haven't looked at it Advance for NPs is a helpful resource.
For our readers it is important to correct at least a portion of some misinformation concerning admission into graduate nursing programs as stated, "A BSN is NOT always required to get into a NP program. Plenty of 2 yr RNs go on to NP school as well". This is absolutely not true. One must have a BSN to get into graduate nursing school. Period. ASN's have never and will never "leap" into any graduate nursing program without that BSN degree whether they had to 'bridge' it with another degree or not, they still HAD to earn a BSN before entering the graduate nursing program. Hope this clears up this misconception for others.
We are all working together to provide the highest quality, cost-effective healthcare we are able to for the healthcare consumer, i.e., your family and friends, my family and friends etc. Whether you're a physician with many years of training or a PA or NP, we all have the same goal and it's important to not lose sight of this fact.
Thank you.
Actually that is not true. I am in the graduate program at UMASS -Worcester, and if you are an RN with an ADN you can enter the MSN program at UMASS-Worcester without first getting your BSN as long as you take 1 or 2 extra classes (once in the MSN program) concerning Community Health Nursing and Ethics/Legal aspects. It's right in our course catalog. Just look at our web site http://www.umassmed.edu I think that no one can make general statements about anything related to nursing, grad school programs, etc...because there are always exceptions. Just a thought. :)
Specializes in Critical Care, Emergency, Education, Informatics.
Actually that is not true. I am in the graduate program at UMASS -Worcester, and if you are an RN with an ADN you can enter the MSN program at UMASS-Worcester without first getting your BSN as long as you take 1 or 2 extra classes (once in the MSN program) concerning Community Health Nursing and Ethics/Legal aspects. It's right in our course catalog. Just look at our web site http://www.umassmed.edu I think that no one can make general statements about anything related to nursing, grad school programs, etc...because there are always exceptions. Just a thought. :)
you're very right. Just about the time I think I've got something cornered, I find an exception to a rule. :) I just wish I could remember that when it counted. :)
hi guys, sorry im new to this forum so don't get mad at me if i ask stupid questions. okay here's the deal i did a lot of research but opinions are always different so i decided to ask nurses out there or students who are going to enter the nursing field. i'm a student right now and i need to declare a major either psychology or nursing. i've done the pre req for nursing school also and i decided what i field i want to get into which is nursing or physician assistant. i would like to hear your opinions between which field would be a better job outlook between PA AND NP? and also who gets pay more and ARE PA REALLY THAT BAD? i heard bad stuff about them, like they dont get pay as much and no one needs them. WHEN IT COMES TO NP is it really worth it, please answer my question i only have 2 months left to transfer to a nursing school or 4 year university. thanks alot
core0
1,831 Posts
Generally they are the same. NPs are going to be limited by what their state nursing act says. PAs are going to be limited by what their supervising physician can do. Both may be limited by hospital credentialing.
David Carpenter, PA-C