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 burn ICU, SICU, ER, Trauma Rapid Response.
It probably depends on what area you live but here in Wisconsin there are many more jobs for PAs than for NPs. Whoever it was that said that nobody wants them is badly misinformed. I don't think either one makes more than the other. For example NP and PA who work for the government make the same. The thing I would prefer about PA is that they can work in any area with any age group, in primary or acute care. NPs are fairly limited by what type of NP they are. For example family NPs can see any age patient but usually only in primary care care. Acute care NPs can only do acute care and not primary care. Of course this all depends on what state you live in.
My advice is to do which ever one is fastest for you and gets you working soonest.
It probably depends on what area you live but here in Wisconsin there are many more jobs for PAs than for NPs. Whoever it was that said that nobody wants them is badly misinformed. I don't think either one makes more than the other. For example NP and PA who work for the government make the same. The thing I would prefer about PA is that they can work in any area with any age group, in primary or acute care. NPs are fairly limited by what type of NP they are. For example family NPs can see any age patient but usually only in primary care care. Acute care NPs can only do acute care and not primary care. Of course this all depends on what state you live in.
My advice is to do which ever one is fastest for you and gets you working soonest.
A lot of NPs can work with any age group. They usually specialize in family practice or acute care and I've seen them in emergency rooms as well. I've seen ortho PAs in peds ortho as well. They do tend to be more specialized though.
In the part of Texas where I work there are far more NP's than PA's and have more flexibility in job choices. Our hospital employees 3 NP's but no PA's.
I think it depends on what you want to do. The reason I'm going to go NP is that I want independent practice, which in Oregon is legal. I would shadow both a PA and an NP in your area and see how you felt about their jobs then. As for pay that varies with location and which job is needed more in that area. Good luck with your choice!
I've been struggling with the same decision, between PA/NP and MD. I've decided to go ahead and get my BSN as my bachelor's because it's the most practical. If you don't get into the PA school you want, or the medical school, you still have nursing to fall back on in the meantime...I plan on applying to both PA/NP school after I get my BSN (I'm ruling on medicine because of my beautiful son), and though I hope to be a PA, because I feel I'm more interested in the MEDICAL aspect than the nursing aspect, I like knowing that my options are open.
With a psychology, chemistry or biology degree, I would have severely limited options with only my bachelor's degree if I were to not get accepted at PA school or Med school. With my nursing degree, my options are wide open.
Also, many PA schools are requiring health-care-related work experience prior to admission, so nursing school is your best bet there.
ARE PA REALLY THAT BAD? i heard bad stuff about them, like they dont get pay as much and no one needs them.
I'm wondering if these comments you heard were about medical assistants and not physician's assistants? They are different. Medical assistants do not get paid as much as nurses, and many of them have very hard time finding jobs... at least around here it seems. Regarding the PA vs NP thing, I have heard that in my area some NPs are working as staff nurses because they make more money that way.
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.
Welcome to Allnurses.com
David Carpenter, PA-C
Hello David, so what is the difference in your opinion between you as a medical assistant and a nurse practitioner ?
In eigIn eight states, including Oregon, Washington DC, Washington state, New Hampshire, and many Mountain/Pacific Time Zone states NPs work totally autonomously, and many choose to open their own clinical practice. PA's CAN NOT.
I work in air medical transport as a BSN and a NURSE/NURSE configuration is considered a higher level of care than a NURSE/MEDIC configuration for transport. Also as a transport RN, mind you not even an advanced practice nurse,use medical diagnosis when communicating to our medical control, and not nursing diagnosis. The PA profession was initially developed to use combat medics from the Vietnam war as healthcare providers under a physicians guidence, and they do an invaluble service, but like I said nurse/nurse is a higher level of care.
Just enroll in an FNP/PA program at Stanford University or UCDavis. They have combined both into one program. That is how similar their roles are so don't let some nit picker confuse you. Choose the program that you believe will give you the greatest advantage in being a health care provider in the future, and I wish you the best of luck in your future.
in eigin eight states, including oregon, washington dc, washington state, new hampshire, and many mountain/pacific time zone states nps work totally autonomously, and many choose to open their own clinical practice. pa's can not.
once again there has been a lot of debate. i would suggest looking at this thread:
as far as many. the best evidence is that the percentage of nps and pas who are in independent practice (defined as pa or np owned practice) is around 2% for both professions. for a demonstration of a pa owned practice i would point you here:
i work in air medical transport as a bsn and a nurse/nurse configuration is considered a higher level of care than a nurse/medic configuration for transport. also as a transport rn, mind you not even an advanced practice nurse,use medical diagnosis when communicating to our medical control, and not nursing diagnosis. the pa profession was initially developed to use combat medics from the vietnam war as healthcare providers under a physicians guidence, and they do an invaluble service, but like i said nurse/nurse is a higher level of care.
i am not sure the point you are making here. i will remind you of the origin of the medevac profession:
(although some credit has to go to the flying doctors).
just enroll in an fnp/pa program at stanford university or ucdavis. they have combined both into one program. that is how similar their roles are so don't let some nit picker confuse you. choose the program that you believe will give you the greatest advantage in being a health care provider in the future, and i wish you the best of luck in your future.
unfortunately the stanford program is no longer available:
the davis program now has a separate fnp program as well as an option for rns in the pa program to get their fnp with additional classwork (due to the requirement for an msn to be licensed as an fnp.
PMFB-RN, RN
5,351 Posts
It probably depends on what area you live but here in Wisconsin there are many more jobs for PAs than for NPs. Whoever it was that said that nobody wants them is badly misinformed. I don't think either one makes more than the other. For example NP and PA who work for the government make the same. The thing I would prefer about PA is that they can work in any area with any age group, in primary or acute care. NPs are fairly limited by what type of NP they are. For example family NPs can see any age patient but usually only in primary care care. Acute care NPs can only do acute care and not primary care. Of course this all depends on what state you live in.
My advice is to do which ever one is fastest for you and gets you working soonest.