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?
I too am thinking of doing a PA-C program...that is a ADN program PA certification.....I am currently a LVN and was thinking of going RN because I felt that could be the ladder for me to NP but after considering that the prereqs for community college are the same for RN i figured I might as well skip over to PA......As far as the degree level....I feel its ignorant to believe that based off of someones general education which is all the BS and MS are....its dumb to say that someone who takes the same program...yes people the program is the same no matter what level you take it at....is of less competency to work as a PA.........of what us is all that extra class work ....non related to medicine.......I don't need to know Philosophy to diagnose a patient....really? I do understand this.....if i get this degree as a PA-C in ADN then in order toi move up the ladder further I would have to continue my education based on the BS and MS......look it up......it is explaned that the PA program is the same at any level....think about it....
I've just started a NP program in Alabama and a friend of mine has chosen to do PA. I've not found much differences in the duties, but the difference lie in to what extent you can do them. A NP license allows him/her to pursue their work under their own license; however, a PA is kinda work under a MD. For instance, a NP can open up his/her on practice, legally, as well as bill for his/her own service in most states. And, a NP CANNOT practice with an associate degree. Although a NP can open up his/her own practice, he/she will have to have a MD to come into the facility so often to do "paper work" sort of like an auditor. PAs cannot open up their own practices. To add, I cannot say that a PA with an associate degree is not skillful bc working in the field of nursing, there are a lot of associate degree nurses who have gotten additional certifications w/ extensive medical background in ICU and they are awesome, referring to being a good resource for all nurses. Moreover, I have often seen medical resident rely on them. So, I think skills come from exposure. Which ever you do, get a lot of exposure and you'll do well at either. Hope this helps.
This isn't true. There are some states that allow NP's to practice completely independent of physician oversight - meaning NO chart audits, etc! Most states won't allow NP's to practice independently. PA's must be supervised by a physician in every single state, but they can definitely own a clinic in some states.
Specializes in ER and family advanced nursing practice.
this isn't true. there are some states that allow np's to practice completely independent of physician oversight - meaning no chart audits, etc! most states won't allow np's to practice independently. pa's must be supervised by a physician in every single state, but they can definitely own a clinic in some states.
pretty much every state allows pas to work without a physician on site.
a pa is allowed to "own" their clinic in every state. a janitor can "own" a clinic. no titles needed to own. just need the cash.
which is scary, considering someone can become an np with no previous rn experience and only 500 clinical hours
yes. i believe it is 665 hours, but yes still scary. there are several "direct entry" np programs around now. two years if you have a bachelors degree. that, in my mind, completely defeats the part about the decreased number of science and clinical hours for nps is due to the candidates rn background.
how can a new grad direct entry np seriously be compared to pa new grad who has taken heavy pre-reqs, the first year of pa school studies, then followed by 2000+ hours of relevant clinicals?
PAs don't commonly work in a NICU. However, PAs can do a residency in neonatology. Here is a description of the 12 month residency.
"The curriculum is designed to provide comprehensive training in areas that may have only been superficially covered during basic PA training. There are two components to the training program. The didactic portion includes lectures on neonatal physiology and pathophysiology and clinical conferences that provide an intensive educational experience for the participants. The clinical curriculum includes 12 months of rotations through the medical services at the Kentucky Children's Hospital. Participants will participate in the care of newborns in the "Well Baby" Nursery and in the Neonatal Intensive Care Unit (NICU), as well as, Neonatal Follow-up Clinic, Ancillary Service (PT, OT, Nutrition), and other clinical services (Pediatric Radiology, Pediatric Surgery, Cardiology, etc). PA residents are expected to take "in-house" call in the NICU."
Typically, PA duties while in a residency are similar if not identical to a PGY-1.
If a PA wants to work in "acute care," it is very doable to get over 1,000 hours in acute care alone in a PA program while getting a generalist education on top of that.
PA's are making their way into the NICU's. I think their is maybe one neonate residency for PAs- correct me if im wrong.
I have a friend who went to PA school, she got to scrub in 7 times their whole month surgical rotation and got to close 4 of those times. She also did her family practice rotation and spent 3 minutes with the patient then the dr. would come in and she would then shadow. She is in a peds practice now and is very competent as far as I know. But she could be a surgical PA if she wanted to be.
Just my experience that everything isn't as 'green" on the other side as it made out to be.
pretty much every state allows pas to work without a physician on site.
a pa is allowed to "own" their clinic in every state. a janitor can "own" a clinic. no titles needed to own. just need the cash.
yes. i believe it is 665 hours, but yes still scary. there are several "direct entry" np programs around now. two years if you have a bachelors degree. that, in my mind, completely defeats the part about the decreased number of science and clinical hours for nps is due to the candidates rn background.
how (without laughing) can a new grad direct entry np seriously be compared to pa new grad who has taken heavy pre-reqs, the first year of pa school studies, then followed by 2000+ hours of relevant clinicals?
no, pa's can't own clinics in every state, they can't do it in texas. just b/c a physician isn't on site, doesn't mean the midlevel isn't being supervised. there is not one single state where a pa doesn't require a supervising physician. there are something like 14 states where np's aren't required to have a supervising physician. in new mexico, np's have been practicing completely independent for years. btw, their patients have done very well.
i don't think np's should be allowed to work independently until they have 5 years of full time nurse practitioner experience!
PAs don't commonly work in a NICU. However, PAs can do a residency in neonatology. Here is a description of the 12 month residency.
"The curriculum is designed to provide comprehensive training in areas that may have only been superficially covered during basic PA training. There are two components to the training program. The didactic portion includes lectures on neonatal physiology and pathophysiology and clinical conferences that provide an intensive educational experience for the participants. The clinical curriculum includes 12 months of rotations through the medical services at the Kentucky Children's Hospital. Participants will participate in the care of newborns in the "Well Baby" Nursery and in the Neonatal Intensive Care Unit (NICU), as well as, Neonatal Follow-up Clinic, Ancillary Service (PT, OT, Nutrition), and other clinical services (Pediatric Radiology, Pediatric Surgery, Cardiology, etc). PA residents are expected to take "in-house" call in the NICU."
Typically, PA duties while in a residency are similar if not identical to a PGY-1.
If a PA wants to work in "acute care," it is very doable to get over 1,000 hours in acute care alone in a PA program while getting a generalist education on top of that.
Considering the fact that NNP have several years of experience with neonates before even going to NNP school, I would HATE being a PA going up against that!
No, PA's can't own clinics in every state, they can't do it in Texas. Just b/c a physician isn't on site, doesn't mean the midlevel isn't being supervised. There is not one single state where a PA doesn't require a supervising physician. There are something like 14 states where NP's aren't required to have a supervising physician. In New Mexico, NP's have been practicing completely independent for years. BTW, their patients have done very well.
I don't think NP's should be allowed to work independently until they have 5 years of full time NURSE PRACTITIONER experience!
no.....but I can own the clinic holding company that hires me AND a doc....I live in Texas.
Considering the fact that NNP have several years of experience with neonates before even going to NNP school, I would HATE being a PA going up against that!
On the other hand the NNP student will get around 600 hours as an NNP student. I know of at least one PA program where students get at least 600 hours of NICU time in addition to the hours they get in peds and the rest of the required PA rotations. There are any number of programs where it would be easy to get 500-600 hours of NICU time. Its a very different model and the units that use PAs have developed a very extensive orientation just like those that use NNPs do.
I was just out in Cali at a wedding and the hospital where my aunt works as a PA in the NICU. She was a nurse in the NICU for 12 years before going to PA school and opted to do all her electives in PA school in the NICU. Her NICU clinical hours far exceeded that you gain in a NNP program and, like said before, that is in addition to being trained in all areas of medicine, including pediatrics.
honeebearLVN
1 Post
I too am thinking of doing a PA-C program...that is a ADN program PA certification.....I am currently a LVN and was thinking of going RN because I felt that could be the ladder for me to NP but after considering that the prereqs for community college are the same for RN i figured I might as well skip over to PA......As far as the degree level....I feel its ignorant to believe that based off of someones general education which is all the BS and MS are....its dumb to say that someone who takes the same program...yes people the program is the same no matter what level you take it at....is of less competency to work as a PA.........of what us is all that extra class work ....non related to medicine.......I don't need to know Philosophy to diagnose a patient....really? I do understand this.....if i get this degree as a PA-C in ADN then in order toi move up the ladder further I would have to continue my education based on the BS and MS......look it up......it is explaned that the PA program is the same at any level....think about it....