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?
What school is this? I researched many programs. There is often no written requirement for clinical experience, so those 4.0 undergrads can slide in to their master's program right away, but after talking to advisors, it became clear that experience is weighted very heavily along with GPA and GRE/MCAT scores. My #1 choice of schools accepts about 10% of their applicants. Two thirds don't even get an interview. Another program even requires 3000 hours of clinical experience up front before you can apply. The admissions staff I spoke to said I would be very competitive if I had some clinical experience, but without it, I probably wouldn't even get an interview. I got my undergraduate degree in an unrelated field 10 years ago with a 3.6 GPA, so that's a factor too.
The requirements for PA programs vary broadly. In general about 1/3 require healthcare experience (HCE), 1/3 prefer HCE and 1/3 do not address it. That being said the average for martriculants last year was around 2.5 years of HCE. So even with a few direct entry programs the average student has a fair amount of HCE. Usually local programs tend to mirror each other since they are in effect in competition.
What this really addresses is that there is no way to accurately forecast what HCE brings to the table. There are some programs that use a points based system where RN/Paramedic/medic is worth more than MA for example. But for the most part hours are hours.
What makes the sysytem work is the checks and balances. The schools have to provide an education that covers all the topics in the blueprint and their students have to pass the PANCE. If the programs don't adhere then they end up on probation or are closed down. So each program develops methods to ensure that their students get the education needed to cover the blueprint and pass the PANCE. They do this knowing the type of student that they have recruited. Programs can tailor their educational environment to play to the strengths and weaknesses of the students. This is one thing that many applicants fail to understand. The program knows best what kind of students work in their environment. This may lead to favoring one category of students vs. another.
I can think of at least one program that actively discourages students with HCE. That program which is a USN&WR top 10 program (for whats that worth) is also the longest program out there. On the other hand the program that I think is arguably the best program recruits essentially from one county in California. If you don't live in that county you have very little chance of getting in. While some might view this as unfair, the program views it as their mission.
Bottom line the variability of programs means that there is probably a program out there aligned with a given students interests and experience. On the other hand if the student is geographically restricted then there may not be.
the number of pa schools that don't require health care experience are about the same as the number of np programs that don't require any rn experience. just because it isn't required doesn't mean it isn't highly factored in.
great grades and great test scores don't always mean you get in either, just like health care experience doesn't guarantee you will get in. things like letters of recommendation and essays pay a large role too. even then, there are a lot of applicants with great everything and schools still have to pick between the cream of the crop. even amazing applicants get denied every year.
i have participated in the admission process several times. letters of recommendations and essays are almost worthless in selecting the applicant. the only time they are of any value is if the recommendation(s) is bad, because what applicant in their right mind selects a bad reference. the essay can be of value if written very poorly. the reality is, if you are applying for a graduate program gpa, hce, and interview skills are the key to success.
i have participated in the admission process several times. letters of recommendations and essays are almost worthless in selecting the applicant. the only time they are of any value is if the recommendation(s) is bad, because what applicant in their right mind selects a bad reference. the essay can be of value if written very poorly. the reality is, if you are applying for a graduate program gpa, hce, and interview skills are the key to success.
when i did interviews we looked at letters. mostly we looked for evidence that the student understands what it is to be a pa. i've never seen a bad reference. on the other hand there were references that didn't clearly demonstrate committment to the profession. in my experience whether you get an interview is a combination of grades, essays and letters. the hce is mostly a check box. from the interview admission is about how you come across in the interview.
Can someone explain the need for the theory and research classes that most NP programs have? I just feel like more theory is a waste of time when I should be learning advanced pathophys and pharm not to mention management of systemic problems.
Can someone explain the need for the theory and research classes that most NP programs have? I just feel like more theory is a waste of time when I should be learning advanced pathophys and pharm not to mention management of systemic problems.
All professions are theory-driven. Trade schools are not. Which do you want?
Yeah I know. Just seems frustrating reading the required courses for the ACNP program near me, three theory and research classes. Only 3 classes of learning how to manage disease/disorders, not to mention pharm and advanced patho.
Everyone except nurses would love to see more advanced anatomy, physiology, patho, microbiology, biochem, pharm, in NP school as well as double the clinical hours.
For all those who defend the NP profession, WHY NOT? What is the harm in adding more advanced science and clinical coursework?
Yeah I know. Just seems frustrating reading the required courses for the ACNP program near me, three theory and research classes. Only 3 classes of learning how to manage disease/disorders, not to mention pharm and advanced patho.
Yea, I wish they would cut it down to the bare basics and save most for doctoral programs.
Everyone except nurses would love to see more advanced anatomy, physiology, patho, microbiology, biochem, pharm, in NP school as well as double the clinical hours.
For all those who defend the NP profession, WHY NOT? What is the harm in adding more advanced science and clinical coursework?
Well, one question that needs answering is what's needed for mid-level practice. Is the PA model it or is that more than enough? What about the Special Forces model or variation of it? Is NP model enough? Does a mid-level program need more courses...till it's almost medical school?
I rarely ever post here but I couldn't help just putting in one little reply. I had to put it at the end because I am not too ashamed to say I haven't figured out how to quote within a post with this 'new format'.
Anyway, I just had to say, with regard to the lady with the alphabet name. I still don't think she ever did get what you were trying to explain about the title thing. I don't think she ever realized the whole point you were trying to make was,,, she had the apostrophe in the wrong place!
oh well,it was good entertainment to say the least.
NP's and PA's are not equal. NP's can practice independently and PA's cannot. They must always have a supervising physician. Of course, not all states allow independent practice for NP's. In my state, 2 years of supervision is required before an NP can legally practice without an indentified supervising physician.
Whether one can practice independently is not a function of skill level. It is entirely dependent on the type of clinician..NP or PA.
In some areas, PA's may find their degree more marketable because they can practice in any specialty for which they receive training. They are all prepared as generalists. They can be supervised by any physician in their area of practice.
NP's are limited by the type of specialty training that they have. A Pediatric NP cannot practice in the role of an Adult NP. Their practice is limited to individuals from birth through age 21. Adult NP's are limited to individuals 12 years and over. They cannot be supervised by a pediatrician and vice versa.
NP's who are practicing before 2015 are not required to have the DNP. Only those newly entering practice have this requirement. If you graduate in 2014, pass your boards before 2015 and are licensed to practice..no DNP needed.
core0
1,831 Posts
The requirements for PA programs vary broadly. In general about 1/3 require healthcare experience (HCE), 1/3 prefer HCE and 1/3 do not address it. That being said the average for martriculants last year was around 2.5 years of HCE. So even with a few direct entry programs the average student has a fair amount of HCE. Usually local programs tend to mirror each other since they are in effect in competition.
What this really addresses is that there is no way to accurately forecast what HCE brings to the table. There are some programs that use a points based system where RN/Paramedic/medic is worth more than MA for example. But for the most part hours are hours.
What makes the sysytem work is the checks and balances. The schools have to provide an education that covers all the topics in the blueprint and their students have to pass the PANCE. If the programs don't adhere then they end up on probation or are closed down. So each program develops methods to ensure that their students get the education needed to cover the blueprint and pass the PANCE. They do this knowing the type of student that they have recruited. Programs can tailor their educational environment to play to the strengths and weaknesses of the students. This is one thing that many applicants fail to understand. The program knows best what kind of students work in their environment. This may lead to favoring one category of students vs. another.
I can think of at least one program that actively discourages students with HCE. That program which is a USN&WR top 10 program (for whats that worth) is also the longest program out there. On the other hand the program that I think is arguably the best program recruits essentially from one county in California. If you don't live in that county you have very little chance of getting in. While some might view this as unfair, the program views it as their mission.
Bottom line the variability of programs means that there is probably a program out there aligned with a given students interests and experience. On the other hand if the student is geographically restricted then there may not be.
David Carpenter, PA-C