Differences (Educative/Clinical) between NP & PA

Specialties NP

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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?

Thank you very much!

Specializes in Advanced Practice, surgery.

Please can we stay on topic this is a discussion about educational differences between NP and PA it's not a DNP or midlevel vs physician debate.

Specializes in Advanced Practice, surgery.

Ladies and Gentlemen, you will notice that there are quite a few posts that have been deleted from this thread. I have not PM'd any of you about it so will explain it here If you can't find your post it's because they are off topic and will, if allowed to continue lead to yet another thread in the advanced practice section to be closed.

Now, this thread is about the educational and clinical differences between NP and PA's,

It is not about the DNP unless your comparing it to PA education

It is not about NP vs Physician debate

It is not going to become yet another battle ground between members about the DNP and the use of the title Dr

Please stick to the topic, I will delete posts that are off topic

You have been warned

Re education: PA's certainly have better standardization of curricula. This is a problem with nursing education at all levels. The reality is that the data support NP's practice as meeting clincial and patient expectations. Maybe PA's are overeducated for basic practice? They are certainly well educated as generalists. NP's are educated to be specialists. Ideally, NP's have experience as RN's first and have the clincial hours from their undergraduate programs and their continuing education and practice. I do not support direct entry into advanced practice programs. I do not believe that they can get the clinical practice through a direct entry program education. They may pass boards based on their didactic education, but they do not have adequate practice experience. I would really encourage those individuals considering this route to choose a PA program instead.

Yes, PAs do rotations in all clinical areas and NPs do rotations in just one clinical area, but it is quite possible for a PA to have equal to or more clinical hours in a specialty area than a NP does PLUS have the generalist education to back it up. Perhaps the PA education is a bit "over the top" with a full 12-15 months of intense science didactic and a solid 12-15 months of clinical rotations totaling over 2,000 hours, but at least in my area, their education is extremely undervalued and NPs are seen as being far superior to PAs. I live in a very PA unfriendly area. One major hospital in my area would pick a new grad directly entry NP to work in the Level I Trauma Center over a seasoned PA who had worked in a Level I Trauma Center with surgical experience for 10 years (there was a small article in the local newspaper about it - the gentleman was not happy). He was instead offered a position as a ED Tech - said it was the best they could due as he was not trained adequately for more. I can't say for sure what he wrote in was accurate - he may have exaggerated a bit due to being upset over losing out on the position, but the area is still very anti-PA.

I do agree with you that direct entry is not good. A minimum 2 years of full time hands on direct patient care should be required before beginning school to become a mid-level. That's why I'm in nursing school to become a RN before I decide what to do next.

Specializes in Consultation Liaison Psychiatry.

The educational requirements for the NP are expected to change in 2015. Anyone considering this profession needs to be well aware of the planned changes and the uncertainty surrounding effects on those of us already in practice when the degree (DNP vs MSN) requirements change.

Specializes in Consultation Liaison Psychiatry.

It's unfortunate that PA's are not well appreciated in your area. In my experience, PA's are excellent clinicians, well prepared for practice and able to specialize with additional training. PA's are well respected and valued in this area, as are NP's.

In addition to the educational programs, an individual should consider the area in which they plan to practice. As you note, not all areas are friendly to one or the other profession.

The RN education will be valuable even if you do pursue the PA program rather than NP.

Specializes in CCU,ED, Hospice.
The current plan to require doctoral preparation for NP's disappoints me specifically because the prgrams do not require even more advanced clinical courses and additional clinical hours. The focus of too many of these programs is on developing leaders and educators...we need to focus on preparing clinicians 1st.

I've been looking at different programs and have been suprised to see the lack of clinical content. :down:

Specializes in Critical Care Nursing AKA ICU.

Just a couple of things, I am in the ACNP program(and will graduate next year) and i must say we spend alot of on "FILLER" classes. why do i have to take 13hrs of "FILLER", why do i need to take another "Theory", 2 more "Research", and a HEalth Promotion class. it's RIDICULOUS, know wonder MDs don't respect the nurse because we take some much nonsense classes. I personally would rather take more pharm, patho, diagnostic, physical exam classes that i will actually use when i get out of school and take care of patients, than these retarded classes. i guess, i will be able to spit out some theory or some research study i read in NP school, to the patient to make him/her feel better :rolleyes:

to be honest i highly recommend my twin brother to go into PA school than this fecal matter.

I have a good friend that just graduated from a PA program and from talking to her and seeing her cirriculum she took NOT ONE class that she felt or that looked useless.

Like right now i'm writing a teaching plan paper over how to prevent obesity in america...STOP EATING JUNK FOOD AND GO PLAY OUTSIDE

In my other class i'm going to write a paper on a current Nurse practitioner issue, again WHO CARES

yes i agree that theory, research and health promotion are important but come on... I need classes that will actually help me take care of my patient and treat his/her condition.

Specializes in Critical Care Nursing AKA ICU.
I've been looking at different programs and have been suprised to see the lack of clinical content. :down:

exactly... because we're taking health promotion, theory, research and other "filler" classes

Just a couple of things, I am in the ACNP program(and will graduate next year) and i must say we spend alot of on "FILLER" classes. why do i have to take 13hrs of "FILLER", why do i need to take another "Theory", 2 more "Research", and a HEalth Promotion class. it's RIDICULOUS, know wonder MDs don't respect the nurse because we take some much nonsense classes. I personally would rather take more pharm, patho, diagnostic, physical exam classes that i will actually use when i get out of school and take care of patients, than these retarded classes. i guess, i will be able to spit out some theory or some research study i read in NP school, to the patient to make him/her feel better :rolleyes:

to be honest i highly recommend my twin brother to go into PA school than this fecal matter.

I have a good friend that just graduated from a PA program and from talking to her and seeing her cirriculum she took NOT ONE class that she felt or that looked useless.

Like right now i'm writing a teaching plan paper over how to prevent obesity in america...STOP EATING JUNK FOOD AND GO PLAY OUTSIDE

This is a critical issue that is severely affecting the health of Americans. You might want to make your paper more indepth than you originally planned. You might even want to become an expert on the subject and have cash-paying clients for your clinic.

In my other class i'm going to write a paper on a current Nurse practitioner issue, again WHO CARES

I care very much as I like to know about what's affecting my paycheck or how I can practice in a certain state..

yes i agree that theory, research and health promotion are important but come on... I need classes that will actually help me take care of my patient and treat his/her condition.

I'm in psych. Imagine me trying to operate without a theory to guide me!

Imagine me not knowing how to read and understand research. I stopped one drug this week on a patient because of a research study.

Health promotion? A great majority of patients are non-compliant. How is your expertise in health promotion? You might be one up on your PA friend and not even realize it...yet.

Classes that actually help you take care of patients? I took more pharm classes than actually needed. So now I'm aware that most the drugs I use don't work or will mess you up big time. Guess I should have focused more on theoretical models.

All you got to do is change how you think about what you have to do. How do I know? I studied that theoretical model also!

Specializes in Trauma, Emergency, Urgent Care.

I agree with RNTwin on this one. If I were in a PA friendly area, I would have gone to PA school in a minute. Way too much fluff (B.S.) in nursing education for my taste. Give me patho, biochem, pharm, etc. Teach me to read xrays not write papers. Teach me to splint and suture not do research. I was disgusted with my BSN education and felt that the MSN education was not much better.

Sorry. I call 'em like I see 'em.

Specializes in Critical Care Nursing AKA ICU.
This is a critical issue that is severely affecting the health of Americans. You might want to make your paper more indepth than you originally planned. You might even want to become an expert on the subject and have cash-paying clients for your clinic.

no thanks

I care very much as I like to know about what's affecting my paycheck or how I can practice in a certain state..

your right didn't look at it that way

I'm in psych. Imagine me trying to operate without a theory to guide me!

lets be serious do you really think we need florence N. theory to tell us that we need to keep the environment clean to promote healing/well being :rolleyes:

Imagine me not knowing how to read and understand research. I stopped one drug this week on a patient because of a research study.

so i need 3 semesters of research class to tell me that a RCT is superior to a quasi...

Health promotion? A great majority of patients are non-compliant. How is your expertise in health promotion? You might be one up on your PA friend and not even realize it...yet.

never knew that patients were non-complaint, i thought people always took their meds as prescribed and never put anything into their bodies that could harm them or participated in risky behaviors:rolleyes:

Classes that actually help you take care of patients? I took more pharm classes than actually needed. So now I'm aware that most the drugs I use don't work or will mess you up big time. Guess I should have focused more on theoretical models.

yes b/c theoretical models shows us how prescribe meds and what to watch out for...

All you got to do is change how you think about what you have to do. How do I know? I studied that theoretical model also!

can you point me to that model so i can change my way of thinking...

bottom line is that we need more "core" classes, i gurantee if you ask any physician on what NPs lack and they will tell you patho/physio/pharm/assessment skills they won't ever mention theory/health promotions/research/adv pract role/information systems :yawn:

Specializes in CCU,ED, Hospice.
All you got to do is change how you think about what you have to do. How do I know? I studied that theoretical model also!

Hmmm.. a different take on things and something to think about... Thanks Zen!

Am still thinking that more pathophys and clinical should be incorporated.

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