Differences (Educative/Clinical) between NP & PA

[jstuben]

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!

[Ellen NP, MSN, NP]

I took advanced pathophysiology, pharmacology, suturing, casting, reading XR in my MSN/NP coursework. I work in Consultation Liaison Psychiatry and I can say with certainty that my ability to write well enhances my credibility with those requesting the consultations. While I don'tplan to do independent research, it behooves all of us to be able to read and interpret research. I don't want to trust the media to interpret findings for me. My ability to care for patients and to continue my own learning requires that I be able to read research studies and apply findings to my practice.

That said, I do wish that furthering my education in advanced practice nursing did not mean MORE theory and research work. Most of my continuing education involves courses designed for Physicians, NP's and PA's alike.

Whether you want to be a PA, NP, or physician, you should be able to read, write, and interpret others' work. Of course, I still believe in a liberal arts education as a basis for further study.

Nursing Education is NOT as well standardized as PA education. You need to study the different programs and select that which offers you the best opportunity to meet your goals.

[zenman]

RNTwin said:

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Let's 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

All professions are theory driven. Trade schools aren't. So you need some theoretical framework to operate from.

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

I think you had more research classes than I did. I don't know what the "appropriate" amount of research classes would be. Depends on content, I guess. But in the health fields you better keep up with research weekly. And you better know how flawed many studies are.

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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:

Know it and being able to do anything about it are two different things. I hear physicians complain all the time about non-compliant patients. All that means to me is that you are lacking in the ability to change your patient's behavior. They came to you for help and you failed.

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

Cognitive Behavior Therapy. It can also help you with your

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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

I agree we need more core courses but don't go so far as to throw out what might be needed. Physicians are trained in really hard science. I personally don't like such a reductionistic approach but to each his own. I prefer to look into the other end of the microscope.

When I was a young pup in a Level I I loved all that technical and procedure stuff. That got boring after awhile. Now I get my giggles by having nothing on me and using just my brain to help someone else. I have a physician preceptor and a couple weeks ago he told me medicine just "sucks your soul out."

Another doctor's daughter was shadowing me and others trying to decide whether to get a Ph.D. in psychology, or go to medical school or go to NP school. Both my preceptor and her dad told her to go to NP school!

[foreverLaur]

I suppose it depends on your background too. I have a degree in psychology and I spent 3 solid years doing health care related research (mostly in oncology) and took multiple statistics classes. I'm not remotely looking forward to more...

[Ellen NP, MSN, NP]

You may be able to test out of additional stat classes or get credit if yours were graduate level

[foreverLaur]

Ellen NP said:

you may be able to test out of additional stat classes or get credit if yours were graduate level

I'm not sure how they would be viewed. A lot of my classes were combo - about half were upper level undergrads and half were masters students.

[RNTwin]

Browndog said:

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.

Thank You...most of the NPs (ACNP) that I know all feel that to much emphasis was placed on how to write a paper and not enough clinical content...

[RNTwin]

Ellen NP said:

I took advanced pathophysiology, pharmacology, suturing, casting, reading XR in my MSN/NP coursework. I work in Consultation Liaison Psychiatry and I can say with certainty that my ability to write well enhances my credibility with those requesting the consultations. While I don't plan to do independent research, it behooves all of us to be able to read and interpret research. I don't want to trust the media to interpret findings for me. My ability to care for patients and to continue my own learning requires that I be able to read research studies and apply findings to my practice.

Exactly were many theories are applicable

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Whether you want to be a PA, NP, or physician, you should be able to read, write, and interpret others' work.

Agree...

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Nursing Education is NOT as well standardized as PA education. You need to study the different programs and select that which offers you the best opportunity to meet your goals.

And it shows from working with many NPs

[zenman]

RNTwin said:

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

You know the old biddy was really smart. Preventative/public health measures have saved more lives worldwide than the most modern medical advances. You know about Dr. Semmelweis don't you? Look how handwashing is viewed even today in hospitals...where you seem to always catch something from staff and die. Sometime I'll tell you about my 4 yrs in Bangladesh and the time I had over 100 kids lying on the floor of my office...and adjoining rooms...puking their guts out from contaminated water. I was lucky that a CDC infectious disease doc was around that day, as well as a few others who stepped in to help.

[AbeFrohman, BSN, RN]

So have a single lecture on handwashing, disinfectants, and antiseptics, then move the frak on. Dr. Semmelweis discovered that medical students washing their hands with chlorinated solution dropped puerperal infection in the maternity ward, but you don't see medical having semester long class on common sense theories of how cleaniness REALLY is good for patients and writing a 10 page paper on it.

EDIT: Haha, I just saw Zenman mention the old doc as well. I remember that story from microbiology.

[RNTwin]

zenman said:

You know the old biddy was really smart. Preventative/public health measures have saved more lives worldwide than the most modern medical advances. You know about Dr. Semmelweis don't you? Look how handwashing is viewed even today in hospitals...where you seem to always catch something from staff and die. Sometime I'll tell you about my 4 yrs in Bangladesh and the time I had over 100 kids lying on the floor of my office...and adjoining rooms...puking their guts out from contaminated water. I was lucky that a CDC infectious disease doc was around that day, as well as a few others who stepped in to help.

i think this a perfect example how nurses cling onto these theories that yes were very important in their time and were REVOLUTIONARY, but we KNOW that hand washing/good hygiene saves lives...why do i need a whole semester on these "Theorist" and write 10 page papers on them

yes do know Dr. S.

[RNTwin]

AbeFrohman said:

So have a single lecture on handwashing, disinfectants, and antiseptics, then move the frak on. Dr. Semmelweis discovered that medical students washing their hands with chlorinated solution dropped puerperal infection in the maternity ward, but you don't see medical having semester long class on common sense theories of how cleaniness REALLY is good for patients and writing a 10 page paper on it.

EDIT: Haha, I just saw Zenman mention the old doc as well. I remember that story from microbiology.

THANK YOU...

[zenman]

AbeFrohman said:

So have a single lecture on handwashing, disinfectants, and antiseptics, then move the frak on. Dr. Semmelweis discovered that medical students washing their hands with chlorinated solution dropped puerperal infection in the maternity ward, but you don't see medical having semester long class on common sense theories of how cleaniness REALLY is good for patients and writing a 10 page paper on it.

EDIT: Haha, I just saw Zenman mention the old doc as well. I remember that story from microbiology.

Before that he noticed that nurse midwives were not killing off as many patients as the docs because they were washing their hands between patients.