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?
In the ED setting I don't see much difference between NPs and PAs. We can see the same patients, write the same orders, prescribe the same drugs, and perform the same procedures.
I have a friend that insists NPs can bill under their own number but that PAs can't. I can't find one shred of anything that backs up her way of thinking but she is insistant about it.
When I was finishing up my program I did clinical rotations at the same time as a PA student. She did fine considering she didn't have my 10 years ED experience under her belt. PA programs are a different type of program because they need to be a different type of program to get a good result. It doesn't mean one is better and one is worse.
If NPs and PAs would somehow band together instead of having conversations like these we could accomplish tremendous things.
For me, It just made sense to go to FNP school instead of PA school.
I just started NP school a couple of weeks ago, but was accepted into a pre PA program here in Indianapolis a couple of years ago before i went of to the war. My rational.. well one of them is cost vs income.. The hospital that I work at posts what NPs and what PAs make.. the tuition for the PA program would cost well over 80k .. 2 yrs of pre reqs and 3 yrs of PA school, VS 2.5 yrs of NP school.. I have my BSN already.
I dont really get into the NP vs PA thing myself. what ever suites your fancy I say..
In the interest of pointing out differences between NPs and PAs......
It does appear that more PAs practice in surgical areas than NPs. I think that is because they rotate through those areas in their education more than NPs. Wasn't really an issue for me. I am not interested in assisting in the OR. However, there are no specific rules that prevent me from doing so if I choose. I am starting to see more surgical related jobs posted for NPs or the equivocal NP/PA option. The call time would keep me out of that kind of role. When I have a day off I like it to be a day off, not a day waiting for the beeper to go off or the cell to ring.
So I chose the perfect practice area for me. Show up at the ED on time, work hard while I am there, then go home and be off for real. No beeper.
So the only real difference I see is a difference in choice and perhaps availability for surgical positions between NPs and PAs.
I still think we should stand up together as a group of "mid level providers" unique from one another in as many ways we are similar. Numbers get things done. When I say stand together, I mean to work for real policy changes that improve the lives and practices of all. It's kinda like being an American while maintaining a connection with our own family heritages. It is how the whole population works, don't see why it couldn't work for us.
As far as I can see--from a practical standpoint and my observations: Practically speaking, where I work, which is a larger company that has both NPs and PAs in all different areas of medicine, ER, FP, GI, Derm, IM, and surgical subspecialties. PAs are more in the surgical subspecialties. However, both are hired by the company and pretty much work under the docs--PAs have their supervising physicians and NPs have their collaborating physicians. Practically, there is really no difference in terms of what the PAs and NPs do in their roles here and what they do.
For some reason, there are some misconceptions. One of the biggest ones is: the terms supervising physician (SP) is often misunderstood. Some seem to think that a PA has to run everything past their SP but that is most often not true in most states. PAs practice with autonomy and are trained to know their limitations and collaborate with their SPs as needed.
At a dinner meeting a few weeks ago with NPs and PAs present, an NP was making a point and addressed all the NPs in the room and stated that PAs couldn't be allowed to be alone ever in the office. This is totally wrong and it is somewhat regular to hear this kind of mis-information.
Please know the laws, facts, etc... BEFORE making assumtions or going by hearsay and we will all be better off.
partnership opportunity for expanding pa owned practice in trauma, orthopedic surgery, neurosurgery, and maxillofacial surgery. this combined with opportunity to work in ed as available. very rare and unique opportunity with flexible hours (full-time or part-time), and great income of $100,000 to $150,000 plus, based on performance. experience not critical as we would train the right candidate. new grads welcome to apply. position now available in las vegas nevada and bullhead city, arizona
april 3, 2006
r.p. musselman, d.o.
contact name: r.p. musselman, d.o.
530 main street
red bluff, ca 96080
phone: (530) 527-6311
fax: (530) 527-7062
i have an exciting opportunity for an individual who would like to have ownership in a family practice clinic. this is a new start up and could be developed into an urgent care and disability clinic as well.
the start up costs are low at this time and will allow someone to buy in at a very low rate. this opportunity is in a semi-rural community in northern california of about 15,000 population.
i know others who own their practices but i am not going to go searching for more websites.
north carolina only requires a "meeting" once every six months with your "supervising physician." sounds a lot like collaboration to me. http://www.ncmedboard.org/
supervision: supervision continuous but physical presence of physician not required at all times. pa must meet with supervising physician monthly for first six months of employment and every six months thereafter to discuss clinical problems and quality improvement measures.
here is a link to a pa who is faculty at a family medicine md residency at duke. the only one who is not a pharmd or md. sounds pretty autonomous and like she does some decision making if she teaches md residents.
We beat this topic to death on the PA forum, remember? I don't know why this has to be a competition. I think it's time to end this pointless discussion as no points are being made on the clinical differences of PA's or NP's. Those interested in finding that out can feel free to private message me for some information on NP's.
We beat this topic to death on the PA forum, remember? I don't know why this has to be a competition. I think it's time to end this pointless discussion as no points are being made on the clinical differences of PA's or NP's. Those interested in finding that out can feel free to private message me for some information on NP's.
Agreed, those who would like ACTUAL info on PAs can PM me. With all do respect FNP it is not only my right to defend my profession but also my responsibility. You know very well that what is being said about PAs is inflamatory, derogatory, etc. and is simply untrue. My post never mentioned NPs as I am only here to correct hateful and misinformed posts about PAs. The post I responded to was very hateful and was in fact, talking about how they thought someone else SHOULDNT be hateful. I thought that hypocritical and felt it necessary to provide factual, hard evidence for those truly interested. The conversation at the PA forum was different. Don't you think its fair for me to contribute to stopping the PA hate over here? I have been quite for over a year.
p.s. I have never started a PA v. NP thread and never will. Its a ridiculous discusion. But impressionable minds read these things and PAs need desperately to be understood, just as NPs do.
Specializes in Education, FP, LNC, Forensics, ED, OB.
hello, caldje and welcome to allnurses.com and the np forum
we really do appreciate the links about the pa positions. and, i appreciate your passion regarding your education as a pa.
please bear in mind, this is a nursing board and many do not know the differences between np and pa. also, nps are forever having to defend themselves against the "world". i know you have probably felt the need to defend the pa, just as you have now.
if ya'll will notice, the recent post to which you made reference (#137), actually quoted a member who has long since gone - november 2004.
let's continue this thread and hopefully, educate others who need to know the clinical differences between np and pa. and, i hope you will come back and provide for others, helpful information about the pa.
i ask that all members who frequent these boards not make disparaging remarks to one another regarding their career choice for we need to band together as hcp and not serve to be divisive.
What's the difference between Nurse Practitioners & Physician's Assistants. Also, What route of education would you goto get both of those. I know you have to go to nursing school and become a RN and go back to school for a NP. What about PA?
There are schools with 4 year PA programs. My best friend, who I met in college, is now a PA. He took a ton of science classes and did an entire year of rotations. It was a 4 year program though where he came out with his BS. He didn't have to go to medical school or anything. The only thing I really know about a PA is that they can do just about everything a dr can do, but always need a dr on duty in case they have questions.
The only thing I really know about a PA is that they can do just about everything a dr can do, but always need a dr on duty in case they have questions.
Are they common in hospitals?
I want to do more surgery-type, so are they in surgery as well, or is that completely different!? (There seems like SO many different jobs in a hospital!)
but always need a dr on duty in case they have questions.
the doctor does not have to be on duty. In all states that I have read the laws of, the physical presense of the doc is not required. however, they must be able to be contacted by electronic means.
PAs are a very popular choice that surgeons make. You will find mostly PAs in surgery although NPs are starting to be used. RNFA would also be a good thing to look into. There are two surgically focused PA programs in the country, cornell and university of alabama. I would look into those programs as they prepare you VERY well to work in surgery. You can also do one of many post-graduate PA residencies at instutions like yale, duke, or john's hopkins. These usually are 1 year long and almost exactly like the 1st year of physician residency. I hope this was helpful. Always research what people tell you because you will hear a LOT of inacurate information about PAs, and NPs too.
ECMOismygame
236 Posts
finally someone who makes sense.