PA vs. RN

Home Health Columnist / Guide · Apr 13, 2006

This question comes up periodically.

See this great thread:Physician assistant versus Nurse practitioner

NephroBSN, BSN, RN · Apr 13, 2006

malika said:
Hi Guys !
I need detailed advice, why would somebody choose nursing over physician assistant. I honestly am confused. Now I have opportunity to go to either one. What should I do. I only know I am interested in Medicine(in general) and patient care. Just wonder why people don't choose PA, which is so similar to M.D. please clarify it to me.

Nursing and medicine are two different areas.

Most of the time a PA still has to work directly under an MD. They have to have their charts reviewed etc.

An NP can hang out his/her shingle so to speak.

Nursing IMHO is a more nurturing profession and is based on a different level than a PA

I also believe that NP's are in greater demand in some areas of the country than PA's.

If I were much younger I'd go NP in a heart beat. Again all my personal opinion.. Mostly from observations of both entities.

marilynmom, LPN, NP · Apr 13, 2006

Well first off there is a difference between RN vs PA, and NP vs PA. NP and PA are both mid level providers with masters degrees and function in very similiar roles and are pretty much the same thing (though they are trained differently, but both function at the same level and can write Rx, diagnose, etc), an RN is a nurse with either a bachelors or associates degree (in most cases).

NP in case you don't know is a Nurse Practitioner (we have a forum for this specialty you might want to visit to ask specific questions).

The first thing I would look at before deciding is what it is like for NPs and PAs in your state or where you plan to practice. Here is Oklahoma for instance PA's rule, you see NPs but they are mostly in clincs and are not paid very well at all, it's just how it is here. So for *me* after nursing school I will go to PA school for my masters--it just makes sense for where I live. In other states NP's rule, in some states there are a lot of both, it really varies. I would look at what it's like in your state and go from there before deciding anything.

EricJRN, MSN, RN · Apr 13, 2006

With PA vs RN, you're comparing two different educational levels. In most cases, the pay and scope of practice for PA is higher, but most PA programs award master's degrees and they will require applicants to already have a four-year college degree before starting the program. For RN, you're looking at a two-year or four-year undergraduate college degree.

Faeriewand, ASN, RN · Apr 13, 2006

If I wanted info on PA's to compare I would also go to a PA board. I'm sure there is one. Anyone know?

RN4NICU, LPN, LVN · Apr 14, 2006

malika said:
Hi Guys !
I need detailed advice, why would somebody choose nursing over physician assistant. I honestly am confused. Now I have opportunity to go to either one. What should I do. I only know I am interested in Medicine(in general) and patient care. Just wonder why people don't choose PA, which is so similar to M.D. please clarify it to me.

It doesn't really make sense to compare PA's to nurses. They have two VERY different roles. A closer comparison would be to compare PA's to NP's. If you are making that comparison, many will chose NP over PA because they are already nurses. The functions of PAs and NPs are very similar - both are midlevel providers and neither is more "similar to MD" than the other. People who are more interested in patient care tend to gravitate toward nursing. People who are more interested in diagnosis and treatment gravitate toward PA or toward advanced practice nursing (especially if they are nurses already). You just have to decide what role it is that you want and take the path that will allow you to have that role.

dnrscott · Jan 31, 2009

First, you have to ask yourself in what type of function would you like to be apart of the medical team. RN's(most AA programs are phased out, so a BSN is now required in many states) work under the ordering scope of PA, NP and MD's. However, the days of ALL liabilities falling to the doctor are gone. As an ER RN working at a major trauma hospital in California for many of years, my observations are the following:

1) PA's are to have their charts CO-signed and present each case to the Lead MD of the day. Does it happen always, NO. It depends upon the MD really. Some want each case presented and others are okay with signing the charts at the end of the day. Keep in mind, the PA must by law be functioning under the direct supervision of an MD. Not on call, but in the building and available. Does it happen always, NO. PA function as diagnosising providers but they are NOT independent of MD's. Liabilty falls back on the MD co-signing the chart as being appropriate and just care rendered.

2) NP's are completely indepenent providers of health care. They diagnose and treat illness at any level of care. But you often see them used in clinics. However, they work in all types of hospital settings and are liable for all that is done. No supervision is needed. The other consideration is this: NP's start making less money than seasoned RN's who have been RN's for years. Interesting, but true. But after a few years, they catch up and eventually make more in the end than remaining an RN.

3) Nursing shortage. Never need to worry about having, finding or rapidly being hired. There are jobs everywhere. And you have the flexablity to go into any field of medicine.

4) Completly different ideas of health care. Diagnois and treat are the function of MD/NP/PA. And as the RN, you are the person supplying the care. You work with the patients and know them. Thus, you find yourself guiding the MD/NP/PA to what needs to be done. Without your knowedge of the patients being inputed, how can anyone medically treat anyone.

5) RNs are the ones respsoble for this that and the other thing. Making sure that this that and the other thing are done, and done appropriately. And trust me, your the one that will hear about it.

6) RN's with a lot of experience tend to ignore the PA's at first, and will frequently questions orders given. Just as you have poor RN's you have poor quality PA's.

7) Responsibiltiy and liability: You give it, your responsible. So you have to know what your doing as an RN.

8) Because of the differences in thought is where, at times, conflict comes into play with all of the above. Does a nusre have to get up from the chair one was sitting in when the MD's make there rounds anymore? NO. Did they use to, yes. Did the hospital once always side with the MD's, YES. But things are changing and that is no longer the case. Nursing is becoming a more supported health care provider more now than ever before by hospital admin, MDs and the like. Now is this the case in Nebraska(sp????) , maybe not as pronouced as above.

So ask yourself???????

What type of role do you want to provide in the health care setting and it will lead you to what type of degree to achieve.

Hope it helped,

Scott

HotDrew · Jan 31, 2009

You can become a RN with an associates degree. A PA is almost always a masters program. Thats probably the biggest reason! NPs and PAs are similarly paid, with PAs making slightly more. However, PAs make significantly more $ than most RNs.

dnrscott · Jan 31, 2009

That is SO untrue. To be an NP in California, by law you now have to have a masters degree......read up on state laws. Certified PA have a masters degree, not all PA have one however. Whatever happens here and in the Northeast will eventually have an inpact on the rest of the states. Associate degree programs are being phased out, and many of hospitals are requiring RN's with AA to have or obtain an BSN upon hire. HOWEVER, if money is your sole idea, you might want to look at a different profession. That isnt or wasnt your objective on becoming any type of health care provider.

HotDrew · Jan 31, 2009

dnrscott said:
That is SO untrue. To be an NP in California, by law you now have to have a masters degree......read up on state laws. Certified PA have a masters degree, not all PA have one however. Whatever happens here and in the Northeast will eventually have an inpact on the rest of the states. Associate degree programs are being phased out, and many of hospitals are requiring RN's with AA to have or obtain an BSN upon hire. HOWEVER, if money is your sole idea, you might want to look at a different profession. That isnt or wasnt your objective on becoming any type of health care provider.

Read up on my post. The OP was asking the difference between a RN and PA. I never said in my post that a NP only needs an associates.

a.malone · Aug 4, 2009

Bravo RN4NICU! I was hoping to hear this...medicine's focal point is treating the disease process...nursing's focal point is treating the patient! I was hoping someone would go there! Thanks!