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Discussion

going to nursing school

So after getting in to nursing school and PA school, i have opted for nursing. Some people think i am crazy for making that choice, but i have several good reasons. Scope of NP's vs PA's in my state for one, as well as what I want to do as a mid level is much easier to do as an NP than a PA. Palliative care is one of these.

I was hoping for some advice. What I am most interested in is where critical care meets palliative care, or better said end of life decision making in maybe not so long term illnesses. I am not sure exactly what I should do or where I should aim for in looking at first jobs. ICU? Hospice? Look strait to palliative care teams? Does one have to pick between managing the illness and managing the end of life care? Or could I carve out a role as a specialty NP (oncology? pulmonology?) who manages said illness as well as coordinate the palliative care. Any thought are appreciated!

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    Our NP's both have specialities and general practices. The oncology and generalist NPs both sit on the Palliative Interdisciplinary team. The oncology NP also attends our hospice IDT meetings. The generalist NPs have independent practices in my state.

    I think you would need to consider the laws of your state governing NP practice and decide from there...

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    Oh, by the way...the CMS regulations for hospice do not allow PAs to direct the care or provide medication orders.

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    I know... one of the reasons I would rather be an NP. the areas I am most interested in are easier billed/practiced as an NP in my state. I really like psych as well, and there is only a handful of PA's working in psych around here, and unlike psych NP's, they cant bill for psychotherapy, and psychiatrists do not take kindly to psych mid levels more so than other docs. That and the hospice/palliative care problem with PA's as well (there is a piece of legislation now being drafted, but who knows how long, or if it ever does, actually pass to allow PA's in hospice).

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