Going to PA as a nurse

Tacomaboy3 · May 7, 2019

I've had thoughts about PA school after a couple years of nursing. I think PA school has a couple advantages:

1) about 3x as many clinical hours with a variety of clerkships/specialty rotations; I feel that the clinical component of programs is where you really learn how to practice medicine. Yes, I believe NPs practice medicine.

2) increased lateral mobility; like RNs, PAs can more freely work in a variety of settings (ED, ICU, internal med, peds, NICU, trauma, outpatient, etc.). NP programs are more pointed towards specific patient populations (albeit FNP is sort of an enigma in that regard). For instance, if a PNP wants to switch it up and work with adults, they'd need to go back to school and earn another certification.

That being said, NP programs have their advantages as well:

1) if you know EXACTLY what kind of work you want to do (e.g. working with neonates), you can enroll in a NNP program - you don't need to "waste your time" learning about things (like how to treat a sick/injured adult) you'll never use. Your ~600-700 clinical hours are all about the population you chose.

2) NP programs often offer more flexibility for working adults. Many are online, self-paced. Many RNs maintain an FTE while attending school (also taking advantage of employer tuition reimbursement).

3) It's easier to find a cheaper NP program (especially masters) than PA program. People might bite my head off for this, but we live in an age in which my generation is plagued with student loan debt. I think the cost of a program should absolutely be a consideration (as should the quality of a program).

WestCoastSunRN, MSN, CNS · May 7, 2019

This is an interesting topic. PA schools require 1000 - 2000 hours of direct patient care (generally) -- which is well satisfied with RN experience. It requires more of the hard sciences as prereqs -- so that represents time and money -- and then it is, as far as I know, a full-time (no time to work) endeavor -- thus more costly (similar to CRNA programs).

I think nursing needs to clean up its act regarding advanced practice academia. That said, I don't see many nurses choosing the PA route simply because it adds time and money to the equation.

myoglobin, ASN, BSN, MSN · May 30, 2019

Keep in mind that perhaps the strongest advantage of NP's relative to PA's is the ability to practice independently. Thus, in over 20 states as an NP you can open your own practice, However, only North Dakota and West Virginia offer this option to PA's. Also, if you plan on doing mental health PA's are at a disadvantage relative to PMHNP. Your education is largely what you make of it.

Advanced Practice Columnist / Guide · Jun 13, 2019

Early in my career before I started NP school, I've met one or two nurses who were attending a PA program. It can be appealing knowing that the program is generalist focused and at the time, I also felt that PA's might have had more opportunities than NP's. Having chosen the NP route, I've gotten the opportunities I wanted and have been satisfied with the direction my career took. If I were deciding these options today, I would only pick PA if I'm financially able to devote two full years of full time study and give up my RN income for that period of time knowing that the job market in the area favors PA's more than NP's giving me a guarantee of a job after graduation.

PMHNP Man, MSN, APRN, NP · Jul 2, 2019

PA will be a much more generalized but high yield program than NP. They're flat out better trained at anything related to primary care.

The programs are usually about 28 months. You will be supervised by doctors so hope for collegiality. I find the physician-physician assistant relationship to be more amicable.

Don't say "only" about any of it. It's a vastly different process than nursing. You'll be flooded with information.

adventure_rn, MSN, NP · Jul 3, 2019

You note that your background is in peds heme-onc. Do you have any interest in working in pediatrics once you enter advanced practice?

The main reason I ask is that you may find more barriers to working in peds as a PA compared to a PNP. PAs spend relatively little class and clinical time on pediatrics (since it's a generalist degree) compared to PNPs, whose coursework and clinical hours are focused entirely on pediatrics. You could have a leg up compared to other PAs since you have a background in pediatric nursing, but that may not make up for the relative lack of pediatric-focused hours and courses when compared to new graduate PNPs. Here's an article from the Journal of Pediatric Healthcare about peds advanced practice providers; I thought it was interesting to note that only 2% of PAs work in pediatrics.

If you're interested in working in peds as a PA, I recently heard about the PA program at University of Colorado with a pediatrics track (called the CHA/PA). The program is 3 years instead of 2, with the 3rd year focusing on pediatric care. However, it looks pretty competitive (apparently 1600 applicants for 44 spaces, though it's unclear if that's for the peds option or the whole program?), and you'd be out of work for an extra year with an extra year of tuition.