I was all set to head towards NP now a dr told me PA. Hmmm

carolinapooh, BSN, RN · Jun 30, 2010

Take a look at sample PA and NP curriculums. I do wish that some NP course fluff was taken out in favor of cadaver labs and more hard core science. We got enough of Nightingale and other nurses' theories in our ADN/BSN progs.

And then compare specific programs against each other in each specialty - it depends on the school you choose as well.

carolinapooh, BSN, RN · Jun 30, 2010

The approach is different? You diagnose a patient with a problem, then treat it. Seems like medicine to me. In addition, PA's will typically have more in the way of chemistry than their nursing counterparts. I am not talking about survey type chemistry courses either.
With that, I have to disagree with your notion that there is a difference in the fundamental job of the NP or PA. As stated earlier, both have essentially the same job.

I think the OP means the mode of teaching - NPs are taught according to a nursing model and PAs are taught the medical model from the get-go. PA programs are based on the shortened form of medical school developed during WWII, so the methodology is a bit different.

Not all PA programs require a higher level chemistry course. Duke requires two semesters of chemistry with labs, two semesters of A&P (labs preferred), a semester of micro (lab preferred), and then another biologically-based course, like immunology or histology. (And Duke invented the PA program concept, so I'd take them as pretty much the standard.) ECU doesn't even require that much science (no upper level biology course is needed, just the general chemistry, micro, and two A&P classes. Yale requires one semester of higher level chemistry, but it's YALE, for crying out loud, and my guess is most of your PAs aren't coming from Yale or even Duke. Texas Tech, another public school, has the same requirements as East Carolina - no upper level chem or biology other than micro and A&P. University of Florida, same thing - and I found it interesting that they required a MEDICAL TERMINOLOGY COURSE, something I didn't even need to go to nursing school at Duke!

These are the exact same classes I took to get into nursing school - as did most of us on this board. So the hard science background theory as a difference isn't quite the case (and I'm pleased to see that in my literally fifteen minute web surfing survey).

Trivia: PA programs were invented to give the returning Navy corpsmen (and other combat medics, but specifically the corpsmen) after the Vietnam war someplace to use their vast skill set. The first PA program was at Duke University.

Me? I'm pursuing the NP, and actually went to RN school with that in mind, since PA was my first consideration.

tejas-nurse · Jun 30, 2010

May I ask which NP program you are applying to? I just think that if we had some more med-schoolish components such as cadaver lab, that might take some of the edge of the criticism that we constantly hear from PAs and MDs.

I think the OP means the mode of teaching - NPs are taught according to a nursing model and PAs are taught the medical model from the get-go. PA programs are based on the shortened form of medical school developed during WWII, so the methodology is a bit different.
Not all PA programs require a higher level chemistry course. Duke requires two semesters of chemistry with labs, two semesters of A&P (labs preferred), a semester of micro (lab preferred), and then another biologically-based course, like immunology or histology. (And Duke invented the PA program concept, so I'd take them as pretty much the standard.) ECU doesn't even require that much science (no upper level biology course is needed, just the general chemistry, micro, and two A&P classes. Yale requires one semester of higher level chemistry, but my guess is most of your PAs aren't coming from Yale or even Duke. Texas Tech, another public school, has the same requirements as East Carolina - no upper level chem or biology other than micro and A&P.
These are the exact same classes I took to get into nursing school - as did most of us on this board. So the hard science background theory as a difference isn't quite the case (and I'm pleased to see that in my literally fifteen minute web surfing survey).
Trivia: PA programs were invented to give the returning Navy corpsmen (and other combat medics, but specifically the corpsmen) after the Vietnam war someplace to use their vast skill set. The first PA program was at Duke University.
Me? I'm pursuing the NP, and actually went to RN school with that in mind, since PA was my first consideration.

james_lankford · Jun 30, 2010

the Yale accelarated 2nd degree nursing program doesn't even require chemistry, A&P or microbiology

http://nursing.yale.edu/Academics/GEPN/admission.html

"The minimum requirement for admission to the Graduate Entry Prespecialty in Nursing (GEPN) is a baccalaureate degree from an accredited college or university. Applicants from all academic majors and backgrounds are encouraged to apply. There are no prerequisite courses for the GEPN program, but applicants are highly encouraged to have undergraduate courses in human anatomy and physiology, statistics, and the biological sciences prior to applying. "

Columbia's accelarated 2nd degree nursing program only requires A&P and microbiology, both of which can be met by taking Excelsior exams

they only require chemistry if you're going into Nurse Anesthesia

Columbia University School of Nursing

nurseangel368 · Jun 30, 2010

its taken me awhile to get here.. but.. i wouldn't trade my np for anything!!!.. i have been an rn for 34 yrs.. and got my np in august.. i do believe it is the way to go.. while the pa's that i have met have been terrific... they don't have the same education as the np and have less autonomy than the np does..autonomy does differ state to state.. when i was in school i precepted with an np which is ok in texas where my school was based.. in california.. pa's are not considered appropriate to precept with and i almost lost a semester of school!!.. check your states licensing for pa's and what they can/can not do as opposed to the np.. and make your decision..

morphed · Jun 30, 2010

the Yale accelarated 2nd degree nursing program doesn't even require chemistry, A&P or microbiology
http://nursing.yale.edu/Academics/GEPN/admission.html
"The minimum requirement for admission to the Graduate Entry Prespecialty in Nursing (GEPN) is a baccalaureate degree from an accredited college or university. Applicants from all academic majors and backgrounds are encouraged to apply. There are no prerequisite courses for the GEPN program, but applicants are highly encouraged to have undergraduate courses in human anatomy and physiology, statistics, and the biological sciences prior to applying. "
Columbia's accelarated 2nd degree nursing program only requires A&P and microbiology, both of which can be met by taking Excelsior exams
they only require chemistry if you're going into Nurse Anesthesia
Columbia University School of Nursing

It may not be required, but how many people do you think they actually accept without chemistry, A&P or microbiology? At the most there might be one or two exceptions for people who have shown significant success/accomplishment in some healthcare related field. It's not like they just accept people with a BA in business and a few years of retail management experience. The minimum GRE score accepted for some CRNA programs is 900-1000...but do you think someone with a 900 is really going to get in?

morphed · Jun 30, 2010

its taken me awhile to get here.. but.. i wouldn't trade my np for anything!!!.. i have been an rn for 34 yrs.. and got my np in august..

Wow, you became an NP after 30+ years of being an RN? Can I ask what finally made you go back to school after all that time? And did you find it very difficult going back to school? Were you able to keep up with everything? Obviously you did since you finished the program, but I mean did you find it much more difficult because you returned much later in life? By the way, congrats!!! Hope is working out well for you!!!

lamazeteacher · Jun 30, 2010

The physician has a point guys. This thread is not asking about the typical NP autonomy bloviation, perhaps we can put that to the side for a moment? Comparing typical curricula, the PA in most cases will have much more in the way of "hard" science background and education. As somebody who appreciates this kind of background, I see the physicians point.

The Starbucks physician's point is that the PA was born due to nurses' refusal to be handmaidens/manservants to doctors. The PA must remain in accord with physicians due to the origination of his/her capacity and need to always work with them.

NPs answer to a higher authority, and have the hands-on experience that really counts, along with "hard science" background. If I was a patient where there was a choice, I'd much prefer to have a NP as they have greater awareness of patients' needs, and the means to resolve symptoms. Fewer of the NPs want to see the puzzle presented to them as that, with treatment seen as a way to have a problem go away. They seemed to me to reach out to physicians as their peers, rather than someone who was more like an underling, in clinics where I've worked.

PAs I've known, really distanced themselves from nurses in their capacity, whereas NPs seemed to be a member of our team. PAs' curricula is set by MDs, who want them to identify with doctors, being on their page, not with nurses. NPs actually read Nurses' notes, while PAs I've known skip them, as do doctors. :nurse:

elkpark · Jun 30, 2010

the Yale accelarated 2nd degree nursing program doesn't even require chemistry, A&P or microbiology
http://nursing.yale.edu/Academics/GEPN/admission.html
"The minimum requirement for admission to the Graduate Entry Prespecialty in Nursing (GEPN) is a baccalaureate degree from an accredited college or university. Applicants from all academic majors and backgrounds are encouraged to apply. There are no prerequisite courses for the GEPN program, but applicants are highly encouraged to have undergraduate courses in human anatomy and physiology, statistics, and the biological sciences prior to applying. "
Columbia's accelarated 2nd degree nursing program only requires A&P and microbiology, both of which can be met by taking Excelsior exams
they only require chemistry if you're going into Nurse Anesthesia
Columbia University School of Nursing

I have no personal experience with Columbia, but I am a Yale SON graduate (as a traditional, experienced-RN student, not a direct-entry student) so I can speak to the school's philosphy. YSN doesn't require any prereqs because the YSN model is to teach you everything you need to know once you're in the program. Many of the direct-entry students with whom I had classes had no science background at all when they were accepted, but all of that was covered in the first, "basic nursing" year of their program (which, I was told, was basically 16-hour days, six days a week, for a full year). Unlike many other traditional MSN programs, the YSN traditional MSN program has no prereqs, either. No one actually ever came out and said it to me while I was there, but I suspect the reason for this is that, in their heart of hearts, they don't really believe any other school can teach up to their standards (whether or not that's true, I certainly got an excellent education in my clinical specialty there :)).

GilaRRT · Jun 30, 2010

The Starbucks physician's point is that the PA was born due to nurses' refusal to be handmaidens/manservants to doctors. The PA must remain in accord with physicians due to the origination of his/her capacity and need to always work with them.
NPs answer to a higher authority, and have the hands-on experience that really counts, along with "hard science" background. If I was a patient where there was a choice, I'd much prefer to have a NP as they have greater awareness of patients' needs, and the means to resolve symptoms. Fewer of the NPs want to see the puzzle presented to them as that, with treatment seen as a way to have a problem go away. They seemed to me to reach out to physicians as their peers, rather than someone who was more like an underling, in clinics where I've worked.
PAs I've known, really distanced themselves from nurses in their capacity, whereas NPs seemed to be a member of our team. PAs' curricula is set by MDs, who want them to identify with doctors, being on their page, not with nurses. NPs actually read Nurses' notes, while PAs I've known skip them, as do doctors.

The PA was essentially developed with the thought that medics who had advanced experiences in the military and the field (Vietnam) could be educated to provide some aspects of primary care. NP's do not answer to a higher authority, unless boards of nursing are now considered the higher medical authority than boards of medicine?

Again, I do believe the NP curriculum has less hard science background when compared to the typical PA prerequisite courses that commonly include several semesters of real chemistry.

As stated, the doctor does have a few points. Clearly, the doctor is incorrect as well, but a typical PA is going to have more in the way of hard science background. It is my personal bias (n = 1) and my bias alone that my provider has to have a better grasp of the science behind medicine than I before I will allow them to see me.

calalilly · Jul 1, 2010

GilaRN you seem to be very bias. I don't understand why you are still harping on the hard science background. In my NP program, and most that I have seen, students are required to have 2 semesters of chemistry, at least one in organic, 2 semesters of biology, 2 semesters of anatomy and physiology. The list goes on. Why are you so concerned with the hard science background? Not only do we have to have those classes as prereq's but we also have to take all of our nursing classes, an assessment class, and pharmacology just to get our RN/BSN. Continuing into the NP portion advanced pathophys, advanced pharm, advanced health assessment are all required. NP's are very much qualified to diagnose and treat patients, and do in fact have a strong grasp of the sciences.

I think you are being a bit blind about how PA's and NP's approaches differ. It is well known that PA's are educated in the medical model, which is focused on the disease and treating the disease process. NP's are educated in the nursing model which is a more holistic approach that focuses on the patient as a whole, the disease being one component or aspect of the patient.

It is true that NP's and PA's practice pretty equally in many circumstances. The goal for both the NP and the PA is to treat the patient. However, training and approach is different. There is a reason there are both PA's and NP's and that is because different people prefer different approaches. I have always found NP's to be more empathetic and have found that they focus on the patient, where many PA's dont seem to see the patient as a person, only a disease to be treated.

foreverLaur · Jul 1, 2010

I think the point is that both pre-NP and pre-PA students take very similar if not identical coursework. PAs take a lot more science coursework at the graduate level than NP students do in addition to all the other coursework.