If you could rewind and do it over again...

BCRNA · Jan 1, 2011

People who would ask why not a PA don't really understand the differences between the two. The job is exactly the same. The difference is that NP's are not as dependant on the physician for their practice. They are not regulated by physicians, but other nurses. The pay is the same also. Very little difference in pay. Have you been told that PA's earn more money faster? I don't know this to be true at all. If anything the RN's do, because their education allows them to work as RN's while in graduate school. Whereas many PA's have a degree in a field that doesn't allow them to get as good of a paying job. Also, NP programs can be done part time. There may be PA programs that are part time, but NP programs (in my opinion) are better tailored to people who work full time and/or have family obligations. There are many pro's and con's to doing either program. If your already a nurse I think it is best to do the NP path because of more flexibility, autonomy.

kakamegamama · Jan 1, 2011

I am actually entering a FNP program this month. And, I chose it in part because I am a Registered Nurse and very proud of the years I spent learning and working in the profession of nursing. I would not even consider a PA program. I want to be seen as an advanced practice NURSE, not a PHYSICIAN assistant.

Guest27531 · Jan 1, 2011

For any of you ARNP's or higher-level nursing degree nurses out there: if you could do it over again, would you still stick with Nursing, or would you jump right into being a PA? People ask me all the time, "why a nurse? why not be a PA?" I realize the first thing they are thinking of is money. I have asked the opinion of different ARNP's and have gotten a mixed bag of answers: "No, because you have to work under a Dr. and also pay more to write scripts per year", "Yes, because you can start earning really good money a lot faster"....
Just wanted to know your opinions. I haven't decided whether I want to go the PA or ARNP route yet. I'm just getting started. But right now, one of those is my ultimate goal.
Happy New Year everyone!

That would be an odd question for a nurse to ask but I just re-read your post and see that you haven't decided where your interest lies. It seems like you are trying to investigate the differences before you commit and that is wise. Let me say, for the record, I have never considered and would never consider being a PA. It is entirely different from nursing. I will tell you what I told a friend of mine who was struggling with the same decision - Medicine (whether MD or PA) is about the "puzzle" and nursing is about the "patient". Much of the knowledge is overlapping and some of the responsibilities but there are essential differences in the professions. I do believe that some people who should be in nursing are PAs for a variety of reasons.

Take this little test for yourself and answer this question:

When considering a medical issue (why someone has a fever, how to treat a sprained ankle) are you more interested in the mechanism of what caused the problem or are you more interested in knowing enough about the problem to help the individual through the crisis? Puzzle or patient?

deftonez188 · Jan 1, 2011

I like the way you phrased that. Thinking of it in those terms, I guess i'm more of a puzzle person - that intrigues me more to be honest.

NurseBanana · Jan 2, 2011

That would be an odd question for a nurse to ask but I just re-read your post and see that you haven't decided where your interest lies. It seems like you are trying to investigate the differences before you commit and that is wise. Let me say, for the record, I have never considered and would never consider being a PA. It is entirely different from nursing. I will tell you what I told a friend of mine who was struggling with the same decision - Medicine (whether MD or PA) is about the "puzzle" and nursing is about the "patient". Much of the knowledge is overlapping and some of the responsibilities but there are essential differences in the professions. I do believe that some people who should be in nursing are PAs for a variety of reasons.
Take this little test for yourself and answer this question:
When considering a medical issue (why someone has a fever, how to treat a sprained ankle) are you more interested in the mechanism of what caused the problem or are you more interested in knowing enough about the problem to help the individual through the crisis? Puzzle or patient?

Hmmm... When I think about it that way, I am still not sure, because I care about both. Maybe after going through my BSN program I will be able to figure it out. But, don't NP's also (especially the family kind) do more of the "puzzle" type of work? I mean, when I go into my Dr's office and see the NP, she is basically taking the place of the Dr....

Guest27531 · Jan 2, 2011

I can see that "puzzle" or "patient" might be confusing since both are addressed. Look, for a moment, at an End of Life situation. A 95 year old frail woman with a history of advanced liver failure comes into the hospital with a chief complaint of Pre-Syncope (nearly passing out). You are assigned to her case and your level of education gives you the knowledge and expertise to make a diagnosis and order appropriate tests (MD, PA, APRN). Picture yourself now coming into her room to see her with a clear picture of the differential diagnoses and your plan of action.

Patient - You are concerned about finding the reason for the Pre-Syncope but you are also well aware that the tests you would like to order may carry risks of their own and, in light of her advanced liver disease, you would like to discuss with her the nature of the tests and whether she would like to pursue this course of action. If her liver failure is far enough advanced, you may consider discussing whether she would like DNR status initiated. You may also explore whether she is ready to discuss end of life care and possibly entry into a hospice program.

Puzzle - You are so focused on the finding the reason she almost passed out that your plan on entering her room is to describe to her the battery of expensive and risky tests (with additional expense) that you are planning to order for her. You will explain to her how important the tests are to find the cause of the problem.

That is the type of difference I'm talking about.

diane227, LPN, RN · Jan 2, 2011

Rules and regs for PA's vs ARNP's are different. In most states, ARNP's have full prescriptive authority but PA's do not. ARNP's are able to function at a more independent level. What would be the advantage of being a PA?

NurseBanana · Jan 2, 2011

I can see that "puzzle" or "patient" might be confusing since both are addressed. Look, for a moment, at an End of Life situation. A 95 year old frail woman with a history of advanced liver failure comes into the hospital with a chief complaint of Pre-Syncope (nearly passing out). You are assigned to her case and your level of education gives you the knowledge and expertise to make a diagnosis and order appropriate tests (MD, PA, APRN). Picture yourself now coming into her room to see her with a clear picture of the differential diagnoses and your plan of action.
Patient - You are concerned about finding the reason for the Pre-Syncope but you are also well aware that the tests you would like to order may carry risks of their own and, in light of her advanced liver disease, you would like to discuss with her the nature of the tests and whether she would like to pursue this course of action. If her liver failure is far enough advanced, you may consider discussing whether she would like DNR status initiated. You may also explore whether she is ready to discuss end of life care and possibly entry into a hospice program.
Puzzle - You are so focused on the finding the reason she almost passed out that your plan on entering her room is to describe to her the battery of expensive and risky tests (with additional expense) that you are planning to order for her. You will explain to her how important the tests are to find the cause of the problem.
That is the type of difference I'm talking about.

When you put it that way, I am definitely going the right path with nursing. Thanks for claifying. :-)

NurseBanana · Jan 2, 2011

Rules and regs for PA's vs ARNP's are different. In most states, ARNP's have full prescriptive authority but PA's do not. ARNP's are able to function at a more independent level. What would be the advantage of being a PA?

The only advantages I can see are that it doesn't take as long to get through school and into a job as it does for an NP...that's where I think most people are "misled" into thinking they are the same job, but one gets paid more. Although depending on where you go to school, that might not be true, either!

Spacklehead, MSN, NP · Jan 2, 2011

As long as one has been a bedside RN in an acute care facility for more than a couple of years, I can not think of any reason going the PA route would be more enticing than becoming a NP. The only reason I can see going the PA route (if you had years of nursing experience) would be if you were interested in mainly surgery. NPs typically don't assist in surgery unless they are already RNFA's. That would be my only reason not to pursue the NP route. If as an RN you were a new grad, then I would probably encourage you to pursue the PA route (of course this opinion will vary greatly - just my take on it as a practicing NP).

I guess the other thing is, though, if the area I currently lived in hired more NPs vs. PAs. Some areas of the country are more PA-friendly, while others are more NP-friendly.

NurseBanana · Jan 2, 2011

As long as one has been a bedside RN in an acute care facility for more than a couple of years, I can not think of any reason going the PA route would be more enticing than becoming a NP. The only reason I can see going the PA route (if you had years of nursing experience) would be if you were interested in mainly surgery. NPs typically don't assist in surgery unless they are already RNFA's. That would be my only reason not to pursue the NP route. If as an RN you were a new grad, then I would probably encourage you to pursue the PA route (of course this opinion will vary greatly - just my take on it as a practicing NP).
I guess the other thing is, though, if the area I currently lived in hired more NPs vs. PAs. Some areas of the country are more PA-friendly, while others are more NP-friendly.

Just out of curiosity, why would you encourage a new RN grad to pursue the PA route?