Just a note on the NP vs PA debate...

RNPATL, DNP, RN · May 28, 2004

Depends on the state as far as independent practice. You can make it happen just about anywhere just have to make the paperwork right for the laws. Medicare reimburses 85% of the physician rate if the doc isn't on site. Everything else is same. (and HMO reimbursement is rediculous no matter what you are)

Thank you.

PA-C in Texas · May 31, 2004

You are slightly mistaken in your representation. IF you are not a Physician Assistant yourself I think that you should stop providing false representation of what a Physician Assistant actually does. I have a great amount of autonomy. I see my own patients in a clinic and the physician works the other end of the hall. Sometimes we dont even cross paths in a day. I know my limitations. I am NOT a physician and likewise nurses are NOT physicians either. You portray PA's to be incompetant little assistants who follow the doc around all day long picking up after him. You could not be further from the truth if you live near my area...I invite you to spend a day with me in the office. I am highly respected by my patients, and colleagues alike (yes including my nurses and supervising physician) On top of that I make EXCELLENT money (40/hour + profit sharing, have EXCELLENT benefits and great working hours (7:30-3:00 M thru F) No Call. great working environment. I dont know where your misconstrued ideas are generated from. Either way I am not going to add anymore fuel to your fire. This message is for those out there reading the rubbish that you write.

I have corrected some of the errors espoused by a few of my NP colleagues numerous times in this forum, but it appears that they choose to still choke them up because they suggest a superiority of NP's to PA's.

I would just add that I don't even SEE a physician except for when a patient's personal physician comes to the ED, or my supervising physician makes his visits to fulfill the supervisory requirements.

In Texas, the last remnant BPAS program just got the axe. PA school is generally longer than NP school, and it resembles the format of medical school moreso than it does other graduate degrees (including MSN degrees). Students are admitted yearly into a class that has a fixed schedule (no part-timing here). Here's the way it went for my masters program: The first year consists of basic bio-science classes, some of which are the same classes that medical students take. The second year is more clinically focused. The third year consisted of eight six-week rotations in various specialties. We had enormous clinical experience in the field before we were actually allowed to go and practice. We didn't have summers off and they didn't offer night classes.

If I ever get compared to a nurse's assistant again I am going to scream.

RNPATL, DNP, RN · May 31, 2004

I have corrected some of the errors espoused by a few of my NP colleagues numerous times in this forum, but it appears that they choose to still choke them up because they suggest a superiority of NP's to PA's.
I would just add that I don't even SEE a physician except for when a patient's personal physician comes to the ED, or my supervising physician makes his visits to fulfill the supervisory requirements.
In Texas, the last remnant BPAS program just got the axe. PA school is generally longer than NP school, and it resembles the format of medical school moreso than it does other graduate degrees (including MSN degrees). Students are admitted yearly into a class that has a fixed schedule (no part-timing here). Here's the way it went for my masters program: The first year consists of basic bio-science classes, some of which are the same classes that medical students take. The second year is more clinically focused. The third year consisted of eight six-week rotations in various specialties. We had enormous clinical experience in the field before we were actually allowed to go and practice. We didn't have summers off and they didn't offer night classes.
If I ever get compared to a nurse's assistant again I am going to scream.

Let me ask if you are equating evening and part time classes to being less rigorous or easier simply because there is some reasonable flexibility built into an NP's education? Let us please remember that before an individual can be accepted into an NP program, they must have at least 2 years of experience as an RN. In addition to this, you can compare your program all you would like, a NP is not in the profession of Medicine. We are in the profession of Nursing. Our role is different than that of the PA. Further more, NP practice off their own license.

I work with many PA's and many NP .... both very competent and both having their place in the health care field today. To compare both is simply not relevent as the programs of education are different as well as their roles. While I can see there are some functions that are similiar .... I am going to become an FNP because I love nursing and the methods nurses employ to care for patients. If I wanted to be a PA, I would take that route. As far as independence is concerned, according to my State's nurse practice act .... the NP has many independent functions and does not have to rely on the licensure of a physician to practice. I know for my own practice once I graduate, I will surely recognize my limitations and have plenty of good working relationships with physicians.

I have never subscribed to the mindset that it is "ok" to beat down another profession because they have some of the same functions, simply because their education is different. We have to remember, when a PA graduates from college, they start their career as entry level. When a NP graduates, they start their career as entry level. The experience one gains by working and using skills learned is what truly defines competence. So, I think we should really look at competence based on practice and experience rather than entry-level issues.

cgfnp · May 31, 2004

I have corrected some of the errors espoused by a few of my NP colleagues numerous times in this forum, but it appears that they choose to still choke them up because they suggest a superiority of NP's to PA's.
I would just add that I don't even SEE a physician except for when a patient's personal physician comes to the ED, or my supervising physician makes his visits to fulfill the supervisory requirements.
In Texas, the last remnant BPAS program just got the axe. PA school is generally longer than NP school, and it resembles the format of medical school moreso than it does other graduate degrees (including MSN degrees). Students are admitted yearly into a class that has a fixed schedule (no part-timing here). Here's the way it went for my masters program: The first year consists of basic bio-science classes, some of which are the same classes that medical students take. The second year is more clinically focused. The third year consisted of eight six-week rotations in various specialties. We had enormous clinical experience in the field before we were actually allowed to go and practice. We didn't have summers off and they didn't offer night classes.
If I ever get compared to a nurse's assistant again I am going to scream.

You're right, even though you don't really know you are. It has nothing to do with what time the class starts or whether you take all of them in two years or four years. It does, however, have to do with the medical model vs the nursing model training. MSN program sucks something awful. I have to write papers about what Sister Calista Roy thinks about hand washing, yet I don't know how to read an EKG. But, I realize this so I'll be teaching myself the important stuff that I know I don't have a clue about because of the MSN bullsh*t. I'm still glad I did it this way because many of the docs in my state are going with NPs because we can practice without them in the building, whereas PAs cannot. Other than that, I'd go PA any day over the pure crap I have to learn at the present.

The scary thing is, most of my classmates and probably many of the current practicing NPs don't have a clue that the training is so terrible, so they think they know what they need and go out and make fools out of the profession. I hear that a lot from docs I work with now. But, the good thing is they can recognize the 1-2 out of 10 NPs that are really good.

RNPATL, DNP, RN · May 31, 2004

MSN program sucks something awful. I have to write papers about what Sister Calista Roy thinks about hand washing, yet I don't know how to read an EKG. But, I realize this so I'll be teaching myself the important stuff that I know I don't have a clue about because of the MSN bullsh*t.

I would really like to know what school you are attending that you think the track for MSN sucks. I have to disagree with you. I have found my program to be very thorough and has certainly taught me a great deal. In relationship to writing papers rather than learning clinical skills, I would have to say that by the time you get to the MSN, I would certainly hope you have read an EKG and can perform this function pretty independently. If not, then perhaps you need to get some additional clinical experience.

I also think that a great many physicians have respect for most NP's. Yes, there are those out there that don't know enough to practice, but I would say they are few and far between. I have known a great many NP's in my time and they have been extremely skilled people and I would not have a problem with them treating me or a member of my family. To make such a broad statement is simply wrong and plays into the thinking that most NP are beneath other advanced trained professionals, which is just not true! If you hate the program so much and think that nursing theorists are not worth learning about, then perhaps you have chosen the wrong profession. I am not sure that PA's would want to have that kind of attitude among their ranks either.

cgfnp · May 31, 2004

I would really like to know what school you are attending that you think the track for MSN sucks. I have to disagree with you. I have found my program to be very thorough and has certainly taught me a great deal. In relationship to writing papers rather than learning clinical skills, I would have to say that by the time you get to the MSN, I would certainly hope you have read an EKG and can perform this function pretty independently. If not, then perhaps you need to get some additional clinical experience.
I also think that a great many physicians have respect for most NP's. Yes, there are those out there that don't know enough to practice, but I would say they are few and far between. I have known a great many NP's in my time and they have been extremely skilled people and I would not have a problem with them treating me or a member of my family. To make such a broad statement is simply wrong and plays into the thinking that most NP are beneath other advanced trained professionals, which is just not true! If you hate the program so much and think that nursing theorists are not worth learning about, then perhaps you have chosen the wrong profession. I am not sure that PA's would want to have that kind of attitude among their ranks either.

You can keep reading about the nursing theorists... I really don't care.

I actually convinced the school to accept me straight out of BSN program, but quit after a semester because I actually thought there would be some good information and teaching. So, I took a year off and practiced in ER. And if you think looking over the doc's shoulder and saying, "yeah, that's what I thought too" about an EKG is learning to interpret one, then I hope no one ever comes to you for heart problems.

True, I shouldn't make generalizations about NPs as a whole, but I can only comment on what I've seen in this area. Here, NPs are beneath in my opinion because there is no interview, there's no admission test, no nothing to screen applicants. So, I have several classmates that are barely smart enough to walk safely much less f*ck with someone's digoxin and coumadin.

I can't tell you where I go because I'm quite the conspiracy theorist now that I've seen more than one classmate who would've been good NPs get booted out for not writing a paper about nursing crap the way the instructor thought it should be written. I don't even fill out the class evals because they're not anonymous enough. Trust me... if you were in my program, you'd feel the same way.

I'm in this profession because I want to practice medicine, period. I don't care about any of the nursing bullsh*t. I can't wait to leave it FAAARRRR behind me and forget it forever.

RNPATL, DNP, RN · Jun 1, 2004

You can keep reading about the nursing theorists... I really don't care.
I actually convinced the school to accept me straight out of BSN program, but quit after a semester because I actually thought there would be some good information and teaching. So, I took a year off and practiced in ER. And if you think looking over the doc's shoulder and saying, "yeah, that's what I thought too" about an EKG is learning to interpret one, then I hope no one ever comes to you for heart problems.
True, I shouldn't make generalizations about NPs as a whole, but I can only comment on what I've seen in this area. Here, NPs are beneath in my opinion because there is no interview, there's no admission test, no nothing to screen applicants. So, I have several classmates that are barely smart enough to walk safely much less f*ck with someone's digoxin and coumadin.
I can't tell you where I go because I'm quite the conspiracy theorist now that I've seen more than one classmate who would've been good NPs get booted out for not writing a paper about nursing crap the way the instructor thought it should be written. I don't even fill out the class evals because they're not anonymous enough. Trust me... if you were in my program, you'd feel the same way.
I'm in this profession because I want to practice medicine, period. I don't care about any of the nursing bullsh*t. I can't wait to leave it FAAARRRR behind me and forget it forever.

Wow - I guess you have answered my questions quite well. Perhaps you should go to med school if you want to practice medicine.

cgfnp · Jun 1, 2004

Wow - I guess you have answered my questions quite well. Perhaps you should go to med school if you want to practice medicine.

That's the whole point of going to NP school. I didn't want to spend the next 8 years (med school and residency... and residency is a whole different discussion I have problems with) away from my family. I'll get to practice medicine (although it is limited in autonomy to primary care/urgent care) and it saved me 6 years and over $1,000,000 in student loans/lost income.

I guess down the road if I want to be a surgeon or something I'll apply to med school. I can't see giving up so much time though....

UCLARN · Jul 20, 2004

Are you sure you were in an NP program. Come to ours, they'll have you working hard. We didn't write papers about Calista Roy or other nursing theorists. You sound very frustrated and bitter, maybe you failed out instead of enrolling out. Regarding NP's as being beneath you, wow do you do this to other nurses (those with an ADN or LVN's)? Can you express yourself in a civilized manner without the use of profanity?

You can keep reading about the nursing theorists... I really don't care.
I actually convinced the school to accept me straight out of BSN program, but quit after a semester because I actually thought there would be some good information and teaching. So, I took a year off and practiced in ER. And if you think looking over the doc's shoulder and saying, "yeah, that's what I thought too" about an EKG is learning to interpret one, then I hope no one ever comes to you for heart problems.
True, I shouldn't make generalizations about NPs as a whole, but I can only comment on what I've seen in this area. Here, NPs are beneath in my opinion because there is no interview, there's no admission test, no nothing to screen applicants. So, I have several classmates that are barely smart enough to walk safely much less f*ck with someone's digoxin and coumadin.
I can't tell you where I go because I'm quite the conspiracy theorist now that I've seen more than one classmate who would've been good NPs get booted out for not writing a paper about nursing crap the way the instructor thought it should be written. I don't even fill out the class evals because they're not anonymous enough. Trust me... if you were in my program, you'd feel the same way.
I'm in this profession because I want to practice medicine, period. I don't care about any of the nursing bullsh*t. I can't wait to leave it FAAARRRR behind me and forget it forever.

ayndim · Jul 22, 2004

What is the big beef between NP's and PA's. Although the training is different surely both have the same level of competency. So what if PA's have to workwith a Dr. Any NP I have seen works with a dr too. And any advantage a PA may think they have in education is countered by the experience an NP has as an RN, right?

R2MD · Apr 11, 2005

CME's...NP's, MD's, and PA's must have them...only the PA has to take the PA exam AGAIN, every 6 years...

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foxyhill21 · Apr 12, 2005

Do PA work in L&D units and what is there actual salary