MD vs NP in the picu setting

PediNurse3 · Sep 7, 2011

In the PICU that I worked in, the NP's could do everything that the intensivests could do, with the exception of putting orders for narcotics in the computer. They could, however, write them on the paper chart. That was the only obvious difference, other than the pay! Line insertions, intubations, change in status, critical labs, my patient just sat up in bed and yanked out their ETT...just about anything you needed.

picurn1972, RN · Sep 13, 2011

I work in a level 1 peds icu and NP's do nothing but round with the fellows/attendings writing their orders. They make no decisions and do NO invasive procedures. Maybe it will change one day but not in top teaching facilities where these fellows need to gain vast experience to care for future sick kids. Only way in our city to d lots of procedures etc is NP in the adult worl. Sorry to dissapoint, but why on earth do 4 yrs bsn, and 3-4 years for NP considering youll need a doctorate to make only maybe 25% of that of the md. Don't forget the tme yull need to spend on the floor getting RN experience. Most reputable NP programs require at least 1 year. In addition thats 8-9 years, compared to 4 yrs premed 4 yr residency and 3 year fellowship 3 extra years to make an easy 300,000 more, not to mention the procedures, intubations, cdes etc. If you can handle it and want it go MD, it is what I advised my stepdaughter

dyslexicandetermined · Sep 15, 2011

oh thanks!!! picurn1972, i never really thought about going down the doctor root but..... know that you brought it up that is an idea or intrest i might want to think about! do you feel that it is worth all the schooling though to become a picu doctor? my mom was a nurse and told me that she rather see me become a np over a doctor because she does not want to see me go through all that schooling! i am only a high school student but i am looking at colleges early! i can see myself going down both paths! what would be better becoming a picu doctor or a picu NP?

picurn1972, RN · Sep 15, 2011

You must decide for yourself. MD is straight thru with no breaks. My brothernlaw is an MD. I regret very much I didn't stay true to the path of MD in my youth. I am to old to work all night. Also, you must realize that as a resident you do 70 hours a week. and the pay is not much. If you are someone who is goal driven and always finishes a project regardless of the time then why not! Try to observe in a picu if that is what you want. Just remember the down side, these are the people who tell parents their children are gone. I have seen it happen to one doc 3x in one week. If you can't handle that then MD not a very good choice. Good luck!

akulahawkRN, ADN, RN, EMT-P · Sep 16, 2011

MD is a huge commitment. After your 4 years of regular college (make sure you've got a very high GPA) and a good MCAT, you'll spend another 4 years in Medical School followed by probably 4-6 years doing post-grad doing ICU and (probably) PICU training before you're an attending. During that time, you'll rack up a debt somewhere in the neighborhood of $150k-300k... and you'll spend the next dozen years or so paying off that debt. Then you'll be making some serious money and doing quite well for yourself.

MD school is long, arduous, and expensive. If you feel you're up to the challenge, go for it!

One more thing to consider: MD's generally have an unrestricted license to practice medicine. NP's won't.

dyslexicandetermined · Sep 16, 2011

i am always up for a challenge! i feel i could handle med school too! i just do not think for me, that it is worth 14 years of my life just learning how to be a doctor. that is why i want to be a NP. the problem with becoming a NP is that i will not be able to do as mutch as an MD can do...... i am not shure what job would be more fulfilling. all i know is that i would like to work with criticly ill kids. i know that i do not need to decide now but like i said before, i am looking at my options. what path would you advise to take .... the NP of MD path?

HazelLPN, LPN · Sep 17, 2011

It depends on so many factors. Medical school is very competitive and much more difficult to get accepted to than nursing school. You must be very good at science and at math. If this is the route you wish to take, then you need to take advanced courses in chemistry, biology, physics and mathematics when you are still in high school.....if your high school had advanced placement courses...all the better....and you need to do well in them. Then be prepared to spend 4 years undergrad probably as a chemistry major, take the MCAT and get accepted to a med school....better have exceptional grades and scores. ...then spend 4 years in med school and 4 years of residency in peds and a fellowship in critical care medicine. In that time, it can be challenging to have a significant relationship or a family if this is what you wish to do. I know....I married a pediatrician (not an intensivist though) and I had to realize early that he was often more married to his job than me. Our first child was born when he was still in medical school and I was fresh out of nursing school. He missed most of her infancy and much of her young childhood. It was a trade off. I never had to worry about money, and I worked part time when I was raising my children, even though sometimes I felt like I was a single parent...especially early on.

Nursing is no easy route either, although its much easier to get acceptance into nursing school than med school.You also need a good background in science and in math because critical reasoning is very important in nursing. You work hard in high school and get accepted to a good nursing school with a good reputation for 4 years for your BSN, work 5+ years in the PICU as an RN and after you have that experience than you can get into a graduate program for an NP.

Follow your dreams, but have a back up plan just in case. You will find that the journey is often more rewarding than the end result.

Best to you,

Mrs H.

dyslexicandetermined · Sep 17, 2011

that was good advice! As of right know i am 18 in my class out of 425 students. i have a GPA of 3.87. i take honors in biology right know. i see your point about becoming a intensivist. i do not want to have to go through all thant schooling and i do not think i could handle putting my job over family that well. i see myself becoming a NP more than i see myself being a doctor but i just feel i could be capable of doing more than what an NP does. so that is my dilema! could i as a NP diagnose patients, prescribe meds, and run tests, just like a doctor can or am i limited on doing thoes things? as of right know i think the NP path works better for me. i would like more input though on this topic. if there are any NP's reading this please put your advise down!

thanks!

dyslexicandetermined · Sep 20, 2011

i thought it over.... and i can see my self being an NP over anything else! any NP's want to give my advise!?

dyslexicandetermined · Oct 12, 2011

just wanted to ask any other nurses out there if they would recommend becoming a pediatric intensivist.? i am not shure what i would rather do, become a picu np or pediatric intensivist.

Pediatric Critical Care Columnist · Oct 13, 2011

You'd be looking at a minimum of 14 years of post-secondary education to become a peds intensivist. An undergraduate science degree, followed by medical school, then a pediatric residency and last, a pediatric critical care fellowship. Not for the faint of heart! Eventually you could expect to make a lot of money, but there will be a lot of lean years before that. Also be prepared for working 100 hour weeks for the rest of your life, if you should happen to land in a place where there aren't a lot of other intensivists to rotate with.