Latest Comments by treejay

treejay 1,421 Views

Joined: Dec 11, '10; Posts: 37 (30% Liked) ; Likes: 23

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    Jules A likes this.

    Quote from Riburn3
    Ouch, this is pretty ignorant.

    It doesn't take into account that most APRN's have years and thousands of hours as caregivers.
    I see this posted time and time again... And I will say it again. It isn't true anymore. The large number of direct entry NP programs have made this blanket statement not truthful. It is true for a substantial number of NPs. But most definitely not all. It's important to be accurate and not misleading.

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    Jules A likes this.

    Quote from BD-RN
    Physicians always bring up the clinical hours, forgetting that NPs function as a RN BEFORE receiving their NP. The total amount of clinical hours spent with patients is well into the thousands by the time the NP BEGINS their training. Most MDs haven't touched a patient except as a volunteer until they are in med school. And, if you still believe the NP FUNCTIONS differently in the PCP role, explain how? Boston FNP's explanation was actually spot on.
    This simply isn't true anymore. It used to be, but with the proliferation of many direct entry programs, it is no longer the case.

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    Quote from nomadcrna

    Don't even try to go with the tired old argument of PAs get more or better education, sigh.

    Please get a clue.
    How do PAs not get more or better education? Not trying to be antagonistic, but I disagree and would like to understand your viewpoint.

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    Quote from mzaur
    There is no standard curriculum for the DNP, as far as I know. So this doesn't meant that the switch to DNP really means anything in terms of more prepared graduating NPs
    Yeah this is too bad in my opinion, because the NP profession really had a chance to fix some of the problems with current NP programs such as limited clinical hours.

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    puppyrunner likes this.

    All things being equal, I do believe PA school has a much more rigorous training based in more hard sciences and many more clinical hours. This is virtually undebatable. All NP preceptors I have rotated with have unequivocally agreed. That being said, there will be certain restrictions once you become a PA that you wouldn't have as an NP. I was in a quandry choosing between the two, and I chose PA because of the educational opportunities, and because I want to enter EM which seems to have more jobs for PAs than NPs, at least in regions I'm in. A big part in the decision I believe should come from what field of medicine you want to practice in. If I was sure I wanted Family Practice, NP hands down far and away. Inpatient settings less so (Peds and OB/Gyn being notable exceptions). As many earlier have said much learning will also come from the job.

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    One more comment about the title NPP vs APC. Non-physician providers defines us what we aren't. Advanced Practice Clinician defines us by what we are. I dunno. To me, it seems the latter is the better term.

    PA Student

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    NURSE2b_EPLFan likes this.

    Quote from mammac5
    I like NPPs in primary care, particularly nurse practitioners. I realize many here will not agree with me, and that's fine, but let's not fight about it!

    There have been studies that show NP care is equal to (in some cases superior to) physician care, particularly with management of chronic illnesses. NPPs are likely to have more time for chronic disease management and that's the role they would fill in the PCMH model.

    NPPs work so well in this area since what chronic disease requires is TIME to talk with patients, listen to their concerns/barriers to self-care, help them set goals, assist them in managing all that comes with living with a chronic disease, etc.
    Just a few comments on the notion that APCs have more time. I think it's a myth in many cases. The only reason why an APC would have more time, is if they're seeing fewer patients. And if one isn't working for themselves, the employer will try to get the provider to see as many patients as possible, as quickly as possible. If an APC is seeing the same amount of patients as a physician in a practice, that math just doesn't pencil out. TIME is determined by how many patients/day one sees, not their degree. Time is required for patient education. Not sure why this myth is so perpetuated that APCs "get to spend more time with patients".

    One area where I do agree with you strongly, is that nursing education is much more consistent with education of patients. Medical educations places ZERO emphasis on that, which as we all know is absurd.

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    Quote from SkiBumNP
    Treejay. Most EDs in the bay use PAs and NPs. CEP has the contract with most of the community EDs and then there are the county hospitals too. If you have any specific questions feel free to PM me. As for kaiser. Last I checked they don't. But I could be wrong.
    Thanks SkiBumNP. I appreciate it. I will PM you in the near future.

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    Does Kaiser use PAs in the ED? Also, what hospitals in the bay area use PAs in the ED? PA student considering a path in EM somewhere on the west coast..

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    Quote from SycamoreStudent
    On the other hand I'm not sure NPs and PAs should be lumped together.
    How come ?

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    and when I say most often causes flushing, i have read that most patients who take niacin at therapeutic doses for HLD, get flushing side effects. it's not widely tolerated.

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    niacin most often causes flushing at therapeutic doses for hyperlipidemia. the vitamin dose it drastically smaller than that used for cholesterol/triglycerides. as far as overmedicating society, definitely. and in no small thanks to the incessant lobbying of the pharmaceutical industry.

    and holistic NPs to my knowledge, at least schools that offer that focus, ultimately sit for the FNP certification

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    Quote from goofeegirl
    I don't believe PAs have prescriptive authority in GA or NY.
    wrong. why not simply type a few words into google for your quick answer?

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    Quote from PMFB-RN
    *** Yes I see that. When I look at the state of PA I see 21 programs listed with 6 having a "B" and one not saying. CA lists 9 programs with 3 having an "A", though "C" & "M" are also listed for those schools. NY lists 23 programs with 8 of them having a "B" listed. Even though masters program have now become the majority it would seem a sizable minority are still below the masters level. I find this to be a real shame.
    I don't know if I agree that it's a real shame. How it's setup by the accrediting agency, PA programs are competency based, not degree based. Graduates of any PA program, associates or master's need to meet the same competencies, and those competencies are stringent. I think this is one of the strengths of the PA education model.

    With all due respect, and not intended to flame, and as discussed in other threads here, shameful might be the online NP program requiring in the ballpark of 500 clinical hours which may vary widely in quality. Theoretically, and i bet it has been done, not just in theory, one can obtain a BSN (or an accelerated BSN in 12 months if already have another bachelors), work very briefly as an RN if at all, then move on to an online NP program and practice after completion of the 500 hours of clinical hours. Granted, I have never met anyone or know anyone first hand who has done this. But it seems like the system is there to do it if one wanted to. And please understand, I point this out not to compare good vs bad, us vs them. I believe it's a fair critique of NP educational model. There are outstanding NP programs and from what I have read here, there seem to be some poor ones too. Huge variance if you will. I think PA education has a leg up in this issue. The standards for accreditation are stringent, well defined, and enforced. It's been discussed elsewhere in this forum. Just curiously, for my knowledge, who accredits NP schools? And what are the standards?

    Don't take me wrong. I'm a uniter of the two professions, not a divider. But even with a vision of unification, there will always be room for critique on both sides. "constructive feedback" so to speak

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    Quote from AbeFrohman
    Glad to see so many defending PAs on here. We need to realize that PAs and NPs can do so much more together. They both have their faults and points of excellence in different places, which culminate in equal care by both. If we come together, we can much more easily overcome scope of practice issues, prescriptive authority problems, ect. We can look at each others educational models and instill the best from both, we can look at how each of our lobbying efforts are successful and mimic it, and we can be 250,000 strong when speaking to elected officials and contributing money to their campaign funds. There are 100,000 PAs and 150,000 NPs. There are nearly 1 million physicians. If we want to stand up to that kind of power, we need to be together.

    If you want to see what NPs, CRNAs, PAs are truly capable of, look no further than the military. All three act independently, especially in combat zones.
    Abe Frohman ?? The sauage king of Chicago ??

    Couldn't agree more. I'm with your vision.

    treejay, PA-S2