NP or PA?

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Hello,

I've been stressing about what I am about to explain to you for quite some time now and decided to come here for advice. I am currently a pre-nursing student in Tennessee and will apply to my college's nursing program in October. I have spectacular grades and have done well in all of my pre-req's. I'm also a CNA and have been for a little over a year. If I decide to graduate with a BSN I fully expect to apply to an NP program as quickly as I am able because I want education beyond a BSN. There is one issue however that is holding me back from wanting to be a nurse. The facility I work in isn't very pleasant, the lateral violence and "bullying" so to speak really sets a negative vibe towards nursing for me. I know hostility and lateral violence is a common problem among nurses and I am also aware that every facility is different. As a CNA I am treated poorly and I do not want this feeling of unimportance to carry on in to my nursing career as I know graduate nurses are often treated this way as well. The majority of nurses that I have encountered are very unhappy, stressed, mean, and just plain hateful. Are you all unhappy with your jobs that much? Do I need to second guess my career plans? Would you go back and do everything differently? Yes, I know it is a high stress job and burnout is a very real thing that happens. I genuinely enjoy patient care and bettering lives and have wanted to be in the medical field my entire life. From experience would you suggest a college student to redirect their career goals? My backup plan is to major in Biology-Physiology and minor in Chemistry and apply to PA programs. What are the pro/cons of NP vs. PA? I simply need advice and for someone to give me insight.

I won't scold you, although it might be a good idea to read the hundreds of threads by users who have asked your exact question for some insight.

It's hard to know what you really want when you're only at the pre nursing stage. You might start nursing school and find its not for you at all. It's good to have long term goals but you might want to wait until you're studying nursing before you start planning your post graduate education.

Also tip: Avoid saying things like "my grades are outstanding" on the forum. It's great you are doing well in your pre reqs, but saying it like that makes you appear pretentious, which I doubt you really are.

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Specializes in Critical Care and ED.

Aww, I think you all could be nicer to the OP. Let her ask a question if she wants without getting cut off at the knees. Your responses kind of prove her point, in my opinion. Young nurses feeling like they can't open their mouth without someone jumping down their throat. I think your question is a legitimate one, and just because something has been discussed here before doesn't mean it can't be discussed again.

In answer to your question, I've been a nurse for 23 years, and if I knew what I know now, and had my opportunities again I might have gone the PA route, but as it is, with all my experience, it made sense to continue as a nurse. I agree absolutely that nurses rip each other to shreds. You have to be tough to work in some of these environments but I will say this: always hold your dignity, never complain in public about your coworkers, never show emotion that is inappropriate, especially in front of patients or families, and always stand up for yourself by documenting and following policy. That is one way to deter bullies. They unfortunately are everywhere, even in the PA field. I suggest shadowing a PA, an NP and an RN individually and see what their day is like and see what you'd rather do before you jump into something. If your grades are as good as you say, then you can literally choose what you want to do. Nursing is not for the faint-hearted, but there are many options and a certain kind of job security, even in these hard times, but PA does also, be it slightly more limiting in some aspects. Good luck with whatever you choose.

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I'm not sure why yall are all attacking op. yes I'm sure there are many threads asking the same question THEN IGNORE HER. how much free time must yall have on yalls hands to go prove she's not "a special snow flake". if yall spent as much time on her profile as u did searching for np vs. pa boards to prove her wrong you would see she's a new user. grow up and quit acting like teenage girls in the locker room.

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I am dissapointed in the tone that many people have taken in this thread. I see bullying is still alive and well. It is not at all ok or appropriate.

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Specializes in Education, FP, LNC, Forensics, ED, OB.

Welcome to allnurses.com

We moved your thread to the Student NP forum since you are interested in possibly pursuing this career. Students as well as NPs will come along and offer some helpful advice.

You will find, especially in this forum, threads about NP and PA.

We wish you well with your decisions as you consider what is best for you.

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This is the first thread I have read on allnurses. Wow

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Specializes in M/S, LTC, Corrections, PDN & drug rehab.
I am dissapointed in the tone that many people have taken in this thread. I see bullying is still alive and well. It is not at all ok or appropriate.

&

I'm not sure why yall are all attacking op. yes I'm sure there are many threads asking the same question THEN IGNORE HER. how much free time must yall have on yalls hands to go prove she's not "a special snow flake". if yall spent as much time on her profile as u did searching for np vs. pa boards to prove her wrong you would see she's a new user. grow up and quit acting like teenage girls in the locker room.

Just *shake my head*.

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The word bullying is SO over used in nursing culture. Some advice is given and everyone cries bully.

If I wanted to go back to the high school girls locker room, it wouldn't be on an online forum, it would be in the movie Heathers, and I would be Shannen Doherty 💅🏻.

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Specializes in Outpatient Psychiatry.

I think many of your concerns are valid. If I had the option, and I make no secret of this here, I would have chosen the PA route. I'll expound on why.

First, NPs. In many of the states NPs have complete independence. They are not constrained in any way by physicians, medical boards, or otherwise policies that limit practice. In most of the states, there is some element of collaboration or supervision by physicians. In my state, the collaboration, is somewhat limiting as collaboration requires what is essentially quality oversight. What this means is I or my employer must find a physician who will enter into a quality assurance agreement with me and randomly audit any number (our choosing) of charts to determine that quality practice has been given. Presently, that quality doc also dictates what classes of medication you may prescribe, however, the physician has no role whatsoever in how you diagnose or what medication in that class you choose. I happen to have a very liberal collaborator, a couple hundred miles from me, who is not really concerned about anything other than the formality of needing a collaborator.

In every state, the PA will need some element of collaboration or supervision. This does not imply that a doctor will hold your hand or tell you what to do at any given moment. I am not a PA and have only interacted with them when I was a RN working in the ED. Having said that, there treatments were basically laid out for them. For X problem they would choose something like Y or Z treatment. If one failed, do the other, etc. They could diagnose and run their show as they pleased, but once the diagnosis was made they were required to treatment by what were apparently predetermined methods although I believe this was more liberal and "open" to the PA's discretion than the similar protocols I used as a paramedic a decade ago. Let it be said, paramedic work was not really a pursuit of mine but merely something I did.

I entered nursing after leaving what we'll just call a government job. My original BS degree was largely science-oriented like yours (think general science, I got to pick the sci. classes I wanted to take). Upon entering nursing, I was also concerned with the treatment directed to students and other nurses by nursing instructors and nursing staff. Quite frankly, I was also dismayed at the total lack of autonomy and in quite shocked at how little any other professional in hospitals cared or respected nurses. However, I knew that I was entering nursing to become a NP as I did not want to relocate for any PA program. As soon as I graduated with the BSN I was enrolled in the MSN, got the RN license, began nurse work, and commenced graduate studies.

I think the best arena I worked in as a nurse was the ED specifically the fast-track or urgent care side. The reasons I liked this was that I found it quite enlightening. Most things of an urgent care nature (and also a primary care nature) are not well taught in nursing school so the ability to spend my time learning and doing things related to shortcomings in my education were great, and I liked learning how to care for and treat the problems most likely to manifest in the lives of my family and myself, i.e. sprains, URI, etc. (Coincidentally, I was also learning about this to some degree in my NP program simultaneously.) In fact, most anything done in the ED is poorly taught or fully omitted in nursing school. You will definitely find catty, mean nurses, and you will more definitely find others in the hospital who feel they know more about your job and what you should be doing at any point. Seriously, nurses get some of the worst treatment as a whole. It was never really so bad for me because I'm male (which helps), I'm somewhat introverted while working (because I choose to work rather than BS), and my previous life taught me to push back when being pushed so I was fortunate that most people stayed off my case. Nurses are generally over worked, stressed, underpaid, and valued not much more highly than CNAs. You're on a nursing site so most people will advocate for you to enter nursing. I'm not a nurse first and so I think of all the negatives. I've never taken a different path into healthcare so I don't know if any others have it worse. Some PAs are grossly undervalued and mistreated while others are merely a part of the club because they too are "medically trained, inclined, and some semblance of a 'physician.'"

First, I'd look at where you want to live, determine the practice organization and regulations of that state, and then decide if NP or PA will best suit you there. For example, if you absolutely want to be fully independent then that may be impossible in the states you want to live in so you'll either have to move to a state where you can be an independent NP. I don't know what the state by state nuances are regarding PA regulation.

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Specializes in Family Nurse Practitioner.

In my area PAs are not utilized as mental health providers although they do provide somatic care. It has something to do with billing I believe. In any event if I would have been able to practice as a PA in psych I definitely would have gone that route because I believe their education and additional clinical hours are superior to our NP education. All that talk of being a nurse first and the repeated self-serving mention of holistic care seem like lame responses in the discussion of lack of clinical hours.

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Specializes in Outpatient Psychiatry.

You know, I think the replies on this forum validate each of the OP's concerns. Great lot of professionals.

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Tsk Tsk!! Shame on you "professionals" who have "scolded" the OP for her post. Relax!! shes a new user and was not asking a question that she felt has been asked before, for the exception of the NP vs PA question.

Now, my opinion to you is to follow your gut on this one. You mentioned you always wanted to work in the medical field. That can be many different roles. A person who decides to be a nurse has to have a lot of heart for the job. Everything about it is tough. The hours, the environment, the stress, the politics, and the patients themselves. There is a lot of bullying that happens in the nursing field, but you will find that every where you go. Unfortunately, this is something you will have to learn to handle and deal with. I have been an RN for 6 years and have worked in the ICU for 3 of them and in the OR prior. Both units have their share of bullies or "strong personalities" if you will. However, there are a lot of nice nurses, both seasoned and new that are just lovely and not at all tough to work with. My advice to you is to stick with nursing. Become a NP in whatever specialty you like. There are soooooo many routes you can take once you have become a RN first. Do not let the people you work with intimidate you with your career choice. I love my job. Could not see myself doing anything else. I am a Student NP now at Drexel University, so my opinion might be biased but I think you are doing the right thing sticking with nursing ;)

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