NP vs PA currently firefighter/EMT

Advanced Practice Columnist / Guide · Jan 28, 2014

You certainly can explore the nursing option but I would think you will also need a certain amount of full time commitment while attending nursing school so your full time job as a firefighter/EMT may also suffer. I know many colleagues who completed either an associate's degree or an accelerated bachelor's degree in nursing and they only worked part-time while they were in school.

What I would offer to you as an option is to maybe look for a job as an EMT/ER Tech in a hospital emergency department. This will offer you maybe some tuition reimbursement as well as a foot in the door so that you could possibly work as an ED RN in the same hospital when you graduate from nursing school. From there, you can pursue further education as you work yourself up to the eventual goal of NP while earning a living.

I'm saying this because I worked as a nurse in a Level I Trauma ED at one point in my nursing career and I've seen ER Tech's who were EMT's who ended up going to med school, PA school, nursing school, etc.

TiffyRN, BSN, PhD · Jan 28, 2014

Make sure you find out as much as you can about NP versus PA. These are based on quite different models of care: nursing versus medicine. EMT & paramedic one is based more on a medical model of care. One isn't better than the other but they are different ways of approaching patient care.

I would also really recommend that if you plan to become an NP; starting as an LPN is an extremely drawn out inefficient way to get there. I would recommend BSN as your entry to nursing. Quite a few NP programs are going to DNP and building to that from an associate degree is going to be a really long haul. Check if your local programs are going that route or sticking with MSN.

Lots to consider; best of luck!!

BCRNA · Jan 28, 2014

I would recommend the RN route to become a NP because it is easier to fit the education into a working schedule. You can look for a BS to MSN program and not have to get a second BS. Also, there is more flexibility down the road if you want to change environments. A PA is more limited in what they can specialize in. As a CRNP you can more easily change specialties (family practice to dermatology/pediatrics/ER). Also, more autonomy as a NP with more job opportunities. There are also many hospitals who will pay half or more of the tuition for an initial nursing degree. It will mainly depend on your career goals and the amount of flexibility in education that you need. Virtually all of the CRNPs I know have gone to school part time and worked full time to support a family.

GucciBeaR143, BSN · Feb 22, 2015

Good idea! In our Level 1 Trauma, they hired more EMT's and GN/SN's (grad & student nurses) rather than CNA's because they could perform more per their scope of practice. Each state is different, of course; so, find out if hospitals in your area will pay more for your FD/EMT experience.

I have friends who were cross-trained as ER tech/CNA/secretary while taking prereq's for nursing school and eventually became a GN's on their senior year. I qualified for tuition reimbursement, scholarships, and finaid while working full time. After graduating with an ADN & passing the NCLEX, maybe you can work and continue with your BSN or MSN. That way you'll have options and can re-evaluate how to continue on with with your goals.

PG2018 · Feb 28, 2015

I have known many, many firefighter/EMS types go to nursing school. Many have done it while continuing to work their FD jobs. I worked full-time, in a different field, through a two year BSN program before becoming a RN. It can be done just not easily. I knew a fire captain go to law school part-time. Having said that, once you get all of the required nursing stuff out of the way you could move onto a NP program and continue to work. I've worked full-time through three years of NP coursework. It's very doable. Actually, the only reason I ever worked a day as a RN was because I had to get 2,000 hours of experience before I could move into the specialty courses for my NP program. Your obligations may differ.

Having said all of this, you'll find that EMT/paramedic and nursing are not the same. You're already aware of the curricular differences, but the philosophical and instructional approaches are vastly different. I have been a paramedic (side job), and although four years or more passed between the last day I ever worked in an ambulance and the first day of nursing school I held that in my mind as an expectation. Paramedic school focused on learning and mastery. Nursing school does not so be ready for that. In fact, I'm still not sure what the focus of nursing school actually was! You get what you put into it, and I focused my studies on the pathophysiology, pharmacology, health assessment, research methods, and mental health class as I never have really had an interest in basic nursing stuff such as dressings, ostomies, pressure sores, constipation, but my interests in emergency and critical care had also waned. Come to think of it, I think I was only there to learn textbook stuff as I'm not really a hands on type other than a few hobbies that I have.

PA school, I've heard, appeals more to EMS types. They have a better curricular model, and although it's true you won't be able to work much, if any, while in PA school you'll probably like the education more. It just makes more sense, and it's also a shorter path. You can become a PA in 28 months. It will have taken me 57 months to start from day one of BSN/RN school to commencement of MSN/NP school. Even though I worked (and wanted to) I wish I could have done this in 28 months and have been done with it years ago. Granted, my chosen area is psychiatry, and PAs don't, as a rule, jump heavily into psychiatry particularly outpatient psychiatry so I'd have not been too well served.

In the end, the salaries are fairly comparable, and PAs and NPs are generally used interchangeably. There are about 4-5 ERs within a 20 minute drive from my house, and they all employ NPs and PAs to staff their ERs not to mention the many urgent care centers. You may find more PAs in surgical specialties and NPs in primary care specialties, but that's about where the difference (which isn't great) stops.