NP vs. PA, how is the military role different, and which is the better option?

jfratian, DNP, RN, CRNA · Sep 3, 2016

First of all, the Army or Navy will be a better option for the front lines infantry support stuff (Navy for the marines).

Second, while deployments can give you the opportunity to do a lot of cool stuff, your stateside duties will be mundane as a PA or just about any medical provider. Most stateside military facilities are super small and most active duty people are very healthy. Deployments aren't a guarantee. Your role isn't a guarantee. Most PAs in the military are working the family health clinic or the urgent care section of the ER.

I think you'll have a much better chance of seeing cool trauma stuff in the military as an ER nurse than as a PA in my opinion. However, those few who can hang might get the opportunity to do the special forces PA thing you seem to want to do. I want to stress that trauma role is the minority and not the majority of folks.

Star_Couch · Sep 3, 2016

Thanks for the reply, it has been difficult to get a good idea of what PAs do in the military. What about Nurse Practitioners in the Army/Navy? Is it pretty much the same as what you described?

Editorial Team / Moderator · Sep 3, 2016

Thanks for the reply, it has been difficult to get a good idea of what PAs do in the military. What about Nurse Practitioners in the Army/Navy? Is it pretty much the same as what you described?

Clinics and administrative positions. The military has also moved to the DNP as a standard for its NPs, so I wouldn't bother with an MSN.

The only way to really get trauma exposure in the military is by deploying, and those are few and far between these days. I know a lot of people who have served their entire active duty period without deploying, despite many requests to do so. While the civilian world has learned a lot about trauma care from the military, experiencing it while in the military in its current state will be difficult, unless you are stationed somewhere like SAMMC (Brooke Army Medical Center) in San Antonio, which is a trauma center that also sees civilian traumas. Those will be regular stateside trauma for the most part, though a good GSW can look combat-related. :)

If you want to join the military in a trauma nurse role, get your CEN. Not sure if they are recognizing the TCRN board cert yet. CEN is the gold standard for the Army 66T (trauma nurse) classification.

Star_Couch · Sep 4, 2016

Alright, I will consider that. Clinics and administration does not sound very exciting. So in your opinion, the best option for trauma as an officer in the military would be as a 66T trauma nurse?

PG2018 · Sep 4, 2016

I'd like to slip through and pose a question to the OP.

What type of trauma are you wanting to see or treat, and do you have a quantity of cases or duration of time in mind?

Editorial Team / Moderator · Sep 4, 2016

Alright, I will consider that. Clinics and administration does not sound very exciting. So in your opinion, the best option for trauma as an officer in the military would be as a 66T trauma nurse?

That is for the Army. I can't speak for other branches of service.

Star_Couch · Sep 4, 2016

several years ago, I had the opportunity to spend a week with several members of the Air Force Pararescue, and since then have been looking for a more non-traditional/possibly out of the hospital approach. I had heard about PAs working as field surgeons attached to infantry battalions and that sounded cool to me. I wouldn't say I have a quantity of time or duration in mind, but the type of trauma I was hoping to treat was battlefield medicine, gsw, burns, etc.

core0 · Sep 4, 2016

The OP will probably get a better idea of the PA role at http://www.physicianassistantforum.com/

There are several Army PAs or former military PAs that routinely post.

The Army routinely uses PAs at the battalion level as battalion surgeon. However, in the current environment, casualties are routinely moved from role 1 (initial point of care) directly to role 3 (Combat surgical hospital) skipping the battalion and brigade aid stations. Usually, in the Army PAs are first assigned to a battalion aid station where you do a lot of sick call and sport injury medicine. If the unit deploys then you will deploy with them. After the first assignment there are a number of options including specialty care such as EM, orthopedics etc. My understanding is that in the current environment deployment is less common.

anchorRN, BSN, MSN, RN, APRN · Sep 4, 2016

Don't do NP in the Navy LOL you'll be a paper-pusher and will NEVER see trauma. PA's are definitely more clinical. Keep in mind that there are very few "Trauma" centers in the military. In the Navy the only true Trauma center we have is on Guam (and thats because there is no other reputable hospital on that island and they end up taking all the locals as well as servicemembers).

I deployed to Kandahar, Afghanistan as an ICU nurse and saw a sh*t-ton of traumas, but those days are gone. And there was no PA or NP in the trauma ICU, only Intensivists and Surgeons (MDs).

anchorRN, BSN, MSN, RN, APRN · Sep 4, 2016

several years ago, I had the opportunity to spend a week with several members of the Air Force Pararescue, and since then have been looking for a more non-traditional/possibly out of the hospital approach. I had heard about PAs working as field surgeons attached to infantry battalions and that sounded cool to me. I wouldn't say I have a quantity of time or duration in mind, but the type of trauma I was hoping to treat was battlefield medicine, gsw, burns, etc.

I really dont want to burst your bubble but that is not at all the norm. As an NP or PA you'll be doing administrative work or seeing the Dependapotamus' and their screaming children in the family clinic. "Battlefield" medicine is what you see on the commercials and recruiting stations to glamorize the job but at the end of the day you arent gonna be going on recon missions daily and playing Rambo. Its just not gonna happen. Especially since theres (basically) no wars going on right now. I thought the same thing coming in as a critical care nurse. I did deploy to afghanistan but that was a short 6 month tour 4 years ago. Besides that I've been a bedside/admin nurse and it comes with all the BS that civilian nursing does.

Editorial Team / Moderator · Sep 4, 2016

However, in the current environment, casualties are routinely moved from role 1 (initial point of care) directly to role 3 (Combat surgical hospital) skipping the battalion and brigade aid stations.

Don't forget the Role II, the Forward Surgical Team (FST) â€” often the first stopping point for traumas and casualties who require immediate resuscitation, stabilization, and/or lifesaving surgery. There are no PAs or NPs on the team â€” only RNs (one ED/trauma, one ICU, and one OR), physicians, CRNAs, medics, and OR techs. These teams are usually further forward, not typically located on the larger FOBs like Bagram or Kandahar, closer to the point of injury.

I deployed to Kandahar, Afghanistan as an ICU nurse and saw a sh*t-ton of traumas, but those days are gone. And there was no PA or NP in the trauma ICU, only Intensivists and Surgeons (MDs).

Yep, this. I was deployed as the ED/trauma nurse with an FST in a remote area in RC-East, and we received many, many traumas â€” not all Americans, either. But yes, those days are long gone. Deployments are rare and people fight to receive the few assignments that come open.

The one PA that was at our larger FOB before it closed and we were sent to a tiny SF camp was assigned to sick call. He assisted with traumas when they came in if we needed extra hands, but he definitely had his hands full with his own duties.