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Nurse Practitioner vs Physician Assistant

Nurses Article   (78,659 Views 34 Replies 699 Words)
by nurselyfe4115 nurselyfe4115 (Member)

nurselyfe4115 has 5 years experience and specializes in Cardiothoracic Intensive Care.

2 Articles; 4,717 Visitors; 25 Posts

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Debunking the myth that Physician Assistants can do more than Nurse Practitioners You are reading page 2 of Nurse Practitioner vs Physician Assistant. If you want to start from the beginning Go to First Page.

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This is not true- I know of NPs who work for surgeons who were OR nurses and may do some office procedures. I have a degree as a FNP but I work in a mental health clinic as I have worked in psychiatry for over 27 years. I became an FNP to be more flexible and have the capability to have more flexibility. Presently there is a great need for psychiatrist and right now NPs who have experience in psych are hired to work in this area. I know of several NPs who work in psych with an FNP.

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chacha82 has 3 years experience.

13,226 Visitors; 613 Posts

PA vs NP comes up again and again. I think we only foster the divide between the two when we start talking about what one is vs the other. Obviously there are differences but I think it just comes down to which one do you want to pursue? Make your choice and have respect for what other people choose. Don't feed in to the narrative about which one does "more" or is "harder." Reminds me of the ED vs ICU vs floor nurse endless debates.

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535 Visitors; 16 Posts

There are a couple of differences in education of the NP or PA. One of those is the PA has to take a couple more classes and attends more rotations. The PA is, in effect, a generalist. They can go from department to department fairly easily. Your PA that was in Ortho today could tomorrow change to Cardiology or Oncology or Surgery. They're already educated to make that switch. The NP is typically trained as more of a specialist so your FNP isn't going to be be able to switch jobs to some other area of medicine without typically having to go back to school to be certified to work in that new position. This is not to say the PA or the NP is a better provider, just that the training they receive is different. Within a given field, a PA and NP should be nearly interchangeable and should draw the same salary. The only major difference is the PA technically requires a supervising physician whereas the NP may (or may not) be legally required to have physician oversight.

It's also true that the PA does have to retake the PANCE every so often while the NP only typically takes their certifying exam once.

This is actually not true. As an FNP you are trained in primary care but you can work anywhere you please and do not have to obtain more schooling. I am an AGNP and started off as an FNP. As an AGNP this puts me in primary care in the adult role where I do not see children where as before as FNP you can go and work in one of those urgent care clinics and see all patients children included. As an AGNP I accepted two positions one in primary care part time taking care of the adult population and my full time I am a Breast cancer nurse practitioner specializing in radiation oncology. I did not have to go obtain extra education. My FNP friends and PA friends we were all pretty much trained as General practitioners and where you went after graduation was your business. Now there are some specialties you can go into that will make you then have to go back like a Midwife they are basically OBgyns. But if you think of internal medicine then the playing field is level.

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5,059 Visitors; 292 Posts

I don't think there is a myth that PA's can do more, if anything there's a myth that PA's are inferior to NP'S...Which seems to be perpetuated by some arrogant nurses.

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VickyCS2001 has 15 years experience and specializes in obstetrics.

510 Visitors; 25 Posts

Working as an OB Pacu Nurse for 8 years, I can tell you that you do not have to be a PA to assist in surgery. We also had RNFA ( RN First Assists). They were awesome and the drs used them or the PAs depending on who ever was available.

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539 Visitors; 8 Posts

About a year ago I looked into these two options, and I started on a path to my NP. I decided on this for two reasons.

First, NPs are recognized all over the world. PAs have many of the same skills, but the role is an American creation, and it seems far easier for NPs to work internationally. I remember finding a few organizations like "PAs for Global Health" whose missions were to help the rest of the world understand the PA role. That doesn't bode well for someone like me who wants to have international options.

Second, looking into positions in San Francisco (my home at the moment), it seems like many of the roles that would be for a PA are open to both PAs and NPs. I'm sure there's a difference in training, but many institutions in SF treat them the same.

To me this says that NPs have all the benefits of PAs without a few of the limitations.

Who knows if all this will still be true when I'm done, but the PA / NP choice was an easy one for me.

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538 Visitors; 8 Posts

In reference to the 'hop between mental health and other areas', it is true that NPs can NOT. I am a Psychiatric NP and ONLY do mental health. FNPs and others do NOT have the training that I and others do unless they go back to school and take the various courses that concern psychiatric care. There ARE NPs who prescribe psychiatric medications but laws are changing so that they will not be able to continue. I for one believe that unless an NP has received the training in mental health - specifically psychiatric diagnosing, co-morbidities and psychiatric medications, they should refer to another provider. This also is what I believe about my practice - I refer patients to their PCP for EVERYTHING other than mental health. I did NOT receive the training and therefore do not feel I am as qualifited.

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1,728 Visitors; 45 Posts

The PA is, in effect, a generalist. They can go from department to department fairly easily. Your PA that was in Ortho today could tomorrow change to Cardiology or Oncology or Surgery. They're already educated to make that switch. The NP is typically trained as more of a specialist so your FNP isn't going to be be able to switch jobs to some other area of medicine without typically having to go back to school to be certified to work in that new position...The only major difference is the PA technically requires a supervising physician whereas the NP may (or may not) be legally required to have physician oversight.

I have to agree with enc123 -- this isn't really true. NPs other than psych are generalists, but divided into acute care vs. primary/chronic/non-acute care, and divided into age groups. You have your FNPs, who are the full spectrum of infants to death and do family medicine, but not acute care (so they are currently phasing the older generation of FNPs out of ICUs, for instance, but you can still work in an ED as long as you are providing care for the non-emergent patient conditions; my ED fast track is staffed by NPs). Then you have adult-gero acute care and adult-gero primary care, and peds acute care and peds primary care. Note that these are very broad categories. NPs within these categories can work in any specialty -- cardiology, orthopedics, endocrinology, rheumatology, etc. Just not psych, that's it's own specialty: the psychiatric mental health NP.

With both NPs and PAs, you receive training in all body systems and you can work in any specialty that is within your scope of practice. But with both, if you work in one for a while, that's going to end up being your specialty. I don't know of any NPs or PAs that get handed around from specialty to specialty.

Lastly, "physician oversight" is not the right term. About half of states still require collaborative agreements -- NOT oversight. This number is dropping every year.

I will say that after almost 40 years, for the most part, the whole nursing practive vs medical practice is a bit of BS. A septic work up is the same no matter if your a PA or an NP.

So true... Can we just call a spade a spade? If you're diagnosing and treating, your practicing medicine, I don't care if you're a PA, an NP, an MD, a DO, etc.

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1,177 Visitors; 98 Posts

Lest anyone forget, NPs are licensed as RNs prior to becoming NPs. That alone says something to me. PAs are great but some of them lack the "nurse touch". Technically I think they are both fine, for me I will take an NP anytime, over anyone. The one's I worked with with rare exception were the best listeners, the most compassionate, the ones who worked the front lines with me. I never called one in anything but an "I need you now" situation and had all my data ready for them, and they knew it. But if I so much as mentioned something to them about a patient they were right on it. It never failed. The PAs I worked with tended to follow the docs around and do what the doctors would do. It could have been the facility where I worked and maybe that is atypical. It was just my experience that I connected with the NPs and we had a really good working relationship.

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firemedic12 has 3 years experience and specializes in Pediatric, Surgical, trauma critical care.

2,091 Visitors; 62 Posts

I recently watched an NP place a chest tube and insert a Swanz. There's really not much they can't do it seems

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Palliative Care, DNP specializes in Family Nurse Practitioner.

17,910 Visitors; 781 Posts

There are FNPs working in Psych but they could have serious scope of practice issues if something goes wrong. Most FNP programs have maybe 1 class on behavioral health and no psychopharmacology. When I took the Firzgerald review the instructor mentioned 3 FNPs working in psych for the VA system that all ended up before the BON after being reported for working outside their scope of practice. We simply do not receive the training necessary to work in psych. Proceed with caution.

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1,416 Visitors; 190 Posts

Personally, I like both nurse practitioners and physician assistants as well. I have had both for my doctors and they both have been wonderful. I have been blessed in both of them really treating me with respect and for helping me with my healthcare. I also had a mid-wife nurse one time for my gynocologist and she was great. In fact, she treated me personally and she also treated my symptoms too. She understood what I told her and did her best to treat whatever I had. I think that it does not matter who treats you as long as they are nice and respectful to you and they can help you feel better.

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