Differences (Educative/Clinical) between NP & PA

Specialties NP

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Hello. I am considering NP and PA school. I have a few years of experience as an ED Tech in a Level 3 Trauma Center in California (busy, but not too intense). Our ED is staffed with PA's no NP's.

I have a few questions about clinical differences between NP's and PA's. I know that PA's seem to have a great ability to work in surgery specialties like ortho, neuro, peds, and cardio surgery. They do pre and post surgery exams, order interprets tests, and prescribe meds (at least in 47-49 states). Are there any NP's on this forum who do this? Are there any in California who can comment?

Second. I know that most PA schools have a much longer clinical component than do NP schools. I have been told it is because NP's already have so much clinical experience as nurses. But can you really compare the two? In our ED, the nurses are not making differential diagnoses, determining etiology of disease, etc. etc., they are monitoring the pt's overall state and response to the treatment ordered by the Physician (or sometimes PA). Therefore, does this experience compare to the rigorous training PA's get in diagnosing?

Part of my interest in medicine is the actual procedures themselves. I want to do chest tubes, central lines, suturing, first assistant surgery, etc. etc. Are there any NP's out there who are doing this?

Finally, I know some people (including some nurses) who deride the "nursing diagnosis" concept. Can anyone offer up a brief rationale for how nursing diagnoses are of value to an NP in clinical practice?

Thank you very much!

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Specializes in Educator.

Actually it's Physician Assistant, not Physician's Assistant. If you want more info on Physician Assistants see: aapa.org

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NP's can and do do many of the procedures you have seen PA's do in the ER. I do agree that clinical components of training are probably less in NP school than in PA school as NP's in general have time in the clinical setting albeit not diagnosis and prescribing etc, this is where the NP training focuses as well as advanced nursing practice concepts.

Hope this helps! Good luck!

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Specializes in Cardiology.

Don't worry about not having any experience for PA school. Some schools don't consider medical experience at all. I applied to a fairly well known school with a ton of healthcare experience, about 10 years worth and they totally did not consider that. The thing they look for more than anything else is your GPA. It's kind of like trying to get into med school only not as cut throat competitive. Some of the people that interviewed with me at this one PA school had NO experience. One girl was 21 and still in college and had no healthcare background at all.

I did not get accepted to the school I applied to but I was interviewed there. I am glad I did not go that route because the facilities weren't that great and the people were quite unfriendly. Even my interviewers "toasted" me.

NPs and PAs are very similar in alot of ways. I think you just have to decide what type of education works better for you and where you would be the most marketable. I actually looked into PA jobs near where I live and the job market is horribly saturated. There are virtually no PA jobs in my neck of the woods. But, there are plenty of NP jobs. All the hospitals where I live hire NPs, no PAs. I thought that was kind of strange, but it might because nurses have their base training in hospitals whereas PAs do most of their training in clinics.

I would say it would be good to pursue either career and go with what you think is best for you!

Best wishes.

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The fact is NP/PA's are both equal. The only time you have someone that will argue that fact is when they fill threatened by the other. You can try and compare the education all you want to....the whole "well PA's have more clinical time than NP's"....but for every argument a PA has an NP has two....lest we forget that there are actually PA's running around out there treating patients with just an associates degree....scary huh....not that I have anything against an associates degree but if someone is going to diagnose me they better have a little more education than a two year community college degree.....see what I mean we can go back and forth all day but in the end the true NP/PA's are out there busting there tails, making there money, and not caught up in these online debates.

Good luck to all those pursuing an NP career I wish you the best of luck....

The market for NP's is on the rise and so is the nursing field...you can't hold a good nurse down!!! ?

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Specializes in ER.
xy/RN 2006 said:
not that I have anything against an associates degree but if someone is going to diagnose me they better have a little more education than a two year community college degree

I know quite a few of these A.S. PAs as, until recently, the local PA program was held a local Community College in conjunction with the local medical school. Most are quite good. Most also had a BA/BS in something in order to get in as the competition for the seats was quite high.

The program is now at the medical college as a MS level program. Actually, I don't think that they changed much - just the level of degree.

There is a PA program offered by the U. North Dakota (or is it So. Dakota?) which requires a BSN for admission. It has only 16 weeks on campus with the rest of the two years in a PCP office near your home.

Chip

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Hi all,

I haven't posted in a while, so what better way to update everyone than in a contentious NP/PA debate?

I am just finishing my first year of medical school, and I have to say, I've got it easy so far. My prior medical education has really helped. There are seven other mid-levels in my class, and we have formed a study group so that we can skip the stuff we already know and go on to the more complex knowledge requirements. Its working pretty well. My new best bud is an FNP who wants to be a neurosurgeon (yikes!), and he and I got a job together at a clinic in a little town about 30 minutes away. Just a few shifts a month.

Anyway, PA's and NP's can do a lot more for themselves when they work together instead of trying to tear the other profession down. There's plenty work to go around.

Hope everyone is having a great holiday season!

_____________________________

Jimmy the Humble

MPAS, LP, FP-C

Impoverished Student.... Again

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chip193 said:
I know quite a few of these A.S. PAs as, until recently, the local PA program was held a local Community College in conjunction with the local medical school. Most are quite good. Most also had a BA/BS in something in order to get in as the competition for the seats was quite high.

The program is now at the medical college as a MS level program. Actually, I don't think that they changed much - just the level of degree.

There is a PA program offered by the U. North Dakota (or is it So. Dakota?) which requires a BSN for admission. It has only 16 weeks on campus with the rest of the two years in a PCP office near your home.

Chip

One major change: for a master's program, you need to score 80% to pass.

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I have trained both NP and PA students (not to mention medical residents) and seen so much variation in both programs that I always fall back on the statement.."Good is as good as you want to be". Good programs don't make good providers but bad programs give you a lot to overcome. Overall, and this is my personal experience, if you have an extensive, critical care, clinical background, consider NP. If you have little, pick a good, well established PA program. I learned a lot of ER medicine when I was working as an ER RN. I read the journals and the text books between patients. I ordered the tests for the MDs and followed through on them. ERs are great places to learn how to do the job, even if you start as a tech. You just have to take advantage of the opportunity. In the end you become the provider that you make yourself regardless of title. I've been doing solo ER and family practice for over 10 years, and some of my regional competition are solo, NP owned practices. Whether this is legally constrained by states or not, as a matter of reality it happens de facto in every state. The only thing that matters is the quality of the product.

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Specializes in Pediatrics, Nursing Education.

I know a PA whose only medical work experience before graduating was a year that she had to do to get into the program. her medical profession of choice? nurse aid.

oh, and she worked at micky d's before that.

this girl is a great PA who works in KC now... she's sooo smart. but i just wanted to debunk the myth that these people had extensive experience before going into their prospective programs.

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AZ also allows NP's to practice independently, i.e. without physician supervision. Unforunately, the same is not true for PA's. I know of one NP, working in the mental health field, that rents an office space and bills to insurance companies.

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CAPNA (www.capna.com)...a group of NP's joining together to form a practice :) NP's make medical diagnoses, as RN's before becoming an NP we made nursing diagnoses.

Being called a "nurse" is a compliment. I don't know one nurse who "gets offended" by being called a "nurse".

Signed,

Proud to be a nurse

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