Interesting Physician Perspective On NPs

Specialties NP

Published

I am not an NP. I am a full time rapid response nurse at a teaching hospital. This morning I stopped in to residents office to update the night residents on what had happened with their patients and what I had done. They were in the middel of sign out to the day team including several interns, residents, the chief resident and the attending. After I was done an intern speaks up and says "PMFB you should become a PA!". This was met with a rousing round of "NOooos" & "no way!" from the residents and attending. The intern looked confused. The chief resident leans over to her and says "PAs are at the bottom of the medical word. PMFB should become and NP, they are at the top of the nursing world".

The attending and other residents all readily agreed. I thought it was an interesting insight into physician thoughts about mid levels.

Specializes in ER.

PA school requires more biology pre-reqs than RN or NP school. NP school wastes time on public policy nonsense and varies from programs to program. PA programs are all the same. PAs scope of practice is defined by the MD that supervises. The NP role is defined by the state and in my state, it means basically nothing. The PAs I have seen are better trained than the NPs and if I midlevel and go to grad school, I want to go to PA school, especially since in the ER, midlevels all have the same scope of practice.

Certainly looking forward to get the "nursing" stigma off of me.

I would have been offended by what the doctors were saying...sounds like a insult to the NPs.

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Specializes in Hospitalist Medicine.
I thought PA's didn't have prescriptive authority where NP's did?

Not true. PAs can prescribe any med a physician can prescribe (because the physician reviews their work). Whereas NPs are limited in what they can prescribe.

I just went through a long, decision-making process on whether I wanted to become a PA or NP after I finish my BSN. I was originally leaning towards becoming a NP because the school is only 5 minutes from home. However, after speaking with quite a few NPs, PAs & physicians, it became evident (at least in the area where I live) that being a PA appeals to me more. I like the fact that they work in unity with the physicians. I like the fact that they are trained in med school. Most PAs in our area have taken over the role of GP physicians because there's such a huge lack of GPs coming out of medical school.

And just to clarify: while a PA may have a bachelor's degree in a non-scientific field before attending PA school, you are still required to complete what is essentially all the pre-reqs to get into a nursing program (e.g. Anatomy, Physiology, Chem, Micro, Stats, etc.) So it's not like Joe English Teacher just magically decides one day to become a PA and in 2 years is prescribing medicine. Most PA schools require you to have a certain number of patient care experience hours before you can even apply. The school I'm considering attending requires a minimum of 100 PCE hours, however the average student accepted into the program has at least 2,500 PCE hours. It's very competitive to get in. The school I would like to attend has PA students & med students in the same classes.

It all boils down to how the roles of each profession are viewed in your area. It's not going to be consistent from state to state (heck, even city to city, sometimes). I also noticed since the opportunity to become an NP in this area is so great (large university nearby), the market here is flooded with NPs. There's a bigger demand for PAs. Yet another reason why I'm choosing to go to PA school an hour away vs. NP school five minutes from home. I want to know I'll have a reasonable expectation of getting a job when I'm done with this expensive education :)

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Specializes in burn ICU, SICU, ER, Trauma Rapid Response.

Really? I see a big difference between the 2. A PA can have any kind of Bachelors degree, and get their PA training in 2 years.

*** Or no bachelors degree and attend an associates degree or bachelors degree PA program.

A NP on the other hand has a BS or BA and a MSN and now more recently has to have a Doctorate in order to become a NP.

*** Or no bachelors degree and no DNP since neither are required to be an NP. A masterd degree is required to be an NP. There are a number of RN to MSN NP programs and DNP isn't required for NP anywhere.

And for the record the fact that a NP can practice independently as where a PA can only practice under a MD makes the NP role above the PA as far as I am concerned.

*** I suppose that is true but in my experience all NPs I have ever worked with worked in a goup that included all levels of providers.

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Specializes in burn ICU, SICU, ER, Trauma Rapid Response.
I plan on receiving my DNP, It will be mandatory by 2015.

*** (sigh) No it won't be.

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I don't know how much of a complement that is since we all know Physicians see nurses as inferior to them (and anyone else who isn't a MD for that matter).

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I plan on receiving my DNP, It will be mandatory by 2015.

Just to be clear, the DNP isn't going to be mandatory by 2015.

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Really? I see a big difference between the 2. A PA can have any kind of Bachelors degree, and get their PA training in 2 years. A NP on the other hand has a BS or BA and a MSN and now more recently has to have a Doctorate in order to become a NP. And for the record the fact that a NP can practice independently as where a PA can only practice under a MD makes the NP role above the PA as far as I am concerned.

Not accurate, in 2 ways:

1) NPs do not need a doctorate, nor is there any timeframe which says they will need one. I'm quite surprised regarding the misunderstanding RNs and others here have regarding this topic. It was recommended that by 2015 Master's training programs start to offer DNP. But there is absolutely no requirement. Amazing how people are continually confused by this

2) True, you can enter PA school with any degree, but most enter with a science degree. And here's why. The prerequisite list is very heavy! Heavier than medical school in many cases. Keep in mind, you can also enter medical school with any degree. Here is the prereq list from my PA school:

[TABLE]

[TR]

[TD]Human anatomy*[/TD]

[TD=width: 120]4[/TD]

[TD=width: 324]Biochemistry[/TD]

[/TR]

[TR]

[TD=width: 188]Human physiology*[/TD]

[TD=width: 120]4[/TD]

[TD=width: 324]Cellular biology[/TD]

[/TR]

[TR]

[TD=width: 188]Genetics[/TD]

[TD=width: 120]3[/TD]

[TD=width: 324]Human sexuality[/TD]

[/TR]

[TR]

[TD=width: 188]Psychology[/TD]

[TD=width: 120]3[/TD]

[TD=width: 324]Immunology[/TD]

[/TR]

[TR]

[TD=width: 188]General chemistry*[/TD]

[TD=width: 120]8[/TD]

[TD=width: 324]Medical terminology[/TD]

[/TR]

[TR]

[TD=width: 188]Organic chemistry*[/TD]

[TD=width: 120]4[/TD]

[TD=width: 324]Pharmacology[/TD]

[/TR]

[TR]

[TD=width: 188]Microbiology*[/TD]

[TD=width: 120]4[/TD]

[TD=width: 324]Spanish[/TD]

[/TR]

[TR]

[TD=width: 188]College algebra or higher[/TD]

[TD=width: 120]3[/TD]

[TD=width: 324]Statistics[/TD]

[/TR]

[/TABLE]

Let us strive for accuracy when making comments. We would only expect the same when taking care of patients.

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I thought PA's didn't have prescriptive authority where NP's did?

On the contray, PAs have prescriptive authority in 50 states. Many of the states includes schedule II. Some states only schedule 3 and above. What is the state laws for NPs and scheulde IIs?

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*** (sigh) No it won't be.

Amazing all the misinformation is out there about this, especially by people posting on this board.

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Personally I think NPs are less knowledgeable than PA's. PA school is essentially medschool-lite whereas NP's take a few pharmacology courses and some. Just my opinion though.

A few pharmacology courses? How about:

1. Major psychopathological disorders

2. Pharmacology

3. Psychopharmacology

4. Diagnosis and Management I

5. Diagnosis and Management II

6. Physical Diagnosis

7. Psych/Mental Health NP-Adult

8. Psych/Mental Health NP-Adult

9. Advanced pathophysiology I

10. Advanced pathophysiology II

11. Therapeutic Group Process

12. Community Mental Health I

13. Community Mental Health Nursing II

14. Human Values and Health Care

15. Research in Nursing

16. Theories of Personality

17. Social Forces and Nursing Practice

18. Theoretical Foundations of Role Specialization

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On the contray, PAs have prescriptive authority in 50 states. Many of the states includes schedule II. Some states only schedule 3 and above. What is the state laws for NPs and scheulde IIs?

My DEA is for schedule 2-5.

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My DEA is for schedule 2-5.

Of course. As is mine for PAs and NPs. But what is the outlook overall for all 50 states?

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