PA vs. ACNP

[ILoveIceCream]

I was wondering if there is any advantage to being an ACNP versus a PA in adult acute care. I can see how, in states where NPs have independent practice, being a primary care NP versus a primary care PA could be advantageous. However, would an NP's level of autonomy really be any different from that of a PA in an inpatient setting--even in states with independent NP practice? I would think some level of physician supervision would be necessary in the critical care arena, for example. What do you all think?

Thanks!

[jlcole45]

Is the original poster already an RN? Then it probably would make more sense to

go on for an NP, especially if you already have your BSN.

My humble opinion is any mid level position will be what you put into it.

If you demonstrate to your supervising/collaborating physician that you are competent, efficient, and dependable then they will come to trust you and you will have a certain level of independence (within your scope of practice), and the money will follow.

I think too many people focus on the money and really the focus should be a broader picture of job satisfaction. Who cares if you are making $20K more a year if you are working 70 hr weeks and have to put up with a lousy boss?

[LobotomyPlzThx]

I would also like to know why PA's average salary is about 5K more than NP's. http://money.cnn.com/magazines/moneymag/bestjobs/2009/full_list/index.html

I was looking at OSU's jobs and the salary range only went up to 115k for NP but 130k for PA...

PA's often work in surgical specialties. That tends to drive up the mean.

To answer the question, "Which is better?" I say they are different, but equal opportunities. PA's can be found everywhere from the OR to family practice. They have more options available in different specialties of medicine. NP's can practice independently, but with that independence comes less autonomy and freedom. NP's can't operate. You'll find PA's in more complex fields (like neurology/neurosurgery), but that's because they have a doctor to be their training wheels. NP's can't do that at all, but they can work in areas such as Family Practice, Psychiatry, and Women's health independently. Choice over which one to hire or which one to become should probably depend on what type of medicine or nursing you want to practice. Do you want to be first assist on a heart transplant next to the guy that wrote the book on the subject or the trusted clinician that can independently (the buck stops with you) make his or her own decisions regarding patient care in conjunction with the patient's wishes. (the last part being what nursing is all about)

Edit: Also, salary differences vary depending on institution, area, and state. Just because national average says that PA's make more than NP's doesn't mean that will be the case everywhere.

[LobotomyPlzThx]

Your correct in most things. One of the other differences is that each states scope of practice and nurse practice act is different. Another problem is that medical staff does'nt understand NP's. THey understand PA's and it shows in the hospital bylaws in some cases. ACNP's are pretty new in the grand scheme of things. For example in one hospital I work the PA's are allowed to place and reposition PA catheters but the NPs aren't per hospital policy. I"m not sure were that came from. As to the $$$ well in one of the hospitals I was CNO at the NP's were paid out of nursing and the PA's by the medical staff.

As to independent practice, not in inpatient medicine. YOu'll be working for a medical group no matter what your state says about independent practice. And you'll have to follow the hospital bylaws and policies.

There are a lot of factors involved and in deciding one or the other you have to look at the location you plan on working and the current work environment.

This makes sense. Nurse Practitioners are by definition, "Registered Nurses that have pursued advanced training" and are licensed by the Board of Nursing, whereas Physician Assistants are licensed by the Medical board and follow a curriculum that is essentially an abbreviated medical school--often taught at schools of medicine.

[departednurse]

In the ICU I work at (virginia) we have criitcal care NPs on critical care medical teams. they can put in Alines, centrals (non-surgical stuff) and intubate

[Dodongo, APRN, NP]

Wow, so much misinformation here. Surprising how nurses seem to know very little about NPs or PAs.

NPs can do anything a PA can do. NPs can practice in any specialty they so choose (within their population foci). They can do any procedure a PA can do. They can scrub in the OR (they dont *need* to be a RNFA). They can also practice "independently" in about half of all states. More often than not NPs are medical staff, and usually when they are nursing staff it's because they chose to be for better salaries (i.e. union). In many states NPs have more privileges than PAs as far as ordering opioids, durable medical equipment, etc.

I have practiced in general surgery where there was no difference between me and the PAs. I have NP friends on trauma surg, neuro surg, vasc surg, etc. All scrub. The NPs also work ICU where we intubate, insert lines, paras/thoras, LPs, etc.

[nurseRNatalia]

On 12/4/2009 at 4:22 PM, Conrad283 said:

I find that statement to be completely false.

I'm a male nurse and my wife is a nurse also. She has much better negotiating skills than I. At my former hospital, the PA's were 50/50 male/female.

IMO, I believe that PA's are more advanced in their training. I've never worked with a NP, but I don't know if they're allowed to put in lines, or perform bedside procedures. Also, I don't think NP's scrub in, in the OR.

There are always exceptions. Males do get paid more... still. I see it daily

[AnnieNP, MSN, NP]

WOW, this thread is from 10 years ago!

[AnnieNP, MSN, NP]

AND, probably still applicable!

[QuestionableTimes]

Bump LOL.

[Tegridy]

I’f you are a nurse and hard set on inpatient adult medicine I would do a good ACNP program with in person procedural training and that finds preceptors for you over PA.