Physician Assistant vs. Nurse Which would you choose?

Nurses General Nursing

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I am trying to weigh my options if I should become a Nurse or a PA? I am currently in the medical field but not with patient care and I make a pretty good living doing it. However, I would like to do patient care but more on the diagnosis and treatment level. Nevertheless,there is still a small part of me that would rather become a nurse due to the job opportunities and flexibility plus it won't take as long to do the program.

So ladies please help me ? pros/ cons?

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To get you started, the required education is probably the biggest difference between the two outside of the diagnosis/treatment aspect you mentioned.

For PA's, the current entry-level degree is almost always the MS these days. For nurses, the most common educational path is the AS or AAS (sometimes referred to as the ADN), although a diploma, BS, or MS are all possible paths of entry into nursing. That said, with the shortage of nursing faculty and the small numbers of seats in some nursing programs, it isn't an easy program to purse.

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Specializes in Critical Care.

I made the decision between being a PA and a nurse. As you can see based on the board I'm on, I chose nursing. I had several reasons.

1. I could finish nursing school sooner than PA school, so I'd be without an income shorter. I was newly engaged, and while we could financially handle me being out of work for 1.5 years (I went through a post-bacc program for nursing), we couldn't afford the 3 years out that PA school required.

2. Nursing offers a wider variety of practice areas. If I wanted critical care, I could do it. If I wanted to go into psych, or public health, or education, I could do that, too. There's more room to find your niche. PA grads are a bit more limited in practice areas.

3. In some states, nurse practitioners can practice without a physician. Not true of PA's (at least, this is to my knowledge-- if I'm wrong, please let me know!).

4. Salaries are pretty comparable for critical care nurse practitioners and critical care PA's.

5. I wanted to hone my bedside nursing/ assessment skills prior to advancing. Eventually, I'll probably do nurse practitioner in some capacity. I would like to have a hand in the diagnostics. I suppose the journey would have been shorter to that point had I just jumped into a PA program. However, my experiences/ skills earned as a nurse will help me as a practitioner.

6. When I'm older and want to retire, I'll be able to cut my hours back and work in a less physically stressful area (case management, clinical education, etc.). If I were a PA, I think I'd be more or less stuck in the PA track until retirement.

7. As a PA, you're often salaried, on-call, and working 12+ hour days, 4-6 days a week. As a nurse, I work 12 hour, shifts three days a week on an hourly pay rate. Anything greater than 12 hours, or three days a week, is overtime. I can choose overtime if I need it/ want to make a big purchase, but can also have 8 days off in a row every two weeks if I so choose. Of course, nurse practitioners are salaried and have the same schedules as PA's. So, if you want NP, that's something to think of. If you have a family, nursing is more forgiving in terms of scheduling than NP or PA, so if you want to devote time to family and then go for PA/ NP after kids are older, nursing miught be better suited.

So, those were the big factors that made me decide to go for nursing. Granted, by now I'd be earning PA pay if I had done the PA program, but if I pick up overtime I'm making PA pay (and I get the freedom of choosing my work days).

I don't think there's a right or wrong choice, as both careers are rewarding. But I do think that if you're desiring PA diagnostics, and you go into nursing, plan on eventually going back for your nurse practitioner. You may not be satisfied with bedside nursing forever, although bedside nursing is a wonderful skill to have and will add to your diagnostic skills.

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A number of people have started as nurses and then became PAs. I'm actually considering doing something along those lines. My tentative plan is to get my ADN, then do the RN to BSN bridge while I'm working as an RN. By the time I get the BSN, I've have been working as a nurse for awhile. Then, if I'm inclined to apply for the PA master's program, I already have the BSN and two years of medical experience (both requirements for entry to the program I'm considering). Also, you say it's just a "small" part of you that wants to go the nursing route. To me that's a pretty major indicator that it might not be what would make you happiest. Life if too short to settle.:wink2:

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Specializes in Acute Care Psych, DNP Student.

I think a better comparison between nursing and PA would be to compare NP v. PA. I have had my sights set on FNP for years. It was unthinkable to me to not become an FNP. Now, with the advent of the DNP for NP, I actually think about switching to PA, at times. I fear the ANA has pushed NP education beyond the point of a reasonable investment on return.

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I agree that the comparison is better between PA and NP. The DNP impending requirements are daunting. For myself, since my ultimate goal is Midwifery, nursing is part of the path. Even a obstetrical PA wasn't going to take me to the place I wanted to be.

I think one should ask themselves what you want out of it. If I were someone who wanted a salaried position with a good starting income and a relatively low level of personal liability caring for patients with relatively few complication...PA is a good choice. I think the benefits of entry level nursing are clearly laid out above by a previous poster. I feel that nursing will provide me with broader opportunities serving the population that I feel called to.

Remember, nothing is permanent either. You always have the opportunity to change course or try something new!

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kgard7777 said:
I am trying to weigh my options if I should become a Nurse or a PA? I am currently in the medical field but not with patient care and I make a pretty good living doing it. However, I would like to do patient care but more on the diagnosis and treatment level. Nevertheless,there is still a small part of me that would rather become a nurse due to the job opportunities and flexibility plus it won't take as long to do the program.

So ladies please help me ? pros/ cons?

There are a number of areas that you have to consider.

As a PA you have your own license but work under the supervision of a physician. This term is frequently misunderstood. What it comes down to is that your scope of practice is defined by that of the physician and that both you (through your license) and the physician (through the supervisory act) are responsible for your actions.

PAs are trained in the medical model with a standardized academic model and required didactic training. The average PA program is 26-27 months in length and will expose you to more than 1500 hours of didactic education and 2100 hours of clinical education. This is necessarily heavy in pathophysiology and pharmacology and well as medical diagnosis.

One of the advantages of the PA profession is that movement among the medical or surgical specialties is quite easy and frequent. While there is a greater prevalence in certain specialties for ANPs there are PA working in pretty much every medical specialty. The complexity of medicine is also quite broad. There are PAs working in primary care and minute clinics. There are also PAs working in critical care, cardiovascular surgery and bone marrow transplant. There are ample opportunities to either carve out your own niche or move around if you get bored. The PA receives a generalist medical training then gets additional education from the physician in the specialty area. Currently the division is between primary care, specialty medicine and surgery is roughly 1/3 for each.

As the other posters pointed out the more usual comparison is between NP and PA. There is a thread here that discusses this:

It's a pretty long thread but if you start on about page 20 you will get the gist.

Another option is a direct entry NP program. This again is somewhat controversial and there is a long thread about that here:

You can find more information on the PA profession here:

http://www.aapa.org/

Final thoughts on the RN vs. PA. I had similar questions (although the RN was clearly a stepping stone to NP) many years ago. I was unable to stomach more than the one nursing theory class that I took. Another issue is pay. As another poster pointed out most PA (and NP) positions are salaried. This limits your opportunity for overtime. If you are looking solely at money RNs in northern California are making more than most PAs and NP (at least in private practice). Especially with a little over time.

Finally you have to take a realistic look at the schooling situation. Most nursing programs here have more than a three year waiting list. While its different in other parts of the country, from what I have heard long wait lists are pretty frequent.

On the other hand getting into PA school is no cake walk. In addition to having the necessary coursework (a big subset of Premed) you have to be able to get into a program. Nationally last year around half of all applicants got into any PA program.

Probably the best way to decide is to shadow both a nurse and a PA. See which seems the best fit.

David Carpenter, PA-C

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multicollinearity said:
I think a better comparison between nursing and PA would be to compare NP v. PA. I have had my sights set on FNP for years. It was unthinkable to me to not become an FNP. Now, with the advent of the DNP for NP, I actually think about switching to PA, at times. I fear the ANA has pushed NP education beyond the point of a reasonable investment on return.

(Not wanting to get off-topic, but, just for the record, Multi, it is not the ANA that is pushing the DNP idea ...)

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Specializes in Acute Care Psych, DNP Student.
elkpark said:
(Not wanting to get off-topic, but, just for the record, Multi, it is not the ANA that is pushing the DNP idea ...)

Yes. Not sure why I typed ANA. It's the American Association of Colleges of Nursing (AACN), right?

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multicollinearity said:
Yes. Not sure why I typed ANA. It's the American Association of Colleges of Nursing (AACN), right?

Yes, and, of course, the universities that are starting up DNP programs. However, in order to make it a requirement, they will have to get the rest of TPTB in nursing to buy into the idea, and there doesn't seem to be a great amount of enthusiasm outside of (selected parts of) academia.

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Hello Friends!

I hope you are all doing well...

I have a few questions, hopefully you can assist me. I am currently deciding between NP and PA as well.

1. Is the PA role as flexible as the NP / RN role? I have talked with a lot of NPs that tell me that they can change fields that they are working in. (Ex: At Lucille Packard's Children Hospital the NPs in ears, nose, throat said that they could just change to cardiology VERY easily)...can PAs switch what field's they are working in?

2. Does anyone know the average salary for California NPs and PAs? (Not including surgery because I am pretty sure that I am not going into surgery)

3. NPs tell me about how they will always be in demand because they can apply for jobs as RNs. They even talk about travel nurses and all these other perks that come along with being a RN. Are PAs also in high demand?

4. Status wise: who is higher?

5. Average work day hours for each?

6. What would you chose: Stanford PA program (16 months) or Advanced Nursing Program to become a NP (3 years)? >>I'm young with no husband, kids, all that so maybe you can offer some advice for me.

Thanks everyone for your help! I learn so much from these boards!

--ginillel

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The stanford pa program is very competitive and while it can be completed in 16 months, many students take advantage of extra rotations to get more experience. I have been told the average amount of time is closer the the 26 month average for all pa programs. I could give advice but I have a bias.

Good luck.

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