PNP vs Pediatrician

pro-student · May 25, 2020

I think it's great that you have a strong sense of your career direction at this stage but you're years away from having to make decision like should you be a PNP or pediatrician. Right now, you're far better off focusing on doing well in college so that both career paths are available to you when the time comes. Nursing is a great major even for those who decide to go on to medical school and, if you plan carefully, you should still be able to complete most if not all pre-med courses by the time you graduate.

I know you're set on pediatric primary care now but I'm going to guess that is based on little or no direct healthcare experience. Working with kids, working with sick kids, and working with parents, and working with parents of sick kids can all be vastly different from what you might imagine them to be or what you have heretofore experienced. I say that not to discourage you at all but just to remind you to keep an open mind and open to experiences that might be different from what you think you want now. One of the best things you can do for yourself is to volunteer with kids and/or healthcare in any way you can. Not only will this give you some valuable experience to help you guide your career choices but will also be something great for applications for jobs/medical/graduate school. Shadowing both types of providers can also be a great way to learn more about what the similarities and differences are and what truly appeals to you. Most of all, though, do well in your classes so that you have the knowledge and grades that will allow you to pursue whatever you choose.

PedsInTraining · May 25, 2020

41 minutes ago, pro-student said:
I think it's great that you have a strong sense of your career direction at this stage but you're years away from having to make decision like should you be a PNP or pediatrician. Right now, you're far better off focusing on doing well in college so that both career paths are available to you when the time comes. Nursing is a great major even for those who decide to go on to medical school and, if you plan carefully, you should still be able to complete most if not all pre-med courses by the time you graduate.
I know you're set on pediatric primary care now but I'm going to guess that is based on little or no direct healthcare experience. Working with kids, working with sick kids, and working with parents, and working with parents of sick kids can all be vastly different from what you might imagine them to be or what you have heretofore experienced. I say that not to discourage you at all but just to remind you to keep an open mind and open to experiences that might be different from what you think you want now. One of the best things you can do for yourself is to volunteer with kids and/or healthcare in any way you can. Not only will this give you some valuable experience to help you guide your career choices but will also be something great for applications for jobs/medical/graduate school. Shadowing both types of providers can also be a great way to learn more about what the similarities and differences are and what truly appeals to you. Most of all, though, do well in your classes so that you have the knowledge and grades that will allow you to pursue whatever you choose.

Thank you so much for the suggestions! I agree, those experiences are vital for making such a big decision. I've actually been interested in pediatrics since my brother was in the NICU 8 years ago. I also work in child care (it was my first job, got it two years ago when I was 16) and I've also got about 200 volunteer hours at a hospital. Those experiences are so valuable, I'll one hundred percent agree with you on that one!

DrCOVID, DNP · May 27, 2020

I'll preface with, I know nothing about PEDs and am childphobic.

That being said, I feel this decision has to do with where you are in your life. If you are early thirties like myself, are jaded to adcademia, and have been a nurse for 10 years ... I would say do NP. I will be a PMHNP in a few months and in terms of the actual job, there is little difference between what I am doing and what the psychiatrist do. I imagine peds would be the same, and you will end up being able to do everything a pediatrician would with some few exceptions.

IMO, the MD/DO is reserved for those who are younger and more naive, really want the title, or are ready to sacrifice the years of life for the love of in depth medical knowledge. That being said, you can provide just as good of care as any doctor can if you take that burden upon yourself as a PNP.

Rnis, BSN, DNP, APRN, NP · May 27, 2020

I really depends where you work. My job is a bit different than the physicians. We do a team concept so I am never a PCP. that definitely creates a hierarchy in how some patients see me....because even they are never truly my patients. On the other hand there are some really complex patients that want me managing them .........even when I would rather then see a MD. ? I like being a nurse practitioner, and I like the collaboration that allows when I complex situations arise. (though everyone collaborates where I work) I feel like I have good wok-life balance and a little a less stress than some of the physicians. However, I didn't become a nurse until I was in my 30s. If I had been sure of my path at 18...........I would have probably gone the MD route for the financial side of things.

When I first started on my path to be a nurse ....I was set on being a peds nurse. now I prefer to only see 2-3 kids a day tops... just not my favorite thing (though still very enjoyable). So try to be open to all the possibilities and be open to explore all of your possibilities.

Guest1144461 · May 28, 2020

8 hours ago, adammRN said:
I'll preface with, I know nothing about PEDs and am childphobic.
That being said, I feel this decision has to do with where you are in your life. If you are early thirties like myself, are jaded to adcademia, and have been a nurse for 10 years ... I would say do NP. I will be a PMHNP in a few months and in terms of the actual job, there is little difference between what I am doing and what the psychiatrist do. I imagine peds would be the same, and you will end up being able to do everything a pediatrician would with some few exceptions.
IMO, the MD/DO is reserved for those who are younger and more naive, really want the title, or are ready to sacrifice the years of life for the love of in depth medical knowledge. That being said, you can provide just as good of care as any doctor can if you take that burden upon yourself as a PNP.

Dat Kool-Aid tho...lmao. Their 4 year residency and thousand upon thousands of hours of clinical experience has nothing on those 600 hours you got! Totally the same job and expected outcomes.

babyNP., APRN · May 28, 2020

I don't think any rational person would say that a PNP is equivalent to a pediatrician, of course a pediatrician has more training and knowledge. But you don't necessarily need all those hours to do basic primary care, which is what adammRN was getting at I think. The pediatrician is more useful for complex cases. I know that in some countries with nationalized healthcare, there isn't such a thing as the well-child check up with a pediatrician, it is only with family practice and the pediatrician only sees complex cases.

I currently work in a community NICU setting where we see run of the mill things every day. The neonatologist is there with me during the day and leads care on rounds, but after they go home, I'm the one that admits, discharges, performs resuscitations and invasive procedures as the patients come in. Yes the neonatologist is "on call" meaning that I can call them to come in but it's not so much to manage the patient as it is that it's nice to have another provider available to help out because while you're stabilizing a sick infant you still have 20+ other patients that don't stop suddenly needing things. I also work at some smaller sites where the neonatologist doesn't come in at all.

At Level IV academic NICUs, of course the neonatologist is much more necessary and shouldn't be run by NNPs alone. Those are the complex and critically ill infants that benefit much more from a neonatologist's years of training much more than the community NICU patients do.

DrCOVID, DNP · Jun 3, 2020

On 5/28/2020 at 12:59 AM, Numenor said:
Dat Kool-Aid tho...lmao. Their 4 year residency and thousand upon thousands of hours of clinical experience has nothing on those 600 hours you got! Totally the same job and expected outcomes.

Yup. Kool-aid where in my city, there are no more MSN programs, wanted the terminal degree so I don't need to go back to school, have more clinical time, and am becoming a independently licensed provider. Pretty sweet Koolaid if you ask me. MSN was never an option and where I am, MSNs are getting their DNPs. It was either go back to undergrad for MD or do three years and make as much as I want. If you start a side business, do consierge medicine or counseling in your free time as an NP you can make 200k+... Like, where is the loss here? Only with limited mindsets as you and others here have demonstrated.

BTW I never made the argument you did. I merely stated that all the psychiatrist I have seen in practice, we do the same thing. Also have personal anecdotes that PATIENTS prefer NPs to MDs, which most others here seem to forget as well we are here for them. I have in my short clinical time seen several patients not want to see a psychiatrist anymore. If you need medical school and 10,000+ hours to figure out how to read guidelines that groups of doctors and scientists put together, I think you probably shouldn't be a provider.

Guest1144461 · Jun 3, 2020

20 minutes ago, adammRN said:
Yup. Kool-aid where in my city, there are no more MSN programs, wanted the terminal degree so I don't need to go back to school, have more clinical time, and am becoming a independently licensed provider. Pretty sweet Koolaid if you ask me. MSN was never an option and where I am, MSNs are getting their DNPs. It was either go back to undergrad for MD or do three years and make as much as I want. If you start a side business, do consierge medicine or counseling in your free time as an NP you can make 200k+... Like, where is the loss here? Only with limited mindsets as you and others here have demonstrated.
BTW I never made the argument you did. I merely stated that all the psychiatrist I have seen in practice, we do the same thing. Also have personal anecdotes that PATIENTS prefer NPs to MDs, which most others here seem to forget as well we are here for them. I have in my short clinical time seen several patients not want to see a psychiatrist anymore. If you need medical school and 10,000+ hours to figure out how to read guidelines that groups of doctors and scientists put together, I think you probably shouldn't be a provider.

Whatever gets you to sleep at night bud. Only if all medicine was as easy as reading from an ACLS algorithm.

In all my time looking for and getting job offers I have never seen a job care about MSN vs DNP. Literally never, but hey I was looking at major cities, maybe some rural backwater hole really wants that online DNP piece of paper.

DrCOVID, DNP · Jun 3, 2020

8 minutes ago, Numenor said:
Whatever gets you to sleep at night bud. Only if all medicine was as easy as reading from an ACLS algorithm

I would sleep 10x better if you stopped posting negative things about the nursing profession having a doctoral program path, finished your personal education, or went to medical school you keep advocating for.

Guest1144461 · Jun 3, 2020

On 6/3/2020 at 7:13 AM, adammRN said:
I would sleep 10x better if you stopped posting negative things about the nursing profession having a doctoral program path, finished your personal education, or went to medical school you keep advocating for.

Hah. I am sorry if me pointing out the obvious inconveniences you. Unfortunately, the head buried in the sand approach does nothing beneficial for the nursing world. I think you would sleep much better if you actually acknowledged that there are gross problems with the NP education system and offered solutions to fix them. Essentially you state a few anecdotes, your possible future salary and describe medicine as a boiler plate algorithms as a form of an argument for your position. This is in fact not an argument.

In addition, I actually did go back to grad school but for fun. So I am furthering my education, but I find the DNP value so clinically brittle that I see no sense in wasting one cent on it. When a terminal degree is looked at as a check the box sort of thing, that's a problem. This a problem that is echoed by many on this board if you actually read the posts. Furthermore, I have yet to find a job posting or offer asking for a DNP in ANY major US city I have applied to so far. They ask for licensure and relevant experience which is pretty reasonable and telling.

I never advocated medical school over the NP path solely. If you actually read my posts, I talk about adding more residencies, tightening the admission standards and increasing clinical hours.

DrCOVID, DNP · Jun 7, 2020

On 6/3/2020 at 9:37 AM, Numenor said:
Hah. If you actually read my posts, I talk about adding more residencies, tightening the admission standards and increasing clinical hours.

Your posts on this subject are paradoxical. About the only thing you actually got correct the problem is the curriculum and clinical time, not the DNP degree itself. The extra year is still a step in the right direction. Clinical hours accumulate as you practice. I'm just happy we agree, practice is what matters. So in the next 4 years, I should forever be ashamed I didn't do MD? Probably not as I can have my own practice.

I know you haven't looked at any research so the DNP would serve you well. There are many studies that show not all providers are created equal. So regardless of your educational path, you can still be a great provider - which was my point to the OP and you clearly missed. Just as easy as the whole DNP v curriculum argument. I'll get the clinical time later and work with some good psychiatrists.

The Koolaid most of the people I know are drinking was an obvious solution - we all wanted to be providers, and not have to return to school with the threat of the MSN going away. I was not gonna be poor for another 5-6 years and go back to undergrad for an MD. Big schools with MSN programs were being phased out when I was entering school. So... not as if I was gonna MOVE or go to an online school just to do an MSN then have to go back later for a DNP.