Coolgramma

After 25 years of being BOTH an NP AND a PA, the misinformation about these two types of advanced practice still boggles my mind. I agree with the authors of the replies who stated that there is plenty of room for both professions. Actually, with the medical journals etc. concerned with the lack of medical students entering "general medicine/family practice", both professions will find PLENTY of work. The reason so many PA's find themselves in specialties such as surgery and orthopedics, ER etc. is related to the origin of the profession. The first "PA's" were the service medics returning from WWII with extensive battlefield experience. Rather than becoming "male aides" (most were male) the idea of assistants to physicians was born. Nurse Practitioners were "born" from the need for health care provider in underserved areas, and populations that were uninsured or underinsured, and their need for more than basic nursing care and the lack of MD's to provide it. The training for each varies but each group has it's strengths and weaknesses. The major difference...for me in my professional life...I practice as an NP...is in licensing. ALL NP's MUST be licensed RN's, passing a NATIONAL STANDARDIZED LICENSING EXAM FOR RN's to be eligible for the advanced training of a Nurse Practitioner, and then qualify for nationally certified via exam & practice, to be an NP.. My "skills" and didactic NP training was in the department of medicine at a large medical center with the medical students, interns, and residents etc. Many PA's have certifications, licenses in varied health fields, including nursing, but there is no NATIONAL, specific standard required to be eligible for the PA programs. ALL PA's should pass the national certifying exam to practice, that requirement varies from state to state. The other major difference is related to licensing. The NP works under her own license (RN's MUST be licensed in EVERY state) and malpractice, with a COLLABORATIVE MD, who acts as a consultant and/or referral, and the NP can be in private practice. For example, prior to the position I now hold, for 17 years I was the Director and primary care giver of college student health centers, 3000 students plus faculty and staff...my "private practice". The collaborative physician was hired and worked for me under his/her medical license! The PA works under the license, malpractice and supervision of the MD (unless the PA has for example an RN license). However, an RN license alone, for a PA does NOT legally allow the unsupervised advanced PA practice. All this being said, we ALL have our gifts and strengths and collaboratively we make a dynamic, and powerful team...much needed in this time of too many folks without access to affordable health care, which BOTH professions provide very successfully. Choose the profession, PA OR NP by what YOU want to do and what draws your interest. Good luck, feel free to contact me if I can help with anything....

I really had to smile when reading all the replies to "discouraged". I, like many of you, was older (30) when I finally was able to start in an ADN nursing program. I did it in two years...with 4 children!!! Several years later I had the opportunity at a large meical center, to become a Nurse Practitioner (before Master's programs for NP's). I did a schedule of 36 hours "on" and 12 hours "off"...this time with 7 children. I now also have a B.S. in Health Education, a M.Ed. in curriculum design and am finishing a second Master's in Nursing Education...I have 15 grandchildren and am in my 60's!!! I am the Coordinator of an LPN program which I developed and teach in which allows students are able to enter the RN ADN program in the second year. Nursing is a profession of life-long learning. When/if any nurse EVER thinks he/she knows "enough" they have become an unsafe practitioner. The sum of all this is LOVE the profession you are choosing and ENJOY each step of the process...it's the hardest job you'll ever love!!!

Hi...I don't know of any LPN to RN on-line programs either but I wondered if your state education department has any way you could gain credit through challenge exams. New York has these for the LPN's who come out of the high school LPN programs where the courses do not have college credit. Maybe then you could apply to an on-line school with an RN program with some "college credits" already in hand. Keep in touch and let us know how you make out with this.

As an NP AND PA, with National Certification in both fields, and have been a member of our State NP organization for over 20 years. I will tell you that being an RN FIRST makes a HUGE difference, and significantly depends on what your RN experience has been!!! The best route is a couple years of basic med/surg followed by ER and/or Critical Care nursing...(I had all fo these). It prepares you for the medical level decisions combined with nursing decisions that NP's are responsible for. I don't know even ONE NP who does the "yes sir, no sir" with MD's. NP's work under their own license and malpractice, in COLLABORATION with the MD, NOT supervised by the MD, and can be in private practice!!! PA's work under the license and malpractice of the physician and legally, must be supervised by the MD. Check your state rules and regulations for specifics. PS I have the PA certification because years ago when I graduated from my NP program, my state had not ammended the Nurse Practice Act to include the expanded practice of nurses in ANY field...it is no longer possible to get the PA certification by challenging the national exams. I maintain the NP certification as my primary credential.

Hi Everyone who posted comments about the LPN vs RN dilemma!!! I posted the following information about one year ago in this forum and hoped that during this time there would have been programs like the following in many more places than it appears to be. I am a Nurse Practitioner and Physician Assistant, nationally certified in both fields with a Master's in Education focused on Curriculum Design and Development and am currently pursuing a second Master's in Nursing Education, focused on teaching nursing. I am the mother of seven children and the grandmother of 15 (God's gift to me for not killing my kids (; -}....) I am currently employed by a private two-year college in New York State. I was hired to design, create, and also teach, an LPN program specifically focused on encouraging folks to begin at the LPN level, and when completed and pass NCLEX-PN, there are college credits, equivalent to the first year of the ADN program, that transfer into the second year of the ADN program. The PN program is 15-months, WEEKENDS ONLY, to accomodate folks who work and/or have families...you can keep your job...hopefully child care is easier on weekends.... The first class graduated this past August, received a Certificate of completion and are about to take the NCLEX-PN exam. The folks who said in their postings that their LPN experience was valuable are right, and those folks do better in RN programs than many "newbies" going directly into an RN program. Our college is now exploring the addition of the BSN which would allow that credential to follow the RN. It takes 4 years to do that in a traditional college without a license to practice until the four years are complete. This new "series will also take 4 years but goes 1+1+2...LPN to RN to BSN. The PN students loved the program, even though giving up weekends for 15 months is HARD...but are finding it worht the time. Several are in the ADN program, several are working for a year before going on, some wanted the LPN and are happy doing that level of nursing. I'd encourage anyone who wants nursing as a profession to sign up for an RN program that will accept LPN's as advanced placement students, and then take the LPN courses while you are on the RN "waiting list". PS Last year, after my first posting, a young woman came from Alaska to this college and is now in the PN program, heading for the RN in a year...Good luck everyone!!!

The wedding ring issue is an interesting one...I noticed that I did not see any where in the responses that folks are WEARING GLOVES!!! As a nursing faculty person, I mandate that students wear gloves for EVERYTHING they do and DOUBLE GLOVE if infectious, or potentially infectious circumstances exist.

[Good morning...Just a little about my background related to my reply: I am a dually certified Nurse Practitioner and Physician Assistant with a M.Ed. getting a MS in Nursing Education. (I am also a grandmother of 15). Currently my professional position is as the Coordinator of the Practical Nursing Certificate Program at a two-year pivate college with an ADN Program that has existed for over 30 years. I am writing the curriculum and teaching the courses. My three adjunct faculty and I share the clinical for the students. The course is weekends only to accomodate the working, parenting population and we are in the last semester of the first program. For the students of this LPN Program, after graduation, they can enter the second year of the two year RN program and finish both in the same two years as if beginning the RN program from scratch. The advantage is that with an LPN license, they can work, get experience which makes the RN program a little easier. Also they do not ever have to go on the waiting list for our RN program since they are considered"continuing" students rather than "new admits". I would suggest you look for a program like this or one that has an articulation agreement between the LPN program and the RN program to eliminate the wait. Good luck...Coolgramma

I am the mother of 7 and grandmother of 15...I have also been a Nurse Practitioner Director of college health centers for 17 years. That being said, I know this response is coming after the fact but felt that some thoughts on the issue might help future similar incidents. The school MUST be included as well as the parents of the offending student. However extreme responses/anger only puts everyone on the defensive and folks shut down when they feel threatened. My concern would be, has this child come to the attention of the school "authorities" in the past? How was it handled then? Are his parents, or the school authorities, willing to mandate counseling. I might see to that for my child also with the cost being borne by the school/other parents. I have had many contacts on the college level with students who were bullies in junior and high school, and are now on the brink of becoming sociopaths. If this was a "stupid kid event" the young man will NEVER forget the consequences of his action if the "punishment" is appropriate...how about something like doing "chores" for the injured family or community service. The consequences need to impact the offending boy more than everyone else...Coolgramma

You can do anything you want if you want it enaogh and are willing to work to get it. I'm 67 years ld (almost 68) and am a Nurse Practitioner and Physician /assistant (nationally certified in both) with a Master's in Education. I am teaching Nursing and for NLN accreditation for my program I need a Master's in Nursing...so I'm back in school doing just that. My seven children always ask if I know what I want to be when I grow up (; -} Who knows...maybe when I finish this I'll try for the Ph.D. Follow your dreams...

Hi all...as you can see by my name, I belong to the "old dogs"!!! The postings I've read make me feel very sad!!! We are a profession that seems to have a hard time supporting each other no matter where we are in the "timeline" of our life work in this profession. I started as an RN student who left school because of pregnancy (you couldn't stay in nursing school i "the olden days" if you were pregnant) became an LPN, went back to school after 4 children for my RN. With this license I worked Med/Surg, OB, Peds, ER, CCU, and received permanent teaching certification. I earned a B.S. in Health Education, became a nationally certified Nurse Practitioner, challenged national certification for Physician Assistant and am certified in both areas. as an NP I have worked for the Department of Medicine of a large teaching hospital, been the Director of College Health Centers for 17 years and during that time earned a Master's Degree in Education focusing on curriculum design and development...all this while raising and educating seven children, all of whom also have college degrees. I'm telling you all this because currently, after 40 years in the profession, I am teaching student nurses. My students tell me that my "stories" illustrating their learning are among the most valuable of their learning. HOWEVER...I learn as much or more from them some days than I could ever teach them. The bottom line is that we can learn so very much from each other if we, nurses, stop being defensive and open ourselves to that learning. I'll stop here and thank you for allowing me to expound on this topic.

I am posting for the first time and HAD to respond to the messages about the value of "letters" after our RN designation. I have been around a LONG time (my grandchildren think I'm as old as dirt!). I have to begin by saying that I LOVE the choice I made when , at the age of 7, I decided that Nursing was what I wanted to do for the rest of my life. I have "lots of letters", and am in the procss of getting a few more.... Let me explain. I am originally from a Diploma program...GREAT education and super experience, however, not acceptable to colleges for the BSN degree, which, at least in NY was being promoted as the requirement for RN's as long ago as the early 1960's!!! I challenged as many courses as I could, got an ADN, then a BS in Health Education, and an M.Ed. in Curriculum Design and Development. Inbetween I became a Certificate prepared Nurse Practitioner in Adult and Adolescent Medicine, Nationally Certified through ANCC, (there were NO Master's programs for NP's yet), and Challenged the National Certification for Physician Assistants, so I am also a PA. I've worked in every area of Nursing except Psych (even though 15 years as Director of College Health Centers exposed my to LOTS of Psych issues). While living in Vermont, I taught in college classrooms, Nursing Schools in the BSN, MSN, and Post-Master's programs, as well as guest lecturer in Med School classes. Now I am back in NY and MUST return to school for a MSN (in ANYTHING) because NYS Dept. of Ed. says I'm not qualified to teach in a college level Nursing program without it...so that's what I am doing. No wonder we are not valued OR respected by other professions when our own professional organizations don't support us or fight for us in the legislative arena. MORE titles DO NOT a profession worthy of respect make!!! NURSES "EAT" THEIR YOUNG!!! Getting nurses to stick together is the hardest job of all. As a founding member of the NYS NP association, struggling to increase membership, I know that we don't belong to the organiztions that could change our status AND as a group let them know what we need and want, so a few make the choices for the many. Legislators see that we don't support our profession, and so why should they??? I am currently teaching nursing, pending my MSN, and my class consists of "mature" adults. Every class I tell them that you CAN make a difference!!! One person can! Look at Mother Teresa! And that this profession will be the hardest job they'll ever love. That will be my legacy to this profession, helping new nurses learn to value and love themselves and what they do. Bt the way, there's NO shame in wanting to make a good salary...valuing yourself and your skills is important. If you don't value who and what you are and can contribute, no one else will either. Thank you for "listening" to 30+ years of struggle and frustration...I admire all of you who are out there fighting to make the difference and for valuing your professional choice...coolgramma