RN, NP, or PA?

Editorial Team / Admin · Jan 11, 2016

If you haven't graduated high school yet, have you taken some time to speak with your guidance counselor? What about looking into shadowing someone from the professions you're interested in?

Palliative Care, DNP · Jan 11, 2016

I will answer this from the perspective of a BSN nurse that is completing a DNP program in May. I will be eligible to sit for the FNP boards upon graduation. If I were beginning today instead of nearly 4 years ago then I would choose the PA route. In clinical sites I have been to the PA students hit the ground running. I was advised by faculty that the average NP student catches up within a year and then there is virtually no difference. I would choose the PA route for the medical model of education they receive. I have taken many classes that I will never use in my career and written many papers that in no way will assist me either. I have spent countless hours on the Capstone Project necessary to graduate that I will not be doing anything with either upon entering the work force. The worst part of NP education in my opinion is finding your own preceptors. It adds entirely too much undue stress on top of everything else and other healthcare professionals are not forced to do that. Some will argue that NPs have more autonomy and that is true in various states. I also am not attending a for profit program. I am at a ranked college in the southern part of the country so that did not play a part in finding preceptors. Students often take the first NP or MD who agrees to precept but that does not ensure a quality experience. Nursing in my opinion needs to formalize our graduate education better if we would like to be respected and the terminal degree is to actually mean something. Again, this is only my opinion and I am prepared for those in disagreement.

TheCommuter, BSN, RN · Jan 11, 2016

By the way, one would need to become an RN prior to becoming a NP unless he/she completes a direct entry program.

Becoming an RN prior to enrolling in PA school is not necessary. However, applicants to PA programs need to have amassed a certain number of hours of verifiable paid hands-on patient care experience.

la_chica_suerte85, BSN, RN · Jan 12, 2016

I am 6 months (158 days to be exact) away from graduating with my BSN (with a prior BA in psych). When I was flailing about in my earlier 20s trying to figure out a way into the medical field, I had considered PA school briefly -- the only caveat is many programs want you to already have several hundred hours of paid experience working in a clinical setting and I had none. So, I bumbled about thinking I would go to medical school and it got to the point that I simply needed to get on with my life. I ultimately chose nursing school (you should always listen to your parents, kids!) and ended up absolutely thriving. I do, however, know that I still flock toward the medical model of things (look up the difference between the "medical model" and the "nursing model" because this can definitely be a factor in what you decide) and, while I thought I wanted to get my PNP after recovering from being in school for 800 million years, I am now leaning more toward a PA track.

If you want to go PA, get your CNA license and get your prerequisites done while you're getting your paid experience prerequisite done. If you want to go NP, consider that it is a path that takes a MUCH longer amount of time. You have to be an RN first and the majority of NP schools require you to work several years as an RN prior to applying. If I had my head screwed on a little straighter when I was first in college, I would have figured out a way to go PA, however. Not to say I don't love nursing, I just am so tired of school.

RainaLuzon · Jan 12, 2016

It's almost a wash in regards to opportunities and scope of practice. HOWEVER, The nursing profession is moving quickly and swiftly away from a master's degree being the entry level for practice; you will need to get a DNP if you decide to enter within the next two years or so. That's something to consider in regards to the rate of return on investment, as the PA profession will probably NEVER move to a doctorate program. People would just go to med school!

Want to move to another country or do aid work? No one outside of the US knows what a PA is. Well, they may, but they aren't recognized. NP's are, and can practice from Brazil to Australia.

You just have to decide what model you want to learn under.:

NP: *to primary care patient presenting with depression* Have you had any sort of stressful situations happen lately? ? That's unfortunate. You know, Cognitive Behavioral Therapy works wonders with depression, and I know a great therapist that I love to refer people to. We can try that first, and then maybe we can talk about some medication options.

PA: *to same patient* How long has this been happening? Is it accompanied with any shortness of breath or pain? Okay, I'm going to start you on some Buspirone in conjunction with Citalopram. We'll see if this will help, and if your symptoms don't improve in a month or two we will try another medication.

At least, that's been my experience having had both NP's and PA's treat me (prefer NP's :yes: ) . But that's not to say that there aren't some awesomely holistic PA's, and some NP's that are just focused on treating the disease.

Either way, they're both great professions with amazing opportunities....and both seem happier than doctors all around!!

anh06005, MSN, APRN, NP · Jan 12, 2016

It's almost a wash in regards to opportunities and scope of practice. HOWEVER, The nursing profession is moving quickly and swiftly away from a master's degree being the entry level for practice; you will need to get a DNP if you decide to enter within the next two years or so.

Nope.

ZERO states are considering to make DNP entry level. ZERO. Yes there are TONS of DNP programs popping up but they are NOT necessary. MSN is still entry level for NP now and in the foreseeable future.

For CRNA they are moving that way but I think it's by 2025???

RainaLuzon · Jan 12, 2016

American Association of Colleges of Nursing | Frequently Asked Questions

they've been planning this since '02 apparently.

https://en.m.wikipedia.org/wiki/Nurse_practitioner

in the 'education requirements section' it mentions it as well. (Even though we all know Wikipedia is just SO reliable!) My mother is also an NP, and teaches Med Surg at a university, and they're already starting to phase out their Masters' Program for NP in preparation for the change; they're taking their last cohort in Fall of '18. The consensus seems to be that it'll almost certainly happen in the foreseeable future. She's been encouraging me to 'hurry up' and get through school so that I won't have to get a DNP.

People who get their NP before this change will of course be 'grandfathered in'.

The same thing is happening to the OT field, which only required a Bachelor's up until 2006. They're now steamrolling ahead to make it a doctorate program.

I think it's about keeping people in school for as long as they can and getting that federa loan money.

Editorial Team / Admin · Jan 12, 2016

American Association of Colleges of Nursing | Frequently Asked Questions
they've been planning this since '02 apparently.
https://en.m.wikipedia.org/wiki/Nurse_practitioner
in the 'education requirements section' it mentions it as well. (Even though we all know Wikipedia is just SO reliable!) My mother is also an NP, and teaches Med Surg at a university, and they're already starting to phase out their Masters' Program for NP in preparation for the change; they're taking their last cohort in Fall of '18. The consensus seems to be that it'll almost certainly happen in the foreseeable future. She's been encouraging me to 'hurry up' and get through school so that I won't have to get a DNP.
People who get their NP before this change will of course be 'grandfathered in'.
The same thing is happening to the OT field, which only required a Bachelor's up until 2006. They're now steamrolling ahead to make it a doctorate program.
I think it's about keeping people in school for as long as they can and getting that federa loan money.

It's a position statement, not legislation. Until the state BONs start requiring DNPs, MSN is still acceptable.

It's been nearly 50 years since the ANA published their position paper on BSN as the entry to practice degree, and how many BONs require a BSN for licensure? Oh, that's right, none.

JustcallmeNurse · Jan 13, 2016

American Association of Colleges of Nursing | Frequently Asked Questions
they've been planning this since '02 apparently.
https://en.m.wikipedia.org/wiki/Nurse_practitioner
in the 'education requirements section' it mentions it as well. (Even though we all know Wikipedia is just SO reliable!) My mother is also an NP, and teaches Med Surg at a university, and they're already starting to phase out their Masters' Program for NP in preparation for the change; they're taking their last cohort in Fall of '18. The consensus seems to be that it'll almost certainly happen in the foreseeable future. She's been encouraging me to 'hurry up' and get through school so that I won't have to get a DNP.
People who get their NP before this change will of course be 'grandfathered in'.

Wikipedia is not a reliable source for anything, and this DNP initiative is state by state so far. I don't think that many states have started requiring a DNP as of yet. In my area most of the schools still have a MSN program and there are many "Top" schools here. Many states that have the grandfather clause allow if you have start the NP program by "X" date then you would be "grandfathered" in to not have to have your DNP.

anh06005, MSN, APRN, NP · Jan 14, 2016

American Association of Colleges of Nursing | Frequently Asked Questions
they've been planning this since '02 apparently.
https://en.m.wikipedia.org/wiki/Nurse_practitioner
in the 'education requirements section' it mentions it as well. (Even though we all know Wikipedia is just SO reliable!) My mother is also an NP, and teaches Med Surg at a university, and they're already starting to phase out their Masters' Program for NP in preparation for the change; they're taking their last cohort in Fall of '18. The consensus seems to be that it'll almost certainly happen in the foreseeable future. She's been encouraging me to 'hurry up' and get through school so that I won't have to get a DNP.
People who get their NP before this change will of course be 'grandfathered in'.
The same thing is happening to the OT field, which only required a Bachelor's up until 2006. They're now steamrolling ahead to make it a doctorate program.
I think it's about keeping people in school for as long as they can and getting that federa loan money.

As others have said the AACN (college accrediting agency) can do what they want but until the STATES require a DNP (and last I heard there were ZERO that do) the MSN will still be around. As a PP mentioned it's similar to RN diploma and ASN vs BSN. BSN may be preferred but the state still gives you license to practice at the RN role. The AACN probably promotes the BSN also.

Zyprexa_Ho · Jan 16, 2016

One thing to keep in mind is that as a PA you are always going to be bound to a doctor. NPs are regulated by BONs, and in some states can practice autonomously