RN Vs. PA?

smk1, LPN · Feb 5, 2006

I think your heart is in the right place with your post but I don't know that I agree with some of your perceptions. As a PA, the only "observation" that takes place is (granted) that my charts are co-signed, then you are correct- However, that co-signature typically occurs days to weeks later. Please know that, however, that as I have my own medicare u-pin number and my care ia accepted by 70% of third party carriers, I bill direct and those notes require NO co-signature. In this case, the only observation that occurs is my physician partners seeing the revenue that I generate.
Second, after 25 years in medicine, I know of no one (reasonably intuitive and humble) that doesn't bounce things off of sombody though such "bouncing" is not required of a PA, at least in Pennsylvania where I have worked for the last 12 years. From a medicolegal perspective, it is actually a good idea to discuss more complicated cases as this offers a venue to consider another perspective that one might have overlooked, or to receive validation that one is thinking reasonably.
As to you perception that only NP's are (legalities aside) able to practice independently, with self-motivation and confident in their skills; well, you are certainly entitled to your opinion. Please know that I disagree as to the generality of this assertion.
The biggest problem with the written word is that one cannot hear the vocal tone, where the pauses in speech occur, nor the body language that is important to avoid misunderstanding what someone is writing (or in this case typing!) Therefore it is possible that I am mis-reading you entirely.
I became a PA for one reason: I wanted to preserve the total sub-specialty preparedness of my RN training that would later allow me to work in nearly every area of nursing, and train within that same construct as a mecial provider. That decision has served me well. I went from internal med, to surgery to pain intervention and I am not aware of a NP track that would have given me this flexibility back in 1991. Maybe it is a "guy" thing, but I didn't know what area I wanted to work within so the PA model fit me.
I think all of the posts here are well considered and I am pleased to see it.
I think that the poser would do well to consider all of them.
Respectfully-
Matthew , RN, PA-c,MS.,D.Sc.
Acute and Chronic Pain Intervention

Matthew, Thanks for your perspective. Do you know if the requirement for "medical training" is still pretty much an across the board thing? and if so, would the original poster fit that criteria with just CNA experience? As i am not going into the Physician Assistant/Associate field, i just know the basics and word of mouth type of info, but kind of assumed medical experience would mean at least EMT-IV or higher or LPN or higher or rad tech/resp tech etc... Perhaps you can shed some light on what (in general) the programs are looking for in terms of prerequisites, medical expeirience and the amount of time the schooling will take. This may help the origianl poster to see more of an accurate representation, though just from one, member of this field. Welcome to the boards! In general we are a pretty good group of folks.:)

BlocDoc · Feb 5, 2006

Matthew, Thanks for your perspective. Do you know if the requirement for "medical training" is still pretty much an across the board thing? and if so, would the original poster fit that criteria with just CNA experience? As i am not going into the Physician Assistant/Associate field, i just know the basics and word of mouth type of info, but kind of assumed medical experience would mean at least EMT-IV or higher or LPN or higher or rad tech/resp tech etc... Perhaps you can shed some light on what (in general) the programs are looking for in terms of prerequisites, medical expeirience and the amount of time the schooling will take. This may help the origianl poster to see more of an accurate representation, though just from one, member of this field. Welcome to the boards! In general we are a pretty good group of folks.:)

Thanks for the welcome. Anything I tell you will be just one opinion and it would not be anything factual, just opinion. However, I might refer you to a thread over on the PA forum where such discussion goes on endlessly as one might expect. http://www.physicianassistant.net/forums/showthread.php?t=6369&highlight=prior+experience

No one knows the minds of college admission committees and I have spoken to very well experienced individuals who have been passed by college selection boards. I think this sort of thing is possible in any area of education. Sometimes you "have the goods" but don't interview well. Worse, you would interview well, if it were not for the "Hello is this microphone on?" blank looks you get from interview teams.

Ultimately, if one feels called to move on from the field of nursing, the education and the role makes you an excellent candidate for any medical discipline (IMHO) and represents a perspective of patient interaction that is not ingrained in any other discipline. Therefore, I feel that the 2 year RN is the best core knowledge program of study going, yet still facilitates progression into other areas of study.

TazziRN, RN · Feb 5, 2006

Did not mean to piss anyone off.

Quote "From what I've seen PA's tend to make more money, "

THIS is the statement I was replying to. I have no idea what your background is, but this statement made me wonder if you were looking for the best paying position. No idea what it's like elsewhere but in the facilities where I've worked, all the nurses I knew who were in it for the money made mediocre to barely average nurses. They cared about the paycheck, not about the patient. Again, did not mean to offend, I was questioning what your intentions were, that's all.

aspentree13 · Feb 5, 2006

Matthew, Thanks for your perspective. Do you know if the requirement for "medical training" is still pretty much an across the board thing? and if so, would the original poster fit that criteria with just CNA experience? As i am not going into the Physician Assistant/Associate field, i just know the basics and word of mouth type of info, but kind of assumed medical experience would mean at least EMT-IV or higher or LPN or higher or rad tech/resp tech etc... Perhaps you can shed some light on what (in general) the programs are looking for in terms of prerequisites, medical expeirience and the amount of time the schooling will take. This may help the origianl poster to see more of an accurate representation, though just from one, member of this field. Welcome to the boards! In general we are a pretty good group of folks.:)

In Colorado there are a couple of different schools that offer a PA program. One is the CU Medical School, and doesn't require you to have medical training, but you do have to already have a BA and take quite a few pre-reqs as well as the GRE. The other school is a community college and requires you to have an associates degree or higher (but prefer BA), they also require you to have medical training 2000+ hours, and yes CNA does count, also you have to take some pre-reqs but not nearly as many (A&P, Microbiology, Math, & Chemistry), also you don't have to take the GRE. The community college is where I plan to apply. Most schools that have a PA program have the requirements listed on their webpage. Hope this helps.

aspentree13 · Feb 5, 2006

The thing is that nurse practitioner really isn't a route I'm looking into due to the time it would take. First I'd have to get my BSN 15 months, then it would take another 2 years to get my masters. I really don't think I'm prepared to commit this much time to a program. I'm getting older and am looking to start a family in a few years, I just want to get it done. So PA or RN are the two routes I'm looking at.

button2cute · Feb 5, 2006

Hello,

I would like to know what is important to you? I believe you have to go where your heart is as one person said in their post. There are numerous of reasons why people select a choice. I do not believe it is motivated by money 90% of the time at all. I believe people inquire about the finance of the careers to meet the bills and to have money for retirement. I believe you need to know what is going to work for you in the future a nurse or a pa. You have to know what can you give into the career and what you can receive from the career as well.

I believe medicine is a career that will demand a lot work, devotion, time, compassion (depending on the job title), giving and respect. As my one friend told me, " I choose to be a CardiologynPhysician because this is my number one devotion in life. Everything is second in my life and third and etc. Whoever I am going to be in a relationship will have to understand my long hours and devotion. I will be making great money, however, take the hours I will be spending and the money I earn will be less than the money offer to me. I do not care if I die single as long I am doing my job as a cardiac physician." She is a very good cardiology physician and she is working at the hospital of her selection. Not everyone is like her and you may feel it is going over the top. Well, she has the characteristics and mental attitutide to be the best cardiologist. Therefore, she is working each day to become better than yesterday.

You have to find what is best for you and your personality. You need to decide how you would like to see your future? and what you want out of your career? Do you want the family, house, and the dog "spot"? or Do you want to be a workoholic? or both? You need to be able to balance life, career, education and relationships no matter what you choose. It is all about you and no one else...unless you are marry than it is about the family and you.

I have heard so many reasons why people chose nursing from I want to give back to someone for the care I received during my illness, I need to get out of a bad relationship and this will help my family and myself to stand on our feet, and from the money. Regardless of the reason/s, it is a career and it will remove you from a past of negative to the present of positive as long as you respect it.

As long you can be devote to your choice and attend school without an unbalance in your life...go for it. Just make sure you do what is asked by the instructors, study every night and day, be prepare for classes and tests, give your best during clinicals, do not act like a know-it-all or a rebal and never quit ...then you will become whatever you choose as a career.

By the way, a patient does not care what your grades were in the courses, they want to see the RN or the PA-C, MSN behind your name that is tailor onto your jacket. Patients want someone that care about them, illness, treatments and be respectful to them.

Therefore, your choice is on you and how you want to proceed in life, no one else will walk into your shoes and it will be your learning experience in life.

Have a great weekend and Go steelers.

button2cute · Feb 5, 2006

Hello, Mathew

It is funny you said "Maybe it is a "guy" thing, but I didn't know what area I wanted to work within so the PA model fit me." I have heard that phrase by PAs (some) who are males. Not sure the correct meaning. Is the correct meaning if the males perfer an occupation that allows for flexability and variety than one that does not provide those elements? Help me out here.

I believe that times are changing for NPs to obtain more of a flexabiity and variety as well. The thing that bothers me most is the NPs must return to school to learn about another area to practice in and to recieve more initials behind their name. Oh, there are several physicians will accept you as you are package and train you into the position. I cannot wait till I locate them...just joking. Back in the past, FNPs were floating around and not enough jobs for them in that specific area. Now, the spaces are available due to the medical school students, residencies, interns are not allow to work over a certain amount of hours during the week. The doors are open for NPs and the surplus of FNPs from the past to apply. It was tough for the FNPs and now it is competive as well for a spot with the FNPs from the past, today and PAs. I know several NPs that work in pain clinics, ers, family practice, cardiac, psyche, holistic, cardiothoracic, public health, long term care facilities, assisted living, corporations, generalist (pennslyvania hospital on walnut), wills eye, and etc. So the field is opening up and giving better days, hours and hopefully better pay scale.

I do not believe that NPs should be under the Board of nursing in their states. If medical hires you than you are under medical and given the appropriate benefits as PA. The BON should not have any say about your salary period and training as well....it is medical's problem. I cannot stand that at all.

Therefore, as time comes and goes, the opporturnities will be there for NPs as well.

Buttons

BlocDoc · Feb 5, 2006

Hello, Mathew
It is funny you said "Maybe it is a "guy" thing, but I didn't know what area I wanted to work within so the PA model fit me." I have heard that phrase by PAs (some) who are males. Not sure the correct meaning. Is the correct meaning if the males perfer an occupation that allows for flexability and variety than one that does not provide those elements? Help me out here.
Buttons

I hate to make a generalization here but for me, I had so many interests that I never stayed put in a particular area for more than a year or 2- I jumped around from specialty to specialty- Phenomenal for a resume in terms of breadth of experience, but clearly not good in terms of demonstrating staying power. I had this tendency LONG before I became a PA- As a nurse I worked in most every inpatient and outpatient arena, from the military to the private sector. Fortunately for me, the good lord let my lead out a bit and let me discover my true love on my own (or so I would like to think). I am proud to say that I have "stayed put" now for 12 years in the pain arena and showing no signs of moving on! I have only had three jobs as a PA. Thanks for the question!

Trauma Columnist · Feb 5, 2006

I don't want to open another can of worms but there doesn't seem to be a standardized educational background for the PA. That is what I see at least here in the land of cornfields. The ANCC now requires a minimum of a masters degree to attain APN status. What type of standardization does the PA education offer?

Just curious as I had not considered a PA when I decided to do the APN route simply because there are no programs nearby.

BlocDoc · Feb 5, 2006

I don't want to open another can of worms but there doesn't seem to be a standardized educational background for the PA. That is what I see at least here in the land of cornfields. The ANCC now requires a minimum of a masters degree to attain APN status. What type of standardization does the PA education offer?
Just curious as I had not considered a PA when I decided to do the APN route simply because there are no programs nearby.

Not to avoid your question, but let me ask another: What is the "standard" background for an MD, a DO, a lawyer, a banker, a school teacher, or an RN-

The fact that advanced practice nursing programs require that you first be an RN, does not preclude that what I will call "alternative life experiences" cannot adequately prepare an individual for a career in a particular field- These programs are designed to provide the necessary education and clinical skills to enter the work force.

And just so there is no misinterpreting the answer to my question, the answer is that there is no standardization, as I think you might agree. I will tell you the fact that I worked as a nursing assistant and then a unit secretary gave me a clear familiarity and ease into my nursing education. However, I went to nursing school with people who did everything BUT interact with the medical field and yet became very competent and productive nurses.

My hope is that I have provided an answer to your question and we leave the "can" alone;)

Trauma Columnist · Feb 6, 2006

Hi BlocDoc - yes you did answer my question nicely too, I might add. May I ask what level of education you had in nursing prior to going to PA school? Did it provide you with a masters degree? Thanks.

carolinapooh, BSN, RN · Feb 6, 2006

In Colorado there are a couple of different schools that offer a PA program. One is the CU Medical School, and doesn't require you to have medical training, but you do have to already have a BA and take quite a few pre-reqs as well as the GRE. The other school is a community college and requires you to have an associates degree or higher (but prefer BA), they also require you to have medical training 2000+ hours, and yes CNA does count, also you have to take some pre-reqs but not nearly as many (A&P, Microbiology, Math, & Chemistry), also you don't have to take the GRE. The community college is where I plan to apply. Most schools that have a PA program have the requirements listed on their webpage. Hope this helps.

Please note that a physican assistant program is a master's level program. This is across the board. There are no longer any BS programs graduating PAs.

The program your community college is touting is NOT a physician assistant program, but sounds a PHYSICIAN'S ASSISTANT program - a medical technologist.

The two programs are not identical.

I struggled with the PA/NP dilemma for a few months before choosing nursing, so I'm familar with PA requirements and that too-close and confusing terminology.

To the OP - programs vary as to requirements, even in the same state. Here in NC there are three programs; one requires 1000 hours of "direct patient contact" and does not count volunteer experience within that context, one recommends prior experience but approves of extensive and intensive volunteer time, and the third claims to have no preference (though I doubt that's the case).

Good luck in your decision; I'm sure you'll do well no matter what path you choose.