Why should I become an rn instead of a pa?

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I am at the very beginning of my health care career exploration. I am trying to gain more perspective on the pros and cons of becoming either an rn or a pa and would love to hear from you. I know the basic differences but am trying to understand why people in those careers feel more attracted to one or the other.

If schooling and salaries were equivalent would you choose to be an rn over being a pa? Why? TIA.

Specializes in Hospitalist Medicine.

No, they don't. A PA's prescriptive ability (not "authority") derives from his/her physician employer in every state. They cannot practice autonomously. In most states, an APRN has his/her own prescriptive authority, granted by the State Board of Registration in Nursing by virtue of the APRN status.

In our state NPs can't write prescriptions on their own. They have to be reviewed by a physician, just like a PA. It really does vary state to state. That's why I said the line can become blurred in some states :)

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Specializes in Adult Internal Medicine.
In our state NPs can't write prescriptions on their own. They have to be reviewed by a physician, just like a PA. It really does vary state to state. That's why I said the line can become blurred in some states :)

This must be Michigan? They have a weird law there because NP and PA practice were setup together. As far as I heard, this has loosened for all but schedule 2s for NPs. And there is no consign required; this is what I think I remember from discussion at the national conference.

Sent from my iPhone.

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First of all, get clear about terms. PA vs RN is like banana vs basketball. I'm assuming that what you are really asking is how Nurse Practitioner differs from Physician's Assistant. If you think you want to be an NP, then becoming an RN is the start of that track. If you want to be a PA, then go to PA school, not nursing school, but you'll usually have to have hundreds of hours as an EMT or ED tech, or Army medic, or something like that, before you can apply to PA school.

As an RN, once you have a BSN (and experience) you can continue training and education and become a Nurse Practitioner. Generally an NP is Masters prepared, although this is changing and will likely demand a doctorate level degree soon. There are some programs where you can get your BSN and Masters in sequence and come out as an NP, but most NP programs (wisely, I think) require at least a year of RN experience just to apply.

A Nurse Practitioner incorporates both the nursing framework AND the medical framework. A PA is trained, often in medical schools, in the medical model. PA's are physician's ASSISTANTS. NP's are nurse PRACTITIONERS. NP's generally have more autonomy. (This is very important!) There are more differences, but since this is about your future take time to continue researching until you are clear in your own mind. Good luck on whatever career path you ultimately decide to follow.

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First of all, get clear about terms. PA vs RN is like banana vs basketball. I'm assuming that what you are really asking is how Nurse Practitioner differs from Physician's Assistant. If you think you want to be an NP, then becoming an RN is the start of that track. If you want to be a PA, then go to PA school, not nursing school, but you'll usually have to have hundreds of hours as an EMT or ED tech, or Army medic, or something like that, before you can apply to PA school.

As an RN, once you have a BSN (and experience) you can continue training and education and become a Nurse Practitioner. Generally an NP is Masters prepared, although this is changing and will likely demand a doctorate level degree soon. There are some programs where you can get your BSN and Masters in sequence and come out as an NP, but most NP programs (wisely, I think) require at least a year of RN experience just to apply.

A Nurse Practitioner incorporates both the nursing framework AND the medical framework. A PA is trained, often in medical schools, in the medical model. PA's are physician's ASSISTANTS. NP's are nurse PRACTITIONERS. NP's generally have more autonomy. (This is very important!) There are more differences, but since this is about your future take time to continue researching until you are clear in your own mind. Good luck on whatever career path you ultimately decide to follow.

First of all, read the entire thread before you comment. I have my terms straight, and not I am not asking about NP vs PA. I have a bachelors in a non-nursing field and am considering one of two options, preparing for a BSN or preparing for a PA program. I am asking about bananas because I would like to know if they are just so tasty and nutritious that everyone have one before playing basketball or any other sports for that matter, or if they are only so so and I should just hurry up and get in the game.

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I am having a hard time with this attitude. I know that each persons reasons are different, but that is exactly why I want to know other peoples' reasons. I want to hear about all the factors that a might possibly go into such a decision to make sure I am not overlooking any. I don't know any nurses or PAs right now, so I can't ask them what they love about their jobs, or why they choose their particular path, or what they would do differently if they could. I came here to ask. These are valid questions and I am really confused as to why, instead of simply answering them, I am being told over and over that they are the wrong questions. Please try and trust that I know which information is useful to me.

Attitude? "All the factors that might possibly go into such a decision..." will be very different for each person. Rather than ask people why they like being one thing or another, get as much information about what it takes to become an RN/NP/PA, or fireman, for that matter, and what they each DO. And then think about what turns YOU on, what fires YOU up.

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I was in the same situation a few months ago. I even have a similar degree already (forestry). When I first started back to school it intentions of becoming a PA, however, as I progressed through my prerequisites (as I'm sure you know there are MANY for PA school) I realized how much I disliked those prerequisites. I began to consider a BSN for several reasons:

1. Time - Prereqs for PA school would have taken me at least two solid (read: no summers off) years to complete. Prereqs for nursing school are taking me a year even with extra classes like EMT and chem 2 (I will finish next month). The nursing school I am going to (UTMB) will also only take 1.5 years versus 26 to 32 months for PA school. So, by choosing nursing school, I will be an RN by May 2016. If I had chosen the PA route I wouldn't have finished until, at the earliest, summer of 2018. That is 2 years difference, which is a long time and leads me to my next point: money.

2. Cost - The amount of debt that you accrue while in school is an important factor. To compare, I got on Excel and made a spreadsheet that took into account the cost of living for each year spent in school (I assumed about $20,000/yr), the cost of school itself (tuition, books, fees, etc.), the cost of transportation (car notes, fuel, maintenance), and any other miscellaneous costs that I could think of. I also took into account the potential revenue lost by going PA over RN (the salary you'd earn as an RN for those two years that you'd still be in PA school). The difference for me was staggering. It was well over 6 figures cheaper to go to nursing school with all of those factors taken into account. In this case, time literally is money.

3. Options - I have spoken to PAs, nurses, and doctors about this subject to get the pros and cons. One point that has been made is that RNs have more choices in which areas that they want to work. You can stay an RN and work in whatever area of the hospital or clinic you want to work in. You could go the CCRN route and work in the ED or ICU. My intentions are to continue on for either ACNP or CRNA. You could get your MSN and do management. The list goes on and I know people have commented on it already. I am even dating PA right now and we discuss the PA vs NP thing all the time. We've come to the conclusion that if you're wanting to do primary care then PA is probably the better option but if you're wanting to do acute care then ACNP is the better option. The experience you'd get working as an RN in the acute care setting would be extremely beneficial over a PA going into that area, most of whom have a month or two of clinical experience in each specialty. This isn't to say that PAs aren't good, because they are. I just think the NPs have the leg up in that area.

4. Autonomy - This is definitely state specific and something that you should research further (I'm sure you already have). It is one reason that I am very interested in the CRNA route. I think in my state, NPs have more autonomy than do PAs but I would say that a BSN would likely have less than a PA. This is something that I can't give too much advice on because I just haven't gained enough experience to make a sound judgement on the subject. If I were you, I would make friends with someone that works in the medical field who is neither an RN or PA and ask their opinion.

5. Job availability - There are a lot of jobs for both fields but PAs are not widely used in every state; RNs are. There is already a shortage of nurses that will continue to grow as many of the baby boomers continue to age and are needing health care. They are also dropping out of the workforce making even more open positions.

The cons of RN: PAs do make more. I know several that have just graduated and for their first job are making $100,000+. Nurses don't make that, especially ones with no experience. Prescriptive authority is a plus but it also brings increased responsibility. PAs don't have to clean up after anyone that has just had diarrhea all over themselves, which is definitely a plus.

I'm just rambling at this point. I hope this can help you decide. Really the main factors for me were time and money.

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Thank you so much ben-ben-ben. That was just what i was looking for and very helpful.

I am leaning towards BSN right now because of geography. There are no PA programs here and with a husband and a baby moving would be difficult. Adding the cost of moving (both financial and otherwise) to the additional time and tuition for PA school makes it less appealing even with the higher starting salary.

The point about primary vs accute is interesting. I think that is particualrly true in the western part of thr US (where I live). The PA prorams I've looked at out here seem very focused on primary care, which really isn't my interest. Finding a more acute care focused program might mean an even bigger move and I don't think my family is ready for that.

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In my opinion, one benefit of being an RN is getting the opportunity to get your feet wet in the healthcare industry, allowing you to be exposed to different specialties. You can see what you'd be interested in. From what I hear, it's harder to move around if you're a PA/NP. Although there is a lot of focus on primary care with these degrees, there are also lots of opportunities in acute care settings, so I wouldn't let that sway your decision.

And, since I don't think anyone else has mentioned it, keep in mind that PA school is incredibly competitive. Having good grades and a high GRE doesn't guarantee admission. But from what I can tell (for the most part) if you have a 3.5 and a decent SAT/ACT score you shouldn't have a problem getting into nursing school. Lots of people get in with pretty average grades and test scores. So if you do decide to try for PA school, think about applying to some nursing programs.

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for me it was between applying to PA vs. nursing school. I already have a bachelor's degree. I decided on applying to nursing school instead because there were fewer prereqs. Also, I talked to some RNs, NPs, and MDs. Many tell me that PAs have to do "scut work" of doctors and that they work A LOT. There are many pathways to nursing. While it might be hard to find a job with an ADN, it's not impossible. Also, with nursing one could always switch specialties and be working full time (3 days a week) while in NP school. Perhaps even have an employer help fund with educational expenses.

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