Physician assistant or nurse practitioner

Any pros or cons on PAs or Nps?

Yeah, it doesn't take as much education to become a PA and damned if they don't get paid more $$ and treated with more respect too.

Hey... We're nurse here.. I would recommend NP for several reasons. And I am all for the money that Sara is talking about but............ As an NP in many states you can have your own practice and I believe NP's are gaining recognition albeit slowly.. And with a good nursing background I believe they give superior care..JMFHO

WR,,, three commas for Becca

The name's changed but I will always be WinidingRoad

A friend is someone who knows the song in your heart and sings it back to you when you have forgotten how it goes.

Well, as a nurse it was natural for me to choose NP over PA.
I've asked docs about both. Some prefer PAs "they are trainged by DR and don't have to unlearn all of that nurse stuff" Others prefer NP as they have more training. I guess it's a personla preference for them too.
However, I have a friend in an NP program, has a year left and he's already been offered 3 jobs by different docs who work in the ER where he's currently practicing.

Sorry, no definative answer!

I hate to be "inflammatory" - BUT - I am an educator who has worked with nurses at all levels of their educational journey. I have also worked with PAs. All one really has to do is look at the "titles": nurse PRACTITIONER and Physician ASSISTANT. That ought to tell you the difference right away.

I have never met a PA who, in all innocence, hasn't been given the "impression" (yes - very often by their university division) that they are "better than" NPs. After 20+ years of educating both, I have to tell you that NPs are hands-down-far-and-away more competent than 99% of the PAs who are out there today. In fact, some of the PA programs I have seen scare me to death. The general public has no CLUE what the difference is, nor how to protect themselves. To tell you the truth, the only PA I would trust is one of those "old guys" who was a medic in Viet Nam.

I agree with you. And those medics are getting old. I know I've dated a couple..But wait, that's another story,,, for another day.

Nursing is not only a science but an art. It's the art of taking care of someone when they can't or won't. It's being there when you are needed. That's what makes it an art. The science part is important but cold sometimes. And unyielding without "proof". Nursing is sometimes a gut feeling, a "I can't put my finger on it, I can't prove it, I just know it" process.

I read once, maybe here even, that PA's are just interns for life.. LOLL If that's the case why bother.

I met one of the most sauvy Nephrology NP's I ever encountered in NC on a travel assignment..And ya know what set her apart. It was her nursing skills and the fact that we spoke the same "language" and had the same goals for our patients. Yes, she "outranked" me by a "degree" but you'd never know it.

JMHO

WR,,, three commas for Becca

Re: Nursing is not only a science but an art.

The difference between a nurse or NP - and a PA or even a physician - begins when the door to the examination room opens. By the time the nurse or NP covers the distance from the door to the patient, he or she is already well into their assessment. On the other hand, I would venture to guess that the PA (and even sometimes the physician) rarely looks up from the chart during a patient visit - and may be unable to even describe the patient within minutes after ending the visit. If I'm the patient - won't somebody PLEASE get me an NP??? LOL

I read once, maybe here even, that PA's are just interns for life.. LOLL If that's the case why bother.

Had to laugh on that one. SO TRUE!!! Unfortunately, many of them "secretly" believe they are physicians... and THAT is NOT a "good thing"...

I had to laugh when I was in NC. In a predominantly black area.. Don't slam me this is no racist. One day I was the only white person in the unit..And some of the tech were talking "trash" and I told a patient they don't think I understand but I do..LOLL

Now we did have several probably less than 10 out of 60 patients who are white. We sent one of them to the surgeon for a fistula placement.. I swear to God his first sentence on the H&P was.. "This Afro American male is well known to me"....How's that for assesment skills..

When I had 3 major vessels DVT the radiologist told the US tech that I did not have ANY clots.. Per radiograph. My leg of course was purple, positive Homan's ( although that is a ?able assessment) and swollen twice it's size, I was on a stretcher in the hallway listening to him argue with the tech..I yelled out how about looking at the clinical picture......

I love it when docs make their rounds and want to raise someone's dry weight on their present BP and the cuff ain't even on their arm...Sorry for the ain't part. I'm just a nurse..


I'll get down now..


WR,,, three commas for Becca

When I was initially dx'd with hypertenison a PA put me on a calcium channel blocker...Had to tell him that's not the first line of defense....HMMMMMMMMMMMMMMMM

I am a PA student and while doing some research I came across this and I am ASTOUNDED to read what you have to say about PAs. I would like to point out a few things about my profession that you may not realize-
- PA's and NP's are trained in two different modes- PA's are trained in a MEDICAL model (that is, based on medical school) while NP's are trained in a NURSING model (that is, based on nursing school).
- PA's are trained as generalists (we recieve training in internal medicine, surgery, OB/GYN, peds, psych, etc etc) while NP's are trained to work in ONE special area.
- Most PA's work in SURGERY, while most NP's work in FAMILY PRACTICE.
- NP's do 200 hours of clinical work toward their degree (this info I got from a Columbia University NP student). I did more than 200 hours in my surgery rotation (enough said)
- BOTH NP's and PA's are required to have clinical experience before entering programs (Most PA programs require 2000 hrs)

Of course I am pro-pa, but I definatly think that NPs have a place in medicine as well. As far as choosing one over the other, it really depends on what field you want to work in- I've yet to see an NP in the OR or ER, but that is mostly what I see in Family Practice and geriatrics.

I'm happy to continue the discussion if intelligent comments prevails.

#1 You are right.. But if I need doctoring I'll go to a doctor if I need nursing I'll go to a nurse.. nuff said there.
#2 I suppose Adult Health isn't general enough.
#3 I've used a PA for years. He's never wielded a knife..Thank God.
#4 I suppose the years of OJT many NP's perform before NP school don't count.


WR,,, three commas for Becca


P.S. When will you hang out your shingle??? Inquiring minds wanna know.


OPPPs late thought.. You have heard of RNFA's haven't you????

there are good and bad both PA's and NP's
I love the NP that works with my personal OB/GYN but for all that training she sure didn't act like she knew how to do surgery when she was hired (neither do the DO students we get) don't even know how to gown and glove correctly and the CST's teach them.
I don't really like the NP that's in our nursery (not family practice neonatology) but our LC who is an 8 yr RN knows more about newborn GI then she does) But a co-worker from L&D went to NP school and is wonderful in with a family practice doc.
But as a student you do know you can learn from a lot of people including RN's, LPN's, CST, CNA as well as MD experiene counts multitudes. We get a family practice consult for a pregnant patient guess who the MD is asking what to do...the regular old floor RNs and LPNs things such as can if give them xyz drug in pregnancy, if nursing guess they forgot that from medical school.

I agree that there are good and bad NPs and PAs, and as a student I do know that I can learn alot from everyone (guess who taught me how to put in an IV). The point I am trying to make is that NPs and PAs recieve different training that allows us to function best in different areas of medicine and I don't really think it is fair for the above commenters to make blanket statements about PA's.

Unfortunately, I believe you are posting on a nursing forum. That might be a slight handicap. And the original poster asked US what we thought.. And as nurse's are prone to do we told her.. We are not stopping you from telling us your thoughts.. The real problem I see is we have a lot of first hand information and you have your research.. HMMMMMMMMM


WR,,, three commas for Becca

I think many PA's kick themselves when they see the opps each group has and they don't want to admit they made a mistake.. Did I just type that...Wow...

There are two modes of thought in the realm of mid level practitioners. One, that is that we should all help each other in the hopes that we can prolong our careers especially in the face of the lobbying powerhouse like the AMA. Whose sole purpose is the total control of the practice of medicine. They really do not like sharing the medical "pie" with anyone. The second mode of thought is that each type of practitioner is in a race to grab what is left of any piece of that pie. The result is that a bitter game of finger pointing ensues and rivalries occur in the workplace. This benefits no one.
Let me add this little bit of knowledge to this discussion. NP's while once having their BSN followed a nursing science curriculum in their undergraduate studies. The science courses like Biology, Chemistry, Organic Chemistry, Biochemistry, Physics have two tracks one for science majors whom end result would be graduate studies in a science discipline, medical school, or PA school (you can only have science major courses in order to be accepted in an accredited program). The other track is for nursing majors where the courses in some universities are combined in multiple courses and offer only a broad overview of these subjects, or they only require the first two of each of the basics. Anatomy and Pathophysiology are not taught as combined courses in PA school or in Med School and therefore are not considered requirements for entry into these programs because of the intense degree in which they are taught in these programs. NP'S do not have the basic science background the MD's and PA's have that is why they are taught in the nursing modality not the medical modality. They have specialized training in one specific area not a multitude allowing them to branch out into a variety of fields.
So to answer someone's question would I let A Np perform sugery on me, only if this individual recieved a Np degree in surgery. Would I let A PA graduate perform surgery on me, I guess since their PA residency programs in Universities like Duke, Yale, Johns Hopkins etc.. My answer would most definitely be yes.

They have specialized training in one specific area not a multitude allowing them to branch out into a variety of fields.


well since the PA has such a broad base instead of speciality I guess I'll let my OB PA do some brain surgery on me. And since I'm a L&D nurse I know NOTHING about pediatrics even though I did that for a few years and the only thing my nursing school must have taught was L&D. Not to sound overly self assured I'd put myself with years of RN experience up against new grad MD's about anyday in my field...where do you think the medical students doing those endless hours of residency learn in the middle of the night? From the floor nurses on EVERY unit they are on. I'd let an experienced scrub tech do surgery on me too before a new PA...I've seen one of them say to an experienced doc before hey you have a round ligament there not a tube...so much for all those advanced A&P classes

Are you saying ADULT HEALTH is a narrow speciality?????


That's an NP speciality.


WR,,, three commas for Becca

And why is it that the powers that be, who ever they are, allow NP's to hang out their shingle and practice as Practitioners and that same "they" don't allow PA's the same advantage???? Care to comment????

P.S. I did a little "reseach" too.. And I found it very ironic that the PA course lead to a Bachelor's degree and the NP course leads to a Master's.. You didn't miss that did you????

Heck I have a Bachelor's and I'm only an RN...


WR,,, three commas for Becca

There is no doubt that RN's with years of experience can definitely teach any new MD or PA lots of practical and background information on any subject they are proficient in.
By the way you sound, it seems like I can tell where your feelings are with mid-level practitioners or should I say just PA's. T

There is no doubt that a nurse can teach a new MD or PA alot of practical or background information in the area they are proficient in. There is not one colleague of mine that would say anything to the contrary. The point you make is a valid one, we do depend heavily upon the RN staff for a multitude of things, to say that we are not appreciative of all that you provide would be unjust. I was merely trying to make a point that NP's have benefited from a multitude of factors in their professional development. One, is that they have a powerful nursing lobby that they can draw funds to help support legislation in their favor i.e. better prescriptive priviledges and practicing rights. Is this totally ethical? In the USA what is ethical equivaltes to dollars not common sense. I worked with a NP student who was working with a Patient one time who had CHF, HTN, NIDDM, High Cholesterol and a HX of a previous MI. The patient presented with lab values across the board and was symptomatic, and all that NP student could think of asking that patient is what he had for breakfast, and that he should consider drinking more fruit juice in the morning. This NP student went to one of the best Universities in this country. This University only required ONE YEAR of previous RN experience and only 200 Hours of clinical rotation time during his NP education. I did that in a couple of weeks in just ONE of my rotations out of the multitude that I have had to take.
My point is that we can go all day and night about who we think is better or worse.
The message for the prospective NP or PA student is plain and simple. If you like Primary Care (Family Practice), Pediatrics, or OB/GYN you can recieve a specialized NP degree in one of those disciplines.
If you like Surgery, Emergency Medicine, Cardiac catheterization, Interventional Radiology, and actually any of the ones listed above, PA should be your choice.

My point is that we can go all day and night about who we think is better or worse.
The message for the prospective NP or PA student is plain and simple. If you like Primary Care (Family Practice), Pediatrics, or OB/GYN you can recieve a specialized NP degree in one of those disciplines.
If you like Surgery, Emergency Medicine, Cardiac catheterization, Interventional Radiology, and actually any of the ones listed above, PA should be your choice.


From you other post you said you can see what I think but I don't think you really do know what I think you'd have to read the whole board to get that idea. Why should PA be the "choice" if one likes the above as stated why not be the MD? People (including my parents and spouse) ask why don't I or didn't I go to medical school...answer choice. I like nursing with my BSN...I was doing MSN with NP classes and just really didn't want to do it. I've had offers for management but I don't want that I want the patient care that I have. As in every profession there are good and bad. I work with a NP I can't stand but there are a couple more that I just love and we're not talking personalities I'm talking practice same for nurses, MD's and store cashiers.

As a Nurse Practitioner, I think that one must understand the real difference between the two (NP and PA) a PA is bound by guidelines that the physician places for the PA it is like giving care only based on Algorithums that he has placed for the PA to practice from. Everything that the PA does has to be signed off by the DR. Also the PA has to work with the Physician, unlike a NP who can set up her own clinic in collaboration with a physician who is no more than 30 miles away and then the DR has to do a review of charts (random) of the NP's work. The PA can write RX but only if the DR approves, and the PA is signing under the MD's number. A NP can apply for a DEA number and write for Narcotics even. A NP is an automous caregiver within their scope of practice, when the case is too complex then the patient is referred to the physician for extended care. Nurse practitioners are viewed less in the military eyes than PA so if you were wanting to do something military and stick with that then PA would be more beneficial for you. But just look at the terms PA and NP. What do they state? PA Physician's Assistant, and a Nurse PRactitioner is a Nurse that practices medicine within their scope of knowledge. I am a Women's health nurse practitioner so I can't treat any males in my scope unless they are begin seen for a sexually transmitted disease. There are only a few similarities between an NP and a PA and many differences.

I want to clear up a few misconceptions that have been stated-
The PA profession is well on its way (and has been for several years) to most programs (and soon all programs) giving Masters degrees. Most students (over 75%) entering PA school have undergraduate degrees, most in a science discipline ie biology, chemistry, etc.

PA's are able to prescribe, apply for a DEA number and prescribe narcotics- we are governed by state laws- in New York PA's can prescribe as follows (from American Academy of Physician Assistants)
PA may prescribe Schedule III-V and non-controlled medications. PA prescribers of controlled drugs must register with the DEA.

(www.aapa.org)

Hi khaki scott
If a calcium channel blocker isn't the first line for hypertension can you tell me what is?..I need the help being a student nurse it's good to know these things and you people have been out in the field and I have barely got to it. Can you also help with my query 'having a tough time'(it's in the male forum as I was replying to someone else because I need some good sound advice and I will be appreciative of all ideas to help. I need to get through this and you people probably have a lot of good answers, want to share?
thanks trier

I am a board certified acute care nurse practitioner. I graduated with my Master's Degree in 2003. I am still looking for employment. It was the worst decision I ever made to become an NP. I had 17 previous years of cardiology experience before being accepted into graduate school. I have lived in 5 states since graduation and still have not found a job. I have experienced everything imaginable as to why they would not hire me. I'm constantly told they want someone with experience as an NP, but how can you get experience if NOONE will hire you. I am an attractive blond haired blue eyed woman, and numerous jobs have denied me employment because the other nurses and NP I guess are intimidated by me. I worked for 3 weeks for a neurologist, but had to resign because the physician was committing medicare fraud. I relocated from another state to work for a group of 7 cardiologists, and the senior partner was constantly critical of me, and I was working at 3 hospitals, 2 LTAC facilities, and 2 offices. He told me that I was not knowledgeable enough about cardiology. He humiliated me on a daily basis as well as sexually harassed me. He told me quote " you are a medical student, you have your credentials, but you have not yet completed your residency". I resigned the next day. Becoming a nurse practitioner has been nothing but a nightmare for me. I feel I am involved in a turf war with the physicians. They challenge me and treat me horribly. I originally had planned on becoming a CRNA. The jobs are in high demand now and they make great money. I would advise ANYONE who is considering becoming a nurse practitioner to choose another path. It cost me 35K and I was gainfully employed until I became an NP now nothing is available. The physicians tend to lean more toward the PA's because they can control them, and they are not regulated by a state board of nursing. I had also considered going to law school and becoming a malpractice attorney previously, and unfortunately I did not choose that path. Don't make the mistake I did stay out of NURSING it is the WORST career that anyone could ever choose. My husband is also a nurse and hates it. EVERYONE PLEASE STAY AWAY FROM NURSING.

ProPA wrote:I am a PA student and while doing some research I came across this and I am ASTOUNDED to read what you have to say about PAs. I would like to point out a few things about my profession that you may not realize-
- PA's and NP's are trained in two different modes- PA's are trained in a MEDICAL model (that is, based on medical school) while NP's are trained in a NURSING model (that is, based on nursing school).
- PA's are trained as generalists (we recieve training in internal medicine, surgery, OB/GYN, peds, psych, etc etc) while NP's are trained to work in ONE special area.
- Most PA's work in SURGERY, while most NP's work in FAMILY PRACTICE.
- NP's do 200 hours of clinical work toward their degree (this info I got from a Columbia University NP student). I did more than 200 hours in my surgery rotation (enough said)
- BOTH NP's and PA's are required to have clinical experience before entering programs (Most PA programs require 2000 hrs)

Of course I am pro-pa, but I definatly think that NPs have a place in medicine as well. As far as choosing one over the other, it really depends on what field you want to work in- I've yet to see an NP in the OR or ER, but that is mostly what I see in Family Practice and geriatrics.

I'm happy to continue the discussion if intelligent comments prevails.

You obviously are misinfomred as a PA STUDENT I am an acute care nurse practitioner board certified. There were 7 graduate students in our class ALL of us had 12 + years of clinical before getting accepted into grad school. I had 17 years of critical care cardiology experience. I had over 700 hrs. of clinical with my ACNP degree. I worked in the ICU, and was on the congestive heart failure consult team, as well as 2 semesters of internal medicine in the ICU and outpatient. ALL of my general knowledge came from an Associate, and Bachelors's degrees. By the time we get into graduate school we are well trained and proficient both academically and clinically. As for your comment about intelligent conversation I have a 4.0 GPA. Something you will learn as you BEGIN in medicine is you will form your patient base by word of mouth and word travels fast. Better think before you speak.

I dropped back by this thread to apologize because my initial reply was too flippant and given from my previous perspective as a military RN seeing how PA's were treated in the military.

My eyes have been opened by seeing the actual world reality and learning more about the differences between the two disciplines. If I can venture to answer the question again I would have to say that I would definitely choose to become a NP.

Other individuals in this thread have given excellent answers that clearly define the differences between each discipline, and it is abundantly clear that NP's have far more clinical experience, expertise, and background knowledge - the ability to practice autonomously rather than be an "assistant to" anyone, to branch into just as many specialty practice areas than PA's, and are far more educated when one considers the BSN degree earned before the MSN.

A NP is able to view patients in a holistic manner and help with all sorts of things PAs are not geared towards, such as health education of the patient and family, socioeconomic implications of their healthcare needs, etc.. being nurses a NP would provide primary care of the entire needs rather than just immediate (technical) care of the presenting problem alone.

Given the choice I would choose to be an autonomous health care provider than an assistant who has to work under the supervision of another providers license (as PAs must do).

medi wrote:I dropped back by this thread to apologize because my initial reply was too flippant and given from my previous perspective as a military RN seeing how PA's were treated in the military.

My eyes have been opened by seeing the actual world reality and learning more about the differences between the two disciplines. If I can venture to answer the question again I would have to say that I would definitely choose to become a NP.

Other individuals in this thread have given excellent answers that clearly define the differences between each discipline, and it is abundantly clear that NP's have far more clinical experience, expertise, and background knowledge - the ability to practice autonomously rather than be an "assistant to" anyone, to branch into just as many specialty practice areas than PA's, and are far more educated when one considers the BSN degree earned before the MSN.

A NP is able to view patients in a holistic manner and help with all sorts of things PAs are not geared towards, such as health education of the patient and family, socioeconomic implications of their healthcare needs, etc.. being nurses a NP would provide primary care of the entire needs rather than just immediate (technical) care of the presenting problem alone.

Given the choice I would choose to be an autonomous health care provider than an assistant who has to work under the supervision of another providers license (as PAs must do).

Excellent Post Medi! :)

ProPA wrote:I am a PA student ...

- NP's do 200 hours of clinical work toward their degree (this info I got from a Columbia University NP student). I did more than 200 hours in my surgery rotation (enough said)

A quick perusal of a local university's (University of Tampa) curriculum shows four courses that EACH require a minimum of 224 hours of supervised clinical practice. These four courses alone approximate at least 900 hours. I'm sure there is additional clinical practice required but I didn't bother to add more to this. (enough said back at ya)

You might want to check again with your buddy at Columbia. I was unable to verify clinical hour times because Columbia doesn't seem to list them on their website.

I Read It All...ha,ha,ha,..nurse Practitioners All The Way!....like Someone Said, Physician "assistant"

Henry wrote: Let me add this little bit of knowledge to this discussion. NP's while once having their BSN followed a nursing science curriculum in their undergraduate studies. The science courses like Biology, Chemistry, Organic Chemistry, Biochemistry, Physics have two tracks one for science majors whom end result would be graduate studies in a science discipline, medical school, or PA school (you can only have science major courses in order to be accepted in an accredited program). The other track is for nursing majors where the courses in some universities are combined in multiple courses and offer only a broad overview of these subjects, or they only require the first two of each of the basics. Anatomy and Pathophysiology are not taught as combined courses in PA school or in Med School and therefore are not considered requirements for entry into these programs because of the intense degree in which they are taught in these programs.

I believe this is different for each school. In the school I'm currently in earning only an Associates Degree as an RN, this most certainly is not the case. It's required that we take anatomy, physiology, pathophysiology, and microbiology! Those are all individual in-depth courses which are not broad overviews and are in no way combined with each other. We are expected to have an in-depth understanding of these sciences. All of these plus more in-depth, non-combined courses are required by the U of MN which I paln to transfer to. They also require labs for each of these courses (some schools seem not to). So I don't see how that gives me only a braod overview! Oh, also these are the same courses required for admission to the U of MN's Medical School. A doctor does have to study even more sciences and physics (which I do not believe is required for a BSN or MSN but could be wrong). I don't plan to become a NP or a PA, I'm actually planning on becoming a Nurse Anesthetist but I think there is more opportunity for advancement as a nurse than as a PA. Not that being a PA is a bad thing but, I would rather be treated by a NP in most cases. Money-wise a PA can make more money faster but a nurse does have high paying options depending where they go with their nursing career. If high paying jobs are what your looking for you could try various branches of the nursing field. The Average wages of a PA in NY were $54,890 for entry level workers and $99,970 for experienced workers. The 2005 National Salary Survey of Nurse Practitioners shows that the average annual full-time salary for a nurse practitioner has reached $74,812. The national for a nurse anesthetis is $133,500.00! The national average for a family practice doctor was $143,000.00 So there are places you can go with a MSN that can pay quite well. I think that it depends more which job appeals to you personally.

Anyone who is looking to become a nurse or is even considering it should really check out this site: http://www.nursingprograms.com/rn-registered-nurse. It has great articles and describes the different degrees you can get in the nursing field.

I'm new in this forum, and I found it really interesting. I was looking for some info about becoming a nurse in the US, thanks for the link!

I stumbled across this forum after a google search...and I must say I am astounded by all of the negative comments about PA's. But, it doesn't surprise me one bit either. I've been a PA for a several years now and wouldn't you know the one professional title that gives us the most difficulty is the RN/NP/LPN/BSN/MSN/ whatever other letters you can add to your names.
The common goal for all of us is to treat/cure the patient. Obviously more of your time is spent worrying who is directing the patients care rather than carrying out your orders (obviously NP's write their own orders).

There is so much negativity on this site. To say PA's do not have a holistic approach is nonsense. True, we are trained in the medical model but please do not state that we don't have this or that included in our training. You have never attended PA school so how would you know? PA curriculum does involve psychosocial training as well as health education etc.

Most of you are quite misinformed how PA's and Physicians act as a TEAM. It is not how you describe it- "The physician tells the PA what to do". Many PA's see their own patients and have their charts reviewed by their supervising physician. There is quite a bit of autonomy being a PA. You just fail to realize it.

And the scrutinizing of the names "Physician Assistant" vs Nurse Practitioner....please! Don't you have anything else to offer than to pick apart a title?

A physician assistant is an integral part of health care. In most cases PA's work in underserved areas providing health care to the poor etc. That is what we are trained to do. Provide health care to those that have difficulty accessing our health care system. And if I'm not mistaken, NP's have been created to do the same thing.

Maybe if you are more open to all levels of health care all of this negativity would disappear. No one is better than the other. We all for the most part have the same intentions- to help people.

Your characterization is unfortunate.
The term "Nurse Practitioner" is an oxymoron. Why do you think we get paid more and have more respect?
Ask yourself this question...how does multiple months of "Nursing Theory" while in NP school prepare students for taking care of patients??

Hmmm...maybe we focus on patient care instead of "Nursing Theory" while we are training

ultimatePA wrote:Your characterization is unfortunate.
The term "Nurse Practitioner" is an oxymoron. Why do you think we get paid more and have more respect?
Ask yourself this question...how does multiple months of "Nursing Theory" while in NP school prepare students for taking care of patients??

Hmmm...maybe we focus on patient care instead of "Nursing Theory" while we are training

Wow. Can-o'-worms.

Seems like a lot of sour grapes by a few people on here. I ‘ve worked with and been treated by both NP’s and PA’s. There are both good and bad ones on both sides. Where I work we have a lot of PA’s and they keep my company a float. One is actually our holistic health coordinator.

PACPROUD wrote:I stumbled across this forum after a google search...and I must say I am astounded by all of the negative comments about PA's. But, it doesn't surprise me one bit either. I've been a PA for a several years now and wouldn't you know the one professional title that gives us the most difficulty is the RN/NP/LPN/BSN/MSN/ whatever other letters you can add to your names.
The common goal for all of us is to treat/cure the patient. Obviously more of your time is spent worrying who is directing the patients care rather than carrying out your orders (obviously NP's write their own orders).

There is so much negativity on this site. To say PA's do not have a holistic approach is nonsense. True, we are trained in the medical model but please do not state that we don't have this or that included in our training. You have never attended PA school so how would you know? PA curriculum does involve psychosocial training as well as health education etc.

Most of you are quite misinformed how PA's and Physicians act as a TEAM. It is not how you describe it- "The physician tells the PA what to do". Many PA's see their own patients and have their charts reviewed by their supervising physician. There is quite a bit of autonomy being a PA. You just fail to realize it.

And the scrutinizing of the names "Physician Assistant" vs Nurse Practitioner....please! Don't you have anything else to offer than to pick apart a title?

A physician assistant is an integral part of health care. In most cases PA's work in underserved areas providing health care to the poor etc. That is what we are trained to do. Provide health care to those that have difficulty accessing our health care system. And if I'm not mistaken, NP's have been created to do the same thing.

Maybe if you are more open to all levels of health care all of this negativity would disappear. No one is better than the other. We all for the most part have the same intentions- to help people.

I like your style PAC and agree with everything you write. The last paragraph says it all.

Thanks

R

I am really honestly curious about the differences between a nurse practioner and a PA. Is there anyone who is able to give a SUBJECTIVE run-down of the two? Pro's and con's........would love to know but only if its subjective and not berating one or the other???

pharmgirl wrote:I am really honestly curious about the differences between a nurse practioner and a PA. Is there anyone who is able to give a SUBJECTIVE run-down of the two? Pro's and con's........would love to know but only if its subjective and not berating one or the other???

To the best of my knowledge, both the NP and PA-C possess the ability to function as a primary care provider. Depending on individual state licensure, the NP may practice as an independent provider whereas, the PA-C must practice under the license of a physician. The educational requirements are similar in that both earn a master's degree and require license to practice. The NP must be an RN prior to enrolling into an AP program.

R

I've worked with a number of NPs and PAs all in ER settings, and I can say that there are good and bad in both professions, just like in nursing and medicine.

Specifically, I think its harder for NPs to practice in ER settings for this reason. As I understand it, ACNPs are licensed to practice on acutely ill adults. If they wish to be jointly licensed for adults and peds, they must sit for multiple boards. The only ERs I have seen use NPs were Adult specific ERs. PAs on the other hand are certified for all patient populations.

I have also worked with NPs that were part of trauma service teams- they responded to trauma cases in the ER and placed chest tubes, central lines, etc. We would call them for orders, etc, but again these were adult trauma teams (i also worked with excellent PAs on the same service).

The real difference between the two has to do with billing, does it not? An NP bills independently for 75% of their charts while PAs can only bill for about 20% (i could be wrong here, this is the last i heard). In addition, while many ERs use PAs, most of the time they won't allow PAs to see any interesting patients, they just get abcesses, lacs, etc. Not that the PAs aren't capable of dealing with more complicated patients, they just seem to get dumped on by the docs.

But the main point is I have seen NPs and PAs function clinically in very similar ways when it comes to acutely ill, hospitalized patients. By and large I usually like working with mid level providers.

medi wrote:Yeah, it doesn't take as much education to become a PA and damned if they don't get paid more $$ and treated with more respect too.

Ahh, last time I checked, the majority of US PA programs were master's programs and required a 4 year degree, healthcare expereience, and a GRE for admission consideration.

The remainder of PA programs that are 4 yr degrees are highly competitive and non-degreed people are usually weeded out for people with previosly earned BS degrees and healthcare expereience.

As far as money, its a national trend to be paid by location, and postition (surgery, ER, ortho surgery and specialty positions are paid more than others in primary care, non surgical/hospital positions). California and East Coast pay more than midwest and southern locations or locations of popular living like Colorado. That said, a primary care NP in CO or WI will likely make less than the same position in Cali or NY. They will also make less than any surgical or hospital based mid level. It may be that NP's are more prominent in primary care, hence the lower pay, but I've not seen any comparison statistics on that. :)

mercynurse wrote:Well, as a nurse it was natural for me to choose NP over PA.
I've asked docs about both. Some prefer PAs "they are trainged by DR and don't have to unlearn all of that nurse stuff" Others prefer NP as they have more training. I guess it's a personla preference for them too.
However, I have a friend in an NP program, has a year left and he's already been offered 3 jobs by different docs who work in the ER where he's currently practicing.

Sorry, no definative answer!

On the contrary, PA programs have more "clinical training hours" within the curriculum of their non-didactic year. A study or survey is available at The American Academy of Physician Assistants (AAPA) One could argue that RN's have more on the job experience/training and hence get more training.... but not technically true regarding "school hours of training".. NP is actually less nationally.

I think the bigger message here, is that all providers need to keep open minds about their peer professions... we're not competing.... we're on the same healthcare team. We just got here at the mid level on different paths related to our background... For me, PA was my only choice because I wasn't going back for an RN degree after getting my first BS. It was faster to get into PA school than get a BSN and then NP.

Khaki Scott wrote:I hate to be "inflammatory" - BUT - I am an educator who has worked with nurses at all levels of their educational journey. I have also worked with PAs. All one really has to do is look at the "titles": nurse PRACTITIONER and Physician ASSISTANT. That ought to tell you the difference right away.

I have never met a PA who, in all innocence, hasn't been given the "impression" (yes - very often by their university division) that they are "better than" NPs. After 20+ years of educating both, I have to tell you that NPs are hands-down-far-and-away more competent than 99% of the PAs who are out there today. In fact, some of the PA programs I have seen scare me to death. The general public has no CLUE what the difference is, nor how to protect themselves. To tell you the truth, the only PA I would trust is one of those "old guys" who was a medic in Viet Nam.

Pretty strong statements you are making here Scott!!! Perhaps you should get into an actual PA school and then judge. You can now say you've "met" a PA student who does not feel he's better than an NP.. in fact, while on rotation, I was trained by 2 NP's on my cardiology service and they were great! They had no reservations about teaching me, a PA student, and I had no reservations about learning from them, APNP's.... I think the bigger picture here is to be open-minded, and supportive of both professions instead of hiding in an RN forum and slamming PA's...

Second point, many PA's and NP's get good at their jobs because they have experience... no one school in either setting can totally teach or make a person competent in what they do.. we all pass boards, get licenses to practice, and begin seeing patients under physician guidance as allowed by state laws that differ among states.... after 10 years, most become good at it, irregardless of schooling type.

PS... I'm a science based person, so I'd like to see your research and data suggesting NP's are 99% more competent than PAs hands down.. I'm sure there are a fair number of both making mistakes in the field.. Good luck with your bias!

All one really has to do is look at the "titles": nurse PRACTITIONER and Physician ASSISTANT. That ought to tell you the difference right away.


Another winner here!!! All I see is the words practicioner and assistant used as adjectives and capitalized...

Using the entire word together as they were meant to be used.. you have "one who is a practioner of nursing" and one who is an "assistant to a physician"...

You see scott, the details of duty are left to state governments who give "scope of practice" limits and allowances.... one isn't limited soley on their title as a practicioner or assistant.

Khaki Scott wrote:Re: Nursing is not only a science but an art.

The difference between a nurse or NP - and a PA or even a physician - begins when the door to the examination room opens. By the time the nurse or NP covers the distance from the door to the patient, he or she is already well into their assessment. On the other hand, I would venture to guess that the PA (and even sometimes the physician) rarely looks up from the chart during a patient visit - and may be unable to even describe the patient within minutes after ending the visit. If I'm the patient - won't somebody PLEASE get me an NP??? LOL

I read once, maybe here even, that PA's are just interns for life.. LOLL If that's the case why bother.

Had to laugh on that one. SO TRUE!!! Unfortunately, many of them "secretly" believe they are physicians... and THAT is NOT a "good thing"...

Boy, your responses keep getting better and better scott... kind of think you are the one that thinks you're a physician.. not the PA's.. Anyway, I was actually trained to take a complete history, and perform a physical exam w/o using a chart or taking notes... we PAs don't need charts during the patient interview.. maybe you should follow some around sometime.. and yes, I can observe body languange for signs of pain, nausea, not feeling well, or nervousness as I "enter the room" without my chart!

ProPA wrote:I am a PA student and while doing some research I came across this and I am ASTOUNDED to read what you have to say about PAs. I would like to point out a few things about my profession that you may not realize-
- PA's and NP's are trained in two different modes- PA's are trained in a MEDICAL model (that is, based on medical school) while NP's are trained in a NURSING model (that is, based on nursing school).
- PA's are trained as generalists (we recieve training in internal medicine, surgery, OB/GYN, peds, psych, etc etc) while NP's are trained to work in ONE special area.
- Most PA's work in SURGERY, while most NP's work in FAMILY PRACTICE.
- NP's do 200 hours of clinical work toward their degree (this info I got from a Columbia University NP student). I did more than 200 hours in my surgery rotation (enough said)
- BOTH NP's and PA's are required to have clinical experience before entering programs (Most PA programs require 2000 hrs)

Of course I am pro-pa, but I definatly think that NPs have a place in medicine as well. As far as choosing one over the other, it really depends on what field you want to work in- I've yet to see an NP in the OR or ER, but that is mostly what I see in Family Practice and geriatrics.

I'm happy to continue the discussion if intelligent comments prevails.

AMEN for an intelligent, non-offensive comment left here.. of course its from a PA student... and yes, you are right.. most NP training programs have only 800-1000 clincal training hours compared to 2000 in PA schools.. this is justified however because most NP's have extensive RN background and training for their work... Most PA students have little to no medical model background and need more procedural training.

Again, the bigger picture here is to be open minded and accepting about both roles in healthcare, unlike the biased RN's blogging here... I can't beleive some of the stuff said either... and pointing out all mistakes that PA's have made on you or your friends???? I'm sure you can find just as many stories about NP's if you look hard enough.. again.. biased!

Anonymous wrote:Unfortunately, I believe you are posting on a nursing forum. That might be a slight handicap. And the original poster asked US what we thought.. And as nurse's are prone to do we told her.. We are not stopping you from telling us your thoughts.. The real problem I see is we have a lot of first hand information and you have your research.. HMMMMMMMMM


WR,,, three commas for Becca

I think many PA's kick themselves when they see the opps each group has and they don't want to admit they made a mistake.. Did I just type that...Wow...

While I agree that this is a nursing forum and its a handicap for other's posting, it should be a correct forum.. not one of bashing other healthcare professionals... All you did was skew or influence the original poster's ideas about PAs... what happens when she gets into the work force and has bias on PA's cause of what you've said? What good is an NP who ASSUMES that a PA is incompetent and useless when she actually could be shown up or good friends w/ a fellow PA professional? If you are going to state stuff, state the facts!

Anonymous wrote:P.S. I did a little "reseach" too.. And I found it very ironic that the PA course lead to a Bachelor's degree and the NP course leads to a Master's.. You didn't miss that did you????

Heck I have a Bachelor's and I'm only an RN...


WR,,, three commas for Becca

There are plenty of Master's programs for PA out there... look around on The American Academy of Physician Assistants (AAPA).. its strictly how each state goverment and school writes law on the level needed... I assure you that my BS school in PA is better than many Master's schools of PA..

Henry wrote:There is no doubt that a nurse can teach a new MD or PA alot of practical or background information in the area they are proficient in. There is not one colleague of mine that would say anything to the contrary. The point you make is a valid one, we do depend heavily upon the RN staff for a multitude of things, to say that we are not appreciative of all that you provide would be unjust. I was merely trying to make a point that NP's have benefited from a multitude of factors in their professional development. One, is that they have a powerful nursing lobby that they can draw funds to help support legislation in their favor i.e. better prescriptive priviledges and practicing rights. Is this totally ethical? In the USA what is ethical equivaltes to dollars not common sense. I worked with a NP student who was working with a Patient one time who had CHF, HTN, NIDDM, High Cholesterol and a HX of a previous MI. The patient presented with lab values across the board and was symptomatic, and all that NP student could think of asking that patient is what he had for breakfast, and that he should consider drinking more fruit juice in the morning. This NP student went to one of the best Universities in this country. This University only required ONE YEAR of previous RN experience and only 200 Hours of clinical rotation time during his NP education. I did that in a couple of weeks in just ONE of my rotations out of the multitude that I have had to take.
My point is that we can go all day and night about who we think is better or worse.
The message for the prospective NP or PA student is plain and simple. If you like Primary Care (Family Practice), Pediatrics, or OB/GYN you can recieve a specialized NP degree in one of those disciplines.
If you like Surgery, Emergency Medicine, Cardiac catheterization, Interventional Radiology, and actually any of the ones listed above, PA should be your choice.

Nice and un-biased!! the way is should be.. I think we need some real APNP's logging in here to give their comments on the RN opinion of a PA.. they'll find something totally different and supportive.. at least that's how the NP's I have met are!

Jenniferwhnp wrote:As a Nurse Practitioner, I think that one must understand the real difference between the two (NP and PA) a PA is bound by guidelines that the physician places for the PA it is like giving care only based on Algorithums that he has placed for the PA to practice from. Everything that the PA does has to be signed off by the DR. Also the PA has to work with the Physician, unlike a NP who can set up her own clinic in collaboration with a physician who is no more than 30 miles away and then the DR has to do a review of charts (random) of the NP's work. The PA can write RX but only if the DR approves, and the PA is signing under the MD's number. A NP can apply for a DEA number and write for Narcotics even. A NP is an automous caregiver within their scope of practice, when the case is too complex then the patient is referred to the physician for extended care. Nurse practitioners are viewed less in the military eyes than PA so if you were wanting to do something military and stick with that then PA would be more beneficial for you. But just look at the terms PA and NP. What do they state? PA Physician's Assistant, and a Nurse PRactitioner is a Nurse that practices medicine within their scope of knowledge. I am a Women's health nurse practitioner so I can't treat any males in my scope unless they are begin seen for a sexually transmitted disease. There are only a few similarities between an NP and a PA and many differences.

Its a good start, but let me bring you up to date in 2008.. Many states now allow for PA's to practice as "autonomous providers" as you state NPs can... Many states are now or already have waived the requirement for "MD signature on all charts" and "prescription co signature".. PA's today also carry their own CMS (medicare/caid) numbers and their very own DEA numbers as well... These are not special numbers for prescribing writes as much as they are for the DEA to "track" your usage as a PA or NP on prescribing Class II narcotics and overuse! The only requirements for a PA is that they have a supervising physician, sometimes w/in a phone call reach instead of 30 miles. I have also seen a PA own their own practice office with a MD as supervising 30 miles away with random chart review.. Its more so the PA can "consult" with the MD rather than be "supervised" by the MD... and yes, scope of practice.

You can throw out the "what we do based on our name" garbage! cause PAs also practice within their and thier MD's "scope of practice"

trier wrote:Hi khaki scott
If a calcium channel blocker isn't the first line for hypertension can you tell me what is?..I need the help being a student nurse it's good to know these things and you people have been out in the field and I have barely got to it. Can you also help with my query 'having a tough time'(it's in the male forum as I was replying to someone else because I need some good sound advice and I will be appreciative of all ideas to help. I need to get through this and you people probably have a lot of good answers, want to share?
thanks trier

Since scott was too busy to get back to you.... I'll answer as a PA student..

Many first line therapies for HTN are hydrochlorothiazides... and if that alone doesn't work, they can be combined w/ ACE inhibitors like Lisinopril if not contraindicated by other disease or med reactions... If a pt fails ACE-Inhib, they can try ARBs or ACE receptor blockers that work on the same physiological system, but a different mechanism. If a patient fails these therapies, you can then go to Beta blockers or CCB's.. I'm sure the PA had a good reason to Start the CCB in this case, but scott wouldnt' know that cause he didn't get to take the history!

Good luck in your carreer..

Sandy Jones wrote:You obviously are misinfomred as a PA STUDENT I am an acute care nurse practitioner board certified. There were 7 graduate students in our class ALL of us had 12 + years of clinical before getting accepted into grad school. I had 17 years of critical care cardiology experience. I had over 700 hrs. of clinical with my ACNP degree. I worked in the ICU, and was on the congestive heart failure consult team, as well as 2 semesters of internal medicine in the ICU and outpatient. ALL of my general knowledge came from an Associate, and Bachelors's degrees. By the time we get into graduate school we are well trained and proficient both academically and clinically. As for your comment about intelligent conversation I have a 4.0 GPA. Something you will learn as you BEGIN in medicine is you will form your patient base by word of mouth and word travels fast. Better think before you speak.

just cause you have a 4.0 doesn't mean you have intelligent conversations... I think you missed his point... he was ridiculing all the CRAP on this site about RN's dissing PA's. It had nothing to do w/ GPA..

SOrry about your job expereiences... what state are you in? I wouldn't work there as a PA or NP... and he was right... all your "training" was on the job expereience.. your school NP "traning" was 700 hours.. significantly less than the 2000 hours a PA clinical course gives.

medi wrote:I dropped back by this thread to apologize because my initial reply was too flippant and given from my previous perspective as a military RN seeing how PA's were treated in the military.

My eyes have been opened by seeing the actual world reality and learning more about the differences between the two disciplines. If I can venture to answer the question again I would have to say that I would definitely choose to become a NP.

Other individuals in this thread have given excellent answers that clearly define the differences between each discipline, and it is abundantly clear that NP's have far more clinical experience, expertise, and background knowledge - the ability to practice autonomously rather than be an "assistant to" anyone, to branch into just as many specialty practice areas than PA's, and are far more educated when one considers the BSN degree earned before the MSN.

A NP is able to view patients in a holistic manner and help with all sorts of things PAs are not geared towards, such as health education of the patient and family, socioeconomic implications of their healthcare needs, etc.. being nurses a NP would provide primary care of the entire needs rather than just immediate (technical) care of the presenting problem alone.

Given the choice I would choose to be an autonomous health care provider than an assistant who has to work under the supervision of another providers license (as PAs must do).

Nice comment, sort of!! PA's are autonomous providers of healthcare that meet the needs of patient and family education and values.. at least that is what I learned in my primary care focused PA program... I work for a doc, but he doesn't sit in the room w/ me and watch me do medicine... I consult when needed. As for training, you may have tons from being an RN before NP school, but PA's such as I have extensive training.. for instance, I have 7 years laboratory expereience in reading/interpreting tests for diagnostics, yet most floor nurses dont' have a clue about how why MDs order tests until they learn lab medicine in NP school.. just as we learn lab in PA school, except that part was a breeze for me cause I didn't ahve to learn anything new... catch my drift?

PACPROUD wrote:I stumbled across this forum after a google search...and I must say I am astounded by all of the negative comments about PA's. But, it doesn't surprise me one bit either. I've been a PA for a several years now and wouldn't you know the one professional title that gives us the most difficulty is the RN/NP/LPN/BSN/MSN/ whatever other letters you can add to your names.
The common goal for all of us is to treat/cure the patient. Obviously more of your time is spent worrying who is directing the patients care rather than carrying out your orders (obviously NP's write their own orders).

There is so much negativity on this site. To say PA's do not have a holistic approach is nonsense. True, we are trained in the medical model but please do not state that we don't have this or that included in our training. You have never attended PA school so how would you know? PA curriculum does involve psychosocial training as well as health education etc.

Most of you are quite misinformed how PA's and Physicians act as a TEAM. It is not how you describe it- "The physician tells the PA what to do". Many PA's see their own patients and have their charts reviewed by their supervising physician. There is quite a bit of autonomy being a PA. You just fail to realize it.

And the scrutinizing of the names "Physician Assistant" vs Nurse Practitioner....please! Don't you have anything else to offer than to pick apart a title?

A physician assistant is an integral part of health care. In most cases PA's work in underserved areas providing health care to the poor etc. That is what we are trained to do. Provide health care to those that have difficulty accessing our health care system. And if I'm not mistaken, NP's have been created to do the same thing.

Maybe if you are more open to all levels of health care all of this negativity would disappear. No one is better than the other. We all for the most part have the same intentions- to help people.

Touchee!!! nicely done!

Ricu wrote:To the best of my knowledge, both the NP and PA-C possess the ability to function as a primary care provider. Depending on individual state licensure, the NP may practice as an independent provider whereas, the PA-C must practice under the license of a physician. The educational requirements are similar in that both earn a master's degree and require license to practice. The NP must be an RN prior to enrolling into an AP program.

R

NIcley and accurately done!!! One misconception out there that NP's will make you believe and tell you is true... is that they are "independent"... be careful on using that term... NP's are not as independent as they will say they are... independence in the exam room and treating people is shared by PA's and NPs, yet independence on case managment and practice rewiew is also done w/ both NP's and PA's... both write scripts and form treatment plans independently, and both are under supervision of an MD, even if 30 miles away for an NP...

schu002 wrote:I've worked with a number of NPs and PAs all in ER settings, and I can say that there are good and bad in both professions, just like in nursing and medicine.

Specifically, I think its harder for NPs to practice in ER settings for this reason. As I understand it, ACNPs are licensed to practice on acutely ill adults. If they wish to be jointly licensed for adults and peds, they must sit for multiple boards. The only ERs I have seen use NPs were Adult specific ERs. PAs on the other hand are certified for all patient populations.

I have also worked with NPs that were part of trauma service teams- they responded to trauma cases in the ER and placed chest tubes, central lines, etc. We would call them for orders, etc, but again these were adult trauma teams (i also worked with excellent PAs on the same service).

The real difference between the two has to do with billing, does it not? An NP bills independently for 75% of their charts while PAs can only bill for about 20% (i could be wrong here, this is the last i heard). In addition, while many ERs use PAs, most of the time they won't allow PAs to see any interesting patients, they just get abcesses, lacs, etc. Not that the PAs aren't capable of dealing with more complicated patients, they just seem to get dumped on by the docs.

But the main point is I have seen NPs and PAs function clinically in very similar ways when it comes to acutely ill, hospitalized patients. By and large I usually like working with mid level providers.

excellent, non biased review of both positions.. while PA's may get dumped on w/ crappy cases, its up to individual mid levels to find a good practice site, or and MD that will allow them to grow and flourish into a capable mid level that can handle more complex cases for the MD as they get better. One downer to becoming an NP is "multiple cert exams for differing areas of practice"... PA's take one exam and can work all'any areas that their physician works in... example, I can do primary care w/ my primary family health MD, and can moonlight in ER on weekends w/ a totally different physcician board certified in Emer Med... I beleive NP's are limited to their "scope of practice" such as fam practice, OR geritatrics, OR peds.. they cannot cross as a PA can w/o taking multiple cert exams..

buckypas wrote:Pretty strong statements you are making here Scott!!! Perhaps you should get into an actual PA school and then judge. You can now say you've "met" a PA student who does not feel he's better than an NP.. in fact, while on rotation, I was trained by 2 NP's on my cardiology service and they were great! They had no reservations about teaching me, a PA student, and I had no reservations about learning from them, APNP's.... I think the bigger picture here is to be open-minded, and supportive of both professions instead of hiding in an RN forum and slamming PA's...

Second point, many PA's and NP's get good at their jobs because they have experience... no one school in either setting can totally teach or make a person competent in what they do.. we all pass boards, get licenses to practice, and begin seeing patients under physician guidance as allowed by state laws that differ among states.... after 10 years, most become good at it, irregardless of schooling type.

PS... I'm a science based person, so I'd like to see your research and data suggesting NP's are 99% more competent than PAs hands down.. I'm sure there are a fair number of both making mistakes in the field.. Good luck with your bias!

I am so disappointed with this site, in fact, embarrassed. I am a practicing NP. I can't believe the level of disdain between these two professions. NP or PA, we should be working together and learning from each other instead of ripping each other to shreds. I have worked with NP's and PA's and have had wonderful experiences with both. There is good and bad in every profession. I have worked with NP's that I cannot believe passed the boards and NP's that are absolutely amazing. My GYN has a PA that I prefer to see over the MD...she is a very competent HEALTH CARE PROVIDER...which is what the ultimate goal is. I learn from from just about every discipline I work with regardless of the title or suffix. Some of my most rewarding experiences come from people that don't have a "title"! The amount of negative interaction between NP's and PA's is clearly destructive on many levels. I refuse to lower my level of professionalism and stoop so low as to think I am better than someone else....especially since our duties are so similar and our anticipated outcome is the same. It is this type of press that decreases the level of respect for BOTH professions. Quite frankly, I believe the designation of NP or PA is not nearly as important as the person who is standing behind it.

NurseP wrote:I am so disappointed with this site, in fact, embarrassed. I am a practicing NP. I can't believe the level of disdain between these two professions. NP or PA, we should be working together and learning from each other instead of ripping each other to shreds. I have worked with NP's and PA's and have had wonderful experiences with both. There is good and bad in every profession. I have worked with NP's that I cannot believe passed the boards and NP's that are absolutely amazing. My GYN has a PA that I prefer to see over the MD...she is a very competent HEALTH CARE PROVIDER...which is what the ultimate goal is. I learn from from just about every discipline I work with regardless of the title or suffix. Some of my most rewarding experiences come from people that don't have a "title"! The amount of negative interaction between NP's and PA's is clearly destructive on many levels. I refuse to lower my level of professionalism and stoop so low as to think I am better than someone else....especially since our duties are so similar and our anticipated outcome is the same. It is this type of press that decreases the level of respect for BOTH professions. Quite frankly, I believe the designation of NP or PA is not nearly as important as the person who is standing behind it.

Amen to that!!! That was my next admission is that all those with issues between the two careers are likely having issues themselves.... Congrats on your hard work, and continued success as an NP.

trier wrote:Hi khaki scott
If a calcium channel blocker isn't the first line for hypertension can you tell me what is?..I need the help being a student nurse it's good to know these things and you people have been out in the field and I have barely got to it. Can you also help with my query 'having a tough time'(it's in the male forum as I was replying to someone else because I need some good sound advice and I will be appreciative of all ideas to help. I need to get through this and you people probably have a lot of good answers, want to share?
thanks trier

Trier, There is a publication called JNC7 that is very helpful when dealing with blood pressure, medication intervention, and comorbities. Before you choose your first line therapeutic intervention, my advise to you is to go online and download a copy of the JNC7. It explains intital therapy very well and gives you guidelines on what initial therapy is best for your patient. Believe it or not, if your patient is black or white can make a difference in what you prescribe...the JNC7 outlines that for you as well! Good Luck

NurseP wrote:I am so disappointed with this site, in fact, embarrassed. I am a practicing NP. I can't believe the level of disdain between these two professions. NP or PA, we should be working together and learning from each other instead of ripping each other to shreds. I have worked with NP's and PA's and have had wonderful experiences with both. There is good and bad in every profession. I have worked with NP's that I cannot believe passed the boards and NP's that are absolutely amazing. My GYN has a PA that I prefer to see over the MD...she is a very competent HEALTH CARE PROVIDER...which is what the ultimate goal is. I learn from from just about every discipline I work with regardless of the title or suffix. Some of my most rewarding experiences come from people that don't have a "title"! The amount of negative interaction between NP's and PA's is clearly destructive on many levels. I refuse to lower my level of professionalism and stoop so low as to think I am better than someone else....especially since our duties are so similar and our anticipated outcome is the same. It is this type of press that decreases the level of respect for BOTH professions. Quite frankly, I believe the designation of NP or PA is not nearly as important as the person who is standing behind it.

first of all, greetings to all everyone involved with the forum, as this is my first post at this site. i'm somewhat of a regular on what is probably the PA forum equivalent, and wanted to go out on a limb to put action into fostering a better understanding of the NP vs PA issue that has been discussed in length at both ends. i hope that i can add my feedback to provide the PA perspective to any issues and comments that people have to help take steps toward stopping this negative and destructive interaction.

frankly, reading NurseP's post was very encouraging. on a general level, there are and always will be distinct differences in our respective professions, however, at any level, competency is the most important aspect of healthcare and not a title... applicable to all MD, DO, NP, PA, etc. alike.

i'll be sure to log in once in a while to add what input i can.

____________________
Samuel Merritt College, PA Program c/o 2010
"Perfection means not perfect actions in a perfect world, but appropriate actions in an imperfect one." (R.H. Blyth)

Please do so!

'Cat'

I support any effort directed toward understanding and collaboration. When we know more, we work better together. So many of our members are seeking information about how to become an N.P. or P.A while other posts are from nurses who seem to want to better understand the role(s). I wonder if our N.P and P.A members can offer some first hand insight into these professions. I for one plan to go into advanced practice some day and would love to hear what others are doing.

R

Wow, I typed in "difference between NP's and PA's and came across this forum. I am trying to decide which way I want to go. I was thinking a PA since I will be graduating with a BS in Mathematics but also was thinking of taking a medical assisting program to get in and give me some experience which is a requirement and just wanted to know if this is the way to go.

I just wanted to know the pros and cons to each profession. My Aunt has been in the nursing field for about 30 yrs I want to say; probably more, and is an NP specializing in Oncology and from what she has told me, her job sounds great and she loves it and is very good at what she does. But she had a lot of experience as an RN before she got her Master's also.

My concern is, what the PA program consist of. Will I be comfortable enough to start working as a PA after this? And the same question goes for an NP degree.

I origanilly wanted to be a Doctor (a Dermatologist), (hence the BS in Math degree), so my other question is.. Is there a specialty like this for NP's or PA's.

And any information on either program you can give me would be appreciated such as the curriculum, the length of the program, any prereqs. or working experience required, etc..... And especially for the RN degree....if I choose this, which is the best program to start with, an ADN or BSN? I hear the pay is the same but the schooling is quicker if you are planning on getting an MSN. Thanks for any responses.

I forgot I also wanted to know, if you want to share of course, of you experiences, what kind of people you work with, how hard schooling was, the most rewarding aspect of the career, what your job consists of and about what pay you can expect in these careers. thanks again

ProPA wrote:I am a PA student and while doing some research I came across this and I am ASTOUNDED to read what you have to say about PAs. I would like to point out a few things about my profession that you may not realize-
- PA's and NP's are trained in two different modes- PA's are trained in a MEDICAL model (that is, based on medical school) while NP's are trained in a NURSING model (that is, based on nursing school).
- PA's are trained as generalists (we recieve training in internal medicine, surgery, OB/GYN, peds, psych, etc etc) while NP's are trained to work in ONE special area.
- Most PA's work in SURGERY, while most NP's work in FAMILY PRACTICE.
- NP's do 200 hours of clinical work toward their degree (this info I got from a Columbia University NP student). I did more than 200 hours in my surgery rotation (enough said)
- BOTH NP's and PA's are required to have clinical experience before entering programs (Most PA programs require 2000 hrs)

Of course I am pro-pa, but I definatly think that NPs have a place in medicine as well. As far as choosing one over the other, it really depends on what field you want to work in- I've yet to see an NP in the OR or ER, but that is mostly what I see in Family Practice and geriatrics.

I'm happy to continue the discussion if intelligent comments prevails.

okay. sure. HAs anyone ever brought up the fact that NP's will have four years of health and healthcare education and clinicals vs. 2 years for a PA? I have a freidn who is going to PA school and has to start by learning the very basics. NP's already have 2 years. inlcuding medical-surgical, psych, pediatrics, pharmocology, patho, maternity... so I think the discussion should end there. bye!

mao wrote:okay. sure. HAs anyone ever brought up the fact that NP's will have four years of health and healthcare education and clinicals vs. 2 years for a PA? I have a freidn who is going to PA school and has to start by learning the very basics. NP's already have 2 years. inlcuding medical-surgical, psych, pediatrics, pharmocology, patho, maternity... so I think the discussion should end there. bye!

Mao,

This is an information sharing venue. It may end up getting a bit competitive but hopefully will remain amicable. Please help us keep it that way and refrain from slam-dunk tactics.

many thanks,

R

SoldierNurse wrote:If, I could do it all over again I'd taken the PA route, rather than RN.

I don't know why, Carey, but that surprises me. You've always seemed so satisfied with nursing as a career. What would you like to do as a P.A.?

R

Ricu wrote:I don't know why, Carey, but that surprises me. You've always seemed so satisfied with nursing as a career. What would you like to do as a P.A.?

R

As a civilian PA I'd work for an Orthopedic Surgeon. Or, in the military as an Army PA.

SoldierNurse wrote:As a civilian PA I'd work for an Orthopedic Surgeon. Or, in the military as an Army PA.

Do I remember correctly that you were a CST before becoming a nurse? Ever think of being an RN First Assistant? I'm sure you would be able to do orthopedics exclusively. A busy orthopedic surgeon would give his eye teeth for a dedicated FA if he didn't have his own PA. It would be a way of merging all of your medical experience and possibly taking a shorter route into something that you would like more.

Just thinking,

R

Ricu wrote:Do I remember correctly that you were a CST before becoming a nurse? Ever think of being an RN First Assistant? I'm sure you would be able to do orthopedics exclusively. A busy orthopedic surgeon would give his eye teeth for a dedicated FA if he didn't have his own PA. It would be a way of merging all of your medical experience and possibly taking a shorter route into something that you would like more.

Just thinking,

R

Yes, prior CST 3 years, plus OR RN 4 years. Also, 1.5 years Telemetry & 4.5 years critical care.

I've already thought about RNFA many years ago. Again, if I could do it all over again I'd chosen PA, rather than RN. Does that make me a bad RN, now? NO!

Thanks anyway.

SoldierNurse wrote:Yes, prior CST 3 years, plus OR RN 4 years. Also, 1.5 years Telemetry & 4.5 years critical care.

I've already thought about RNFA many years ago. Again, if I could do it all over again I'd chosen PA, rather than RN. Does that make me a bad RN, now? NO!

Thanks anyway.

Having thoughts about a career path different than the one you're currently on doesn't mean that you're not dedicated to or that you don't enjoy what you're doing. If I gave you the impression that I thought otherwise, I apologize. I was really just curious about why you didn't, or wouldn't become an RNFA. Obviously you have excellent insight into the specifics of the job.

R

Ricu wrote:Having thoughts about a career path different than the one you're currently on doesn't mean that you're not dedicated to or that you don't enjoy what you're doing. If I gave you the impression that I thought otherwise, I apologize. I was really just curious about why you didn't, or wouldn't become an RNFA. Obviously you have excellent insight into the specifics of the job.

R

No problema. As you know, an RNFA does not make rounds on post-op patients as does an Ortho PA.

SoldierNurse wrote:No problema. As you know, an RNFA does not make rounds on post-op patients as does an Ortho PA.

Good point. I also, would rather work with people in an awake state more than asleep or anesthetized. That, and I would prefer to concentrate on disease prevention more than treatment which is why I've decided to pursue advanced practice in family medicine instead of anesthesia.

R

Good grief. I can't believe how much negativity there is going on here. PAs attacking NPs and vice versa. Who cares? PAs and NPs are both considered midlevel providers and instead of attacking each other each profession should support the other.

healthyone wrote:Good grief. I can't believe how much negativity there is going on here. PAs attacking NPs and vice versa. Who cares? PAs and NPs are both considered midlevel providers and instead of attacking each other each profession should support the other.

Healthyone,

Welcome to the forum. I'm curious, what area of nursing practice do you work in? While your input is valuable, I'm not sure where you see so much negativity and attacking. There are people vested on both sides of this discussion and commuication becomes intense at times but rarely hostile. Professionals working in these areas understand that and we're working to understand how these disciplines are similar and different.

R

I’m curious as to if PA’s take one licensing exam or if they have to sit for an exam in the specialty they are going in to? Peds, Family Practice, Surgical, ect.

OldSquidNewNurse wrote:I’m curious as to if PA’s take one licensing exam or if they have to sit for an exam in the specialty they are going in to? Peds, Family Practice, Surgical, ect.

Good question, Squid. I know PAs working in all of those areas but never thought to ask them. Are there any reading this thread who can answer?

R

healthyone wrote:Good grief. I can't believe how much negativity there is going on here. PAs attacking NPs and vice versa. Who cares? PAs and NPs are both considered midlevel providers and instead of attacking each other each profession should support the other.

IMHO, no one attacked anyone.

OldSquidNewNurse wrote:I’m curious as to if PA’s take one licensing exam or if they have to sit for an exam in the specialty they are going in to? Peds, Family Practice, Surgical, ect.

I work with PA's and to the best of my knowledge they do not take "specalty" exams.

SoldierNurse wrote:IMHO, no one attacked anyone.

I agree, and I do appreciate it, folks!

We always have encouraged healthy discussions here, and appreciate non-flaming of fellow members.

Thankfully Soldier is an RN, though. :)