MSN vs NP vs PA

[utgliderdave]

Hello. I few months ago I made rounds with a Nurse Practioner in a rural clinic and I really liked her job. Almost doctor like. Very independant.

So now I have started the road to nursing by taking Chemistry, Anatomy and Physiology at the University of Utah. This has not been easy because I'm a computer programmer and must work a 40 hour week.

My initial plan was to apply to the Nursing College there and quit my job while my wife supports us, assuming I can squeeze past the 1/6 acceptance ratio. But now I have learned of a slightly different path that perhaps makes more sense.

The relatively new "Academy of Nursing" here in Salt Lake offers an Associate Degree and prep for the NCLEX test, and it's all night classes. Then I could get a nursing job and go to the University of Phoenix (mostly virtual classrooms) to get a Masters of Nursing degree.

My question is about these higher level degrees. Is a MSN similar to a NP which is similar to a PA? What must I do to become a NP once I have earned a MSN?

Thanks for any comments.

David

[TracyR]

First of all, you must have the MSN, along with additional training, to become a Nurse Practitioner (NP, ARNP, etc...). You will take a separate exam to become a licensed as a NP.

Secondly, a Nurse Practitioner has far more formal education than your average PA...they are not similar at all. In fact, a NP may have an independant practice in many states, as well as prescriptive privileges, a PA does not and will never have that right. PA= Physicians ASSISTANT, ARNP= ADVANCED REGISTERED NURSE PRACTITIONER.

[utgliderdave]

I am now enrolled in the Nursing Academy. The culture is very different. I'm taking Microbiology and a mostly psych class called Lifespan Development.

We'll see how it goes! Thanks for your reply.

[Aaron C.]

cool. Please explain the "Nursing Academy"...

[jlsrnp]

I am a Nurse Practitioner for the public health department.
One could say my state is mostly rural. I do mostly woman's health. I was a RN but was sent to NP school by my employer.
I love my job!!!! I am often the primary care provider for my patients due to the MD shortage.

[jsmiddleton4]

"a Nurse Practitioner has far more formal education than your average NP...."

I'm sorry but that is a broad generalization that is not necessarily true. NP's may have more nursing education and education related to being a NP but to say PA' are less formally educated is simply not so. I worked with a PA who has his master's degree in Human Anatomy and Physiology as well as being a PA. He KNEW his stuff. And I'm sorry but that kind of statement, "NP's has far more formal education", is exactly the kind of narrow-minded inbred mindset that is hurting nursing as a profession.

Are there some PA's who don't have as much "formal" education as NP's? Sure. Is it also the case that there are some PA's that have more "formal" education than NP's? You bet!

The generalization doesn't hold up is all I'm pointing out.

"as well as prescriptive privileges..."

Again not completely accurate. I worked with PA's in our county ER system for some time. ALL of them I worked with in the ER and Acute Care walk-in wrote their own prescriptions. Some of the NP's had to get co-signatures for narcotics as they hadn't completed that part of their licensure. Exactly what the process is to be able to write your own scripts is unclear to me. But to say NP's can and PA's can't write their own is not the whole story. Which is my point.

If I had it to do over again, I'd be a PA not an RN. The poster above failed to mention that PA's can and do make more than NP's, PA's can do surgery, work as first assists, and around here many do the harvesting for bypass surgeries as well as the follow-up in patient care for post-op, help with rounds for renal patients, all kinds of things NP's don't do.

And for the NP's I know, they say almost always the same thing the above poster said "... do women's health..." Me I'd rather not being doing PAP's and chlamdia smears all day if you don't mind.

My advice is to contact a PA program in your area as well as the PA association and find out for yourself what the PA practice limits are and how you'd fit in.

I have worked in East Africa, did so for almost 6 years. I had to learn alot to be productive and provide care. Often I was the only one with medical knowledge. I was glad I had been a corpsman with the Navy assigned to the Marines during Vietnam Era. Because of that training, NOT my RN training, I was able to think like a provider and actually provide care. In most of the rest of the world PA's are called Community Health Officers, or CHO's, and they are a fundementally important part of providing healthcare.

It is my humble opinion that you would not be selling yourself short by becoming a PA instead of a NP. My opinion, based on real world experience, is that by being a PA you'd open up many options to yourself that NP's do not have.

Regardless of who you talk to in our country a nurse is a nurse is a nurse. A NP comes with a whole set of culturally mandated expectations including salary reimbursement ranges because it is STILL nursing. (For those NP's I know, I've worked with several, this is what drives most of their complaints. "I still get treated like a nurse!") Even the nurse anesthestist I know complains in this regard too.

Do some research and consider as many options as you can so as to put yourself in the best position possible to make the most of your skills in the market place.

Jim

[John-Texas]

Hi friend,

Let me tell you my perspective as a practicing NP in Texas. I as many others did not have the luxury of going to school only. I had to work 40 hours a week, and also went to school full-time. Nursing is a wonderful career, I was able to first get my ADN at a local community college and advanced thru the ranks and finally made it thru NP school (MSN). As far as the differences between NP's and PA's Tracy is mostly right, let me explain.

1- NP's in general have more training than PA's due to the fact that the entry level for NP'S is a master degree, and for PA's (in most states) is a bachelor degree. Shure some PA's may have masters degrees, but is not a requirement. Second, most MSN (NP) programs require RN's to have a minimun of 1 year experience in your are of specialty (for example CRNA's need ICU experience). Remember as an NP you must first be an RN (have taken boards), then an NP (more Boards).

2- In the basis of authonomy, NP's are trained to be independent practitioners. NP's do not have to have a supervising physician like PA's do. In many states NP's have their own private practices, while in others NP's require that the physician reviews a certain percentage of the NP's charts. NP's are generally "LICENSE" thru the board of nurse examiners, while PA's are "CERTIFIED" by the state's medical board. NP's and PA's both can assist during surgical procedures, and in some states they are even able to perform procedures such as EGD's and Colonoscopy's. As a matter of facts in one of the national GI medical associations the president is not a doctor but an NP. I for example receive many invitations from national medical organizations looking for NP's to join in.

3- As far as prescriptive authority, this depends on your state. Here in Texas my prescriptive authority comes from the board of nurse examiners. I am able to prescribe schedules II thru IV (narcotics to general medications). In Texas I must first obtain a number from DPS (department of public safety)(about $40-50), then get the DEA number (about $400 for 3 years). The process for narcotic prescription is mostly the same for NP and PA's (PA's prescriptive authority is thru medical board).

I think that nursing is a great career, you can jump from nursing homes to hospital. From medsurg floor to ER, ICU, or OR. The job oppotunities are many, and you have the flexibility of working as a floor nurse, a unit manager, a hospital CEO, a drug rep, consultant, and with more education even become a nurse practitioner. I think over all nursing is a great field. If your thing is making money, then maybe nursing is not for you. If your thing is making a difference while caring for those in need, then you are nursing material.

Nursing had come a long way, and I am proud to be one.

John.

ps. NP's and PA's are paid based on experience and area of specialty.

[Faizi]

I am new here and this post caught my eye.

I am a LPN and I have worked closely with many doctors and with a few PAs and two NPs.

Several excellent doctors. A few not very good PAs. A couple of fairly good PAs. I have only worked with two NPs -- no, three. All three -- especially the two -- were excellent beyond belief. Very focused scientifically -- more so than most of the doctors.

I work with one NP now who astounds me with her diagnostic abilities. It is the sharp focusing that dazzles me. She is a walking biopsy needle. If there is something yucky to be found, she will find it. She is a very precise probe.

Most doctors do not have that same sort of focus. They tend to glad-hand more or something -- placate. When this NP comes into the room, she is completely focused on finding evidence and she is incredibly sharp at picking it out.

Whatever they teach 'em in NP school, they need to be doing the same in med school.

I wonder if it is because some doctors become doctors for the so called glam factor and NPs become NPs because they are genuinely interested.

NPs have to battle ignorance. One of the most common statements of ignorance is, "Why should I pay the same price to see a NP when I can see a doctor?"

I can't say it, of course, but I want to say, "Why would you pay to see an idiot when you can see someone with a scientific mind?"

Well, there are many nuances but I have great respect for those two NPs -- especially the one I work with now. I trust her judgement completely.

I never have medical problems but, if I did, I would go to her first and I would come back to her for her opinion about what any specialists were doing.

I cannot say enough good about NPs.

Faizi

[crystalRN]

Hello! I have been a RN for almost a year and a half. I've always wanted to further my career and have decided on going the NP route. My reason for this decision is that I love nursing! I enjoy the options and the patient care and would like to stay in the field. I'd like to start school by next fall ('07). I don't really know where or how to start looking for programs and I have a few questions.
1- Which is better, NP or MSN to NP?
2- are online programs a good option or should I stay away from them?
3- What is the difference between NP and CNS and which is better?
Any input on this would be helpful.

[stillearning]

Good luck with your nursing academy -- it sounds interesting.

I would be surprised to learn that Univeristy of Phoenix (online) is accepting Associate Degree nurses into any Master's level program in nursing without a BSN.

Also, Nursing offers MANY kinds of Master's degrees -- some lead to the NP certification, others to a CNS (Clinical Nurse Specialist) others to a Nurse Educator or Nurse Administrator.

Be selective -- choose your education based on which doors it will open for you. Choose those opportunities which will give you a wider array of choices later in your career, not those which will limit your future.

Choose wisely!

--p