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  1. #1

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    Physician Assistant vs. Nurse Practitioner

    I was wondering if anybody on this board was involved in healthcare in a way to be able to understand and explain the benefits/disadvantages of becoming a physician assistant as opposed to a nurse practitioner. I am finishing up my Chemistry degree, but it appears that in order to get a decent job in Chemistry, I will have to attend more school for it, which I'm not sure I would like to do. I was told by my aunt, that is a Doctor, that Physician's assistant is the way to go. But speaking to a Nurse practitioner, she made it sound like Nurse practitioners can make just as much but have a little more autonomy from doctors. I understand they are both mid-level healthcare providers, but the more people I ask, the more I realize that the answer details tend to depend a lot on bias. I had no idea it would be so political! Does anyone on FSU have any insight?

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    Comparison of PA and APRN

    My experiences: my cousin is an APRN and she has great bedside manner, is employed as with a hospitalist practice. Hospitalists are those practices in a hospital setting that oversee patient care within the hospital coordinating care then any dismissal information/care is given to the primary care provider. My niece is considering becoming a neonatal nurse practioner again in the practice with the hospital setting. Both APRN's can do certain procedural things such as insertion of chest tubes, insertion of central IV and IA (intra-arterial) lines, etc. Both I consider to be awesome care providers.

    My PA in the physician office that i go to is awesome. She is professional, investigates all my symtoms, some of which are difficult diagnois issues. Another PA I know is in a cardiothoracic practice, he does many diagnostic procedures like assisting with surgical procedures, etc.

    I would research the practice laws in your state to help determine which you want to be.
    Last edited by numbers123; 06-09-2010 at 10:18 PM.

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    My SIL is a surgical PA, the surgery center she works at is sending her back to school to get her RN, she will make more money.
    Without fear you cannot find courage

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    With a chemistry degree, PA training may be shorter than NP. Most states require a BSN as a pre-req to an NP program so you'd have to do at least 2 more years as an undergrad before applying. Many PA programs accept science grads.
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    You mentioned that you weren't sure if you want to attend more in school in order to get a good job in Chemistry but becoming a PA will require two more years of school also, the same as for getting an M.S. in Chemistry. Down the line would you rather be a research chemist, teach, ie or work in the healthcare field?

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    The PA education and training is more like that of an MD as opposed to NP which is a nursing degree. It is incredibly intense as you are taking the same courses as medical students and then some. PA's can go on to perform procedures such as assisting in surgery and so on if you are interested in that kind of thing.

    numbers123 posted a pretty exhaustive comparison info sheet.
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    Quote Originally Posted by IceAlisa View Post
    PA's can go on to perform procedures such as assisting in surgery and so on if you are interested in that kind of thing.
    uh so can APRNs, I know many who have. NNP's do UA, PICC and other line insertions, do chest tube insertions, do ECMO management, etc. I know of several APRNs who work with Cardiothoriac surgeons, pediatric surgeons, pediatric oncologist surgeon practice, etc.

    If brina has a degree in chemistry and looking for a shorter tract, then the PA route is better. You can get a BSN in a fast tract with a science degree (usually 18 months) but most APRN programs recommend that you have some nursing experience before going into the APRN program.

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    I would go for an NP if I were to do a Masters Entry Level program because NPs can also work as RNs, RN Case Managers, Nurse Managers, Nurse Educators, Public Health Officers, Healthcare Administrators . . . and an RN license is accepted worldwide.

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    Quote Originally Posted by numbers123 View Post
    uh so can APRNs, I know many who have. NNP's do UA, PICC and other line insertions, do chest tube insertions, do ECMO management, etc. I know of several APRNs who work with Cardiothoriac surgeons, pediatric surgeons, pediatric oncologist surgeon practice, etc.

    If brina has a degree in chemistry and looking for a shorter tract, then the PA route is better. You can get a BSN in a fast tract with a science degree (usually 18 months) but most APRN programs recommend that you have some nursing experience before going into the APRN program.
    PA's can actually open the chest for the cardiothoracic surgeon and sow it back up. I don't know if NPs can do that.
    "Nature is a damp, inconvenient sort of place where birds and animals wander about uncooked."

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    It really varies by state what a PA or a RNPA can do as the rules are set by state boards rather than national. Look at the state in which you want to live and work and see what the differences are.

    My friends with chemistry degrees all went for a PhD, MD or into something else. Even a MS in chemistry won't get you very far unless you teach in a community college. It's a good science degree to take you into a more specialized field.
    Those who never succeed themselves are always the first to tell you how.

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    A good number of PA schools will also require healthcare hours - i.e. volunteering, shadowing, etc. does not count. It must be hands on, such as working as a nurse, medical assistant, EMT, paramedic, clinical research assistant, etc. I decided after junior year of college that I wanted to go to PA school, and I'm in the process now of taking an MA class in hopes of finding an MA job after graduating for a few years before applying, since most of the schools I've been looking at have flat out said that they almost never accept graduates fresh out of college.

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    Quote Originally Posted by IceAlisa View Post
    PA's can actually open the chest for the cardiothoracic surgeon and sow it back up. I don't know if NPs can do that.
    At least the one I knew did.

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    Yeah, my biggest concern about PA school is that they seem to be looking for older, experienced people from the healthcare field, not exactly people graduated fresh from college. I understand that whether it is a master's or going for a BSN or PA school, it is going to be more school, but like already mentioned by rfisher, even a masters would likely not be enough in Chemistry. I know someone with a PhD in chemistry that couldn't find a job! It just seems like too much time and effort to be in that situation, whereas the BSN accelerated programs here can be completed in 15 month or less. But anyway, my NP friend make it sound like as long as I have a decent GPA for my BSN, it won't be too bad going for the master's to become a NP. I would have to take prerequisites for both the PA and BSN programs, but with the PA program it seems like it would be less of a chance I would get in due to my lack of experience. I'm not sure I want to risk the time and money. Bartoob, my SO is studying for a field that can take him just about anywhere in the world, so that is useful information to know. I wonder if the PA program may be like that anytime soon... thanks for all your help everyone.

    Oh and I do realize that it is recommended to work a while as an RN before going for the NP, but a friend in NP school I know said that she has had no issues working nearly full-time while studying. As long as I can support myself I don't mind the extra time, I guess.
    Last edited by brina; 06-10-2010 at 03:42 AM.

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    brina - can you clear out your PM box?

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    Know that if you go back to get a second bachelors, you won't be eligible for certain types of financial aid. You'll usually be relying on certain types of loans. Thus one suggestion I have for you, if you go back for a BSN, is that in addition to applying to any other schools you desire, you also apply to some public unis in your home state. The nursing programs there tend to be of very good quality, most offer second degree programs, and they could save you some money.

    While you're considering your options, continue to try to find a job as a chemist. Did you do research/lab work while you were an undergrad? You should be able to find a job as a junior chemist. Of course, I don't know where you are and what the demand is like there, but here there are jobs available - right downstairs in my company's labs - for BS Chem.
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    I graduated with a biology degree and went to PA school. I wasn't at all interested in the nursing side of things and had no interest in needing to obtain a nursing degree prior to heading to NP school. I think it is more common for students to come straight out of college into PA school now than it was 15-20 years ago. Those of us in my class who had done that had a bit of an advantage because we were still used to studying, etc., versus those who had been in allied health careers for a while. It was a brutal schedule when I went, not sure if it is the same now or not. 12 months straight academic work (including the medical school level anatomy in 6 wks of summer school so we would be done before med school started) that included many classes with the medical students. Then 12 months of various clinical rotations. But 2 years to a degree like that is a good tradeoff for the brutality of the schedule IMO.

    I know you can somewhat specialize after PA school - there are a few graduate programs (or at least there used to be back in the 80's...) in occupational health and surgical specialities.

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    Direct entry nursing student here, meaning I have a bachelor's degree in a non-nursing field and am enrolled in a master's level program where I'll become an RN after three semester and an NP after three more (BSN and MSN awarded along the way). There are two year programs available as well if you work through the summer. Because it's a graduate-level, I'm eligible for federal Stafford loans.

    In the end, NPs and PAs are pretty similar, though it does vary based on your state's practice acts. I wish we took gross anatomy like PA/MD students, but I think the RN training is invaluable. You learn how to care for PEOPLE, not diseases. I don't love doing bed baths and bed pans, but I love learning how to treat someone with dignity and attend to their physical needs during their most vulnerable time. Do some reading on the medical model versus the nursing model; they're not the same. While you may not incorporate the model you're trained under into your eventual practice, it will have a significant impact on your school experience.

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    As I tried to explain to Brina in an email, there is some difference in a medical model of practice and a nursing model of practice. Neither one is totally the best overall. And both models need the other to provide total care for patients (clients is my preferred word, but that is not the generally accepted word). I don't wish to offend anyone but I would try to explain it in this manner.

    Say someone has a open draining infected wound. Both the PA and APRN would be ordering cultures of the drainage, looking at lab results, determining the best antibiotic therapy for the infection. Let's say that it clears up, the wound looks like it is well on its way to healing. The patient goes home from the hospital. In 2 weeks the site looks as bad as it did before the patient was dismissed from the hospital. Again both professionals would look at lab results, determining what is the best treatment for the infection. Both may ask for an infectious disease doctor to some consult on the problem. Again both might consider non-compliance of medication or possiblity of another underlying disease, such as diabetes.

    The PA would continue to think in terms of disease processes or noncompliance issues while the APRN might also think in terms of what it preventing the patient from doing someing.

    NEITHER MODEL IS RIGHT OR WRONG, WE NEED BOTH MODELS IN OUR HEALTHCARE ENVIRONMENT.

    what I dislike the most is someone telling the nurse that they are so smart they should have gone to medical school. or the either model claiming that they are the best practice model. Who is the most important person in this scenario - the patient (client). the rest of us can continue to argue until the cows come home, but in the end the patient (client) is the most important person.

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