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Thread: NP vs. PA

  1. #1

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    NP vs. PA

    I know this question may have been posted before... it might even have been posted by me a long time ago (I don't really remember), but does anyone have any insight on to whether I should pursue being a NP or a PA? I understand there are a lot of similarities between the two professions; They are both mid-level providers. I also recognize that PA school follows the medical model, while NP school follows the nursing model. I am currently in an accelerated BSN program because I initially chose the path to become an NP, but I am having second thoughts as the prerequisites for nursing school are essentially the same as PA school around here. I also will have to take the GRE in order to get into the master's program at the nursing school anyway, so it makes me want to take a second look at the PA option.

    The thing that really frustrates me about being a PA is it seems like the schooling is more rigorous, because it is two years of medical school and one year of residency (I believe), but PAs appear to have less autonomy than NPs. In my state, PAs aren't allowed to write prescriptions, while NPs can. I also believe in some states, NPs only need "collaborating physicians" while PAs need more oversight by physicians.

    I enjoy nursing school so far, but I think I might be more fit for the medical model. Nursing school so far seems to be focused on making assessments and practical aspects of being a nurse, such as putting in IVs and foley catheters. It also really stresses the humanistic aspect of health care. I believe this to be important, but I have taken one pathophysiology course as part of the curriculum, and I absolutely LOVED it and did excellent in it. However, it doesn't seem like this knowledge is actually applied in my other courses. I seem to be more attuned to the biophysical aspects of a person's condition, instead of the spiritual/holistic ideal nursing seems to really push. I understand that both are important, and I value the nursing perspective, but I tend to look at it more technically than my classmates, and even my professors sometimes.

    Anyway, this is a long rant. I was hoping some people had some insight into which option would be best. I appreciate any help you all have to offer.

  2. #2
    drinky typo pbp, closet hugger
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    I got nothing in terms of your question, but I think the way in which you are assessing which path would be the best fit for your talents and interests is great, and will only strengthen your abilities whichever career your choose.
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    From what I've seen (from the consumer end) there seem to be some differences in the kinds of jobs they do: the NP's I've seen have either worked in peds, obg, or primary care, all providing primary care. I've seen PA's more as assistants in specialized medical practices -- a PA came through the hospital to do cardiology rounds checking up on patients after procedures and doing discharges, the PA in my orthopod's office takes out stitches, does casting, handles obtaining informed consent, and I think was there during my surgery as an assistant. The PA at my derm's office sees patients and does everything up through biopsies. In my state, PA's seem to be able to write prescriptions -- maybe they're restricted as to what they can write them for, but I don't know about that. I guess my take on it is that the PAs I've seen have been more involved on a technical level, and less general primary care. But that may just be because I've seen a small sample. I've been very pleased with all of the NPs and PAs I've encountered over the years; glad it is an option.
    Last edited by barbk; 08-16-2011 at 10:33 PM.

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    I worked in a research hospital for a few years and I couldn't tell you the difference between the 2 in practice, but there were definitely more NPs than PAs. If the education is different maybe you should consider whether you might want to go to medical school in the future.

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    I don't believe I quite have what it takes to get into medical school--I took the prereqs as part of my degree but I didn't get all As or anything. That, and I am not sure if I'd want to spend the decade to get an MD.

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    Quote Originally Posted by brina View Post
    I enjoy nursing school so far, but I think I might be more fit for the medical model. Nursing school so far seems to be focused on making assessments and practical aspects of being a nurse, such as putting in IVs and foley catheters. It also really stresses the humanistic aspect of health care. I believe this to be important, but I have taken one pathophysiology course as part of the curriculum, and I absolutely LOVED it and did excellent in it. However, it doesn't seem like this knowledge is actually applied in my other courses. I seem to be more attuned to the biophysical aspects of a person's condition, instead of the spiritual/holistic ideal nursing seems to really push. I understand that both are important, and I value the nursing perspective, but I tend to look at it more technically than my classmates, and even my professors sometimes.
    Yes, you did ask the question before, but now you have a few more specific questions.
    Remember that in the BSN program you will be doing some of the nursing tasks, like IV insertions, dressing cares, etc. Once you get into the NP programs you will have less routine tasks and more complex practice procedures. You can PM me again with some very specific questions and I can help answer them or direct you to the appropriate resources.
    And you will be using the pathophysiology course information later in your education. Right now, you are being focused on the nursing basics.

  7. #7

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    Quote Originally Posted by barbk View Post
    From what I've seen (from the consumer end) there seem to be some differences in the kinds of jobs they do: the NP's I've seen have either worked in peds, obg, or primary care, all providing primary care. I've seen PA's more as assistants in specialized medical practices -- a PA came through the hospital to do cardiology rounds checking up on patients after procedures and doing discharges, the PA in my orthopod's office takes out stitches, does casting, handles obtaining informed consent, and I think was there during my surgery as an assistant. The PA at my derm's office sees patients and does everything up through biopsies. In my state, PA's seem to be able to write prescriptions -- maybe they're restricted as to what they can write them for, but I don't know about that. I guess my take on it is that the PAs I've seen have been more involved on a technical level, and less general primary care. But that may just be because I've seen a small sample. I've been very pleased with all of the NPs and PAs I've encountered over the years; glad it is an option.
    This is a pretty accurate description of how PAs practice in OK and NC (the two states in which I have held certification) regarding more specialized procedures, but there are still some that practice as a primary care provider. I wasn't aware that there were still states that didn't allow Rx privileges for PAs, so that is surprising to me. I chose PA school because I had no interest in going to nursing school in order to become an NP. However, in the back of my mind it seems like if you have a nursing degree, that you could always fall back on that in the event that you are unable to find a pure NP job?

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    I think it depends on what you want to do. I analyze health care data for major carriers as well as state governments and see a pretty equal split between NP's and PA's in all types of practices. NP's work for major medical centers and physician practices etc., but some of them are independent entities and directly bill for compensation if they are able to provide a package of patient services that are successfully marketable to the general public, i.e. diabetic education and counseling.

    While the same may be true of PA's, generally I am finding they are employed by physician practices and medical centers. However, the range of things that they are able to do appears to far exceed that for NP's and the degree of authority possibly much greater. My next door neighbor was a cardiac surgery PA and actually did some minor CABG's and other invasive cardiac diagnostic procedures. I have seen NP's that have done some minor GYN procedures, etc.

    I have seen both professions serve as primary care providers for a large number of patients, especially in rural or semi-rural areas as well.

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    In the Boston area, hospitals are PA-centric and outpatient services are NP-centric. Most of the PAs I know work the same rotations that doctors do and have a similar on-call schedule. Two of my friends are NPs and chose that path due to lifestyle issues, knowing that they could find good jobs in the outpatient space.
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    Thank you for all of your insight. I'm thinking that I'd like to work in a faster-paced environment then outpatient, but that's just my impression right now.

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