Confused

[Smurf]

I plan to attend MWU in AZ next year to become a PA. My cousin plans to attend U of A to become a NP. We constantly argue about which profession is the best. She tells me that PAs are not as educated, and don't have any confidence in their abilities because they have to be supervised. She is currently a medical assistant, and therefore thinks she knows more than I do. I have done lots of research on this, and still feel that the PA program is the way to go. Is there anybody who had the same dilema, but chose NP instead. I'd like to know what you think!



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[Temple1st]

I can talk about both models b/c I am both Nurse/Med stud. PA's are trained in the allopathic model while NP's are trained in the nursing model. Bottom line in my opinion: NP's are better trained right after school compare to a new PA grad b/c of the years as a nurse. However, the PA has had a greater science background and in the long run I feel is better trained. After a couple years of practice the PA will far exceed the nurse. The NP will ALWAYS still be a nurse whose training also included bed making and colostomy bags while the PA does not have any of this servant type training occluding his/her medical train of thought. Remeber PA's train on cadavers in school some nursing programs not linked to med schools use cats for anatomy. Who do you want putting in a chest tube on you; someone who has seen a human pleural cavity or that of a cat's?

The university where I graduated from (BS Biology) the BSN's took chem for nurses, micro for nurses, bio for nurses, stats for nurses, etc.. The bio majors could not take these classes b/c they were to brief, not enough concentration in the subject material. So the ones who wanted to go to PA school had to take the upper level courses. This is why I say PA's are more trained in the basic sciences which is needed to fully understand disease process and to trully understand pharm. at the molecular level.

 

[DixieRN]

The NP will ALWAYS still be a nurse whose training also included bed making and colostomy bags while the PA does not have any of this servant type training occluding his/her medical train of thought.

Grrr, this kind of crap I hear from some PAs and MDs makes me not respect them very much. You call nurses SERVANTS??? Just who the hell do you think you are? I am a nurse and I am not a servant. I assess my patients every two hours during a shift and report the changes to the doctors that are on the case. I ask for the orders I think I need for the patient rather than wait for the doctor to give them to me. I have learned how to do many technical skills, some of which I use on a daily basis and some of which I rarely use in the ICU. My knowledge of how to attach a colostomy pouch is not going to occlude my thinking someday when I am a CRNA, no more than my knowledge of how to change the oil in my car or make a margarita will occlude my thinking.

The university where I graduated from (BS Biology) the BSN's took chem for nurses, micro for nurses, bio for nurses, stats for nurses, etc.. The bio majors could not take these classes b/c they were to brief, not enough concentration in the subject material.

Exactly how long would you make a nursing program to include enough hours to qualify as a minor in science? According to the catalog at the university I graduated from, it took 124 credit hours to earn a BS or BA, but 140 to earn a BSN. Do the math; that's at least an extra semester. Should some nursing classes be cut out so that nurses can have a minor in biology? And for your information, the only science class that I took that was "for nursing" was chemistry, which covered chem, biochem, and organic briefly in one semester. All the rest of the classes I took (biology, anatomy, physiology, and microbiology) were full of pre-med majors along with nursing and other science majors. One of the nursing schools I was looking into before I ended up where I did required all regular science classes; no "nursing" science classes were allowed.

Before I go back to school to obtain my MSN in anesthesia, I am going to retake chemistry and also take biochemistry, organic chemistry and physics. I think redoing these classes will do me some good in learning about anesthesia, as I agree that a higher level of scientific knowledge is necessary for any advanced nursing degree. However, I do not necessarily think they are appropriate for bedside nursing. I'm sure if you looked into it, the nursing students who took the science classes made for nurses could have also earned credit if they had taken the regular science classes. Most nursing students, I'm sure, chose the easier route. A BSN is not an easy degree to obtain, no matter how stupid some MDs and PAs may think nurses are.

Who do you want putting in a chest tube on you; someone who has seen a human pleural cavity or that of a cat's?

No offense, but I want a DOCTOR putting a chest tube in me, thank you very much.

 

[Smurf]

DixieRn,
I understand you have strong feelings regarding the previous comment. But do you have anything to help me with my decision?

 

[Temple1st]

Wow! What a strong reply! I must have hit a nerve or 2, GVE and GSE. Remember the question was about PA vs. NP; not about the level of respect nurses demand. Ok, NP will take much longer and require some work experience. PA is straight forward, get BS then get PA degree. Also, remember with the PA route u wont be stuck learning a bunch of Total Patient care stuff ie.. bed making, cleaning of incont. patients, feeding, etc. Dixie, I do not think everyone should have a science degree but look at all the BSN as 2nd major options. If u already have a BA or BS you can go to an accelerated program and graduate in one year with a BSN. This is already condensing a BSN program into 1 year. So, I don't see why the 140 hours are needed if u can do it in a year. All I was saying is that I think the nursing model is slack in the basic sciences. Maybe they should just change all the programs to just 3 years of preqs and science and then the 1 year of nursing. That's basically what these 2nd degree programs are doing anyway.

 

[DixieRN]

Sorry, Smurf, Temple did hit a nerve with me. I'm a RN and I do take offense when someone makes the assertion that nursing is just wiping people's butts and bedmaking. I make assessments and decisions every day that are life and death. It's up to me to call a doctor with some problem, lab result, etc, that a patient has; I can't just wait till one of the doctors makes rounds when one of my patients has a K of 1.9 or a H&H of 5 and 14 or goes in to a-fib (or worse v-tach).

So Smurf, I'll answer your question. It really doesn't matter what background you come from; if you study hard and learn what you need to know, you will make a good PA or NP. I've found that NPs tend to be a little slower in the clinic setting (both nurses and NPs are taught a holistic approach to patient care) at first, but they learn over time how to make a focused assessment. PAs learn the medical model from the beginning (unless it's a RN becoming a PA) so they tend to do things more the way doctors do. However, I've found there quite a few doctor wannabes among the PAs that I've worked with. I haven't noticed this among NPs.

Some states allow NPs to work independently as long as they have a doctor with whom to consult as needed. In the state I live in now, NPs and PAs must work for a doctor and have the care they do overseen by a doctor. I'm not sure, but I don't think PAs can work independently of doctors.

If you want to be a PA, be a PA, and you and your cousin can agree to disagree.

 

[DixieRN]

Temple, you cannot learn nursing in one year! At least not at the level of RN. These programs that are turning out BSNs in one year if they have a BS or BA in something else have a low pass rate on the NCLEX and produce RNs with poor clinical skills. I don't think I got enough clinical experience in the four semesters I was in the hospital two days a week. I learned so much in the first year out of nursing school, and the more I learn, the more I realize how much I didn't know. I can't imagine how little I would have known if that had been cut in half.

I agree that many nursing programs are weak in sciences. I personally think that ADN (associate) degrees can have watered down sciences and BSN degrees should either have harder sciences or at the very least the option to take the harder sciences. Some nursing schools do offer the option of taking the harder sciences and some don't even offer "nursing" science classes. I graduated with a girl who had a BS in biochemistry who was required by my school to take the "nursing" chemistry class. Personally I think it's just a good way for the university to make money from credit hours.

However, I don't see how learning patient care could get in the way of being a good PA.

 

[Temple1st]

Good points Dixie. I also don't think that learning pt. care will trully hurt ability to dx. However, if that is your original (Physician extender) goal then why waste time. Just go straight for what u want. In the long run it probably doesnt matter, I think the practice acts are almost identical. So if you are starting from "scratch" go to PA: if you are a nurse go for NP. Now, Dixie, you said the pass rates were low for 1 year BSN schools. Not true! They currently have near 100% pass rates and are ranked higher than traditional schools ( Check national counsel website). However, these pass rates are from the best of the best. It is highly competitive to get accepted to these schools, your 1st undergrad GPA better be high or they wont even consider you. Also, since this is a 2nd degree option traditionaly the students will be a little older with years of test taking strategies.

 

[PNP2MD]

Smurf,

I am a pediatric nurse practitioner(PNP) so I will comment on your question about PA vs. NP from a PNP perspective. I will try to be succinct; however this is likely to be a long post.

There are definitely differences between PA and NP education. PA education is based on the medical model. Whereas Np education is based on the nursing model. Entry level for NPs is now Master's level. PA programs range from granting AA, BS, and MS degrees. PA program provide 2 yrs science and clinical experience in a variety of areas such FP, OB, peds,surgery etc etc. Nurse practitioners generally have practiced as RNs before becoming a NP. Also, NP programs concentrate on a specific area rather than many. For instance there are pediatric nurse practitioner programs, family nurse practitioners, neonatal nurse practitioners, adult nurse practitioners, geriatric nurse practitioners , acute care nurse practitoners. I had 6 years of education with a strong science foundation and many hours in peds.

In my case, I received a BS in nursing. My BS cirriculum was strong with liberal arts and many science courses as a foundation and then nursing courses in addtion for 2.5 of the 4 years. I must also add that my science courses were rigorous. As nursing magors we took the same science classes as the premeds , except we were not required to take physics. For example I took a 5 hour anatomy course with human cadavers. We did our own dissections. No I have never dissected a cat.

I practiced for 7 yrs as a PICU RN then 8 years as a PNP in primary care. I see my own pts much the same as my pediatrician colleagues. I am well respected among my PNP and MD colleagues.

I have great respect for all my colleagues including PNPs and MDs.
I hope this was helpful. Essentially you will need to choose whatever is right for you. Good Luck!
Shirl