NP/PA- nursing model and medical model

[mslinzyann]

Ugh. I am really torn on whether to go into PA or NP, and I often see the 'medical model' being mentioned as a difference between the two. Yet, for all my googling, I cannot seem to figure out, what is the difference between the medical model and the nursing model?
I also am looking for some help on this PA/NP thing. I am trying to figure out what is right for ME, not which is better. So I'm not looking for a fight. Here are my considerations.
1. Time spent in school in relationship to money made- money is tight for me, so I need to get out into the workforce and earn relatively soon. This really isn't my main concern, but it is something I am thinking of.
2. Holistic/compassionate considerations: I keep hearing "NPs are considerate and kind, PAs are cold and medical." But the thing is, I really care about being compassionate towards patients, viewing them holistically and caring about being human. But thats not necessarily DISCOURAGED in a PA school, right?
3. I am interested in primary care, family medicine, pediatrics, neonatal, working with underserved populations. Not particularly interested in surgical specialties.
4. Having an MD or DO on staff is important to me, something I consider important to being a midlevel. I would like prescription rights, and the ability to practice somewhat independently- but its important to me, when I need help, that there is someone I can bounce things off of and get help from.
5. Hours. I want to be able to see my family and have a life outside of work. I would prefer a 40-50 hr workweek...I DO want to work, guys, but I also care about my family and life outside of work.
Thanks so much you guys. I could really use some experiences and ideas on this.

Lindsey

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[DNP student]

From your post, you could go either way. How much college do you currently have?

1. For NP school, you must first get a BS in nursing and pass NCLEX (used to be called state boards). Most reputable NP schools also require 1-3 years experience as an RN prior to acceptance). Some don't, but you won't get as much out of school if you haven't done much pt care yet. You will probably get out of PA school quicker (depending on the school). However, from what I understand, PA school may be more competitive, therefore, harder to get into. Nursing school is easier to get into, but harder to get out of.

2. The nursing model is more holistic than the medical model. Essentially, the nursing model is a caring model while the medical model is a curing model. However, there are NP's that practice more from a cure model and PA's that practice more from a care model. It really depends more on your personality and style. Personally, I think you'll find nursing school more holistically-oriented than PA school.

3. Both practice in the areas you mentioned.

4. Both tend to have MD/DO's available, but it will largely depend on the state and the practice.

5. Again, this will depend on the practice where you work. I know PA's and NP's that work a strict 40 hour week, and some of both that work 80 hour weeks. Look at the MD/DO practice. You will probably come close to mirroring their hours whether you are a PA or NP.

I think PA's in general make more than NP's, but again, it depends on the practice. I know NP's that make more than PA's, but they are in different physician groups. From what I see, the more money you make, the more hours will be expected.

 

[deleted6669]

From your post, you could go either way. How much college do you currently have?

1. For NP school, you must first get a BS in nursing and pass NCLEX (used to be called state boards). Most reputable NP schools also require 1-3 years experience as an RN prior to acceptance). Some don't, but you won't get as much out of school if you haven't done much pt care yet. You will probably get out of PA school quicker (depending on the school). However, from what I understand, PA school may be more competitive, therefore, harder to get into. Nursing school is easier to get into, but harder to get out of.

2. The nursing model is more holistic than the medical model. Essentially, the nursing model is a caring model while the medical model is a curing model. However, there are NP's that practice more from a cure model and PA's that practice more from a care model. It really depends more on your personality and style. Personally, I think you'll find nursing school more holistically-oriented than PA school.

3. Both practice in the areas you mentioned.

4. Both tend to have MD/DO's available, but it will largely depend on the state and the practice.

5. Again, this will depend on the practice where you work. I know PA's and NP's that work a strict 40 hour week, and some of both that work 80 hour weeks. Look at the MD/DO practice. You will probably come close to mirroring their hours whether you are a PA or NP.

I think PA's in general make more than NP's, but again, it depends on the practice. I know NP's that make more than PA's, but they are in different physician groups. From what I see, the more money you make, the more hours will be expected.

nice summary
pa's and np's working in the same group make the same $$. pa's on avg make more because we do more inpatient and specialty work(hospitalist/surgery/er/ortho) while np's tend to do more outpatient(fp/peds/ob) type of work. but there are ob pa's and surgical np's so it varies a lot by location.
for pa related info see:
www.aapa.org general site
www.physicianassistant.net pa specific forum
www.appap.org optional pa residencies in a variety of fields

 

[mslinzyann]

I am currently in my junior year of studies as a psychology major and working on completing the pre-requisites for one of two possibilities; either applying to PA school or applying to a one year accelerated BSN program.

 

[DNP student]

I would advise you to be careful with the one year acceleted BSN program. These programs tend to be very intense with a high wash-out rate. You will do all the classroom and clinical hours that the traditional students do in 2 years; but you will do it double-time in one year. Most state boards require the same number of hours in order to sit for boards; they don't care how many years, just how many hours. I would ask someone in the program for their attrition rate for this accelerated program. Even though it sounds good on paper, it may be worth it to do 2 years if NP is the way you choose to go.

 

[deleted6669]

I would advise you to be careful with the one year acceleted BSN program. These programs tend to be very intense with a high wash-out rate. You will do all the classroom and clinical hours that the traditional students do in 2 years; but you will do it double-time in one year. Most state boards require the same number of hours in order to sit for boards; they don't care how many years, just how many hours. I would ask someone in the program for their attrition rate for this accelerated program. Even though it sounds good on paper, it may be worth it to do 2 years if NP is the way you choose to go.

for either path you should also get some clinical experience before applying. if you go np work as an rn for a few yrs 1st. if you want to go pa either work as an rn and apply pa or get alternate training(emt, etc) and do this for a while before school. the best pa/np folks are the ones with prior training and clinical experience.

 

[Salamandrina]

From your post, you could go either way. How much college do you currently have?

1. For NP school, you must first get a BS in nursing and pass NCLEX (used to be called state boards). Most reputable NP schools also require 1-3 years experience as an RN prior to acceptance). Some don't, but you won't get as much out of school if you haven't done much pt care yet. You will probably get out of PA school quicker (depending on the school). However, from what I understand, PA school may be more competitive, therefore, harder to get into. Nursing school is easier to get into, but harder to get out of.

"Most reputable NP schools also require 1-3 yrs experience as an RN prior to acceptance"

Huh?

I am applying right now to UPENN, UCSF, Johns Hopkins, Columbia and Yale. NONE of them require experience in nursing. Guess they aren't "reputable" any more, eh?

 

[deleted6669]

"Most reputable NP schools also require 1-3 yrs experience as an RN prior to acceptance"

Huh?

I am applying right now to UPENN, UCSF, Johns Hopkins, Columbia and Yale. NONE of them require experience in nursing. Guess they aren't "reputable" any more, eh?

PHRASED DIFFERENTLY...most reptable/quality np( and pa) graduates had experience prior to becoming midlevels....you can go to yale, etc and still be a bad provider and you can also go to podunk and be a great provider. it's more about what you bring to the program than what the program teaches you....

 

[Salamandrina]

PHRASED DIFFERENTLY...most reptable/quality np( and pa) graduates had experience prior to becoming midlevels....you can go to yale, etc and still be a bad provider and you can also go to podunk and be a great provider. it's more about what you bring to the program than what the program teaches you....

Yeah, it is what you bring to the program. But that doesn't mean that someone with experience who is an dingus and treats their patients like **** is better prepared for being a good provider than someone that has no experience but is humane.

Point is, the first post said that reputable programs require experience. I called them on it so then you say that it is really about what you bring to the table. Oooooh! What a novel idea! I am sure that no one has ever thought or considered that before. All programs assess what you bring to the table. Experience is only one part of that assessment.

 

[deleted6669]

"Experience is only one part of that assessment"

the most important part...much more relevant than gpa, gre score, or shadowing time....
tone don't the hostility a bit, ok....

 

[MacGyver]

The whole "medical" vs "nursing" model is a charade.

The nurses like it that way, because it gives them a legal loophole for scripting drugs and doing other stuff thats usually relegated to doctors.

The nurses call scripting meds the practice of "nursing" because if they were honest and admitted what it really is: the practice of medicine, they would be guilty of practicing medicine without a license and subject to fines/jail time.

 

[Salamandrina]

"Experience is only one part of that assessment"

the most important part...much more relevant than gpa, gre score, or shadowing time....
tone don't the hostility a bit, ok....

Happy to, provided you tone down the condescension, okay?

BTW, off to a raging start on that one. But then again, so am I.

 

[Jengirl18]

Maturity and professionalism are needed in both professions

 

[DNP student]

"Most reputable NP schools also require 1-3 yrs experience as an RN prior to acceptance"

I said "most" not "all."

 

[DNP student]

Maturity and professionalism is needed in both professions

 

[Salamandrina]

Maturity and professionalism is needed in both professions

I agree. Not that it pertains to typing on an internet forum though.

I mean, c'mon, sobriety is also needed in both professions, doesn't mean I can't get tanked tonight.