Why would a RN decide to go to PA school?

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medicalcami

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I have a question, what would be a reason/reasons for a RN to decide to go to PA school instead of going to a NP graduate program?

Pros/Cons from both sides would be appreciated


-Thanks :love:

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more clinical time. typical pa program > 2200 hrs clinical rotations in all major specialties learning the medical model vs 300-700 hrs at typical np program learning" advanced practice nursing". also a pa can work in any specialty. np's are limited to one area( adult np, peds np, obgyn np) of study and have less flexibility changing fields.compare the pa and np programs at the same school (duke for example) and go from there.30% of all current pa's are former rn's.


PA or NP - What's the Difference?

Two popular alternatives to becoming a physician have been Physician Assistant (PA) and Nurse Practitioner (NP) programs. Both positions are usually obtained after completing advanced training, generally a two-year program. Each specialty provides the opportunity to see individual patients and to provide basic clinical health care. Both offer the opportunity to prescribe medications (depending upon state regulations), and order diagnostic tests in the treatment of their patients. What is the difference? While the professions have similarities, they are also diverse tracks of health care and have differing underlying philosophies to training and practice.

The first PA program was established in 1965 at Duke University with the first class graduating in 1967. The first group of PA's consisted mainly of former military corpsmen who desired to continue to use their medical training in civilian life. Shortly after Duke established their program, both the University of Utah and the University of Washington established programs. The emphasis of all of these programs was to train individuals to fulfill some, but not all, of the roles of a physician. It was expected that PA's would spend more time in patient education and preventive medicine, but prevention was not the prime goal. PA's skills were designed to be similar to and not very different from a physician's skills. The expectation was that they would be capable of diagnosis and treatment of patients and have a degree of independent judgment. Before entering a PA program most individuals will have completed a bachelor's degree including courses in anatomy, biology, chemistry, microbiology, human physiology and psychology.

In the same year (1965) that the first PA program was established, the University of Colorado created a pediatric nurse-practitioner program. The program was created in the traditional nursing philosophy of total patient care. The push for nurse-practitioners began along with a rising demand for medical services, rising health-care costs and a shortage of primary care physicians due to greater specialization. Nurse-practitioners must first be registered nurses and most have worked as registered nurses (RNs) before becoming nurse-practitioners.

The greatest difference between the two fields is an underlying philosophy toward patients and disease. PA's come out of and are trained in a medical model. Their training is very similar to that of a physician because, from the outset, they were seen as an extension of the physician, not as a replacement for the physician or as a different type of independent practitioner. The medical model defines health as the absence of disease and the focus is on the treatment, cure and management of disease. The model has a biological focus and tends to look at the symptoms and not the social and behavioral causes of illness.

Nursing, on the other hand, has the concept of humanism as its dominant philosophy. The focus is on understanding the relationships between humans, their environments and health. The view is holistic in nature and sees people as not being made up of discrete parts. The profession recognizes the importance of health promotion and disease prevention. In part, the reason that nurse-practitioners have striven for independence is because their underlying philosophy of health care is different from the medical model and requires a different set of skills. Many nurses-practitioners believe that physicians should not supervise them because the knowledge and skill base utilized by nurse-practitioners is different. In short, the PA medical model is more focused on patient "cure" while the NP nursing model is more focused on patient "care".
 
Excellent post / reply. This may start a flame war, but if I had to go back and choose between the two, I would pick the PA route, even though I have been an ICU/ED RN for several years. My experiences with the two groups have always been professional and courteous, but I was more impressed by the PA medical model. The clinical time is considerable and it is medical based. The clinical differences are apparrent within the medical environment. There is such a wide diversity of NP programs out there that standardization is a problem with degree attainment. Many nurses I work with, including myself, do not necessarily like the nursing model. I read medical texts while in the units concerning drugs/therapies/diseases.
I went back to crna school, so I took a third route out from the bedside.
The only time I even thought about NP was through Case Western where it is a NP program but the ultimate preparation is for Flight Nursing.

JMHO

rn29306
 
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medicalcami said:
I have a question, what would be a reason/reasons for a RN to decide to go to PA school instead of going to a NP graduate program?

Pros/Cons from both sides would be appreciated


-Thanks :love:

In my PA class there were six RN's, and I got to know three of them well enough to ask that same question (not at the same time). All three replied in basically the same manner. They were disgusted with the overall lack of professionalism and poor training while in RN school. After seeing the way that PA's were trained, they decided that although they wanted to become clinicians, they didn't want to pursue the nursing profession any longer. My impression is that they nonetheless hold the RN profession in high regard....
 
Thank You emadpa for you reply... it helped me understand the two professions better and I now know I am on the right track.

Also, thanks dermpa02 and rn29306 for your insight on this matter as well. :)
 
medicalcami said:
I have a question, what would be a reason/reasons for a RN to decide to go to PA school instead of going to a NP graduate program?

Pros/Cons from both sides would be appreciated


-Thanks :love:

Hi,
I am an RN who chose to go to PA school for a lot of the reasons that were mentioned in the above posts. I have posted on this before in this forum. Basically, the last response before mine hit it on the head for me.
I just didn't want to be "one of them". "Them" being those who think the nursing model is all a patient needs, thinking that some ICU experience as an RN and two years of part-time school made them "better" than doctors and equipped to handle all a patient's problems, thinking that NP's receive enough training to be independent, thinking that spending all day in a university doing meaningless research on therapeutic touch gives them the right to teach students about how to care for a patient, and teaching the nursing model to students who will eventually be expected to practice medicine, and so on. I could go on, but I am certain you get my point.
My other point is that I know and work with some great NP's. I would trust mine or my family's life to many of them. The truth is that those great NP's know that all the "nursing model is the cure all" and "NP's deserve independence" hype is a bunch of crap. They basically distance themselves from this gargabe once they graduate.
Good luck in your decision,
Pat
 
I became a Neonatal Nurse Practitioner because I've never met or seen a PA work in neonatology nor have I seen any PA programs that offer that option. For me, neonatal is the only field I want to work in so my decision was based on that. I guess NNP's might be different from other nurse practitioners but I'm happy with the level of independence and decision making I can do. At least where I work, I'm not restricted as to which kind of patients I can have under my team. I can manage the PPHN babies right down to the feeder-growers. And in my program I didn't spend endless hours researching how therapeutic touch was going to help my babies. :rolleyes:
 
pa's have worked in neonatology for >20 years. there is even a pa postgrad residency in peds/neonatology at a yale affiliated hospital:


Norwalk Hospital/Yale University
PA Residency Program
Department of Pediatrics
Peggy McCloskey, Administrative Assistant
34 Maple Street
Norwalk, CT 06856
(203) 852-2662
(203) 855-3683 - Fax
E-mail: [email protected]
Length of Program 12 months
Class Size 2 residents
Starting Date:
Ending Date:
PROGRAM DESCRIPTION AND HISTORY:

The PA Pediatric Postgraduate Program conducted jointly by the Departments of Pediatrics, Norwalk Hospital and Yale University School of Medicine is an intensive twelve month training program. The program combines the resources of the Departments of Pediatrics at Norwalk Hospital and Yale University School of Medicine, providing a major commitment to the education of the PA Pediatric resident. The program is planned to assist the development of cognitive and technical skills in the achievement of sound medical judgement and prepares the PA for major responsibilities. Graduates are actively involved in inpatient pediatrics, neonatology, pediatric emergency medicine, outpatient pediatrics, including pediatric subspecialty areas, as well as in the academic setting.
CURRICULUM:

The curriculum is designed to concentrate heavily on areas that were only surveyed in basic PA training:

A. The didactic portion of the program is directed to an in-depth understanding of major aspects of clinical pediatrics. As such, the curriculum covers a wide variety of basic and advanced topics in pediatrics.

* There is an intensive orientation series of basic pediatric topics which begins annually in September. These topics include basic CPR, a variety of neonatal topics including mechanical ventilation, stabilization of the neonate, the neonate during the transitional phase, as well as a neonatal resuscitation course. In addition, there are introductory lectures in pediatric medicine and lectures on the cognitive aspect of pediatrics, including the developmental assessment of children, children's reaction to hospitalization and mental status examination.
* There is an ongoing lecture series which covers topics in general pediatrics designed for the pediatric physician assistant.
* There is a monthly resident conference at which pediatric PA residents review a topic of interest and present this topic to other members of the staff.
* There is a weekly grand rounds which is offered by members of the Department of Pediatrics at Yale University School of Medicine as well as by visiting lecturers from a variety of institutions.
* There are daily teaching rounds on the pediatric inpatient unit and in the neonatal intensive care unit.
* There are periodic weekly neonatal section conferences offered by one of the neonatologists to review topics of general interest in neonatology.
* Lectures are offered by members of other departments, for example, orthopedics, obstetrics, and ENT, on areas in which the practice of their specialty impacts upon pediatrics.
* Pediatric PA residents participate in courses sponsored by the Department such as the annual Neonatal Symposium as well as the Neonatal Resuscitation Course. Upon completion of the Neonatal Resuscitation Course, Pediatric PA residents receive certification. Pediatric PA residents also take the Pediatric Advanced Life Support Course.
* During the rotation at Yale University School of Medicine, residents attend daily conferences, grand rounds and lectures by faculty and visiting specialists.
* The Pediatric PA resident is encouraged to take full advantage of all learning opportunities available to them at both institutions.

B. The clinical curriculum encompasses a full calendar year of rotations. Residents take an active role in the assessment, management and daily care of patients. They have the opportunity to learn the technical skills that are essential in caring for the pediatric patient. Two months are spent at Yale University and ten months are spent at Norwalk Hospital.

* Clinical rotations at Norwalk Hospital include neonatology, pediatrics, pediatric special care and adolescent medicine.
* The rotation at Yale encompasses two months on the pediatric service, including the emergency department.
* Clinical situations at both institutions are supplemented by informal and formal didactic lectures.
* While at both institutions there is an on-call experience involving both night and weekend call.

UNIVERSITY AND INSTITUTIONAL AFFILIATIONS:

The Pediatric PA Residency is a joint program of Norwalk Hospital and Yale University School of Medicine. This program is a member of the Association of Postgraduate Physician Assistant Programs. Yale University School of Medicine is a large teaching institution with a national and international reputation for excellence in clinical services and research. Norwalk Hospital, located on Long Island Sound is a 366 bed acute care hospital. The newborn service has been designated as a regional resource in neonatology and, as such, receives transports from a variety of area hospitals.

The Newborn Intensive Care Unit consists of eighteen stations and is staffed by three full-time Neonatologists. The Pediatric Inpatient Unit includes a fourteen-bed general pediatric to care for older infants, children and adolescents.
ENTRY REQUIREMENTS:

* The applicant must be a graduate of an ARC-PA accredited Physician Assistant Program.
* The applicant must have passed, or be eligible for, the National Certification Examination for Physician Assistants. (Passage of this exam is a prerequisite for obtaining the CT license.)
* CT licensure must be procured by February 1 in order to complete the residency.
* The applicant must complete the application form, submit college transcripts, provide a resume, three completed recommendation forms, one of which must be filled out by the PA Program Director or Coordinator, an official copy of board scores, if certified, and a brief, typewritten narrative stating why they wish to become a pediatric physician assistant.
* Selection factors include a strong interest in pediatrics and neonatology, academic achievement, excellent interpersonal skills, and a commitment to continued education.
* All written applications are reviewed by the Admissions Committee. After a review of application materials, a personal interview, at the applicant's expense is required for admission tot he program. Interviews are held at Norwalk Hospital in the spring, preceding the beginning of the program year.

CREDENTIAL AWARDED:

Upon graduation, the physician assistant resident receives a certificate signed by the Department Chairmen at Norwalk Hospital and Yale University School of Medicine, the President of Norwalk Hospital and the Dean of Yale University School of Medicine. In addition, physician assistant residents receive Neonatal Resuscitation certification and are eligible for Pediatric Advanced Life Support certification. The Norwalk/Yale Pediatric Physician Assistant Residency is approved for the maximum CME credit (50 hours) by the American Academy of Physician Assistants.
FINANCES:

* Salary or stipend. The current stipend for physician assistant residents is approximately $35,000 annually.
* Benefits: Flexible benefit program through Norwalk Hospital. This includes a variety of options for life insurance, medical coverage and dental coverage and can include coverage for spouse as well as children. Flexible benefit accounts are available for child care and uncovered medical and dental expenses. Malpractice insurance is provided by the hospital.
* Housing: Housing is available in the hospital owned apartment complex. Efficiency, and one-bedroom apartments are available on a furnished or unfurnished basis. Utilities are included.
* Vacation: There are three weeks paid vacation.

CALENDAR OF EVENTS:
A. Application filing period Must be completed by April 30
B. Interviews Mid-late May
C. Notification of acceptance to program Two weeks following the interview
D. Program starting date Early September
 
I'm a PA student in my clinical year & LOVED my neonatology rotation. I just did a search on the neonatology.org website for job postings for PAs & got 41 hits.

Pubmed has an article about the expanding role of PAs in neonatology, & it was written in 1986. Looks like we have also been taking care of the little ones for quite a while.


I appreciate the important role NNPs have in the nurseries & NICU's, but it's always good to do your homework before making any blanket assumptions about another profession.

Take care,
M :)
 
emtp2pac said:
pa's have worked in neonatology for >20 years. there is even a pa postgrad residency in peds/neonatology at a yale affiliated hospital:


Norwalk Hospital/Yale University
PA Residency Program
Department of Pediatrics
Peggy McCloskey, Administrative Assistant
34 Maple Street
Norwalk, CT 06856
(203) 852-2662
(203) 855-3683 - Fax
E-mail: [email protected]
Length of Program 12 months
Class Size 2 residents
Starting Date:
Ending Date:
PROGRAM DESCRIPTION AND HISTORY:

The PA Pediatric Postgraduate Program conducted jointly by the Departments of Pediatrics, Norwalk Hospital and Yale University School of Medicine is an intensive twelve month training program. The program combines the resources of the Departments of Pediatrics at Norwalk Hospital and Yale University School of Medicine, providing a major commitment to the education of the PA Pediatric resident. The program is planned to assist the development of cognitive and technical skills in the achievement of sound medical judgement and prepares the PA for major responsibilities. Graduates are actively involved in inpatient pediatrics, neonatology, pediatric emergency medicine, outpatient pediatrics, including pediatric subspecialty areas, as well as in the academic setting.
CURRICULUM:

The curriculum is designed to concentrate heavily on areas that were only surveyed in basic PA training:

A. The didactic portion of the program is directed to an in-depth understanding of major aspects of clinical pediatrics. As such, the curriculum covers a wide variety of basic and advanced topics in pediatrics.

* There is an intensive orientation series of basic pediatric topics which begins annually in September. These topics include basic CPR, a variety of neonatal topics including mechanical ventilation, stabilization of the neonate, the neonate during the transitional phase, as well as a neonatal resuscitation course. In addition, there are introductory lectures in pediatric medicine and lectures on the cognitive aspect of pediatrics, including the developmental assessment of children, children's reaction to hospitalization and mental status examination.
* There is an ongoing lecture series which covers topics in general pediatrics designed for the pediatric physician assistant.
* There is a monthly resident conference at which pediatric PA residents review a topic of interest and present this topic to other members of the staff.
* There is a weekly grand rounds which is offered by members of the Department of Pediatrics at Yale University School of Medicine as well as by visiting lecturers from a variety of institutions.
* There are daily teaching rounds on the pediatric inpatient unit and in the neonatal intensive care unit.
* There are periodic weekly neonatal section conferences offered by one of the neonatologists to review topics of general interest in neonatology.
* Lectures are offered by members of other departments, for example, orthopedics, obstetrics, and ENT, on areas in which the practice of their specialty impacts upon pediatrics.
* Pediatric PA residents participate in courses sponsored by the Department such as the annual Neonatal Symposium as well as the Neonatal Resuscitation Course. Upon completion of the Neonatal Resuscitation Course, Pediatric PA residents receive certification. Pediatric PA residents also take the Pediatric Advanced Life Support Course.
* During the rotation at Yale University School of Medicine, residents attend daily conferences, grand rounds and lectures by faculty and visiting specialists.
* The Pediatric PA resident is encouraged to take full advantage of all learning opportunities available to them at both institutions.

B. The clinical curriculum encompasses a full calendar year of rotations. Residents take an active role in the assessment, management and daily care of patients. They have the opportunity to learn the technical skills that are essential in caring for the pediatric patient. Two months are spent at Yale University and ten months are spent at Norwalk Hospital.

* Clinical rotations at Norwalk Hospital include neonatology, pediatrics, pediatric special care and adolescent medicine.
* The rotation at Yale encompasses two months on the pediatric service, including the emergency department.
* Clinical situations at both institutions are supplemented by informal and formal didactic lectures.
* While at both institutions there is an on-call experience involving both night and weekend call.

UNIVERSITY AND INSTITUTIONAL AFFILIATIONS:

The Pediatric PA Residency is a joint program of Norwalk Hospital and Yale University School of Medicine. This program is a member of the Association of Postgraduate Physician Assistant Programs. Yale University School of Medicine is a large teaching institution with a national and international reputation for excellence in clinical services and research. Norwalk Hospital, located on Long Island Sound is a 366 bed acute care hospital. The newborn service has been designated as a regional resource in neonatology and, as such, receives transports from a variety of area hospitals.

The Newborn Intensive Care Unit consists of eighteen stations and is staffed by three full-time Neonatologists. The Pediatric Inpatient Unit includes a fourteen-bed general pediatric to care for older infants, children and adolescents.
ENTRY REQUIREMENTS:

* The applicant must be a graduate of an ARC-PA accredited Physician Assistant Program.
* The applicant must have passed, or be eligible for, the National Certification Examination for Physician Assistants. (Passage of this exam is a prerequisite for obtaining the CT license.)
* CT licensure must be procured by February 1 in order to complete the residency.
* The applicant must complete the application form, submit college transcripts, provide a resume, three completed recommendation forms, one of which must be filled out by the PA Program Director or Coordinator, an official copy of board scores, if certified, and a brief, typewritten narrative stating why they wish to become a pediatric physician assistant.
* Selection factors include a strong interest in pediatrics and neonatology, academic achievement, excellent interpersonal skills, and a commitment to continued education.
* All written applications are reviewed by the Admissions Committee. After a review of application materials, a personal interview, at the applicant's expense is required for admission tot he program. Interviews are held at Norwalk Hospital in the spring, preceding the beginning of the program year.

CREDENTIAL AWARDED:

Upon graduation, the physician assistant resident receives a certificate signed by the Department Chairmen at Norwalk Hospital and Yale University School of Medicine, the President of Norwalk Hospital and the Dean of Yale University School of Medicine. In addition, physician assistant residents receive Neonatal Resuscitation certification and are eligible for Pediatric Advanced Life Support certification. The Norwalk/Yale Pediatric Physician Assistant Residency is approved for the maximum CME credit (50 hours) by the American Academy of Physician Assistants.
FINANCES:

* Salary or stipend. The current stipend for physician assistant residents is approximately $35,000 annually.
* Benefits: Flexible benefit program through Norwalk Hospital. This includes a variety of options for life insurance, medical coverage and dental coverage and can include coverage for spouse as well as children. Flexible benefit accounts are available for child care and uncovered medical and dental expenses. Malpractice insurance is provided by the hospital.
* Housing: Housing is available in the hospital owned apartment complex. Efficiency, and one-bedroom apartments are available on a furnished or unfurnished basis. Utilities are included.
* Vacation: There are three weeks paid vacation.

CALENDAR OF EVENTS:
A. Application filing period Must be completed by April 30
B. Interviews Mid-late May
C. Notification of acceptance to program Two weeks following the interview
D. Program starting date Early September


Thanks for the information but I don't reacall saying that the programs didn't exist, I said I've never seen one. And I was talking about programs that are exclusively for neonates; not one that includes peds. My clinical time was ALL related to neonates. How much of the 2200 hours do PA's spend on one discipline? Would it compare to how much time I spent in clinicals on my one discipline? I know, I know medical model vs nursing model.

By the way, I found this on the aapa website:
Norwalk
Hospital and the Yale School of Medicine co-sponsor
the only PA postgraduate program in pediatrics.
 
Monika said:
I'm a PA student in my clinical year & LOVED my neonatology rotation. I just did a search on the neonatology.org website for job postings for PAs & got 41 hits.

Pubmed has an article about the expanding role of PAs in neonatology, & it was written in 1986. Looks like we have also been taking care of the little ones for quite a while.


I appreciate the important role NNPs have in the nurseries & NICU's, but it's always good to do your homework before making any blanket assumptions about another profession.

Take care,
M :)

Before you go on attacking me, I never said that PA's don't work in neonatology, I said I'VE NEVER SEEN ONE! So how is that making a blanket assumption about your profession? A blanket assumption would have been if I said PA's don't work in neonatology. I haven't assumed anything. Before I went to NNP school I was a travel nurse for 3 years. I worked at well over 16 different hospitals in 12 states all in level 3-4 NICU's. I was nurse in my home state 2 years prior to that. Currently I work in North Carolina as a NNP and I have still NEVER come across a PA working in neonatology. It was a statement based on MY OWN experiences.
I don't think I've disrespected PA's or made any assumptions about PA's in any way. Goodness. The original question was why one would pick PA over NP and I gave the reason why I picked NNP over PA. And one more thing, I'm not turning this into who's better blah blah blah......never made any comment about it. My statements applied to MY decision to do NNP over PA because I did consider PA but after doing some research (yes I did research) NNP was a better fit for ME as far as my career goals were!
 
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Monika said:
but it's always good to do your homework before making any blanket assumptions about another profession.

What "blanket assumptions" are you referring to? I saw none in Mw560g's posting. The only thing I saw was someone who mentioned their own experiences, and that is not a blanket assumption. Furthermore, that person has evidently done their homework, since they are a practicing provider, which is something *you* are not....

dermpa02
 
Mw560g said:
I became a Neonatal Nurse Practitioner because I've never met or seen a PA work in neonatology nor have I seen any PA programs that offer that option. For me, neonatal is the only field I want to work in so my decision was based on that.

apparently she didn't look very hard given that there are lots of pa jobs in neonatology and a residency that has been around for over 20 years. "blanket assumptions", no.
sloppy research? yes.
 
emtp2pac said:
apparently she didn't look very hard given that there are lots of pa jobs in neonatology and a residency that has been around for over 20 years. "blanket assumptions", no.
sloppy research? yes.


Whatever makes you happy.
Got this from neonatology.org. Guess I wasn't alone in what I found in my sloppy research.

To Whom It May Concern, I am a Physician Assistant student graduating from Western University in four months. I am currently doing a rotation in the NICU at UCI. I absolutely love it! In light of your available PA position I was wondering if you would be willing to host a PA post-graduate residency program. Apparently there use to be many specialization programs for PA's in neonatology but they weren't cost effective since so many PA's are going into Primary Care and they are all gone. I am seeking further education and a career in neonatology and I am without an opportunity for further training. If you have any ideas or would be willing to host such a program please contact me by email or phone @ (949) 887-2364. Thank you for your time and advice. Sincerely, Bobbi Borning PA-S

and once again

NorwalkHospital and the Yale School of Medicine co-sponsor
the only PA postgraduate program in pediatrics that takes 2 residents.
 
the beautiful thing about pa school is that you don't have to go to a specialty fellowship program to work in any specialty, you can take electives in that specialty while in school and get a job as soon as you gradaute from a general pa program. so, someone who was a former nicu rn could do peds rotations and nicu electives in school and get a nicu job right out of the chute. yes, a postgrad residency is great, but for many jobs it is not required.
I am not trying to start a np vs pa war here I am just reinforcing the fact that pa's, even without subspecialty fellowship training, can get a nicu job right out of school. I imagine that many of the current nicu pa's out there did just that. apparently the job market for nicu pa's and np's is strong at this point so getting jobs by either path shojuld not be a problem for future grads.

also...there is also a masters level peds focused general pa program in colorado http://www.uchsc.edu/chapa/pas an overview.htm
that allows one to do lots of time in the nicu if desired, so yale is not the only option(although as stated above any program of the 135 out there can arrange a nicu elective).
 
emtp2pac said:
the beautiful thing about pa school is that you don't have to go to a specialty fellowship program to work in any specialty, you can take electives in that specialty while in school and get a job as soon as you gradaute from a general pa program. so, someone who was a former nicu rn could do peds rotations and nicu electives in school and get a nicu job right out of the chute. yes, a postgrad residency is great, but for many jobs it is not required.
I am not trying to start a np vs pa war here I am just reinforcing the fact that pa's, even without subspecialty fellowship training, can get a nicu job right out of school. I imagine that many of the current nicu pa's out there did just that. apparently the job market for nicu pa's and np's is strong at this point so getting jobs by either path shojuld not be a problem for future grads.

also...there is also a masters level peds focused general pa program in colorado http://www.uchsc.edu/chapa/pas an overview.htm
that allows one to do lots of time in the nicu if desired, so yale is not the only option(although as stated above any program of the 135 out there can arrange a nicu elective).






Thank you. I wasn't trying to start a war either. I just am unfamiliar with Pa's in the NICU. I really considered PA. When my daughter was 17 months old she was diagnosed with AML and was taken care of by a wonderful PA after her first BMT. I talked with him at length about PA school. She also had very good NP's and good MD's taking care of her and each was an important part of her treatment. So even if I didn't sound like it in my previous posts, I really really respect and understand the importance of all members of a healthcare team and how each brings a different perspective to caring for patients. From the CNA's to the MD's it opened my eyes a lot and I don't ever try to get into the this profession is better etc because they all contributed in very important and differents ways to her treatment. I know a lot of people make fun of NP's training and their nursing model based education but as a mom of a child with cancer, there comes a time when that's just what is needed. When continuing on with medical interventions becomes futile, at least this is how it was with my baby, sometimes families feel so pressured into just trying one last thing. When it became apparent to me (and it took a LONG time for reality to set in) that my daughter wasn't going to get better despite any medical intervention, the best advice I got was to just be a mom. And one of the best interventions was being given permission to let my daughter go if that makes any sense. So all the endless searching for medical interventions ended and I got to spend the last 2 months of her life just being a mom.

sorry for rambling but just wanted to reinforce that I do value all members of the healthcare team and wasn't trying to say I thought NNP's are better than neonatal Pa's. I value my education and I'm a true believer in how important the entire team is when it comes to treating patients.

Thanks again for listening and helping me understand a PA's training better.

Merry Christmas
 
and merry christmas to you as well.......I'm sure we can all see beyond the pa/np issues and just deliver good care to all of our pts. god bless-e
 
thank you for sharing about your daughter. your point is definitely an important one.
happy holidays.
 
"I'm a true believer in how important the entire team is when it comes to treating patients."

Wonderful point, thanks for sharing your family's story.


Merry Christmas & God Bless,
M
 
:clap: :clap: :clap: Thank you to everyone that posted, I have received some valuable info...HAVE A SAFE AND HAPPY NEW YEAR!!!!!!!!!
 
emedpa said:
np's are limited to one area( adult np, peds np, obgyn np) of study and have less flexibility changing fields.

True, if you take those educational track. But, if you do FNP, you can do just about whatever you want (except neonates). This may change soon, especially in hospitals.
 
emedpa said:
Nursing, on the other hand, has the concept of humanism as its dominant philosophy. The focus is on understanding the relationships between humans, their environments and health. The view is holistic in nature and sees people as not being made up of discrete parts. The profession recognizes the importance of health promotion and disease prevention. In part, the reason that nurse-practitioners have striven for independence is because their underlying philosophy of health care is different from the medical model and requires a different set of skills. Many nurses-practitioners believe that physicians should not supervise them because the knowledge and skill base utilized by nurse-practitioners is different. In short, the PA medical model is more focused on patient "cure" while the NP nursing model is more focused on patient "care".

Emed is so right here... and it's such crap. I am a NP and went through the program telling them what they wanted to hear so I would pass and adopted the medical model on my own. In fact, one of my "weaknesses" according to one of the NP instructors was that I use the medical model instead of the nursing model. HA!

PA school would have been much better training and I would have enjoyed it much more, but in Missouri, I'm still glad I went NP due to law differences and lobby strength.
 
lloydchristmas said:
Emed is so right here... and it's such crap. I am a NP and went through the program telling them what they wanted to hear so I would pass and adopted the medical model on my own. In fact, one of my "weaknesses" according to one of the NP instructors was that I use the medical model instead of the nursing model. HA!

PA school would have been much better training and I would have enjoyed it much more, but in Missouri, I'm still glad I went NP due to law differences and lobby strength.

Hi Lloyd,
I was an RN who chose to go to PA school instead of NP school just because of that "crap". I could have went to NP school and stayed working as an RN full time, but instead I quit work and went to PA school for the medical training. It is crap, and good NP's like yourselves know it's crap and throw it out the window when they graduate. The one's who don't tend to nearly kill people trying to practice on their own with two years of essentially part-time study!
Good NP's are just like PA's, they go to school and then do the real learning on the "outside". Good NP's know that they are practicing "medicine" when they graduate.
Pat
 
hospPA said:
Hi Lloyd,
I was an RN who chose to go to PA school instead of NP school just because of that "crap". I could have went to NP school and stayed working as an RN full time, but instead I quit work and went to PA school for the medical training. It is crap, and good NP's like yourselves know it's crap and throw it out the window when they graduate. The one's who don't tend to nearly kill people trying to practice on their own with two years of essentially part-time study!
Good NP's are just like PA's, they go to school and then do the real learning on the "outside". Good NP's know that they are practicing "medicine" when they graduate.
Pat

Thanks buddy... I bet we'd make a good team. I couldn't agree more with your thoughts.

This week is a good example of what you're talking about. I saw a 12 year old boy at urgent care Wednesday, came to me with fever, N/V and vague abd pain x 1 week. Hx of eosinophilic esophagitis. CBC/CMP was all normal. Mild cough, non-productive (but didn't cough during exam at all). Didn't look very ill (up and talking... just looked fatigued). So, I thought it was a viral thing and sent him home with cough syrup and phenergan and told him to push the clear liquids.

They called the next day saying his fever was 103 that night and he got worse. So, I had them come back and he looked pretty sick/pale. Also told me he hadn't had a BM in several days. Other than that, exam was about the same, except a little more tender in the lower quadrants of the abd. I started with an abdominal series xray and called my collaborating doc in to see him too as I was quite worried about him by now. Chest film showed RML pneumonia. Before the film I was thinking hot appe.

It's those atypical presentations that will catch you, and NP/PAs have to know when to get the doc involved (especially newbies). We can do a lot of good for a lot of people if we practice that way. But, we could really hurt someone if we assume we know everything.

I gave the boy a gram of ancef and started him on Zithromax, but the next day they paged me (I gave them my pager # because I was worried about him). They told me he got worse and coughed up blood so I met them at the ER today (just got home from that, actually). We got him admitted and on IV antibiotics and fluids and the parents were elated and shocked that I came to the ER to make sure he was okay. He actually looked better to me but we put him in just to be safe.
 
hospPA said:
Good NP's are just like PA's, they go to school and then do the real learning on the "outside". Good NP's know that they are practicing "medicine" when they graduate.
Pat

Have you found there to be any conflicts in NP's practicing "medicine"?
 
medicalcami said:
Have you found there to be any conflicts in NP's practicing "medicine"?
No I have not seen any issue with this at all. Everone knows that is what they are doing. Those "collaborating" docs are supervising the NP's practice, hence them practicing medicine. I think the issue would arise when they try to practice medicine on their own.
Pat
 
I guess you can say it's kind of contradictory to go through NP school and "practice medicine"

What do you think? :confused:

Comments anyone...
 
medicalcami said:
I guess you can say it's kind of contradictory to go through NP school and "practice medicine"

What do you think? :confused:

Comments anyone...

Yes it is. It is this way because the powerful but misguided nursing lobby thought it necessary to establish "pseudo" independence.

Pat
 
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