After undergrad, midlevel education: Go PA or go NP?

I say, go PA.

Go Physician Assistant.

Physician Associates baby!

Do you prefer science/medicine or nursing theory?

foreverLaur said:

Do you prefer science/medicine or nursing theory?

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I still don't understand nurse theory. How can one theoretically treat disease? How can a nurse provide enough "care" to treat disease and injury?

Surely at some point they're bound to learn differential diagnosis and so forth so they can diagnose sickness and treat it rather than just care it away.

I really don't get it and nurses can't explain it at allnurses.com either so I'm guessing they just don't know...

ArkansasRanger said:

I still don't understand nurse theory. How can one theoretically treat disease? How can a nurse provide enough "care" to treat disease and injury?

Surely at some point they're bound to learn differential diagnosis and so forth so they can diagnose sickness and treat it rather than just care it away.

I really don't get it and nurses can't explain it at allnurses.com either so I'm guessing they just don't know...

Click to expand...

I'm with you.... that's one of many reasons why, IMO, PA>>>NP.

ArkansasRanger said:

I still don't understand nurse theory. How can one theoretically treat disease? How can a nurse provide enough "care" to treat disease and injury?

Surely at some point they're bound to learn differential diagnosis and so forth so they can diagnose sickness and treat it rather than just care it away.

I really don't get it and nurses can't explain it at allnurses.com either so I'm guessing they just don't know...

Click to expand...

Nursing theory is the manipulation of the environment to promote well being. If you look at Florence Nightingales report from the Crimean this was the first opportunity for nursing to differentiate itself from treating disease medically. Nursing theory really started to bloom in the late 70's as nurses tried to prove a "worth" separate from carrying out medical orders. The problem as I see it is that a lot of the nursing theories like providing fresh air and clean linens have been adopted by the medical community. Other areas that were within nursing theory such as looking at the patients social needs have been co-opted by social work and such leaving very little that is solely nursing care.

What nursing theory has spawned is an entire academic industry devoted to making new theories that are then foisted upon unsuspecting students. These students then arrive in the work place to find out that most nurses see nursing theory as a waste of time. It also kills large amounts of trees (or fossil fuel in the case of computerized charting).

At least thats the way that I understand it. Nursing theory is the main reason that I'm a PA not an NP.

David Carpenter, PA-C

core0 said:

Nursing theory is the manipulation of the environment to promote well being. If you look at Florence Nightingales report from the Crimean this was the first opportunity for nursing to differentiate itself from treating disease medically. Nursing theory really started to bloom in the late 70's as nurses tried to prove a "worth" separate from carrying out medical orders. The problem as I see it is that a lot of the nursing theories like providing fresh air and clean linens have been adopted by the medical community. Other areas that were within nursing theory such as looking at the patients social needs have been co-opted by social work and such leaving very little that is solely nursing care.

What nursing theory has spawned is an entire academic industry devoted to making new theories that are then foisted upon unsuspecting students. These students then arrive in the work place to find out that most nurses see nursing theory as a waste of time. It also kills large amounts of trees (or fossil fuel in the case of computerized charting).

At least thats the way that I understand it. Nursing theory is the main reason that I'm a PA not an NP.

David Carpenter, PA-C

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I hear you. The deciding factors for me to rule out RN/NP was a total lack of hard science as well as clinical experiences. It seems most RNs get out of school and then have to get added training to do almost everything after that. The whole "you can train a monkey to do procedures. We train nurses" line applies here. Maybe they should be training their students to be proficient at a nurse's scope of practice upon graduation / licensing without having to incure a vast amount of OJT.

I still don't see how advance practice nurses can justify building a curriculum off nursing theory since at that point you should really go beyond caring and initiate some treatment which is going to have to be based off of science. The whole concept of it all seems illogical. Clean sheets, bed baths, and warm blankets seem like a no brainer. Why get a degree in it?

I was a high school teacher for a while, and I know, without even having taken a single undergraduate course in education, that education theories, or philosophies as they're commonly referred to, are constantly evolving with veterans teachers sitting in the lounge lamenting or laughing, depending upon the experience, about bygone theories - all of which were crap.

VassarLiberal said:

Sounds like when I asked a math teacher about "New Math"...

Regarding PA practice, has anyone heard of PAs doing preventative medicine or public health, or, perhaps, PAs with an MPH or PhD doing epidemiological work?

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Sure. There are even several programs that combine MPH and PA degrees, such as the one at Georgetown....

ArkansasRanger said:

I hear you. The deciding factors for me to rule out RN/NP was a total lack of hard science as well as clinical experiences. It seems most RNs get out of school and then have to get added training to do almost everything after that. The whole "you can train a monkey to do procedures. We train nurses" line applies here. Maybe they should be training their students to be proficient at a nurse's scope of practice upon graduation / licensing without having to incure a vast amount of OJT.

I still don't see how advance practice nurses can justify building a curriculum off nursing theory since at that point you should really go beyond caring and initiate some treatment which is going to have to be based off of science. The whole concept of it all seems illogical. Clean sheets, bed baths, and warm blankets seem like a no brainer. Why get a degree in it?

I was a high school teacher for a while, and I know, without even having taken a single undergraduate course in education, that education theories, or philosophies as they're commonly referred to, are constantly evolving with veterans teachers sitting in the lounge lamenting or laughing, depending upon the experience, about bygone theories - all of which were crap.

Click to expand...

I learned how to do a whole lot more than give bed baths, change linens and hand out blankets when I was a nursing student. Perhaps you shouldn't talk about what nursing students do/do not learn when you don't have the first clue what you're talking about.

I graduated in the day when students got out of school and could "hit the ground running." Yes, I probably do use nursing theory in my everyday practice, but I just don't think about it in the gobbledygook manner the ANA elitists would have us spout it off. It's almost second nature.

VassarLiberal said:

Sounds like when I asked a math teacher about "New Math"...

Regarding PA practice, has anyone heard of PAs doing preventative medicine or public health, or, perhaps, PAs with an MPH or PhD doing epidemiological work?

Click to expand...

There are quite a few PAs doing public health. Probably between 80 and 300 depending on how you define it. I know there are a few (5-10) PAs working at CDC here in Atlanta doing epi work. Of course there is always this:
http://www.cdc.gov/eis/

David Carpenter, PA-C

fab4fan said:

I learned how to do a whole lot more than give bed baths, change linens and hand out blankets when I was a nursing student. Perhaps you shouldn't talk about what nursing students do/do not learn when you don't have the first clue what you're talking about.

I graduated in the day when students got out of school and could "hit the ground running." Yes, I probably do use nursing theory in my everyday practice, but I just don't think about it in the gobbledygook manner the ANA elitists would have us spout it off. It's almost second nature.

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You have to talk about what nursing student do/do not learn because as a whole the profession does a very poor job of explaining what they learn as well as what roles they serve in healthcare. I may indeed have no clue as to what I'm talking about but after speaking with other members of your chosen occupation, reading, and observation that I still had to ask.

VassarLiberal said:

Just a quick theoretical question. If a person straight out of undergrad who wanted to go to grad school to be a midlevel, would it be more advantageous for living standards and location to go in as a PA or NP from the standpoints of

- Income
- Ability to work in multiple fields (PAs have the advantage here, no?)
- Choice of location
- Ability to provide advanced care to patients

?

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A major question you need to ask yourself is if you want the ability to practice independently. NPs can practice independently in 13 states/jurisdictions at the current time and more states are pushing for this authority. PAs always practice under the supervision of a physician even though that supervision may be informal and on paper only. But, it does make a difference if you are interested in autonomous practice.

I practice independently as a psychologist and, when I wanted to add Rx authority to my scope, I decided to train as a psych NP vs. PA because I would be able to practice independently in my state as a NP. PA route would have meant that I would have had to be supervised.

Yes, there is a lot of BS fluff and filler in nursing school. But it was marginal and not something that I would say would keep me from doing it over again.

medium rare said:

A major question you need to ask yourself is if you want the ability to practice independently. NPs can practice independently in 13 states/jurisdictions at the current time and more states are pushing for this authority. PAs always practice under the supervision of a physician even though that supervision may be informal and on paper only. But, it does make a difference if you are interested in autonomous practice.

I practice independently as a psychologist and, when I wanted to add Rx authority to my scope, I decided to train as a psych NP vs. PA because I would be able to practice independently in my state as a NP. PA route would have meant that I would have had to be supervised.

Yes, there is a lot of BS fluff and filler in nursing school. But it was marginal and not something that I would say would keep me from doing it over again.

Click to expand...

If you want to be one of the two percent of NPs that practice "independently" then thats probably important. If you want to be one of the 2% of the PAs that own their own practice and practice with with considerable autonomy then you could go PA. BTW how do you bill for Medicare?

David Carpenter, PA-C

I really don't understand wanting to practice independently. If your goal is to hang out your own shingle then by all means become a doctor. If you're prepared to complete a master's degree and treat most everything that walks through your door then go ahead. You can always order more tests and make referrals but then that shows you're really not helping out healthcare all that much afterall. I personally wouldn't feel comfortable doing that. I can understand not wanting to take every chart to a doctor and have him sign off on it, but that's not that likely to happen because it renders the role of midlevels irrelevant although I have heard of such setups which puzzles me. It's also not very kind to the self-esteem, but many jobs aren't.

I'm a workplace supervisor/manager/administrator (pick a title), and I can understand wanting to be higher in rank. It has its perks, and if that's what you're looking for then you're only going to get it if you work by yourself (independently) or automatically get hired into a position where you're subordinate to no one. Likely if you're a NP, PA, MD/DO, or any thing else you're going to have someone else dictating your hours, your pay, and whatever else you do at work since very few people are now independent practitioners these days. Given our current path in the U.S. you're less likely to do that in the future.

If you want to be at the top then put in the time and effort to achieve that. Without the effort, you're not going to get there.

core0 said:

If you want to be one of the two percent of NPs that practice "independently" then thats probably important. If you want to be one of the 2% of the PAs that own their own practice and practice with with considerable autonomy then you could go PA. BTW how do you bill for Medicare?

David Carpenter, PA-C

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I'm in Arizona and there are several independent NP practices and they bill and collect from Medicare without a problem - I've asked a few of the FNPs I know about this and that's what they've told me. I know other states are different.

I can't speak to this directly because I have opted out of Medicare. However, I can (and have) billed Medicare as a psychologist in the past when I saw Medicare patients and it was never an issue for me.

You're right, you can have an independent practice as a PA, but the cost for paying the supervising physician can add up. As an NP in this situation, there would be no cost for supervision which equates to a considerable reduction in overhead.

medium rare said:

You're right, you can have an independent practice as a PA, but the cost for paying the supervising physician can add up. As an NP in this situation, there would be no cost for supervision which equates to a considerable reduction in overhead.

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But does this come with the trade off of being at increased risk in terms of liability/ insurance? I could see a situation where the PA makes a mistake but has some protection since they are operating under the MDs license vrs the NP who is out on their own. Do people who practice on their own have to pay higher malpractice premiums than those who are supervised?

jbar said:

But does this come with the trade off of being at increased risk in terms of liability/ insurance? I could see a situation where the PA makes a mistake but has some protection since they are operating under the MDs license vrs the NP who is out on their own. Do people who practice on their own have to pay higher malpractice premiums than those who are supervised?

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The short answer is no. Malpractice insurance premiums are based on actuarial data and only increase when there is a increase in claims paid. In fact, my malpractice premium as an NP is less than my malpractice rate as a psychologist.

And, as an interesting side note, I know of at least two FNPs here in AZ who run their own practices and have been approached by FP and IM physicians wanting the NP to employ them in their practice because the NP can hire the physician as an employee and pay a fraction of the cost to insure them as an employee of the practice compared to what it would cost the physician to insure him/herself independently.

medium rare said:

The short answer is no. Malpractice insurance premiums are based on actuarial data and only increase when there is a increase in claims paid. In fact, my malpractice premium as an NP is less than my malpractice rate as a psychologist.

And, as an interesting side note, I know of at least two FNPs here in AZ who run their own practices and have been approached by FP and IM physicians wanting the NP to employ them in their practice because the NP can hire the physician as an employee and pay a fraction of the cost to insure them as an employee of the practice compared to what it would cost the physician to insure him/herself independently.

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That doesn't make any sense. If the numbers are based on actuarial data (and they are) the cost (and risk) should be the same regardless of how they are employed. Since they are moving to new claims made policies (presumably) the cost will be less the first couple of years but will soon rise to the same level that they were at. In addition they will have to pay a tail for the old policies (unless they are occurrence). It works out the same in the end usually.

David Carpenter, PA-C

medium rare said:

And, as an interesting side note, I know of at least two FNPs here in AZ who run their own practices and have been approached by FP and IM physicians wanting the NP to employ them in their practice because the NP can hire the physician as an employee and pay a fraction of the cost to insure them as an employee of the practice compared to what it would cost the physician to insure him/herself independently.

Click to expand...

I call BS on that. There are several aspects that make no sense.

Sorry, duplicate post.
Please delete this post.
Thank you.

You don't just learn "theory" in nurse practitioner program. What can just learning theory do in assessing and diagnosing the patients?

A lot of the NPs were registered nurses with thousands of hours in clinical experience that involve assessment skills (palpation, auscultation, percussion, otoscope & ophthalmoscope usage).

Here is the curriculum

Acute Care Nurse Practitioner:
http://nurseweb.ucsf.edu/www/cur-acp.htm

Year 1
Fall:
Assessment/Skills Lab
Clinical Practicum and Conference
Human Pathophysiology & Aging
Theories Related to Nursing Care
Assess & Mgt Psych Signs & Symptoms
Advanced Health Assessment
Health Promotion in Acute Care

Winter:
Diag. & Therapeutics Lecture
Issues in Acute & Critical Care
Human Pathophysiology & Aging
Research Methods
Clinical Pharmacology
Clinical Practicum & Conference

Spring:
Clinical Practicum and Conference
Exacerbations of Chronic Illness
Diag. & Therapeutics Skills Lab
Symptom Assess. & Mgmt.
Research Utilization
Cardiac Rhythm and Theory
EKG Practicum
Antibiotic Therapeutics

Year 2

Fall:
Dx & Rx of Acutely Ill/Injured Patients I
ACNP Residency I and Conference
Dimensions of Advanced Practice Nursing
Introduction to Human Genomics
Clinical Nutrition (unless already taken)
CXR Interpretation

Winter:
Dx & Rx of Acutely Ill/Injured Patients II
ACNP Residency II and Conference
Health Care Economics/Policy (unless already taken)

Spring:
ACNP Residency III & Conference
Cardiac Rhythm and Theory
EKG Practicum

Post Masters:

Fall:
Assessment/Skills Lab
Clinical Practicum & Conference
Assess. & Mgt. Psych Signs & Symptoms
Dx & Rx of Acutely Ill/Injured Patients - I
Advanced Health Assessment
Clinical Nutrition
Health Promotion in Acute Care

Winter:
Diagnostic & Therapeutics Lecture
Clinical Practicum & Conference
Dx & Rx of Acutely - Ill/Injured Patients II
Clinical Pharmacology

Spring:
Exacerbations of Chronic Illness
Diagnostic & Therapeutics Skills Lab
Assessment & Mgmt. of Signs & Symptoms
ACNP Residency III & Conference
Cardiac Rhythm and Theory
EKG Practicum
Antibiotic Therapeutics

Summer:
ACNP Residency & Conference
Chest X-Ray Interpretation



Physician Assistant Curriculum:
1
Fall
Clinical Medicine 1
Clinical Laboratory Medicine 1
Behavioral Medicine
Physical Diagnosis 1
Pharmacology 1
Spring
Clinical Medicine 2
Clinical Laboratory Medicine 2
Physical Diagnosis 2
Pharmacology 2 Clinical Skills
Clinical Rotations


2



Internal Medicine, 4 weeks
Family Medicine, 4 weeks
General Surgery, 4 weeks
General Pediatrics, 6 weeks
Obstetrics & Gynecology, 4 weeks
Psychiatry, 4 weeks
Emergency Medicine, 4 weeks
Orthopedics, 4 weeks
Geriatrics, 2 weeks

http://www.dyc.edu/academics/physician_assistant/curriculum.asp

foreverLaur said:

Do you prefer science/medicine or nursing theory?

Click to expand...

Both

DNPDoctor said:

You don't just learn "theory" in nurse practitioner program. What can just learning theory do in assessing and diagnosing the patients?

A lot of the NPs were registered nurses with thousands of hours in clinical experience that involve assessment skills (palpation, auscultation, percussion, otoscope & ophthalmoscope usage).

Click to expand...

...and a lot are from direct-entry programs, or have done a bare minimum of bedside clinical work before continuing on in NP programs. Further, what RNs, in what settings, are regularly using oto and ophthalmoscopes? One also has to assess what these nurses did with their "thousands of hours in clinical experience." If they were like the nurses that I used to work with on the floors back in my tech days, then I don't care if they've been doing their job for twenty years, they still don't know anything about medicine or taking care of patients. However, if they are more like some of the nurses I work with in the ED and ICU settings, then I'm more apt to accept that their clinical experience is worth something when attempting to transition to medicine (even if the number of years/hours may be substantially less). However, no amount of experience as an RN makes up for a relative lack of clinical training for their role as providers. Those hours need to be able to stand on their own, as they should deal with being directly in charge of the assessment, plan, and overall management of that pt and their disease process. A few hundred to a thousand hours is barely a drop in the bucket, and most medical and PA students do that in the first half of their first clinical year.

emedpa said:

The pa curriculum includes > 2000 hrs of clinicals.
how many hrs for the np curriculum you posted?

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No where near as PA's 2000 hours
However, instead of spreading the hours among different specialties, NP focuses on one.

Allow me to preface my comment by saying I absolutely respect my profession and I am truly proud of the good work I do and the care I provide as a registered nurse. In spite of this, I suspect some nurses are going to look at me like Uncle Ruckus the self loathing nurse; however, this is not my intention.

First, I simply cannot see how nursing experience equates to diagnostician experience. While some nurses entering NP programs may indeed have many years of RN experience, I cannot see how this equates to "practitioner" experience. With that, the entire concept is void due to the fact that nurses with little to no experience following their core nursing education are entering APN programs. Therefore, we must consider the lowest common denominator of experience so to speak.

Next, I am not sure I agree with the specialty argument. Take a FNP for example. FNP's work in environments that include critical care, acute care, emergency medicine, primary care, internal medicine, and multiple other specialty areas. However, less than 1,000 hours of clinical experience beyond the initial RN clinical experience sufficiently covers all of these environments?

Finally, I am not sure the pre-requisite nursing educational experience is even adequate to ensure foundational concepts of pharmacology, pathophysiology, and diagnostics provide an adequate foundation. Come on guys, entry level nursing education is quite literally a mess.

I look at this whole situation like this: I am a pretty smart guy, though some may argue. I have over a decade of health care experience. I am board certified in flight and emergency nursing with a lengthy alphabet soup of initials after my name. In addition, I work in the relatively autonomous critical care transport environment where I frequently make decisions based on my assessment of labs, radiographic studies, patient history, and presentation. Yet, with all this experience, I am constantly stumped and alpha maled by other providers in real world diagnostic scenarios.

This concept was driven home when I was off by my lonesome pulling remote medical clinic support in a clinic just outside of Kabul Afghanistan. I remember having six different patients present with six different "rashes" one day. I essentially looked at pictures in a book and played the where is Waldo diagnostic game. The reality of the situation was not lost on me however. I was playing Russian roulette with people's lives. Perhaps most of the skin lesions were benign and self limiting; however, did I really know? You can bet, I was on the phone with one of our doctors every day reviewing every case in as much detail as possible.

If relatively simple problems like "rashes" can stump a smart and experienced nurse (obviously, this is rather subjective statement), will giving that nurse less than 1,000 hours of clinical experience and two years of didactic experience really produce a well rounded primary care provider?

Is that not what we are discussing here? NP's and PA's essentially taking over the role of the family or internal medicine physician in the primary care setting.

These are the ramblings of a person who is most certainly not a physician, and is not a mid level provider either. Therefore, you can take the worth of my comments any way you please.

With that, I apologize to the OP for a thread that has most certainly gone way off topic.

You are wayyyy underrepresenting a PA school curriculum.

My alma mater is 4 semesters of didactic work from 17-20 credit hours per semester, all clinical med focused, with 3 semesters of clincal rotations. lets be fair, and not represent PA school as 4 semesters long, because it not; its often 6-8 semesters....

bradt9881 said:

You are wayyyy underrepresenting a PA school curriculum.

My alma mater is 4 semesters of didactic work from 17-20 credit hours per semester, all clinical med focused, with 3 semesters of clincal rotations. lets be fair, and not represent PA school as 4 semessters long, because it not; its often 6-8 semsters....

Click to expand...

Agree. Just because they dont list each concept as its own standalone class does not mean its not being covered, even in that PA curriculum you posted above. ARC-PA ensures that all topics are covered adequately to maintain accreditation. I really dont think you want to play the curriculum posting game of PA vs NP...

This is my program:

Curriculum Outline

Year I—fall
COURSE TITLE SEMESTER HOURS
PAS 510 The Physician Assistant Profession 2
PAS 513 Human Physiology and Pathophysiology 3
PAS 515 Genetics 3
PAS 516 Primary Care Psychiatry 3
PAS 518 Clinical Pharmacology I 3
Total 14
All library modules and Medical Terminology exams must be completed during the fall semester of year one.

Year I—spring
COURSE TITLE SEMESTER HOURS
PAS 520 Clinical Pharmacology II 3
PAS 524 Gross Anatomy 5
PAS 526 Professional Practice Issues 2
PAS 528 Diagnostic Studies 2
Total 12

Year II—fall
COURSE TITLE SEMESTER HOURS
PAS 530 Principle and Practice of Primary Care Medicine 5
PAS 532 Manifestations and Management of Disease I 6
PAS 535 Electrocardiography 1
PAS 538 History and Physical Examination I 4
PAS 538L History and Physical Examination I – lab 2
Total 18

Year II—spring
COURSE TITLE SEMESTER HOURS
PAS 540 History and Physical Examination II 4
PAS 540L History and Physical Examination II–Laboratory 2
PAS 542 Manifestations and Management in Disease II 6
PAS 546 Patient Assessment 2
PAS 548 Clinical Therapeutics 4
Total 18

Beginning in the first summer session following the 2nd year, each student begins a series of required clinical clerkships for a duration of 48 weeks.
Year III Clinical Clerkships
Summer I and II, 15 s.h.
Fall Semester, 15 s.h.
Spring Semester, 15 s.h.
From the following clerkship offerings:
PASC 600 Internal Medicine Clerkship 5 s.h.
PASC 601 Pediatrics Clerkship 5 s.h.
PASC 602 Psychiatry Clerkship 5 s.h.
PASC 603 Surgery Clerkship 5 s.h.
PASC 604 Emergency Medicine Clerkship 5 s.h.
PASC 605 Women's Health Clerkship 5 s.h.
PASC 606 Ambulatory Care Clerkship 5 s.h.
PASC 607 Geriatrics and Rehabilitation Clerkship 5 s.h.
PASC 608 Elective Clerkship 5 s.h.

Total required to complete degree: 107 s.h.


Here's an NP program from the same exact school...


Year I—fall
COURSE TITLE SEMESTER HOURS
NUR 701 Professional Role Development in Nursing 3
NUR 704 Theoretical Foundations of Nursing Practice 3
NUR 706 Advanced Pathophysiology 3
Total 9

Year I—spring
COURSE TITLE SEMESTER HOURS
NUR 702 Human Diversity, Ethics, and Social Issues 3
NUR 703 Advanced Health Assessment across the Lifespan 4
NUR 707 Advanced Pharmacology 3
Total 10

Year I—summer
COURSE TITLE SEMESTER HOURS
NUR 705 Policy, Organization, and Financing of Health Care 3
NUR 708 Evaluation Research and Statistical Analysis 3
NUR 709 Education: Theory, Research, and Assessment 3
Total 9

Year II—fall
COURSE TITLE SEMESTER HOURS
NUR 801 Family Health Nursing: Theoretical Foundation 3
NUR 811 Family Health Nursing: Intervention 3
NUR 812 Family Health Nursing Practicum 3
NUR 820 Master's Thesis in Nursing 3
Total 12

Total Credits for FNP Program (40)


Garbage.

PS, here is the rest of that curriculum you posted. It's from a BS/MS program.

BS/MS Track

Course of Study for 4 1/2-year BS/MS

Pre-Professional Phase

First Year — 34 Credits

Fall
English Communication 1
Human Anatomy & Physiology w/Lab
General Chemistry w/Lab
Computers & Computing
Developmental Psychology
Spring
English Communication 2
Human Anatomy & Physiology w/Lab
General Chemistry w/Lab
Elementary Practical Statistics
Sociology
First Year Summer — 9 Credits

3 Humanities
Second Year — 34 Credits

Fall
Organic Chemistry w/Lab
Microbiology w/Lab
Ethics or Religion & Social Responsibility
Medical Terminology
Choice of PSC/ECO course
History
Spring
Biochemistry
Survey of Human Gross Anatomy
Challenges of Death
Bioethics Seminar
Pathophysiology
Second Year Summer — 9 Credits

3 Electives
Professional Phase

Third Year — 26 Credits

Fall
Clinical Medicine 1
Clinical Laboratory Medicine 1
Behavioral Medicine
Physical Diagnosis 1
Pharmacology 1
Spring
Clinical Medicine 2
Clinical Laboratory Medicine 2
Physical Diagnosis 2
Pharmacology 2 Clinical Skills
Clinical Rotations
Fourth Year — 30 Credits

The clinical rotations in the fourth year of the program will consist of rotations in the following disciplines:
Internal Medicine, 4 weeks
Family Medicine, 4 weeks
General Surgery, 4 weeks
General Pediatrics, 6 weeks
Obstetrics & Gynecology, 4 weeks
Psychiatry, 4 weeks
Emergency Medicine, 4 weeks
Orthopedics, 4 weeks
Geriatrics, 2 weeks
Fifth Year — 30 Credits

Professional Issues, Clinical Elective I, Clinical Elective II, Primary Care, Graduate Seminar I, Graduate Seminar II, Applied Research Methods, Applied Project Seminar I, Applied Project Seminar II, Choice of two of the following: Neuroanatomy, Advanced Medical Microbiology, Alternative Medicine, Medical Epidemiology

DNPDoctor said:

No where near as PA's 2000 hours
However, instead of spreading the hours among different specialties, NP focuses on one.

Click to expand...

So you fill a specific niche and healthcare and aren't a generalist. That's not necessarily a good thing since it's more generalists that society seems to need. You could always complete OJT to be a specialist.

DO2Be2013 said:

I call BS on that. There are several aspects that make no sense.

Click to expand...

I can't speak to the validity of those comments, it was an interesting comment that I had heard other NPs making at local NP society meetings. I have no direct experience with it.

What I can say with certainty is that my malpractice rate as a psych NP is less than what I pay as a psychologist. This is because in my state, as a group, NPs have had fewer claims made against them than psychologists have. Hence, the higher rates for psychologists - at least that is how my carrier explained it to me.

The nature of NP programs seems to be designed for RNs with a substantial nursing background. So why are they letting in people with 0-2 years of experience? I'd be a much bigger fan of NPs if the program was for experience RNs only.

I work with RNs every day and the ones that have been around for quite a while have pretty substantial knowledge. The new grads seems to have a massive learning curve.

Hello, I am a new member and this is admittedly my first post, but i thought i chime in on the subject with my hello. I recently graduated an acute care NP program in miami (only 2 so guess) and just thought id share my experience.

the program is pretty difficult. i ended up with about 1000 hours of clinical. more than required for graduation but the nature of the clinicals just ended up that way. Most of these were done in jackson/hollywood in various ICU settings. (my chosen specialty)

First my criticisms. i do believe in the idea that RN training/experience can be used as a stepping stone for advanced practice training, but schools need a more strict/uniform set of criteria for what constitutes RN experience. There are many badass nurses out there but we need a better process for weeding out the slackers. Get rid of the fluff and raise the minimum clinical hours.

the best part of the program were the clinicals. Jackson in miami uses a nurse practitioner intensivist team to run trauma ICU, SICU, and CVICU. These nurses were badass. They performed all sorts of ICU procedures (line placement, perc trach, CT tube placement, bronch, Peg...),intubations, managed ABX, tpn, ventilators..just about everything there MD counterparts normally do. they also took on the role of instructing the medical students and residents. The attending MD would be there durning morning rounds but there services are usually required in the OR.

Though i do feel my training was excellent, it certainly is not a replacement for MD training. The fellows at jackson know there s**t, and I was humbled by there depth of knowledge more than once. you just dont know what you dont know.

lapelirroja said:

PS, here is the rest of that curriculum you posted. It's from a BS/MS program.

BS/MS Track

Course of Study for 4 1/2-year BS/MS

Pre-Professional Phase

First Year — 34 Credits

Fall
English Communication 1
Human Anatomy & Physiology w/Lab
General Chemistry w/Lab
Computers & Computing
Developmental Psychology
Spring
English Communication 2
Human Anatomy & Physiology w/Lab
General Chemistry w/Lab
Elementary Practical Statistics
Sociology
First Year Summer — 9 Credits

3 Humanities
Second Year — 34 Credits

Fall
Organic Chemistry w/Lab
Microbiology w/Lab
Ethics or Religion & Social Responsibility
Medical Terminology
Choice of PSC/ECO course
History
Spring
Biochemistry
Survey of Human Gross Anatomy
Challenges of Death
Bioethics Seminar
Pathophysiology
Second Year Summer — 9 Credits

3 Electives
Professional Phase

Third Year — 26 Credits

Fall
Clinical Medicine 1
Clinical Laboratory Medicine 1
Behavioral Medicine
Physical Diagnosis 1
Pharmacology 1
Spring
Clinical Medicine 2
Clinical Laboratory Medicine 2
Physical Diagnosis 2
Pharmacology 2 Clinical Skills
Clinical Rotations
Fourth Year — 30 Credits

The clinical rotations in the fourth year of the program will consist of rotations in the following disciplines:
Internal Medicine, 4 weeks
Family Medicine, 4 weeks
General Surgery, 4 weeks
General Pediatrics, 6 weeks
Obstetrics & Gynecology, 4 weeks
Psychiatry, 4 weeks
Emergency Medicine, 4 weeks
Orthopedics, 4 weeks
Geriatrics, 2 weeks
Fifth Year — 30 Credits

Professional Issues, Clinical Elective I, Clinical Elective II, Primary Care, Graduate Seminar I, Graduate Seminar II, Applied Research Methods, Applied Project Seminar I, Applied Project Seminar II, Choice of two of the following: Neuroanatomy, Advanced Medical Microbiology, Alternative Medicine, Medical Epidemiology

Click to expand...

Ohhhhhh LOL. You cracked his egg wide open. High five!

ArkansasRanger said:

Ohhhhhh LOL. You cracked his egg wide open. High five!

Click to expand...

I only listed the last two years because they are part of the professional phase while the others are not.

You take most (if not more) of the things listed in the first two years in BSN (Bachelor's degree in nursing)

http://www.nursing.ecu.edu/curriculumPlan.aspx?cpid=72

Nursing Bachelor's degree

Year 1
Fall:
CHEM 1120 Basic General, Organic & Biochem. I
ENGL 1100 Composition (WI)
#MATH 1065 College Algebra
#PSYC 1000 Introductory Psychology
#SOCI 2110 Introduction to Sociology

Winter:
CHEM 1130 Basic General, Organic Biochem. II
ENGL 1200 Composition (WI)
#EXSS 1000 Lifetime Physical Activity and Fitness
#HLTH 1000 Health in Modern Society
#Humanities/Fine Arts Elective (Ethics)**
#Free Elective
ASIP 2000 Intro to Computer Literacy*

2nd year:
Fall:
BIOL 2140 Human Physiology & Anatomy I
BIOL 2141 Human Physiology & Anatomy Lab I
#PSYC 3206 Developmental Psychology
#Statistics (Math or Psyc)
#Humanities/Fine Arts Elective
Humanities/Fine Arts Elective

Winter:
BIOL 2110 Fundamentals of Microbiology
BIOL 2111 Fundamentals of Microbiology Lab
BIOL 2150 Human Physiology & Anatomy II
BIOL 2151 Human Physiology & Anatomy Lab II
#Humanities/Fine Arts Elective
#Social Science Elective
NUTR 2105 Nutrition

Year 3:
Fall:
NURS 3200 Introduction to Professional Nursing
NURS 3270 Clinical Nursing Foundations I
NURS 3271 Clinical Nursing Foundations I Practicum
NURS 3210 Nurse as Care Provider
NURS 3211 Nurse as Care Provider Practicum
NURS 3020 Health Assessment
NURS 3021 Health Assessment Lab
NURS 3410 Concepts of Pathophysiology for Nursing

Winter:
NURS 3040 Pharmacotherapeutics for Nursing
NURS 3330 Nursing Care of Families During the Childbearing Phase
NURS 3331 Nursing Care of Families During the Childbearing Phase Practicum
NURS 3340 Nursing Care of Children
NURS 3341 Nursing Care of Children Practicum
NURS 3370 Clinical Nursing Foundations II
NURS 3371 Clinical Nursing Foundations II Practicum

Spring:
##NURS 3510 Nursing Research
##NURS 3520 Trends and Issues in Professional Nursing

4th year:
Fall:
NURS 4010 Nursing Care of Clients with Alterations in Mental Health
NURS 4011 Nursing Care of Clients with Alterations in Mental Health Practicum
NURS 4020 Nursing Care of Adults
NURS 4021 Nursing Care of Adults Practicum
NURS 4100 Health of the Older Adult
NURS 4150 Nursing Leadership

Winter:
NURS 4210 Nursing Care of Populations and Communities
NURS 4211 Nursing Care of Populations and Communities Practicum
NURS 4500 Theory Capstone
NURS 4511 Clinical Capstone

High Five!

What you did, was cherry pick a bachelors program's last 2 years when the complete picture is more appropriately over 4.

Not a very good way to go head to head to compare a MS NP program to a BS PA program.

As we have already pointed out to you, the curriculum for most PA programs is much longer, and much more in depth than you have represented here. Here is the link to the Methodist University Master's program:


http://www.methodist.edu/paprogram/curriculum.htm

Compare it to the MS program you cited. Which has more of a clinical focus?

Take that back to allnurses and choke on it.

bradt9881 said:

What you did, was cherry pick a bachelors program's last 2 years when the complete picture is more appropriately over 4.

Not a very good way to go head to head to compare a MS NP program to a BS PA program.

As we have already pointed out to you, the curriculum for most PA programs is much longer, and more more in depth than you have represented here. Here is the link to the Methodist University Master's program:


http://www.methodist.edu/paprogram/curriculum.htm

Take that back to allnurses and choke on it.

Click to expand...

That's a nice curriculum.
Good for you

acuteNP said:

Hello, I am a new member and this is admittedly my first post, but i thought i chime in on the subject with my hello. I recently graduated an acute care NP program in miami (only 2 so guess) and just thought id share my experience.

the program is pretty difficult. i ended up with about 1000 hours of clinical. more than required for graduation but the nature of the clinicals just ended up that way. Most of these were done in jackson/hollywood in various ICU settings. (my chosen specialty)

First my criticisms. i do believe in the idea that RN training/experience can be used as a stepping stone for advanced practice training, but schools need a more strict/uniform set of criteria for what constitutes RN experience. There are many badass nurses out there but we need a better process for weeding out the slackers. Get rid of the fluff and raise the minimum clinical hours.

the best part of the program were the clinicals. Jackson in miami uses a nurse practitioner intensivist team to run trauma ICU, SICU, and CVICU. These nurses were badass. They performed all sorts of ICU procedures (line placement, perc trach, CT tube placement, bronch, Peg...),intubations, managed ABX, tpn, ventilators..just about everything there MD counterparts normally do. they also took on the role of instructing the medical students and residents. The attending MD would be there durning morning rounds but there services are usually required in the OR.

Though i do feel my training was excellent, it certainly is not a replacement for MD training. The fellows at jackson know there s**t, and I was humbled by there depth of knowledge more than once. you just dont know what you dont know.

Click to expand...

Nice post.
I can see NP program lengthening its clinical portion in the future while focusing all of its clinical hours on a single specialty.

DNPDoctor said:

I only listed the last two years because they are part of the professional phase while the others are not.

You take most (if not more) of the things listed in the first two years in BSN (Bachelor's degree in nursing)

http://www.nursing.ecu.edu/curriculumPlan.aspx?cpid=72

Nursing Bachelor's degree

Year 1
Fall:
CHEM 1120 Basic General, Organic & Biochem. I
ENGL 1100 Composition (WI)
#MATH 1065 College Algebra
#PSYC 1000 Introductory Psychology
#SOCI 2110 Introduction to Sociology

Winter:
CHEM 1130 Basic General, Organic Biochem. II
ENGL 1200 Composition (WI)
#EXSS 1000 Lifetime Physical Activity and Fitness
#HLTH 1000 Health in Modern Society
#Humanities/Fine Arts Elective (Ethics)**
#Free Elective
ASIP 2000 Intro to Computer Literacy*

2nd year:
Fall:
BIOL 2140 Human Physiology & Anatomy I
BIOL 2141 Human Physiology & Anatomy Lab I
#PSYC 3206 Developmental Psychology
#Statistics (Math or Psyc)
#Humanities/Fine Arts Elective
Humanities/Fine Arts Elective

Winter:
BIOL 2110 Fundamentals of Microbiology
BIOL 2111 Fundamentals of Microbiology Lab
BIOL 2150 Human Physiology & Anatomy II
BIOL 2151 Human Physiology & Anatomy Lab II
#Humanities/Fine Arts Elective
#Social Science Elective
NUTR 2105 Nutrition

Year 3:
Fall:
NURS 3200 Introduction to Professional Nursing
NURS 3270 Clinical Nursing Foundations I
NURS 3271 Clinical Nursing Foundations I Practicum
NURS 3210 Nurse as Care Provider
NURS 3211 Nurse as Care Provider Practicum
NURS 3020 Health Assessment
NURS 3021 Health Assessment Lab
NURS 3410 Concepts of Pathophysiology for Nursing

Winter:
NURS 3040 Pharmacotherapeutics for Nursing
NURS 3330 Nursing Care of Families During the Childbearing Phase
NURS 3331 Nursing Care of Families During the Childbearing Phase Practicum
NURS 3340 Nursing Care of Children
NURS 3341 Nursing Care of Children Practicum
NURS 3370 Clinical Nursing Foundations II
NURS 3371 Clinical Nursing Foundations II Practicum

Spring:
##NURS 3510 Nursing Research
##NURS 3520 Trends and Issues in Professional Nursing

4th year:
Fall:
NURS 4010 Nursing Care of Clients with Alterations in Mental Health
NURS 4011 Nursing Care of Clients with Alterations in Mental Health Practicum
NURS 4020 Nursing Care of Adults
NURS 4021 Nursing Care of Adults Practicum
NURS 4100 Health of the Older Adult
NURS 4150 Nursing Leadership

Winter:
NURS 4210 Nursing Care of Populations and Communities
NURS 4211 Nursing Care of Populations and Communities Practicum
NURS 4500 Theory Capstone
NURS 4511 Clinical Capstone

High Five!

Click to expand...

Yeah, but RN studies are just that - RN studies. Nurses will be quick to tell you that they don't diagnose nor practice medicine so how can that actually be preparation for advanced medical practice which is what an NP is technicall doing isnt she/he? It's understood that the basic studies classes are going to be involved somewhere. Heck, I took all the first and second year stuff in your BSN curriculum, and I wasn't even studying anything clinically oriented. I was a general science major. They were just fun electives for me.

Also, please define for me "Nursing Care." I don't know what it means, and I don't think anyone really does. I posed this question the other day. It's not treating disease, and nurses now seem to detail it as more psychosocial support than anything else although sick people need medical treatment not psychosocial support. Maslow's pyramid even suggests that. You've got to have air and water before you can have self-actualization. See a doctor. Then see a social worker. I must also add that other things equal, (same time and space) if I were in college all over again, and this was the year 2000 I'd major in RN/BSN stuff in addition to my paramedic hobby classes I did at night. I just don't know what nurses are actually learning in "nursing care." I'd only do nursing because there are elements in there that are interesting, plus it's a marketable skill. I looked up a syllabus the other day and it specified what topics would generally be covered in Med/Surg I and II, but again I don't grasp "nursing care." Why isn't it just something like treatment of the surgical/medical patient. ?????

ArkansasRanger said:

Yeah, but RN studies are just that - RN studies. Nurses will be quick to tell you that they don't diagnose nor practice medicine so how can that actually be preparation for advanced medical practice which is what an NP is technicall doing isnt she/he?

Click to expand...

I guess the only way for you to find out is to actually go through the nursing program

What are you studying?

ArkansasRanger said:

Also, please define for me "Nursing Care." I don't know what it means, and I don't think anyone really does. I posed this question the other day. It's not treating disease, and nurses now seem to detail it as more psychosocial care than anything else although sick people need medical treatment not psychosocial support. Maslow's pyramid even suggests that. You've got to have air and water before you can have self-actualization. See a doctor. Then see a social worker.

Click to expand...

You don't know what it means because you're not in nursing, and you haven't studied the nursing courses provided by the BSN program.

From the posts that I have been reading, I don't think you've done proper research on the nursing programs. A lot of your writing shows ignorance.

Answer the question below, and you'll find the answer to your question.

What does a nurse do?

http://lmgtfy.com/?q=nursing+care

ArkansasRanger said:

I must also add that other things equal, (same time and space) if I were in college all over again, and this was the year 2000 I'd major in RN/BSN stuff in addition to my paramedic hobby classes I did at night. I just don't know what nurses are actually learning in "nursing care." I'd only do nursing because there are elements in there that are interesting, plus it's a marketable skill. I looked up a syllabus the other day and it specified what topics would generally be covered in Med/Surg I and II, but again I don't grasp "nursing care." Why isn't it just something like treatment of the surgical/medical patient. ?????

Click to expand...

Good luck doing paramedic courses while being in a RN program.

Nursing program is not like what it has been back 10-20-30-40-100 years ago.
It is constantly evolving.

It's sad sacrificing most of your free time during the nursing school, only to graduate and find people ridiculing the profession and disrespecting hard working nurses who are caring for others.

Maybe you should buy nursing textbooks from your local college book store. It may help you understand better.




If some of you are trying to destroy the other profession or bicker about it (to fulfill your own agenda?), feel free to go for it.

I simply don't care anymore.

Life is too short to be angry and bickering about turf wars.

It's not my time that you're wasting.

DNPDoctor said:

Good luck doing paramedic courses while being in a RN program.

Click to expand...

Totally doable. I came to medicine through EMS, and plenty of my colleagues did just that.

DNPDoctor said:

You don't know what it means because you're not in nursing, and you haven't studied the nursing courses provided by the BSN program.

Click to expand...

Half my friends are nurses, and they can't define "nursing care" either.

psychbender said:

Half my friends are nurses, and they can't define "nursing care" either.

Click to expand...

lol

If they can't, that's really sad.

Are they registered nurses?

psychbender said:

Totally doable. I came to medicine through EMS, and plenty of my colleagues did just that.

Click to expand...

Not so sure about this. Most of the Paramedic programs I've seen are full time. I think it would be a pretty tough to be taking paramedic while taking a full time nursing program. Also why would you do both at once? To make the medic worthwhile you really need to work as a medic for a year or two. Having gone through the class isn't nearly as valuable as having worked as a medic for a few years. I could see doing medic first and a few years later doing RN or PA. But taking both classes at once would be pretty tough to swing, especially since neither program likes to hear "oh, I can't go to that required activity because I have a required class for my other class."

DNPDoctor said:

I guess the only way for you to find out is to actually go through the nursing program

What are you studying?

I graduated college six years ago.

You don't know what it means because you're not in nursing, and you haven't studied the nursing courses provided by the BSN program.

From the posts that I have been reading, I don't think you've done proper research on the nursing programs. A lot of your writing shows ignorance.

I asked the questions on allnurses.com and the statements I've given here are a direct response to the answers provided there, and I must say they were all answers showing ignorance.

Answer the question below, and you'll find the answer to your question.

What does a nurse do?

Well, let's see I know nurses change bed sheets, fluff pillows, give shots, take notes, hmmm I could go on from what I've seen in observation.

http://lmgtfy.com/?q=nursing+care



Good luck doing paramedic courses while being in a RN program.

There was a girl in the paramedic program ahead of me, the program I also finished six years ago that I completed while completing a B.S. in an unrelated field, did both simultaneously.

Nursing program is not like what it has been back 10-20-30-40-100 years ago.
It is constantly evolving.

As is any profession.

It's sad sacrificing most of your free time during the nursing school, only to graduate and find people ridiculing the profession and disrespecting hard working nurses who are caring for others.

I didn't have any free time in school either since I took a full course load at two different colleges at the same time. No sympathy.

Maybe you should buy nursing textbooks from your local college book store. It may help you understand better.

Nah. I'll just ask on forums and "do the Google."



If some of you are trying to destroy the other profession or bicker about it (to fulfill your own agenda?), feel free to go for it.

No, I'm just curious. You're the one that took offense for some reason.

I simply don't care anymore.

Life is too short to be angry and bickering about turf wars.

It's not my time that you're wasting.

Click to expand...

I have way too much free time personally. That's why I'm here, lol.

DNPDoctor said:

lol

If they can't, that's really sad.

Are they registered nurses?

Click to expand...

Yes, they are all RNs from a mixture of BSN and ADN programs. Most of them take it as just one of the many nebulous fuzzy terms that they were forced to learn for class, then promptly forgot once they entered the real world.

Not so sure about this. Most of the Paramedic programs I've seen are full time. I think it would be a pretty tough to be taking paramedic while taking a full time nursing program. Also why would you do both at once? To make the medic worthwhile you really need to work as a medic for a year or two. Having gone through the class isn't nearly as valuable as having worked as a medic for a few years. I could see doing medic first and a few years later doing RN or PA. But taking both classes at once would be pretty tough to swing, especially since neither program likes to hear "oh, I can't go to that required activity because I have a required class for my other class."

Click to expand...

For most, they started as EMT-Bs, then got accepted to nursing school. While in nursing school, they began an ALS program (generally evening/night classes), and scheduled their medic clinicals so as not to interfere with their nursing classes and clinicals. In my area, most people in EMS have a second full-time job, so most of the training programs are very flexible when it comes to scheduling your clinicals. Now, they all work as RNs in the ED, and run as medics on their off time. It has really helped getting hospital buy-in when we wanted to do something new that would require their cooperation.

jbar said:

Not so sure about this. Most of the Paramedic programs I've seen are full time. I think it would be a pretty tough to be taking paramedic while taking a full time nursing program. Also why would you do both at once? To make the medic worthwhile you really need to work as a medic for a year or two. Having gone through the class isn't nearly as valuable as having worked as a medic for a few years. I could see doing medic first and a few years later doing RN or PA. But taking both classes at once would be pretty tough to swing, especially since neither program likes to hear "oh, I can't go to that required activity because I have a required class for my other class."

Click to expand...

This was all hypothetical again about doing RN and EMTP, however, as I said, if this were the year 2000 that's what I'd be doing.

I got my B.S. in general science (biology really) at the exact same time (2003) I got my paramedic coursework completed. I never filed for earning the associate's degree that came with it, however. I literally took double the courseload allowable for four sememsters because I was enrolled in the paramedic program, with subsequent 4.0, while pursuing the normal college stuff at a state university an hour from there by day. Challenging and fun. Two schools. Same time. Neither program knew I was enrolled in the other.

The RN student that I know in medic school was allowed to cross count certain skills. Like doing IVs for example. Both programs required a certain number of venipunctures, and the medic instructor let her use those documented in nursing school and so forth.

Say no more! Wikipedia has spoken.

http://en.wikipedia.org/wiki/Nursing_care

Summarily, Wiki says nursing care is five things: 1) infection control, 2) records, 3) vital signs, 4) medication, and 5) diet.

Finally I know.

Some of the catch phrases on that page are custard, advanced practice nurse, bowel movements, charts, and alcohol gel.

The link that the kind Doctor Nurse pointed me to my answer. Thank you!

Below is a link to the "process of nursing." Note the acronym ADPIE. I guess VINDICATE can go by the way side.

http://en.wikipedia.org/wiki/Nursing_process