Advice/Opinions on PA, NP, or CRNA

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erchick85

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I'm thinking of either becoming a PA, NP, or CRNA. I have worked in the ER as a tech for 2 years and I know I love a fast paced setting so I'm thinking either emergency med, surgery (love ortho), or the CRNA route. I'm afraid that as a NP I will get pidgeon-holed into fam practice or ob-gyne. But nursing is very versatile and if I decide I don't like it I could always move into management, forensics, teaching, ect. And I have heard that NP jobs are easier to come by than PA jobs. A CRNA sounds like a pretty sweet gig. A PA would be easier to get since I already have my bs in bio, whereas nursing I would have to do an absn program then the np program.

So...any opinions or advice would be more than welcome. Thanks.

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I'm thinking of either becoming a PA, NP, or CRNA. I have worked in the ER as a tech for 2 years and I know I love a fast paced setting so I'm thinking either emergency med, surgery (love ortho), or the CRNA route. I'm afraid that as a NP I will get pidgeon-holed into fam practice or ob-gyne. But nursing is very versatile and if I decide I don't like it I could always move into management, forensics, teaching, ect. And I have heard that NP jobs are easier to come by than PA jobs. A CRNA sounds like a pretty sweet gig. A PA would be easier to get since I already have my bs in bio, whereas nursing I would have to do an absn program then the np program.

So...any opinions or advice would be more than welcome. Thanks.

Th PA route sounds best for you since you are far closer to getting to a paycheck and doing what you want. There is good flexibility too as a PA. NP tends to be limited to the program you are in and the kind of RN you are. CCRN is not an alternative to the ER if you like the ER. And, the job market is excellent for both good PAs and NPs equally.

If you have 2000 hrs paid med experience, then you can already apply to most if not all PA programs.
 
Th PA route sounds best for you since you are far closer to getting to a paycheck and doing what you want. There is good flexibility too as a PA. NP tends to be limited to the program you are in and the kind of RN you are. CCRN is not an alternative to the ER if you like the ER. And, the job market is excellent for both good PAs and NPs equally.

If you have 2000 hrs paid med experience, then you can already apply to most if not all PA programs.

Just for clarification, CCRN is a certification exam for nurses working in critical care areas; it's not the same thing as CRNA.

If you like critical care and want to do advanced practice nursing, you can go the acute care nurse practitioner route (ACNP). You don't have to do FNP.

What you need to ask yourself is how much time you want to invest in going to school and do you really want the option of independent practice. There are numerous threads about the levels of independence you can have as a PA, and I will defer to people like emedpa and core-0 to address that since they are PAs. Many NPs don't want to work independently even though it is an option. There has been a recent push for this from certain members of nursing academia, but that doesn't mean that all NPs are in favor of it.

PA school would probably be a shorter pathway, but I am in no way suggesting it would be easier. Nursing makes you do more BS, so it takes longer, unless you already have a bachelor's degree; then you can go through an accelerated program.

PAs are educated in the medical model. NPs are educated in the nursing model.. There are benefits and negatives to both. Who do you find yourself gravitating toward in the ED? The doc or the nurses? That might be one clue to tell you which path would be more satisfying.

Search this forum; you'll find lots of info.
 
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I'm thinking of either becoming a PA, NP, or CRNA. I have worked in the ER as a tech for 2 years and I know I love a fast paced setting so I'm thinking either emergency med, surgery (love ortho), or the CRNA route. I'm afraid that as a NP I will get pidgeon-holed into fam practice or ob-gyne. But nursing is very versatile and if I decide I don't like it I could always move into management, forensics, teaching, ect. And I have heard that NP jobs are easier to come by than PA jobs. A CRNA sounds like a pretty sweet gig. A PA would be easier to get since I already have my bs in bio, whereas nursing I would have to do an absn program then the np program.

So...any opinions or advice would be more than welcome. Thanks.

If you look at the areas that you have listed PA would be the better path. Surgery (especially ortho) is almost completely dominated by PAs. More and more ER positions (not urgent care/fast track) seem to be going to PAs because of limitations on nursing certification. As far as CRNA you are looking at a BSN then at least one year of critical care experience before you can even apply. You could also look at AA if you already have your BS. There is also a PA/ AA bridge program but I have a hard time with the opportunity cost.

David Carpenter, PA-C
 
If you look at the areas that you have listed PA would be the better path. Surgery (especially ortho) is almost completely dominated by PAs. More and more ER positions (not urgent care/fast track) seem to be going to PAs because of limitations on nursing certification. As far as CRNA you are looking at a BSN then at least one year of critical care experience before you can even apply. You could also look at AA if you already have your BS. There is also a PA/ AA bridge program but I have a hard time with the opportunity cost.

David Carpenter, PA-C

David,
sorry to hijack the thread, but could you elaborate more on the above in bold?

Thanks
 
Just for clarification, CCRN is a certification exam for nurses working in critical care areas; it's not the same thing as CRNA.

If you like critical care and want to do advanced practice nursing, you can go the acute care nurse practitioner route (ACNP). You don't have to do FNP.

What you need to ask yourself is how much time you want to invest in going to school and do you really want the option of independent practice. There are numerous threads about the levels of independence you can have as a PA, and I will defer to people like emedpa and core-0 to address that since they are PAs. Many NPs don't want to work independently even though it is an option. There has been a recent push for this from certain members of nursing academia, but that doesn't mean that all NPs are in favor of it.

PA school would probably be a shorter pathway, but I am in no way suggesting it would be easier. Nursing makes you do more BS, so it takes longer, unless you already have a bachelor's degree; then you can go through an accelerated program.

PAs are educated in the medical model. NPs are educated in the nursing model.. There are benefits and negatives to both. Who do you find yourself gravitating toward in the ED? The doc or the nurses? That might be one clue to tell you which path would be more satisfying.

Search this forum; you'll find lots of info.

I have fat fingers or brain cramp, I meant CRNA not CCRN.
 
David,
sorry to hijack the thread, but could you elaborate more on the above in bold?

Thanks
We have discussed the idea of opportunity cost but for those unfamiliar with it it is the value of benefits of some other thing that might be done with your time. EMEDPA did an analysis of the cost of a PA going to medical school. For a PA the cost is the cost of medical school plus the cost of not working as a PA during medical school plus the difference in salary between a PA and a resident. Usually you can look at this as the number of years it would take you to make up the money. For example if EMEDPA made $100k a year and medical school cost $25k per year then the opportunity cost of four years of medical school would be $500k (these numbers are for demonstration purposes only). For residency if the salary was $50k per year then the opportunity cost would be a further $150k. So if you were looking for a six year payback you would have to make $150k more per year to make up for the opportunity cost for attending medical school and residency.

Now look at the case of PA school and AA school. The average salary here is closer but the time is less. You are looking at two years and a cost of school. I don't see the costs of PA-C track but the average debt for the AA track is $73k. If you are making average PA salary of $85k then the opportunity cost is around $250k or so. The issue with movement for a PA to AA is that unlike moving from PA to EM for example the salary scales of the AA and the PA overlap. The starting salary of the AA is higher at an estimate $95k-120k (according to the AMA) but that is within the 75% of experienced PA salaries. The 90% are similar and if you look at high paid specialties it is possible to do better. So if you are looking at the difference between average PA salary and say $110k it would take 10 years just to make back the money spent on moving to AA.

Now there are other reasons beside money to move profession. Classic economic theory looks only at monetary cost. You also have to consider the scope of practice and locality.

David Carpenter, PA-C
 
As a PA do you feel like you're overworked and underpaid (I know everyone in healthcare feels this way, but do you think it applies more to PAs)? I know it varies where you work and who you work for, but do you sometimes feel like the MDs bitch? I already have that feeling with my job now and I couldn't go through life like that. Thanks for all the input!
 
If a PA feels that way, they have the option of quietly finding another job. Plenty of people have horror stories about working with/ working for an MD who just didn't catch on to how and why it benefits them to treat a PA as a colleague and an asset to the group. Those stories are almost always in the past tense.
 
I think it's best to spend time with midlevels and talk about their careers, shadow them at work... see for yourself what the career is about and which one really fits your way of life. You'll know what to do.

Really knowing who you are and why you're heading a particular direction is not only good wisdom, it's also very helpful in getting accepted into a program!
 
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