Confused on route to take....

[pacjeffery]

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Hello all. I am 38 years old. I've been a CNA for 3 years now. This fall I am taking EMT & AEMT in the spring. Also currently in A&P 1 (taking part 2 & Micro fall). By May 2014 I'll have done basic science prerequisites. I have a BA in Chemistry (1997).

Not sure what path to take. RN, NP, PA, MD/DO (time?) or another allied health position. I understand to be a NP one must be an RN first. With whatever I choose I'd like to be around the family practice setting or an ED. I'm not overly concerned about pay because if I work hard it'll be there. I just want something I can do for 25-30 years and support my twin boys (due this September).

Currently I'm leaning towards PA. Possibly in an ED. Also with AEMT certification & RN I looked into flight nursing (with experience of course). And if it helps I'm relocating back to southern California.

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[Dynamo24]

Hello all. I am 38 years old. I've been a CNA for 3 years now. This fall I am taking EMT & AEMT in the spring. Also currently in A&P 1 (taking part 2 & Micro fall). By May 2014 I'll have done basic science prerequisites. I have a BA in Chemistry (1997).

Not sure what path to take. RN, NP, PA, MD/DO (time?) or another allied health position. I understand to be a NP one must be an RN first. With whatever I choose I'd like to be around the family practice setting or an ED. I'm not overly concerned about pay because if I work hard it'll be there. I just want something I can do for 25-30 years and support my twin boys (due this September).

Currently I'm leaning towards PA. Possibly in an ED. Also with AEMT certification & RN I looked into flight nursing (with experience of course). And if it helps I'm relocating back to southern California.

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I'm a little confused, in your last thread you sounded like you were firm in your choice of PA. My recommendation is to shadow, ask questions, research, make a decision.

 

[pacjeffery]

I want to do that. I'm concerned about the two-year gap of no working. Just want to make sure I'm doing what's best for my two boys (financially).

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[sarjasy]

I'm concerned about the two-year gap of no working. Just want to make sure I'm doing what's best for my two boys (financially).

You just need to crunch the numbers, and include calculations that factor in when you'll will start earning higher salaries. PA may require 2.5 years of no income, but you'll start earning PA money 2 or more years sooner that going the nursing route in many cases. If it takes you 4 years to become an NP vs. 2.5 years to become a PA, that's an additional 1.5 years which translates into over $100K.

 

[pamac]

You just need to crunch the numbers, and include calculations that factor in when you'll will start earning higher salaries. PA may require 2.5 years of no income, but you'll start earning PA money 2 or more years sooner that going the nursing route in many cases. If it takes you 4 years to become an NP vs. 2.5 years to become a PA, that's an additional 1.5 years which translates into over $100K.

I worked my way through nursing school, and plan on workIng through NP school. My NP school will be considerably cheaper than PA school (around 30k total cost) and my work will pay for a good chunk of it.

 

[sarjasy]

I worked my way through nursing school, and plan on workIng through NP school. My NP school will be considerably cheaper than PA school (around 30k total cost) and my work will pay for a good chunk of it.

It is no doubt possible, but it can be tough. A 2 year ADN program can allow for work, but many BSN programs leave little time for work outside. Likewise, an NP program that can be gotten through in two years also makes anything more than part-time work difficult. Going NP for a non-nurse usually takes a minimum of 4 years and to do it in 4 years, you're not going to be working a ton and the OP is a CNA right now, so his lost earning potential as a PA is even more magnified. Going a slower pace of 5-6 years while working some as an RN for NP is an option, but lost earning potential is still a large factor.

There are numerous options going the NP route, but it depends on the programs available to the OP. Some combinations are accelerated ADN or BSN then part-time NP while working as an RN, direct entry NP (not recommended, and is still longer than PA), traditional ADN while working as a CNA then part-time NP while working as an RN, etc. That's why he needs to crunch numbers taking into account the income he can earn during school but also how soon he can earn higher NP or PA salaries. In many cases (not all), PA still makes the most since financially because you earn that higher salary sooner even when high tuition rates and 2.5 years of no income are accounted for.

People seem to ignore lost future income when making these decisions. They only look at how much they can or can't work during school and how much tuition is. But graduating 2 years later going one route vs. another will cost you $150K+ in lost earnings. Earning $10-30 hr working 16 hours a week while in school and/or a $40K difference in tuition is trivial in comparison.

 

[Dynamo24]

Don't underestimate your chances for scholarships and grants as a non-trad with children.

 

[pamac]

It is no doubt possible, but it can be tough. A 2 year ADN program can allow for work, but many BSN programs leave little time for work outside. Likewise, an NP program that can be gotten through in two years also makes anything more than part-time work difficult. Going NP for a non-nurse usually takes a minimum of 4 years and to do it in 4 years, you're not going to be working a ton and the OP is a CNA right now, so his lost earning potential as a PA is even more magnified. Going a slower pace of 5-6 years while working some as an RN for NP is an option, but lost earning potential is still a large factor.

There are numerous options going the NP route, but it depends on the programs available to the OP. Some combinations are accelerated ADN or BSN then part-time NP while working as an RN, direct entry NP (not recommended, and is still longer than PA), traditional ADN while working as a CNA then part-time NP while working as an RN, etc. That's why he needs to crunch numbers taking into account the income he can earn during school but also how soon he can earn higher NP or PA salaries. In many cases (not all), PA still makes the most since financially because you earn that higher salary sooner even when high tuition rates and 2.5 years of no income are accounted for.

People seem to ignore lost future income when making these decisions. They only look at how much they can or can't work during school and how much tuition is. But graduating 2 years later going one route vs. another will cost you $150K+ in lost earnings. Earning $10-30 hr working 16 hours a week while in school and/or a $40K difference in tuition is trivial in comparison.

True enough. Unless its an accelerated bsn, it's arguable whether one would be busier than an ADN program. There is a reason ADN to bsn bridges are a cake walk... It's because the bsn can be filled with fluff. Accelerated programs (which would make more sense to the OP) would take a lot out if your day.

If a person had prereqs close to being done and had a decent shot at getting into a PA program on the first try, then it makes a lot of sense to do PA. But that year between cycles can be killer. Every attempt that you don't land a seat sets you back considerably. A lot of times that doesn't enter the equation either. There are folks out there spinning their wheels taking or retaking prereqs that aren't necessarily moving them toward anything concrete. The op sounds more squared away, though.

 

[pamac]

Don't underestimate your chances for scholarships and grants as a non-trad with children.

Can't rely on those showing up, though. At least in the case of PA school, you generally are dealing with schools that are so expensive, and talent pools that are filled with so many sharp people, that those are also a drop in the bucket. Loans will be the primary provider of funds.

And non traditionals are less non traditional now that a tough economy is putting more older workers back in the market for school.

 

[pacjeffery]

I do gravitate towards the PA. But in retrospect I should be saying I want to be a mid-level provider and am not sure which is more commensurate with raising twin infant boys. By the time I'm done with either route they'll be going on 4 years old.

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[pamac]

I do gravitate towards the PA. But in retrospect I should be saying I want to be a mid-level provider and am not sure which is more commensurate with raising twin infant boys. By the time I'm done with either route they'll be going on 4 years old.

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Both would be great. I assume you are trying to figure out which one will work for you as far as raising them and training for your career. Both options will impact you in different ways. PA school will take up all the time you would put into working and going to school, but it's 2 years and you are out makin cash. I'm assuming you'll have support from a spouse who will primarily take care of the twins while you do school and clinical. You'll be busy, but folks deal wih that all the time. Tons of pa students have kids. So you'll have to juggle new babies just like them, so nothing there is remarkable. You'd have to deal with time away from them if you juts had a full time job.

If you go nursing, you might be tempted to try to work in order to make a little bit of money and pay the bills as you go. In that case, I don't know that you would work enough to really make it worth your while. It's like a three legged stool.... The more you take from any one leg, the more unbalanced things become. I'd venture to say that between work and nursing school, that would leave little time to devote to family. It was worth it to work for me because a) I made decent money, b) my boss was extremely accomidating as far as scheduling, and c) all of the places I needed to be (work, school, clinical, and home) were all very close by (within 5 miles). I also have no children yet, and a wife that not only worked very nearby, but also is in the medical field, so she knows what kind of support I needed. This was my window of opportunity, so I took it.

The price you pay for a career as a PA is money... It can be expensive. But so can an accelerated bachelors degree at a for profit school, and an NP degree. But I factored in lost income into my equation, and once again, my lab job paid well enough that my numbers were skewed more than they would have been had I made less. I'd honestly just go to PA school if I were you, provided you can get in in the first application. If your grades and appeal to a program are low, and you won't get right in, I'd go nursing.

 

[pacjeffery]

As it stands, I'm prepared to go either route. For the sake of time, I'll most likely take whomever accepts me first. The difference in money over the next 25 years is roughly $70k (in favor of the PA route).

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[Dynamo24]

Can't rely on those showing up, though. At least in the case of PA school, you generally are dealing with schools that are so expensive, and talent pools that are filled with so many sharp people, that those are also a drop in the bucket. Loans will be the primary provider of funds.

And non traditionals are less non traditional now that a tough economy is putting more older workers back in the market for school.

I agree, but having kids is a huge factor for grants, so I would bet he could get some free money each year.

 

[sarjasy]

I agree, but having kids is a huge factor for grants, so I would bet he could get some free money each year.

Maybe in undergrad, not so much in grad school to my knowledge. If he were to do an ADN or BSN, already having a BS can hurt you as well with regard to aid (loans, grants).

 

[sarjasy]

I do gravitate towards the PA. But in retrospect I should be saying I want to be a mid-level provider and am not sure which is more commensurate with raising twin infant boys. By the time I'm done with either route they'll be going on 4 years old.

As for which educational path is more compatible with family time, you'll have 2-2.5 years of being slammed in PA school with not much time. Accelerated RN, 1-1.5 years of little free time + NP school of which you can dictate the speed and thus have more family time, but you are just spreading out the misery over time. 🙂

As for which career is better in regard to family, it depends entirely on what kind of job you take and where, and there is tremendous variability. There are part-time NP/PA's and there are those that work 60+ hours a week (and everything in between). I seem to hear of more PA's being required to work longer hours, but that is purely anecdotal. It also depends on your specialty, e.g. if you work ER or inpatient you may be doing nights and weekends.

 

[pamac]

Maybe in undergrad, not so much in grad school to my knowledge. If he were to do an ADN or BSN, already having a BS can hurt you as well with regard to aid (loans, grants).

That's true... A lot of grants and subsidized loans dry up when you are looking at obtaining a second degree. Then it's on to private loans.

And spreading out the misery as, sarjasy mentions, is a good description of what it's like. If I had pursued PA school, I'd probably be practicing right now with no monkey on my back as far as schooling. Instead, Im working (at a good wage and with no debt) and gearing up for NP school. School always weighs heavy on me, because I know that I can always do more to study. That means its on my mind a lot more than just working. I look forward to the day when school assignment deadlines don't weigh over me. My lifestyle has been such that I've always been able to afford cool trips, but I also bring a backpack with books and a laptop to study and do coursework on the road. Not as cool as letting everything go.

I think at this point, you really should drop the focus on the fine points of lifetime income and see what profession you actually want to align with based on personality. There are differences between both. Even though in many functions, an NP and PA are interchangeable, there are some differences that may matter to you. To me... One thing was independent practice. I personally like the possibility of having the option to practice solo if I find I need to. It may be limited or unfeasable, but it's a safety measure not to have to place your entire livelyhood on the back of another provider and their whims. Another thing I like about NP is the nursing aspect. I actually like the notion of having to be an RN before moving on to another function. It means I have a good grasp of what's going on around me in the healthcare environment. Once I'm a provider, ill be able to function in 3 different career fields if I have to. If I need to function as a nurse for a spell, I can fall back on nursing. But that's specific to me, and you might have some things that meet your specific situation.