I think there are few significant differences between NP vs PA in terms of career after clinical work. This is because BSN RNs and even practicing NPs are pursuing DNPs in much greater numbers now. This route is significantly more flexible than typical MSN NP, even if it is debatable whether it pays significantly more.
This is because a DNP has a quite a few more administrative roles that can be filled versus an MSN NP or PA. Just in case you decide that you don't want to stay clinical your entire life, DNPs can pretty easily pursue numerous administration, leadership, research and education roles. Examples that are fairly common are head nurses and nurse executives, patient administration, patient safety, informatics, ethics, JC (formerly JACAHO) committees, hospital protocol groups, bed coordinator, teaching, research committees, etc. It's true that many of these roles are currently filled with BSN or MSN RNs with experience combined with some certs. (Usually the leadership nursing roles are filled by BSNs with an MBA or MHA, or an MSN with an administration focus), however, I'm seeing more and more of these roles being filled by DNPs, either with an administration focus, or DNPs that practiced clinically for a while and then stepped into the role later. More and more, DNPs are being preferred as clinical instructors at graduate universities since it's deemed that DNP students should be taught by doctorate level nurses rather than master level nurses. In fact, there is a trend now of giving DNP nurses tenure for positions that traditionally only PhD nurses would hold. Also, switching from clinical to an administration, education, research or leadership role can be easily done by a DNP since many DNPs have multiple focuses that can be changed after graduation by taking the additional graduate classes in the other focus at a later date, saving a lot of time over getting an MBA/MHA or entire other degree.
Anyways, just thought that I'd have to put this out because I didn't see much discussion on futures of PA vs NP that pointed out that nursing has a much greater administration role to it than PA, especially after doing years in clinical environments. Oh, and I almost forgot, nurses sometimes pursue PhDs as well, and since a nursing PhD is essentially an individually tailored degree, you can specialize in just about anything. I have looked into pursuing a PhD in nursing and wanted to do research on the biochemical and neurological structure differences among various personality disorders. Obviously this takes a fairly comprehensive background in both neuropsychology, neurobiology, medicine, and psychology and the proposed curriculum tas set up for me through University of Maryland, Baltimore, was heavy in basic sciences and courses from various departments other than nursing. I think about 2/3rds of the proposed curriculum came from the departments of neuropsychology and biology and 1/3rd from nursing.
Some advantages of the PA route: Deeper understanding of pathophysiology, minor surgery, radiology, and more overall clinical hours, especially in surgery, ER, and physician specialty areas. Also, a PA can switch their specialty just by switching their physician. That's huge!
NPs have to specialize at graduate level in a certain milieus (Psych, family practice, acute care, administration, women's health, and public health are the most prevalent and standardized in nursing at this point). Also, focus and general philosophy is a little different. Nurses emphasize the importance of the patient experience, including the communication with patients, how to get patients to be more active in their own care, the experience the patient receives as a whole from their environment, and trying to affect and understand what patients do in their lives outside of the hospital/clinic (like importance of making things more convenient, enjoyable, understandable or motivating to increase adherence, etc.), whereas the medical approach emphasizes that patients need help from medical professionals to alleviate or eliminate a specific disease process. The medical approach emphasizes the role of the medical provider as more of an authoritative role in the patient's life, seen as a consultant whose job it is to tell the patient what to do or to do a specific procedure that will eliminate the disease or symptoms of the disease. This role is better for acute processes or clearly defined disease processes where the role is intermittent and temporary.
I personally believe that both approaches have their merit and glad that there exist both professions to provide a different emphasis and approach to healthcare and in the end, that just gives consumers more choices.
