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Interesting concept....though what is left out to make this possible?
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sleep
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Being from the West Coast, I've known a handful of PA/NPs. They were graduates of the UC Davis program although I think Stanford used to offer the combined PA/NP. They were all nurses except for one firefighter who had to take extra nursing classes to get in. In general they were well-trained and had fairly good respect, except for the firefighter dude who was not bright at all. He bounced around from job to job.........
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i haven't heard much of this save for the west coast.
where i'm at, flexibility isn't a concern, so either one would
serve you well.
however, more surgical assists are PAs than NPs.
where i'm at, flexibility isn't a concern, so either one would
serve you well.
however, more surgical assists are PAs than NPs.
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It used to be that since the PA program more than covered the minimums for the FNP program, RNs in the Davis and Stanford program could practice as FNPs as long as they had some sort of Masters. There were a number of changes in national reimbursement and California law that essentially required a Masters in Nursing to work as an FNP. Stanford chose to drop their dual program. UC/Davis chose to work with CSU Sacramento. After completing the PA program the students can then finish up an MSN at CSUC. This will allow them to sit for the FNP boards. It will be interesting to see how many people in the program actually do this. It will also mean that the graduates are limited to working as PAs only for their first year.
David Carpenter, PA-C
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I think combining PA/NP training is the best option for improving both NP and PA education. Just to evolve the debate a little: I have seen some atrocious education programs for both nursing and PAs. Turf battles hurt both professions as some PA programs are not friendly to RNs (I won't name them and their directors here) and NP programs have 1/2 the clinical and medical science curriculum of PA programs. Combining the two would force the education political turf battles to the side and bring in people with excellent pt care experience (RNs) and give them the best clinical training in PA programs. Practicing NPs general want the better training, but did not like the treatment they got from flunky EMTs who went back to school to become PAs.
However, I am living in a dream world to think that any of the program directors would willingly give up academic turf to join with self-perceived mid-level rivals. There are a lot of vested interests resistant to change. Med Schools and Deans need to force the change.
However, I am living in a dream world to think that any of the program directors would willingly give up academic turf to join with self-perceived mid-level rivals. There are a lot of vested interests resistant to change. Med Schools and Deans need to force the change.
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There is no reason from a PA standpoint to combine training. The goals are too different. More importantly the PA profession has developed a number of criteria for PA programs that are quite detailed and would for the most part be unacceptable to NP programs. Part of this is regulation for that specifically protects PA students from the programs. This type of regulation is missing in NP program regulation.
There are very few schools that are not friendly to RNs. I am aware of most of them, and for the most part they are not friendly to anyone with medical experience. On the other hand there are many programs that enroll a significant percentage of their students as RNs. If an RN has met the prerequisites and has the academic credentials that all other students have then they will have an excellent chance of getting into a PA program. Until recently there was one program that only accepted RNs.
The biggest issue is that RNs are going to have to do the same program everyone else does. No credit, no time off, they have to do the same work. If NP programs wanted to achieve the same level of clinical training as PA programs, the blueprint is there. All they have to do is implement it. If you look at the first PNP program and the CHA program at University of Colorado when they were created 4 years apart they were pretty much identical. 40 years later they are light years apart in terms of clinical experience. The NP program chose to alter their clinical experience while the CHA/PA program has been pretty much true to form.
I have tremendous respect for the NPs that I work with. I think that their educational environment is currently stacked against them. From a PA standpoint This is not something that we need to import.
David Carpenter, PA-C
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Good discussion. Agreed on much of your assessment of NP higher education. Similar problems with overall RN educational leadership as well. Academic turf wars do injustice to students' capabilities. When I'm in charge, I'll PM you and we'll fix it.
As for those few PA programs that are hostile to medical experience: would you care to share? I have some ideas of my own about a few. I think the worst programs are the ones that view themselves as in competition with NPs and tend to view healthcare as a heirarchy. I think they do not understand or downgrade the role of RNs in pt care - but that is conjecture.
I had a flame war with a bunch of adolescent residents in the military forum who have a low opinion of RNs and expect to be treated special as MDs. So, that is part of the basis of my suspicions of poor PA or MD programs hostile to RNs.
As for those few PA programs that are hostile to medical experience: would you care to share? I have some ideas of my own about a few. I think the worst programs are the ones that view themselves as in competition with NPs and tend to view healthcare as a heirarchy. I think they do not understand or downgrade the role of RNs in pt care - but that is conjecture.
I had a flame war with a bunch of adolescent residents in the military forum who have a low opinion of RNs and expect to be treated special as MDs. So, that is part of the basis of my suspicions of poor PA or MD programs hostile to RNs.
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do you think that NP programs should be more medical model driven? i agree, (since i've been thru ACNP program, and that i was always looking for more), that NP programs lack. and their clinical training, if you will, is something to be, uh, desired. of course, this does depend on where you train, but still not like the PA model. would you think that nursing model would be willing to gravitate toward medical model? i'm not so sure, but even if it did, i still think nurses would get heat from the medicine side of it...
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I'm really not in a position where I can name names for a number of reasons. I think that programs that don't value nurses as students fit into one of two categories. There are a few programs that do not value medical experience at all. The mantra of these programs is that the medical experience detracts from their ability to train PAs in the way they want them to be trained. Essentially that you have to unteach stuff first. If you are associated with PA education at all these are pretty apparent. One of them if I recall is in the USN&WR top 10.
The second case is a little more complex. There are areas of the country where nursing is incredibly hostile to PAs. If you look at the history of the PA practice act in Mississippi for example you can see not only overt resistance to PA practice but the MNA blocking the creation of PA schools. There are several other areas in the Midwest, southeast and west that are like this. In this case the bias against nurses may be because the program directors know that an RN will face such hostility in the practice environment that it will be impossible for the PA student to have a good clinical experience. It is easier in the short run to simply discourage these students. Its not really about a hierarchy as much as survival. There is a huge shortage of clinical slots and programs are loath to jeapordize them.
As much as nursing would like to pretend that they exist independently from medicine the vast majority of the clinical sites are in physician run practices or offices. From that standpoint the hostility comes from the competition for resources.
Also PAs tend to get caught in the middle of internecine warfare among nursing. Recent examples would be RNFAs against everone or the conflict between ACNPs and FNPs over inpatient positions. Fortunately when I was told that I had to get my RNFA to work in my OR my SP had enough pull to tell the chief of the medical staff to piss off. Other PAs may not have as much support.
David Carpenter, PA-C
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in my limited 8yr experience, i haven't seen much competition or controversy betw/ RNFAs and surgPAs..
however, that is my area...
you've gotta agree that USN&WR is just bunk..
those that are responding is such bias, it makes it
completely unreliable in a broad aspect.
don't believe it....
this goes for any ranking as those that offer and proffer
from submissions make it ridiculous to believe..
i have to agree that most of the NPs locales are physician run,
but i have met many dox that feel they could never "make it"
without them...