NP vs CLS can't decide!

[deniz_serifoglu]

Hello everyone!
I am so glad I found this forum! So, I just finished my BS degree in microbiology. Currently, I am thinking about CLS (training program) and direct entry NP programs because I always wanted to do med school but I am not willing to study for such a long time! It may sound worried for you but I have my own timeline with schools. I live in San Diego, CA so there is only one CLS training program which is extremely competitive to get in (UCSD). I don't really enjoy the lab environment (less contact with the patients) but the outlook of the job is very good especially here in San Diego. I will need to take one more class before I apply (clinical chemistry). Regarding NP (FNP) it seems more enjoyable for me as it's very similar to what doctors do, I will need to take three classes (anatomy, physiology, and psychology) which I don't mind at all I can take them all this semester. I'm so confused about the direct entry NP programs like they're all master level but is master enough to apply for FNP/NP? money wise, NPs make more money for sure but not a huge different (CLS makes 80k-90k) and it will cost around 10k in ca while NPs around 120s and will cost a lot (it can be 100k if not more)! If you were me what would you choose? Any advice will be greatly appreciated

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[pamac]

I think you are answering your own question. Do what you want to do.

 

[phagocytosis41]

Hello everyone!
I am so glad I found this forum! So, I just finished my BS degree in microbiology. Currently, I am thinking about CLS (training program) and direct entry NP programs because I always wanted to do med school but I am not willing to study for such a long time! It may sound worried for you but I have my own timeline with schools. I live in San Diego, CA so there is only one CLS training program which is extremely competitive to get in (UCSD). I don't really enjoy the lab environment (less contact with the patients) but the outlook of the job is very good especially here in San Diego. I will need to take one more class before I apply (clinical chemistry). Regarding NP (FNP) it seems more enjoyable for me as it's very similar to what doctors do, I will need to take three classes (anatomy, physiology, and psychology) which I don't mind at all I can take them all this semester. I'm so confused about the direct entry NP programs like they're all master level but is master enough to apply for FNP/NP? money wise, NPs make more money for sure but not a huge different (CLS makes 80k-90k) and it will cost around 10k in ca while NPs around 120s and will cost a lot (it can be 100k if not more)! If you were me what would you choose? Any advice will be greatly appreciated

Yeah SLP and NP are 2 way different careers and NP probably would take 2-3 years longer.
I have a Bachelors in Nursing and tried to get into the NP route so I know a little bit about this. To become an NP (They make around 80-90 starting not 120 unless you get XP FYI unless you are lucky enough to get into a good specialty but you generally start in General practice first) you need that BSN first which would take 2-3 years depending on whether its a direct entry or 2 year program and since you need to take prerequisites and apply, it will take 3-4 years. Then Once you get that RN license, you really need 1-2 years experience to even qualify to gain admission to an NP program. These NP programs are a min of 2 years, so that makes it AT LEAST 6-7 years to even become an NP.
So yeah Sure go for that NP, but don't assume it will take a very short amount of time. If you want to do what is 'very similar to what doctors do,' BECOME A DOCTOR LOL.
... Hint, thats similar to what I did.
So not trying to discourage you, but if you are just trying to go into nursing just to become an NP, take a big long look, most people in the nursing field will hate you or despise what your trying to do. I mean most people in nursing aren't NPs, their RNs and function in a capacity as an RN and get offended that you don't want to do RN stuff you want to do NP stuff. Hey whatever floats your boat, but people are sensitive and YOU WILL get that response from 70% of people (some will support you, most won't). And don't assume you'll necessarily become an NP, I mean things happen, who knows you'll have to work or you don't get into NP school. Not so say you won't get it, but things happen and this is life, not paradise. So... if you want to do what a doc does and you won't want to go to med school, try to do PA, but again, this is also hard to get into, taking into account the limited PA seats, HC Paid experience required, etc.
PM me if you have any advice. Good luck.

 

[pamac]

I guess in California, a CLS can make decent money, and I did ok when I did that before RN/NP school, but they tend to make at least 15-20 percent less than nurses from what I found, and you end up working hours that are spread out more across the week. The industry rarely has overtime like nursing too, so that cuts into the profit margin quite a bit. So as an RN I loved my 3 day workweeks. As a CLS, I was working spread out over the week more, and going to work at strange times. So much is automated, and its even more that way now. I was supervising the robots while they did their work. It was cool in a lot of ways, but it might not be what people expect.

Yes, NP takes a while, just like what was suggested above. It can take less time, but I personally have never seen someone that cruised through as fast as some detractors have suggested is common. Like was mentioned above, life takes over, and after a couple years of nursing school, most folks want to take a break before heading to more school while working at the same time. It seemed that everyone around me when I was a nurse were gunning for NP school, but the CRNA folks tended to most commonly have a quick timeline vs the NP's. Most NPs aren't starting out with the big money either. A lot of nurses realize that making the jump from making $75k (with the option for significant overtime) and working 3 shifts per week to making $90k salaried and working 5 days per week isn't as appealing as they initially imagined. I have NP friends who take call, work weird hours, have worse benefits, less time off, etc, all for a few thousand more than they made as RNs. I think that long range, NP works out better than RN, especially on the body, but lately, I've been running into nurses that are in no hurry to make the jump to even starting work as an NP after they get their degree and take their exam. I was ready to go once I was done, but quite a few of my peers were taking their time, getting in some vacation, and looking for the right job before they jumped into the NP workforce.

 

[prozone]

I live in San Diego, CA so there is only one CLS training program which is extremely competitive to get in (UCSD). I don't really enjoy the lab environment (less contact with the patients) but the outlook of the job is very good especially here in San Diego. I will need to take one more class before I apply (clinical chemistry). Regarding NP (FNP) it seems more enjoyable for me as it's very similar to what doctors do, I will need to take three classes (anatomy, physiology, and psychology) which I don't mind at all I can take them all this semester. I'm so confused about the direct entry NP programs like they're all master level but is master enough to apply for FNP/NP? money wise, NPs make more money for sure but not a huge different (CLS makes 80k-90k) and it will cost around 10k in ca while NPs around 120s and will cost a lot (it can be 100k if not more)! If you were me what would you choose? Any advice will be greatly appreciated

Definitely don't do CLS if you value patient contact. Yes, job outlook is good but not much better than nursing (if that).

A NP will certainly make more money than a CLS so in the long run, that's probably a better bet. If your financial situation requires you to minimize upfront costs or to make decent money quickly, the CLS route is not a bad financial decision.

I guess in California, a CLS can make decent money, and I did ok when I did that before RN/NP school, but they tend to make at least 15-20 percent less than nurses from what I found, and you end up working hours that are spread out more across the week. The industry rarely has overtime like nursing too, so that cuts into the profit margin quite a bit. So as an RN I loved my 3 day workweeks. As a CLS, I was working spread out over the week more, and going to work at strange times. So much is automated, and its even more that way now. I was supervising the robots while they did their work. It was cool in a lot of ways, but it might not be what people expect.

I agree about your comments about the lesser pay and the crappy scheduling (my biggest gripe about CLS work) but overtime availability probably depends on the lab. Granted, I can't speak about how much OT nurses generally get but I've been able to get enough OT as a CLS to bump my earnings 20% above my base pay over the course of a year. But again, it depends on how the lab distributes OT opportunity - some places heavily favor seniority and the more senior techs might hog all of the OT lol.

 

[pamac]

There are a few states where CLSs make great pay. Overtime might be plentiful as well. What I noticed in my organization was that being in the lab out of sight meant that admin was not averse to cutting back to the bone on hours. But when you need a worker, you need a worker, and if a place wants to cut back on full time employees, then they can use overtime workers to do that. Everyone can be happy in that scenario if they work it right.

As a nurse, I just noticed that of all the workers in the hospital, including docs, nurses seemed to have admin by the nose in a lot of ways. Our differentials are better. Our opportunities for OT are better. They never question things for me as a nurse like they did when I was a CLS. But that could be variable to my state vs California. Seems like a lot of work environments are better in a lot of ways there. Worse in others, but better at making workers feel like they know where they stand in the big picture.

 

[8jsi37]

Have you ever considered PA? If your passion is truly to become a doctor for the patient interaction, try PA. idk much about a NP direct entry, but generally for NP programs you need a BSN first which is 2-3 years, then NP programs can be 1-3 years depending on which specialty. It's shorter than med school which is 4 years of med school and a minimum of 3 years of residency. For PA, you're looking at around a 2 year program and you can go straight into practicing medicine as a PA with patient interactions. On top of that, you may get paid the same or more as a PA compared to a NP in cali (don't quote me tho). I may be wrong on this as I dont know much about the rules and regulations for PA, but in cali, from what i see PA can operate on their own and do what a physician can do as long as they have a physician in charge there as well. I don't know if it's something for you, but it's a different possibility for you! It seems like you might not enjoy a CLS.

 

[pamac]

One may do an accelerated BSN in one year if you already have a bachelors degree of some sort. Then you can do an NP program and be done in two years.

Prereqs for PA school can take a considerable amount of time. For a student without excellent grades, one faces the problem of landing a spot in a PA program. If you don’t get in during one year, you wait another year before the application cycle opens up again. The application process is fairly expensive as well (although a drop in the bucket when you consider the total cost of PA education). Simply applying to 10 schools or so can cost a couple thousand dollars. Add in costs for traveling to interviews, and it’s an expensive gamble. Then there are the relocation costs, and the lack of income for those two years. The big picture is that I have friends that have PA school debts in the range of $100k for school, and another $70k for living expenses for two years, and whatever was left over from undergrad. The two years they didn’t work cost roughly $40,000 per year in lost wages. Then they entered a job market that is tight, and are working for $95,000 per year and hoping to buy a house and live. They are essentially $250,000 down on the game of life before they even get a home mortgage.

I had a friend with a business degree that went back to school for a year to get an accelerated bachelors of science in nursing. Cost $25,000. Got a job out of school that paid $75,000 as an RN. Immediately started NP school, which cost $35,000 for the two years. Started working as an FNP for $100,000. Total costs: $60,000 for education. But was able to work as an RN making $75,000 per year for 2 years during NP school.... so made roughly $150,000. Came out ahead by $90,000. That’s simply the rough numbers that don’t count taxes and things like that, but the theory is pretty sound overall. The two paths are $340,000 apart in cost. Then you get into the more political aspects such as freedom of practice rights, which vary by state.

Personally, I’d be wary of PA school unless you have excellent grades. Even then, one should be aware of cost issues, because I’m finding that quite a few of my PA colleagues are saddled with huge debts while entering a market that is tightening up. Cost issues like the ones I described are what compelled me to change course and go to NP school, which was the best decision I could have made. I have a friend who went to the PA school I initially wanted to go to. My friend went there and I went to nursing school. My friends graduated before I even became an NP, and here we are several years later, and I’m still well ahead financially. There is more to consider than just the mantra of “get into school and everything will be ok.”

 

[pamac]

I’ll throw something else in about the NP vs PA choice, even though the thread was started to compare NP and CLS.

The national org for PAs is all a flutter about the potential to change the name of physician assistant to something else. One popular theory is they will push to call themselves MCPs or “medical care practitioners”. MPC is the name of a prototype physician assistant that the British national health service is looking into starting. That role in Britain will be a very subservient role with direct and close supervision. Nobody in the PA world over here is even aware of the name origins. PAs want their new shorthand name to be “medical practitioner” to counter “nurse practitioner” (but “medical practitioner” isn’t a term they can legally protect so they hope to back door it by adding “care” to the name). A name won’t save them as a profession. What they need right now is not a new battle to change their name, and have to explain it to the world. I’d argue it’s the last thing they need. They also don’t need what they call “optimal team practice” which is their way of decoupling from physician supervision in favor of “practice supervision”. OTP simply shifts PA supervision to the facility or practice. Despite being a stealth push for independence, it doesn’t move the needle for them in the big picture because it’s a marginal step towards independent practice vs just coming out and seeking what they really want. It’s extra energy expended, with a guarantee that more energy need to be expended in the future. So what they have ahead of them is chaos on 50 different state levels as they seek to push a new name into 50 different states legislative bodies, and then 50 different stealth “OTP” approaches to becoming independent providers, all while they face a glut market of expensively obtained degrees.

What I see among PA folks on the internets is a profession undergoing the perfect definition an existential crisis. It’s understandable, and is probably unavoidable. I saw this coming a decade ago. My personal advice to someone looking at the career would be to keep in mind what is going on in that realm, and steer clear for the sake of personal finance and professional progress. I don’t mind throwing that out there because there are so many PA program seekers that it’s unlikely that any advice I give will have any effect overall. On an individual level, anyone taking my advice will at worst end up $340,000 ahead of the game by choosing to become an NP, so I also don’t feel like I’m steering anyone into a course that would hurt them. So go to Np school if you want to become part of a profession that knows itself and it’s goals, and has a unified front.

 

[8jsi37]

One may do an accelerated BSN in one year if you already have a bachelors degree of some sort. Then you can do an NP program and be done in two years.

Prereqs for PA school can take a considerable amount of time. For a student without excellent grades, one faces the problem of landing a spot in a PA program. If you don’t get in during one year, you wait another year before the application cycle opens up again. The application process is fairly expensive as well (although a drop in the bucket when you consider the total cost of PA education). Simply applying to 10 schools or so can cost a couple thousand dollars. Add in costs for traveling to interviews, and it’s an expensive gamble. Then there are the relocation costs, and the lack of income for those two years. The big picture is that I have friends that have PA school debts in the range of $100k for school, and another $70k for living expenses for two years, and whatever was left over from undergrad. The two years they didn’t work cost roughly $40,000 per year in lost wages. Then they entered a job market that is tight, and are working for $95,000 per year and hoping to buy a house and live. They are essentially $250,000 down on the game of life before they even get a home mortgage.

I had a friend with a business degree that went back to school for a year to get an accelerated bachelors of science in nursing. Cost $25,000. Got a job out of school that paid $75,000 as an RN. Immediately started NP school, which cost $35,000 for the two years. Started working as an FNP for $100,000. Total costs: $60,000 for education. But was able to work as an RN making $75,000 per year for 2 years during NP school.... so made roughly $150,000. Came out ahead by $90,000. That’s simply the rough numbers that don’t count taxes and things like that, but the theory is pretty sound overall. The two paths are $340,000 apart in cost. Then you get into the more political aspects such as freedom of practice rights, which vary by state.

Personally, I’d be wary of PA school unless you have excellent grades. Even then, one should be aware of cost issues, because I’m finding that quite a few of my PA colleagues are saddled with huge debts while entering a market that is tightening up. Cost issues like the ones I described are what compelled me to change course and go to NP school, which was the best decision I could have made. I have a friend who went to the PA school I initially wanted to go to. My friend went there and I went to nursing school. My friends graduated before I even became an NP, and here we are several years later, and I’m still well ahead financially. There is more to consider than just the mantra of “get into school and everything will be ok.”

I 100% agree with pretty much everything you say. When my friends ask me about nursing vs pa, i would have them go into nursing first because it is a much easier and just as lucrative (if not more), mainly because the standards of PA schools are pretty high and they are getting higher and higher each year. I do agree that PA has that stigma and it's not gonna go away any time soon unless society is willing to change.

Can you explain the math on how you got to $340k differential? I'm not sure what I am missing. My math doesn't include taxes or anything btw. You said Pa is 100k + 70k (living expenses even though that is a lot for two years), +40k "lost salary". Total PA is 250k as you said. You're done after two years and start working your third year at $95k. At the end of three years, you're at "155k" and at the end of four years you're at 60k

Then Nursing is 25k BSN tuition + 60k NP tuition (total two years) + 40k per year lost salary (1 for BSN accelerated) You have to include the lost salary for nursing too if you're gonna include for PA to keep things equal and uniform. The same for living situations as well. So if you were to add like 40k for one year in accelerated BSN and 70k for living expenses (just to make things uniform). Total NP I see is $195k. But during NP school you're working as a RN making 75k/year, so you net 150k at end of two years. At the end of 3 years and you are out $45k (195k-150k) and by the fourth year you're completely "debt" free without any taxes involved.

Differential between PA and Nursing is maybe at most $100k-110k mainly due to the ability to work during NP school. Am I doing something wrong or missing a key component because I dont see it being upwards of 300k+. At the end of the day 100k in loans is still a big difference. But these numbers can change easily especially in Cali where many nursing school tuition can be 50-60k and NP school tuition can be around there too. I think it really depends which part of the country you're from, but over I do agree the amount of loans for nursing can be less than PA. PA is getting harder and harder in gpa/gre/paid healthcare clinical hours to get into but their pay isnt going up at the same rate. While nursing is a bit more forgiving on gpa and extracurriculars (maybe not teas/hesi), but NP gets paid the same if not more later on (at least the case in the area of cali im from).

I just think overall, each health professional occupation is unique in their own way. OP or anyone else applying to pa/ RN or NP/ etc should think if X is really for them and if it is a good fit for them in the long term of things. You have to really want to be X to go to that specific health professional school, so I just think everyone has to choose wisely and choose which is the best fit for them. If pa or np is what OP or anyone wants, then do it.

 

[pamac]

As far as numbers, I’ll break it down again. It takes some getting used to. So to start out in a hypothetical year can go something like this:

You decide in February of 2020 to apply for PA school. The gates open in May or June to apply, and you apply. Then, over the course of the rest of 2020, and the beginning of 2021, you go to interviews and then get in. You start in fall of 2021. Then you go to two years or so of PA school. My family basically costs $35,000 per year (at least) to operate, which includes housing, food, entertainment, other expenses. So for two years of school, my expenses for living are $70k total. Tuition is $100k total. I was assuming an income from a job like CNA or something was like $40,000k per year for two years ($80k total). In my case over 10 years ago I was making close to $60k when I was considering nursing or PA school, but $40k per year seems pretty reasonable for someone working. An undergrad might consider this high, but I wasn’t an undergrad. So that comes out to roughly $250k in costs for PA.

The nursing route:
If you decide in February of 2020 to apply to an ABSN program, you can be starting in fall of 2020. If it’s a yearlong program, and you take a year off of whatever work you are doing (which is probably what you’d need to do), let’s say your cost in lost wages is $40k as well. And throw in $35k for expenses, which I might have left out. So one year of ABSN at lets say $25k (which would be a very good price.... I’ve seen them as high as $75k, but $25k is doable). Expenses for that year are $90k. Then you start working for $75k for the next two years. Total wages of $150k. During that two years that follow, you go to NP school, which costs $30k total (I think you thought I meant $30k per year, but NP school is cheap compared to PA school). So total outlay after 3 years leveraged against wages is $30k in the plus. Compared to $250k in the minus for PA school, that’s around $280k difference. I didn’t originally compute the lost income for ABSN school, which I should have. But I never compute the living expenses for life as an RN for the two years of NP school, even for uniformity, primarily because I know PA students that need to take out the money for life expenses as debt, and the difference in debt is mostly what I focus on when I talk about that. So the math comes out a bit more fuzzy on that, and I can see why it may seem like bad accounting to consider lost income and the cost of life that way. Something similar could be said for the gap year when a PA applicant is waiting to hear back from school and still working. Maybe even add back in another year of income at $40k, but then subtract back out another $35k for expenses for that gap year. But then application fees and travel for interviews takes out a large chunk of that remaining $5k.

 

[pamac]

So debt for The PA route I calculated at $100k for school, $70k for living expenses. Add in $80k for lost income and that’s $250k.

Total outlay for nursing is $25k for ABSN, and $30k for NP. Total of $55k. After wages of $150k for two years, one is $95k ahead. Difference of $345k.

Alternate method For considering nursing, (which makes sense to consider): Add in living expenses of $35k per year x3 years = $105k. Lost income for one year of ABSN = $40k. That means a total nursing outlay of $50k. If this is all considered, you end up with a difference between nursing/NP and the PA career paths of $200k at the beginning of the 3rd year when both the PA and NP would start practicing in 2023.

Your method of considering everything is probably more apples to apples, but I think the difference between that and how I calculate it has to do with how we consider the 2 years of work the nurse does while they are in NP school. I see the point when they start working as the point when their living expenses aren’t in the same category as if they are borrowing that money, but I see your point. $200k difference is still a big difference to me because if both the amp and the PA are getting laid the same, then over 10 years, it’s as if the NP is getting $20k more per year out of their wages than the PA.

 

[phagocytosis41]

So debt for The PA route I calculated at $100k for school, $70k for living expenses. Add in $80k for lost income and that’s $250k.

Total outlay for nursing is $25k for ABSN, and $30k for NP. Total of $55k. After wages of $150k for two years, one is $95k ahead. Difference of $345k.

Alternate method For considering nursing, (which makes sense to consider): Add in living expenses of $35k per year x3 years = $105k. Lost income for one year of ABSN = $40k. That means a total nursing outlay of $50k. If this is all considered, you end up with a difference between nursing/NP and the PA career paths of $200k at the beginning of the 3rd year when both the PA and NP would start practicing in 2023.

Your method of considering everything is probably more apples to apples, but I think the difference between that and how I calculate it has to do with how we consider the 2 years of work the nurse does while they are in NP school. I see the point when they start working as the point when their living expenses aren’t in the same category as if they are borrowing that money, but I see your point. $200k difference is still a big difference to me because if both the amp and the PA are getting laid the same, then over 10 years, it’s as if the NP is getting $20k more per year out of their wages than the PA.

ouch, thats about the same as med school.