NP vs PA -your real thoughts

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thenursingstudent

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Hello all,

I wasn't sure where to put this topic, apologies if not the correct forum.

I graduated in May 2018 with a Bachelor's in nursing and biology. I took mostly non-nursing bio classes. I thought about going to medical school, and decided against it.

I started working in a hospital as a nurse, really loving every chance I had to learn from a physician. Anyway long story short. I was accepted into the University of Alabama at Birmingham for nurse practitioner in a pediatric dual primary and acute care and first assist program. I struggled between physician assistant and nurse practitioner for a while. What changed my mind was considering how nurse practitioners have the numbers, and will continue to grow. NPs will have the numbers to influence the policies and politics, and protect their profession, and I feel like eventually they're going to wean PAs out more and more (this may not happen at all or may take decades). I don't necessarily want to see NPs scope of practice expand, but I want the job availability to increase and be protected. Some NP programs are terrible. I did a lot of research to choose mine, and would begin this fall.

That said. I have the opportunity to move to Raleigh, NC. Duke's PA program is something I had had my eyes on since I graduated. The deadline for the CASPA is Sept 1, then I'd need to take the GRE and get some more shadowing in by Dec 31, and I may not be accepted for Fall 2020 anyway. The program is the same length as my NP program would be at UAB, and twice the cost. I have a decent chance to get in being non-traditional and also my cumulative undergrad GPA is very competitive, but I still might not get into such a popular and top notch school.

The reason I'm asking on this forum is because physicians have worked with both NPs and PAs. I would like to know your opinions please on which profession you think comes out more prepared, an NP or PA. Please only consider NPs with a good educational background, if possible. In my mind, if I want to specialize in pediatrics, it makes more sense to devote 3 years to mainly pediatrics in an NP program, than 3 years of having my didactic work and clinical rotations in varying areas, as is the case in PA programs. When I look at Duke's curriculum for the PA program, I'm not as impressed it's the best way to go...or I should say if I didn't have a background in nursing then yes. (not saying a nurse is comparable to a PA, just saying I want to get the most from my time, education and money). In the end, I just want to do what will prepare me the best.

Thanks in advance for your opinions, and thanks for reading.

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In pediatric critical and acute care, they are viewed more or less the same. They function as residents. While NPs have more bedside experience overall, after a year or two, it becomes a wash. Overall PAs and NPs carry more bedside experience than residents and are more efficient because they are geographically centered, as opposed to residents who bounce around from rotation, so they are like senior residents if they have more years of experience. They are also more costly. I think from a institutional standpoint, NP versus PA, is mostly subjective and the biggest decider is the hiring cost (cheaper usually wins out).

My two cents...

Edit: I will say that I think generally speaking, NPs have more opportunity for leadership/administrative positions than PAs within a healthcare system, but I don’t know the numbers that support that, just my peripheral observation.
 
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Duke is the home of PA studies, and is remarkably strong. There is much more variability among NP programs. Personally, if I got into Duke for PA, I'd go there in a moment (I am a doc, though, and did my residency there).
 
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The reason I'm asking on this forum is because physicians have worked with both NPs and PAs. I would like to know your opinions please on which profession you think comes out more prepared, an NP or PA. Please only consider NPs with a good educational background, if possible. In my mind, if I want to specialize in pediatrics, it makes more sense to devote 3 years to mainly pediatrics in an NP program, than 3 years of having my didactic work and clinical rotations in varying areas, as is the case in PA programs.

I'd still take the PA in most situations. NPs can be excellent, but the curriculum at most NP schools are not geared towards the science and clinical aspects like PA programs are. This is typically evident when discussing the foundational basic science knowledge that clinical skills and knowledge are built on. I say this because the dozen or so NP curricula I've seen (some from "strong" NP programs and some from online diploma mills) all have a much heavier focus on administrative aspects and less of a clinical focus/exposure than PA curricula. So if you're just looking to learn algorithms and clinical pearls to manage patients then NP is fine*, but if you want a better understanding of the underlying mechanisms of the diseases and treatments I'd go PA.

*Some NPs do have strong basic science knowledge, but in my experience this was knowledge gained before entering their NP program and most NPs I've worked with are pretty lacking in that area.
 
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I think PAs are better at trained, I think NPs are better at lobby legislators
 
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Generally I think that PA's are better trained. That said, if you already have your BSN, you have essentially already done half of the work to get to your NP. I don't understand why you would need to go through 3 more years of schooling for your NP. This should be achievable in 1-2 years (probably part time).

Does not make sense to go for PA over NP at this time even if that is your preference. Clinical priveleges/roles are close to the same with either qualification, so go for the NP. Also it makes no sense to pay triple the cost to go to Duke. You'll make the same salary when you get out if you go to state school, so consider that.
 
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