PA education?

[hunnybee24]

Which schools in the US teach NP and PA students exactly the same way? I heard it was somewhere in California. Any thoughts?

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[deleted6669]

Which schools in the US teach NP and PA students exactly the same way? I heard it was somewhere in California. Any thoughts?

uc davis and stanford, both in ca, are the only 2 dual pa/np programs.
enter as a bsn and you are eligible for both cert exams upon completion of the programs.

 

[core0]

uc davis and stanford, both in ca, are the only 2 dual pa/np programs.
enter as a bsn and you are eligible for both cert exams upon completion of the programs.

There is some question about how long this will continue.

"At present, RNs who complete the program may practice in California as FNPs. However, effective January 1, 2008, the California Board of Registered Nursing requires that nurse practitioners hold a Masters degree. The Masters degrees available through the PCA Program (MPH and MMS) will qualify for FNP practice in California. However, without a Masters degree in nursing and national certification, an FNP cannot bill Medicare or Medicaid for services rendered. This may limit the FNP's practice opportunities."

The move to DNP will probably make this even less possible.

David Carpenter, PA-C

 

[DogFaceMedic]

I liked the idea of the joint style programs; it allowed people to practice as they chose with the same solid education foundation. I think the CA RN board is cutting its own throat trying to undercut the Stanford and UC Davis programs -- Stanford has a little more clout than the Board.

If the Board goes further and demands DNPs, then they will price themselves out of the market. I'm already seeing signs of MDs hiring NPs over PAs to fill patient education roles because they can do simple things like adjust meds for follow up visits and they will work for less. In EM & cards, they will hire NPs who were cards RNs, but prefer PAs.

Having spent some time in CA, I witnessed the short-sighted self-serving policies of the self-proclaimed leaders of RN education and the Board, lead to an RN shortage. They irritate real RNs with the obstacles they create.

If the Board expands the scope of NPs through legislation, the CA lawyers will be waiting for the increase in malpractice.

 

[Bandit]

i have seen just the opposite. Docs are hiring more PAs because they are more comfortable and recognize the training as similar to thier oun.

I have been pulling for a united cert exam for all mid level practioners. It would put out alot of fires.

 

[DogFaceMedic]

Let me be more precise: for patient education-type roles where minor changes to meds are frequent, like Diabetes or HTN visits, NPs will work for less in a FP/PCP office. For more advanced roles in specialities and ED, you are right that PAs tend to be hired more.

Also, a unified board exam sounds like a very good idea because the scope of practise is virtually identical, and would eliminate duplicate oversight agencies -- but, a lot of PA/NP bureaucrats would be out of cushy work and have to go back to real medicine.

 

[core0]

i have seen just the opposite. Docs are hiring more PAs because they are more comfortable and recognize the training as similar to thier oun.

I have been pulling for a united cert exam for all mid level practioners. It would put out alot of fires.

To have a unified cert you would have to have compareable education. You would need to add 1500 hours of didactic and the same amount of clinicals to the FNP and add ER, IM, PEDs, psych, OB and surgery rotations. The FNP is not the same as the PA education. One produces an advanced practice nurse who has additional training in family practice nursing. The other produces a generalist medical practitioner.

The NP's need to fix their own certification problems. There are multiple certifications in acute care, adult, peds and family NP. Some of these have different scope of practice. As PA's we have one of the best certification systems in the world. It has buy in from medicine and has internal and external validation. Just as there is one way to become a physician (go to medical school), similary if you want to be a PA you go to PA school.

David Carpenter, PA-C

 

[tiredfeetED]

There is some question about how long this will continue.

"At present, RNs who complete the program may practice in California as FNPs. However, effective January 1, 2008, the California Board of Registered Nursing requires that nurse practitioners hold a Masters degree. The Masters degrees available through the PCA Program (MPH and MMS) will qualify for FNP practice in California. However, without a Masters degree in nursing and national certification, an FNP cannot bill Medicare or Medicaid for services rendered. This may limit the FNP's practice opportunities."

The move to DNP will probably make this even less possible.

David Carpenter, PA-C

I still cannot get a clear answer from the program director of Stanford about the future of FNP being awarded. This next graduating class ( mine) will just fall under the deadline. Woot!

 

[core0]

I still cannot get a clear answer from the program director of Stanford about the future of FNP being awarded. This next graduating class ( mine) will just fall under the deadline. Woot!

This is probably as close as you are going to get:
"Licensure for FNPs: At present, RNs who complete the program may practice in California as FNPs. However, effective January 1, 2008, the California Board of Registered Nursing requires that nurse practitioners hold a Masters degree. The Masters degrees available through the PCA Program (MPH and MMS) will qualify for FNP practice in California. However, without a Masters degree in nursing and national certification, an FNP cannot bill Medicare or Medicaid for services rendered. This may limit the FNP's practice opportunities. "

This is the medicare regulation they are speaking of:
(v) Be a nurse practitioner who on or
after January 1, 2003, applies for a
Medicare billing number for the first
time and possesses a master’s degree in
nursing and meets the standards for
nurse practitioners in paragraphs
(b)(1)(i) and (b)(1)(ii) of this section.

David Carpenter, PA-C

 

[Bandit]

Dave--that was my point. We can wash all our differences by adding t the NP education (why would anyone be against that) and all mid levels take the same competency boards. After all--arent all board exams considered "minimal competentcy tests?"

 

[core0]

Dave--that was my point. We can wash all our differences by adding t the NP education (why would anyone be against that) and all mid levels take the same competency boards. After all--arent all board exams considered "minimal competentcy tests?"

You can add to the NP education if you want but if I have to take one nursing theory course I quit .

Actually the fundamental problem that I have with NP education is the specialization. I like being a jack of all trades. I am an employee, I will not be a partner, I move on when I need a new challenge. I will use my first two jobs as an example. I did Peds GI then moved to adult GI. As a PA this is all within my scope. As an NP I would have to retrain to get additional certifcations. A FNP does not prepare you for the full range of medical training.

David Carpenter, PA-C

 

[burntcrispy]

I'm a physician but was a nurse before going to medical school. I have some friends who went to NP programs and I used to tutor for the PAs when I was in medical school so I'm quite familiar with the training in each program.

From my prospective:

PAs are trained more like physicians. They take watered down medical school courses but are taught on the medical model which is science based training.

NPs write alot of papers on Nursing Theory and spend very little time (and much less depth than PAs) on the science. I'm talking A LOT of papers.

I don't know how they would be able to make a test which would include both programs when their education is so different. Also, the nurses are quite militant about nursing so I don't see this collaboration happening anytime soon.

Burntcrispy,MD

 

[RAMPA]

You can add to the NP education if you want but if I have to take one nursing theory course I quit .

Actually the fundamental problem that I have with NP education is the specialization. I like being a jack of all trades. I am an employee, I will not be a partner, I move on when I need a new challenge. I will use my first two jobs as an example. I did Peds GI then moved to adult GI. As a PA this is all within my scope. As an NP I would have to retrain to get additional certifcations. A FNP does not prepare you for the full range of medical training.

David Carpenter, PA-C

just today i saw a clinician. on the right side of the lab coat it said:

Cardiothoracic Surgery
on the left side: John Doe, FNP

is this within the scope of practice?

 

[deleted6669]

just today i saw a clinician. on the right side of the lab coat it said:

Cardiothoracic Surgery
on the left side: John Doe, FNP

is this within the scope of practice?

nope...fnp's are credentialed to work with outpts only. if they were doing preop physicals only then yes, but if they were going to the o.r. or following pts on the floor then no.
in order to do inpt tasks an np needs to be an acute care np( anp) and to go to the o.r. they need to be an rnfa( 1st assist credential).

 

[core0]

just today i saw a clinician. on the right side of the lab coat it said:

Cardiothoracic Surgery
on the left side: John Doe, FNP

is this within the scope of practice?

Depends on the state. Some states do not limit scope for APN's others do. The National Boards of Nursing state that a NP should not practice in an area that they have not attained didactic and clinical training.

The NONPF says that FNP's "The family nurse practitioner is a specialist in family nursing, in the context of community, with broad knowledge and experience with people of all ages. Family nurse practitioners demonstrate a commitment to Family-centered care. Family nurse practitioners practice primarily in ambulatory care settings."

Interestingly neither the AANP or the ANCC certification address scope of practice. From the competencies the FNP would certainly be outside their scope. However most BON's do not enforce this. If they are working in surgery they would need an RNFA. If they are working on an inpatient service they would need an ACNP. Both of these can be obtained post graduate.

David Carpenter, PA-C

 

[qwerty1]

I'm a physician but was a nurse before going to medical school. I have some friends who went to NP programs and I used to tutor for the PAs when I was in medical school so I'm quite familiar with the training in each program.

From my prospective:

PAs are trained more like physicians. They take watered down medical school courses but are taught on the medical model which is science based training.

NPs write alot of papers on Nursing Theory and spend very little time (and much less depth than PAs) on the science. I'm talking A LOT of papers.

Burntcrispy,MD

Wow... in ONE POST you **** all over both nurse practitioners AND physician assistants.

Dang... nothing like a good, evacuative bowel movement huh?

Do ya feel better now?

 

[burntcrispy]

I feel fine. I wasn't trying to be disrespectful at all. I was only pointing out why having a test which would cover both PAs and NPs isn't likely to happen.. I have nothing against PAs and NPs. I work with both in differnt capacities in the hospital and am mostly pleased with the work that they do.