Hello, I've heard upon doing some research regarding graduate schools that some offer Nursing Practitioner and Physician Assistant program. What are the benefits in being both a NP and a PA?
PA & NP dual track program?
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None. Most NPs desire to be PAs (their training closely resembles AMA), so NPs can then be respected by their peers.
On the other hand, no PA would ever want to be a NP period.
If you go over to the pa forums and dig up a few threads, you'll find plenty of PAs that express interest in a way to gain certification as an NP, and openly lament the fact that in many places, If they were NPs, they would have much more latitude in their delivery of healthcare. One PA in particular would love to sign off on certain forms that NPs can, but he can't. A bunch would also love to get reimbursed for electronic medical records to the tune of $40000 dollars, which NPs qualify for under obamacare. Juanita sounds bitter. But like Juanita, I don't know an NP that wants to be a PA.... period. Lol.
I have a choice between NP and PA, and chose to do NP. I didn't want to be part of a profession that had such a weak advocate as the AAPA. Im interested in being an independent provider. At least one additional state per year, and often two, grants NPs independent status. I know several NPs that have their own practices. My state will allow an NP to do that. A PA has to hire a physician to be their "supervisor". After researching and shadowing, it was worth it to me to take the extra time to become a nurse and then pursue an NP. I want to be more of a master of my own destiny than what being a PA would offer me. To practice as a PA, I would have to be totally dependent on acquiring an agreement with a doctor to work. Then there's the name.... But almost every PA is dissatisfied with that aspect too. The PR campaign thought up my the AAPA, and what many PAs on the PA forums already do, involves actively not using the actual title of "physician assistant", but to use "PA" exclusively.
PAs receive excellent training, but their hands are tied in ways I don't like, which is unfortunate. I find it unnecessary, and frustrating. But the fact is that it is happening. I really don't see that aspect changing any time soon, either.
PAs receive excellent training, but their hands are tied in ways I don't like, which is unfortunate. I find it unnecessary, and frustrating. But the fact is that it is happening. I really don't see that aspect changing any time soon, either.
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I actually had a few RNs in my class(both med school and PA school) that voiced displeasure with NP education.
NP lacks hard sciences, and that's not a small thing to be sure. I've clashed with that fact with certain NPs that lacked competence. Any RN like myself that had completed prereqs to become a PA or MD would by default have more hard science background than your typical NP that wasn't similarly prepared. My upper division undergrad science courses would demolish even what would be taught in NP graduate programs. One NP I worked with wouldn't even talk to me after I told her I'd be applying to NP school when I had a fraction of the time in nursing she did. She proceeded to tell me how she had been an RN for well over a decade when she felt ready to make the jump. I followed a conversation between her and a doctor where she didn't have a clue about basic immunology concepts. But yeah, after I told her my plans, she went out of her way to try to make clear that her nursing judgement that she built up over years as an RN trumped anything else, and made sure to try to tell me how to be a floor nurse whenever she could (and was wrong the majority of the time). She seems to suck at both nursing and being a provider, so mostly I blame her attitude for her follies rather than her school. I've never had a PA walk by and get up in my business (and be wrong at is as well) like I've had 2 NPs do to me. The PAs I know come in and are cool and we chat about outside interests.
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I think your story has some truth to it, but not all.
I was a hard sciences undergrad and passed over med school. I then got my doctorate and then thought I would rather be an FNP. So I went back to nursing school. Nursing school after pre-med was a cake walk especially with the information and math we had to know and use. The clinical side was no issue because of my previous clinical training for my doctorate.
I think NP school is what a nurse makes of it. It's two different ways of thinking though too. Nursing requires a certain application of knowledge and often people who are book smart fail miserably in nursing school. PA school is a lot tougher than nursing school I will give it that, but if a nurse is really learning the information and the why and not just studying to pass the test, then I think an FNP can stack up pretty closely to a PA in basic clinical skills, and in my experience often beat a PA in bedside manner. I have worked with several PA's and NP's over the years. I have seen both have horrible results. PA's often are quite good in their specialty areas because of the extra training, just as an FNP can be quite good in say Psych nursing if they have the extra training.
Do I think an RN with 10 years experience knows more than a PA? Nope sorry it's apples and oranges. The issue you have with NP's jumping on someone and being wrong unfortunately is a holdover from very angry nurses who seem to think they know it all and the doctors are idiots, but yet they couldn't explain to me basic microbiology or genetics. I think it's an unfortunate side effect that is going away. Although in my RN program I had at least 1 lecture a week where someone in the program was doctor bashing.
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Actually, IIRC you went the nursing route because you could still work part time and your facility paid for it or something.
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Neither should be independent but you are correct that nurses are getting there faster
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PA's beat out NP training, hands down. I know of Rn's who went the PA route because they realized that PA's are much better trained. A PA with a Master's degree usually has more didactic hours and more clinical rotation hours than a NP with a doctorate if you do the math. As for the independent NP thing--that is a joke. NP's would like everyone to think they are independent. Every state, however, requires that if an NP at any level wants to prescribe medication or perform any procedures they must have a signed written agreement with a physician. In reality this is no different than the physician-PA relationship. I know of situations where physicians are walking out on collaborative relaitonships with NP's and guess what--the "independent" NP's are suddenly no longer practicing.
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That is incorrect. States that have "independent" NP practice do not require a signed written agreement with a physician. Other states, on the other hand, have varying degrees of physician collaboration or supervision required for NP practice. The scenario you describe above does not occur in actual "independent" states, but could in others.
Nope... there were several factors looming over my decision, and the level of independence that NPs enjoy has always been a big focus for me, as well as other issues. I may not detail each point extensively every time I post, but I certainly wouldn't be well served if the only reason I decided to go to nursing school, then get a BSN, then get an NP... was because my facility reimburses me for it. I would have been a PA for 3 years now if I had gone that route. I may make about as much working as an RN as a new PA here, but I'm also hefting patients every shift and running myself ragged. Being debt free is a plus, but there would have been distinct perks to being a provider at this point of my career. From the PA name, to the weak national organization, to my own personal finances, to my tendency to want a more independent relationship with other providers.... I've mentioned all of those things as motivators for choosing NP, and done so repeatedly. My circumstances aren't the same as what everyone faces, and I often suggest people choose to go to PA school if their perspective and background doesn't match mine.
NYCguy is correct about independence and NPs. Some states require a collaborative agreement, but ones that are independent like my own demonstrate significant differences between the oversight of NPs vs PAs. The PAs are at a significant disadvantage if their supervising physician walks (or insists that the PA does the walking), and it can be months before they are back working again. The NPs here aren't connected at the hip, so if a business relationship dissolves, the parties move on to their own arrangements. Several threads on the PA forums lament the difficulties many of the posters faced when problems arose with their SPs. I know several NPs who run their own practices independently, but maintain a relationship with a physician they can feed business to when the need arises to have a physician's expertise. It all comes down to state law, and the list of states granting independent practice rights to NPs grows. But plenty of states operate like PTBAPA says.
