RN considering PA- Looking for advice

[Derekit0]

Advertisement - Members don't see this ad

Hi everyone, first time posting because I'm looking to see what some of your opinions might be about my situation.

Im currently a Registered Nurse working in a medical-surgical intensive care unit at a level 1 trauma center, at the moment I have 1 year of full time experience but I'm already considering my next move and I'm strongly leaning towards Physician Assistant rather than Nurse Practitioner. I feel this way because I believe they have much better curriculums, a more flexible practice, and use the medical model.

While that is all fine and dandy there is no doubt that the real thorn in my balls is my GPA. My GPA for my bachelor work is a 3.1 with a strong trend upwards, which is good. My overall GPA however, when also considering my freshman and sophomore year, is about a 2.8-2.9 from what I calculated myself- also with a strong trend upwards. My science GPA is somewhat of a mystery because its tough to know what classes they even consider as science from my nursing coarse work, id estimate it as something like a 3.o, I guess.

Now I still have prerequisite courses to take that a pre-med route would include that my nursing path didn't- so thats always a chance to increase my GPA. However, the overall weight of these additional classes, even with scoring As, really doesn't make a dent to my overall GPA.

With this considered:
1. I believe I have excellent quality of experience and will have a large amount of hours by the time I apply
2. My GPA is the weight to break my legs.
3. I haven't taken the GRE yet.
4. Getting letters of recommendation from a DO, PA, and my nurse manager won't be a problem.

Ive already isolated schools that have lower GPA requirements or do things such as only count the last 60 credit hours, etc. That way my odds of admission would obviously be higher due to trending.

In this situation would you say forget the PA route and go NP just because it will make my life a lot easier, or do you think that with my current situation I have a chance of getting into some PA programs?

I appreciate the time you took to read!

 

[Boatswain2PA]

First, you're right, most NP education is a joke compared to PA education. Just a few nights ago I was working with a new NP in a busy ED and she turned to me and just unloaded on me about how she didn't know ANYTHING, and how it is becoming glaringly evident to her how insufficient her NP education was for practicing medicine.

I told her congratulations, she is going to be a terrific provider in a couple of years. She realizes her NP education was, as she said, "full of writing papers" with very little education on taking care of patients. But now that she realizes this, she is going to overcome that deficit by extreme studying. She's going to be great, despite her typical NP education. (oh, and btw, she's a "doctor", not that she would EVER refer to herself as one in the hospital/clinic environment).

My point in telling you that story is that NPs can, indeed, be terrific providers.

As to your specific question - I would go NP. Let's say you're making $50K as an RN. It will likely take you a year of pre-req's for PA school (most don't accept the basic chemistry classes that many RN programs accept, OChem, Stats, etc), and then 2.5 years for PA school and you're out $175K in opportunity costs alone (can't work in PA school). Add to that the cost of PA programs (most are very expensive), and it may cost you $250+ to go PA.

Conversely, do an on-line NP program while you work full time and the only thing you are out is your tuition, which many hospitals will help you with. You probably don't need any more pre-requisite courses, so you can be done in 3 years...less time than if you went PA.

Financially it makes more sense for RNs to go NP than PA.

Best of luck to you. If you do decide to go PA, look at PhysicianAssistantForum.com for more info on the profession.

 

[pamac]

So your prereqs are going to be a lot to bite off. They are a lot harder than the coursework you took to get into nursing school. Several will probably be harder than anything you took in nursing school. You are looking at upper division anat and phys, gen chem, and enough o chem to qualify for biochemistry, as well as biochemistry itself. Basically, you'll need to treat it like you are a full time student for the near future, along with your full time job as a new nurse. It won't be something you'll be simply dabbling in, so plan for that. Your GPA isn't a deal breaker, but it puts you in the position that you really should be getting as good marks as you can, so that adds to the pressure you'll be under to do well. You really need to break the 3.0 barrier to feel comfortable about your chances, otherwise odds are iffy. Those schools that take lower gpa have a lot of applicants with even better HCE than yours, and maybe better grades overall. You'll be putting a lot of time into your prereqs, you don't want to have to then take a couple cycles to get into school on top of that. Then when you get to PA school, you'll have to quit working as a nurse. You'll pay a large premium for your quest to pursue the medical model. And the flexible practice environment of the past is changing to be less fluid for a variety of reasons. PAs are jumping around a lot less. They still have a lot of latitude to start off in the specialties that they want to. If you dig surgery, then PA is the place to be, but otherwise, you can break into other areas as an NP for the most part, but that can vary depending on region. Where you are located, it might be that PAs are preferred for certain roles.

Right now in my NP program I'm doing a management course that a physician or PA would never have to take, so yes.... There is a difference between what I'm doing, and what the PA students near me are taking (they go to school pretty much all day focusing strictly on medically pertinent subjects). But, virtually none of the local PA students have ever managed anything medically complicated before PA school, so if you are a believer in the value of prior HCE (which I'm not completely convinced is as pertinent as others think), then that's not a huge factor. As a person with a couple biology degrees to my name, I like the idea of my medical provider having a good grasp of things like how mitochondria work on a molecular level... I think it helps overall. You'll never get that kind of depth from NP school, nor NP prereqs. I'm not as worried about what NP school lacks for me because my background is really heavy in biology, but most NPs don't have that benefit. However, I know many nurses that have a firm grasp of how the body works, and really know their stuff, and do a good job of making the transition to becoming a provider because they put in the effort and are humble. The NPs that I've had problems with are know-it-alls who sucked at their nursing jobs, and are out to prove something. Most of my bad interactions actually involved them trying to critique my RN nursing (and which I was performing correctly, and which they were not right about). That tells you that their NP skills probably sucked as bad as their RN skills.

The GRE sucks. You'll hate it. I've taken it in years past, but didn't need it in my recent NP school application because my GPA was well above 3.5. A lot of programs will waive it if your GPA is high enough. That was a relief to not have to take it again.

It is possible for you to get into PA school, but it it's true that it would be a lot easier to get into and do NP school. It's up to you what you want to put into it. Only you know that. But it's also true that the overall cost of that route is likely to be well over 200k. For me, I calculated it was going to cost me over $250k in lost income, direct cost, and other expenses. That's more than my house. There was no way I was going to opt for that. I also live in a place where I can practice independently as an NP. I'm not going to restrict myself by taking on a career that is dependent on another career to function.

 

[762513]

So your prereqs are going to be a lot to bite off. They are a lot harder than the coursework you took to get into nursing school. Several will probably be harder than anything you took in nursing school. You are looking at upper division anat and phys, gen chem, and enough o chem to qualify for biochemistry, as well as biochemistry itself. Basically, you'll need to treat it like you are a full time student for the near future, along with your full time job as a new nurse. It won't be something you'll be simply dabbling in, so plan for that. Your GPA isn't a deal breaker, but it puts you in the position that you really should be getting as good marks as you can, so that adds to the pressure you'll be under to do well. You really need to break the 3.0 barrier to feel comfortable about your chances, otherwise odds are iffy. Those schools that take lower gpa have a lot of applicants with even better HCE than yours, and maybe better grades overall. You'll be putting a lot of time into your prereqs, you don't want to have to then take a couple cycles to get into school on top of that. Then when you get to PA school, you'll have to quit working as a nurse. You'll pay a large premium for your quest to pursue the medical model. And the flexible practice environment of the past is changing to be less fluid for a variety of reasons. PAs are jumping around a lot less. They still have a lot of latitude to start off in the specialties that they want to. If you dig surgery, then PA is the place to be, but otherwise, you can break into other areas as an NP for the most part, but that can vary depending on region. Where you are located, it might be that PAs are preferred for certain roles.

Right now in my NP program I'm doing a management course that a physician or PA would never have to take, so yes.... There is a difference between what I'm doing, and what the PA students near me are taking (they go to school pretty much all day focusing strictly on medically pertinent subjects). But, virtually none of the local PA students have ever managed anything medically complicated before PA school, so if you are a believer in the value of prior HCE (which I'm not completely convinced is as pertinent as others think), then that's not a huge factor. As a person with a couple biology degrees to my name, I like the idea of my medical provider having a good grasp of things like how mitochondria work on a molecular level... I think it helps overall. You'll never get that kind of depth from NP school, nor NP prereqs. I'm not as worried about what NP school lacks for me because my background is really heavy in biology, but most NPs don't have that benefit. However, I know many nurses that have a firm grasp of how the body works, and really know their stuff, and do a good job of making the transition to becoming a provider because they put in the effort and are humble. The NPs that I've had problems with are know-it-alls who sucked at their nursing jobs, and are out to prove something. Most of my bad interactions actually involved them trying to critique my RN nursing (and which I was performing correctly, and which they were not right about). That tells you that their NP skills probably sucked as bad as their RN skills.

The GRE sucks. You'll hate it. I've taken it in years past, but didn't need it in my recent NP school application because my GPA was well above 3.5. A lot of programs will waive it if your GPA is high enough. That was a relief to not have to take it again.

It is possible for you to get into PA school, but it it's true that it would be a lot easier to get into and do NP school. It's up to you what you want to put into it. Only you know that. But it's also true that the overall cost of that route is likely to be well over 200k. For me, I calculated it was going to cost me over $250k in lost income, direct cost, and other expenses. That's more than my house. There was no way I was going to opt for that. I also live in a place where I can practice independently as an NP. I'm not going to restrict myself by taking on a career that is dependent on another career to function.

Go NP. DNP if you want to teach in the future, if not get your MSN FNP. Make sure you put in the extra effort to get the knowledge they don't teach in the program.

 

[W19]

If NP school is so bad as some of you are saying here, how come they provide better care than physicians according to their studies?

 

[762513]

If NP school is so bad as some of you are saying here, how come they provide better care than physicians according to their studies?

Troll status confirmed.

 

[pamac]

Those studies are fundamentally flawed and can be dismissed.

They might be. I guess the answer is to go do your own study and see what the results are. Maybe the AAPA or PA's For Tomorrow should fundraise from unhappy PA's (maybe some med students as well), and compile some data showing that your anecdotal evidence is indeed based in fact. It would be the best chance to improve the PA image of anything on deck that they could come up with. With one motion, PA's could take your rightful place as the chosen extenders of physicians.

I think the best answer I've heard to counter pro-NP studies is that the research compares physician results with NP's operating in collaboration. What also stands out to me is that the same nurse seems to have her name on both the papers that everyone cites, and she's rabid about NP's being equivalent with doctors.

 

[pamac]

In the meantime, read this article that mentions NP's:

http://www.businessinsider.com/osca...ext-to-the-jay-street-metrotech-subway-stop-1

 

[762513]

They might be. I guess the answer is to go do your own study and see what the results are. Maybe the AAPA or PA's For Tomorrow should fundraise from unhappy PA's (maybe some med students as well), and compile some data showing that your anecdotal evidence is indeed based in fact. It would be the best chance to improve the PA image of anything on deck that they could come up with. With one motion, PA's could take your rightful place as the chosen extenders of physicians.

I think the best answer I've heard to counter pro-NP studies is that the research compares physician results with NP's operating in collaboration. What also stands out to me is that the same nurse seems to have her name on both the papers that everyone cites, and she's rabid about NP's being equivalent with doctors.

I've never seen a study solo authored by a PA, but I've seen thousands written by PhD RNs. The PAs would need to take some of the "fluff" classes they so despise to be capable of authoring a research paper.

 

[pamac]

Well, and everyone complains about the DNP not enhancing clinical skills. Who has ever heard anyone in nursing education imply that it was supposed to? You go to any forum like this, or especially the PA ones, and they complain about two things over most others: the power of the nursing "lobby", and how their status as dependent providers to physicians is cramping their style. Look over any DNP course description and it should be clear that those crazy nurses don't want to be stuck in the place where PAs don't seem to be satisfied occupying. So they loaded up a degree that really should be titled "doctorate of infiltrating healthcare management". Their long term vision doesn't involve passively relying on the good will of others to succeed. DNPs take courses that show them how to get into positions of influence, do some influencing, and be the ones calling the shots in healthcare so they can look out for their own. That's how you get nice things like independent provider status across the entire VA health system over the objection of every physician advocacy group of prominence. Then you have the poor PAs showing up hat in hand saying "us too please". Sorry, us nurses were too busy to bring you along because you distracted us by complaining about how bad we suck as new grads.

 

[762513]

Well, and everyone complains about the DNP not enhancing clinical skills. Who has ever heard anyone in nursing education imply that it was supposed to? You go to any forum like this, or especially the PA ones, and they complain about two things over most others: the power of the nursing "lobby", and how their status as dependent providers to physicians is cramping their style. Look over any DNP course description and it should be clear that those crazy nurses don't want to be stuck in the place where PAs don't seem to be satisfied occupying. So they loaded up a degree that really should be titled "doctorate of infiltrating healthcare management". Their long term vision doesn't involve passively relying on the good will of others to succeed. DNPs take courses that show them how to get into positions of influence, do some influencing, and be the ones calling the shots in healthcare so they can look out for their own. That's how you get nice things like independent provider status across the entire VA health system over the objection of every physician advocacy group of prominence. Then you have the poor PAs showing up hat in hand saying "us too please". Sorry, us nurses were too busy to bring you along because you distracted us by complaining about how bad we suck as new grads.

👍 This.

 

[Boatswain2PA]

Well, and everyone complains about the DNP not enhancing clinical skills. Who has ever heard anyone in nursing education imply that it was supposed to? You go to any forum like this, or especially the PA ones, and they complain about two things over most others: the power of the nursing "lobby", and how their status as dependent providers to physicians is cramping their style. Look over any DNP course description and it should be clear that those crazy nurses don't want to be stuck in the place where PAs don't seem to be satisfied occupying. So they loaded up a degree that really should be titled "doctorate of infiltrating healthcare management". Their long term vision doesn't involve passively relying on the good will of others to succeed. DNPs take courses that show them how to get into positions of influence, do some influencing, and be the ones calling the shots in healthcare so they can look out for their own. That's how you get nice things like independent provider status across the entire VA health system over the objection of every physician advocacy group of prominence. Then you have the poor PAs showing up hat in hand saying "us too please". Sorry, us nurses were too busy to bring you along because you distracted us by complaining about how bad we suck as new grads.

Doctorate of Infiltrating Healthcare Management....perfect description!

 

[pamac]

Doctorate of Infiltrating Healthcare Management....perfect description!

I wish the PA world would take a page from what nurses are doing, but I don't see it happening before the landscape changes in the years to come. It's encouraging to see them start to get feisty and have conversations on PA forums, and see interest at the level of the national organization. When I was considering PA school, those kinds of conversations were not even remotely taking place among anyone at the leadership level. It was a complete turnoff for a prospective PA. But I'm not sure if the change in attitude is happening in time to gain momentum. The folks hitting the PA field aren't the self starters of the past. New PA's seem to be content with things as they are, are young, and are walking into their first career with no concept of bargaining power.

I would love to see PA's gain as much independence as NPs. It would promote a healthy relationship for them as employees, and I don't see how it would hurt patients. It would also help NP's a great deal to have PA's reach parity with them. To begin with, it would force NP educators to up their game in the aspects of our training that causes you guys a lot of concern... and I really think they would then step up to the plate and increase standards once there was another independent provider out there on the market. Second, it would give the world that many more examples of how well a nonphysician provider can function without being attached in a servile framework with doctors (although I think it would also help doctors to be cut loose from that too). Ultimately, its the right thing to do. PA's are too well trained to have to enter into a practice framework that treats them like the are squires to the MD knights. Just free everyone to be agents for themselves. With physician practice ownership changing, I think its time to change things up.

 

[Derekit0]

Thank you everyone for the replies, I appreciate it. I just have one more question, I'm not sure if anyone here can answer it but here we go:

On the CASPA website in the GPA section there is an area that says: "Why is my GPA different than the one on my transcripts?"
Then it states that one of the reasons is because: "CASPA’s numeric scale for letter grades may be different than the one used at your home institution."

When getting my BSN degree the institution does use a different grading scale than what is listed for CASPA. For the institution I attended the grading scale was:
A: 93-100, B: 86-92, C: 78-85.

Meanwhile it seems that CASPA uses the typical: A: 90-100, B: 80-90, C: 70-80.

So, considering all this do you think that CASPA would alter the GPA for my undergraduate BSN degree? If so, this would make a big difference in my GPA. Any insight on this would be a great help. Thank you again everyone for taking the time to reply!

 

[deleted6669]

I've never seen a study solo authored by a PA, but I've seen thousands written by PhD RNs. The PAs would need to take some of the "fluff" classes they so despise to be capable of authoring a research paper.

Plenty of PAs now have doctorates and write research papers. I even have stuff in pubmed.
The best known PA researcher is Rod Hooker, PA, PhD. He has > 200 articles to his credit.
http://pahx.org/hooker-roderick-s
here is one.
https://www.ncbi.nlm.nih.gov/pubmed/21886331

 

[762513]

Plenty of PAs now have doctorates and write research papers. I even have stuff in pubmed.
The best known PA researcher is Rod Hooker, PA, PhD. He has > 200 articles to his credit.
http://pahx.org/hooker-roderick-s
here is one.
https://www.ncbi.nlm.nih.gov/pubmed/21886331

So he's a PhD then. My point still stands. Show me a PA as the only preparation on a research article.

 

[762513]

So he's a PhD then. My point still stands. Show me a PA as the only preparation on a research article, also, what's his PhD in?.

 

[deleted6669]

His PhD is in health policy. Mine is global health. I had published several times before getting my masters and several times since getting my doctorate.
take my word for it, there are plenty of PAs without doctorates, or even masters degrees, who have written hundreds, if not thousands of published research articles over the last 50 years. Research is not a priority for most PAs, but the ones who enjoy it tend to be fairly prolific.
Most programs for PAs taught at the MS level now include research methodology coursework and require a masters thesis of publishable quality. many of these folks submit these for publication upon completion. Mine was published in a well known peer-reviewed medical journal.

 

[762513]

His PhD is in health policy. Mine is global health. I had published several times before getting my masters and several times since getting my doctorate.
take my word for it, there are plenty of PAs without doctorates, or even masters degrees, who have written hundreds, if not thousands of published research articles over the last 50 years. Research is not a priority for most PAs, but the ones who enjoy it tend to be fairly prolific.
Most programs for PAs taught at the MS level now include research methodology coursework and require a masters thesis of publishable quality. many of these folks submit these for publication upon completion. Mine was published in a well known peer-reviewed medical journal.

How in the world would they have time for a top rated research degree during their one year of classroom instruction?

Something sounds fishy. Nursing PhDs are in nursing. That's my point. You can't get a PA PhD, and if you could, I bet it would be filled with all the "fluff" that doesn't help take care of patients, which is exactly the argument against the DNP.