What would you do??

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MexicanDr

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I currently work as an RN in critical care and have been doing it for less than a year, but my long term plan is to be a midlevel provider.. Currently, I am really confused on which route I should take, either NP or PA.

Here is a bit about me:

30 y/o male, worked as an EMT before becoming an RN and have a B.S. in Public Health. I attended an ADN/ASN program in nursing since I had a B.S. already. Currently, I am debating if I should complete a 1 year RN-BSN degree which I would start in the summer then apply to an NP program; or simply take advance level classes in Biology/Science and apply to PA school.

I like how PA focuses in the medical model and how it seems PAs have more flexibility from going from specialty to specialty compared to NPs. I would like to work ER/ICU and Family Practice as a midlevel provider; I am just not sure on what to do.. My overall GPA is about 3.1 with a strong upward trend in the last 60 units consisting of just As and Bs.

Will doing the 1 year BSN be a smart idea even if I still decide to do PA school or should I only do the BSN if decide to do NP? Or, should I simply take advance science classes, add maybe a minor in Biology/Chemistry and apply to PA school? Either of the two paths I chose will show the continuous upward trend in my GPA and with my experience in EMS plus an RN in critical care/er hopefully help me out.

I am wanting to start a PA/NP program by Summer of 2014; which of these two options do you feel are the best? What would you do?

Thanks in advance.

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I currently work as an RN in critical care and have been doing it for less than a year, but my long term plan is to be a midlevel provider.. Currently, I am really confused on which route I should take, either NP or PA.

Here is a bit about me:

30 y/o male, worked as an EMT before becoming an RN and have a B.S. in Public Health. I attended an ADN/ASN program in nursing since I had a B.S. already. Currently, I am debating if I should complete a 1 year RN-BSN degree which I would start in the summer then apply to an NP program; or simply take advance level classes in Biology/Science and apply to PA school.

I like how PA focuses in the medical model and how it seems PAs have more flexibility from going from specialty to specialty compared to NPs. I would like to work ER/ICU and Family Practice as a midlevel provider; I am just not sure on what to do.. My overall GPA is about 3.1 with a strong upward trend in the last 60 units consisting of just As and Bs.

Will doing the 1 year BSN be a smart idea even if I still decide to do PA school or should I only do the BSN if decide to do NP? Or, should I simply take advance science classes, add maybe a minor in Biology/Chemistry and apply to PA school? Either of the two paths I chose will show the continuous upward trend in my GPA and with my experience in EMS plus an RN in critical care/er hopefully help me out.

I am wanting to start a PA/NP program by Summer of 2014; which of these two options do you feel are the best? What would you do?

Thanks in advance.

Your GPA is going to be low to get into a lot of PA schools, I am not so sure about NP schools. You do however, seem have a lot of HCE which is a great counter balance for many programs and IMO is more important.

If I were you I would apply to both. I personally think there are a lot of advantages of being a PA, as I am a PA student(pay a bit more, seemingly more flexibility in transitioning specialties, team approach to work, autonomy if you want, medical model of training), but I am sure that any NP will point to all their benefits.

I think that either way you'll be good, see what works best for you and your family. What will be an easier transition for you? What will be most affordable? Will you have to relocate your family? Do you want to work independently of a doctor? Do you think that you will want to ever work in other specialties?

Make a list of pros and cons for each and see which one appeals to you the most.

Good luck!
 
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I currently work as an RN in critical care and have been doing it for less than a year, but my long term plan is to be a midlevel provider.. Currently, I am really confused on which route I should take, either NP or PA.

Here is a bit about me:

30 y/o male, worked as an EMT before becoming an RN and have a B.S. in Public Health. I attended an ADN/ASN program in nursing since I had a B.S. already. Currently, I am debating if I should complete a 1 year RN-BSN degree which I would start in the summer then apply to an NP program; or simply take advance level classes in Biology/Science and apply to PA school.

I like how PA focuses in the medical model and how it seems PAs have more flexibility from going from specialty to specialty compared to NPs. I would like to work ER/ICU and Family Practice as a midlevel provider; I am just not sure on what to do.. My overall GPA is about 3.1 with a strong upward trend in the last 60 units consisting of just As and Bs.

Will doing the 1 year BSN be a smart idea even if I still decide to do PA school or should I only do the BSN if decide to do NP? Or, should I simply take advance science classes, add maybe a minor in Biology/Chemistry and apply to PA school? Either of the two paths I chose will show the continuous upward trend in my GPA and with my experience in EMS plus an RN in critical care/er hopefully help me out.

I am wanting to start a PA/NP program by Summer of 2014; which of these two options do you feel are the best? What would you do?

Thanks in advance.

I'd do NP, but im biased towards the path im taking because it seems to work best for me. I'm in the process of just finishing up my ADN, and will go on to be a provider after I hammer out the BSN completion and get more critical care experience. For a while I considered PA school, but that faded when I discovered the breadth of opportunities within nursing. To me it makes more sense to stay within that sphere if you are already a nurse. If I decide to to anesthesia at some point down the road, its a seamless transition. Same thing if I get burned out and decide to do administration. A lot of the nursing admin near me either have FNPs, or are getting them. I could see lateral moves within the PA world getting more difficult before I could see them getting easier (or even being as easy as they have been). And lateral transitions seem to be what PAs are limited to vs nurses being able to move up the chain. Since im in one of the more NP friendly states, it doesnt make sense to go PA and sacrifice options. I agree that PAs are very well trained, though.

Heres how it is near me, and this is kind of what colors my view of what I want to do, since I want to stay in this region: I dont really see many NP's in the hospital ICU where I am (I dont see PAs there much either but I see them there in greater numbers than NPs of any stripe). In ERs where I am, all of the different facilities almost exclusively use NPs, but there are PAs in that capacity that I hear of occasionally. I hear the only reason this is the case is because the different emergency groups here have decided that NPs bring less liability to them because of their level of independence.

With your grades and background (as well as doing well in any additional sciences you take as prereqs), you could probably have a good shot to get into the only PA schools that I think are worth going to, which are the ones that require real HCE.

But if you want to start school in 2014, I'd definately do an NP program. You could continue getting great ICU experience and do your NP program, working and networking to line up jobs when you are done. Along the way, your nursing degree and your past experience in EMS could get you some cool work in flight, or critical care transport. I know an individual who is a flight NP, and another that volunteers with a tactical team... both of them working in their scope as NPs. You'd never see a PA doing something like that within thier scope because no SP would see a reason to sign on the bottom line.

There are just so many cool options out there with that nursing degree that dont involve being in a clinic all day if you don't want to. I'm not really interested in doing any of those things I mentioned, but being associated with the nursing world opens a lot of different doors. For me, I hope to settle into family practice, and I mention the diversity as a way to highlight the fact that as a nurse, you are part of a broad movement (whether thats good or bad for healthcare as a whole is your call). I think that being part of the PA movement means being tugged at from different directions, and few of those are PA driven.
 
I know an individual who is a flight NP, and another that volunteers with a tactical team... both of them working in their scope as NPs. You'd never see a PA doing something like that within thier scope because no SP would see a reason to sign on the bottom line.

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I know PAs who do both of these things. the docs they work with are also on the same flight and tactical teams. also, most states do not require 100% of notes signed anymore. some require 0%, some require 5-10% and some require only certain types of charts(admissions for example).
also PAs on federal DMAT (DISASTER) Teams are not even required to have a team sp of record. they have a defined scope of practice but no formal oversight other than what other team members(docs included) have.
 
I know PAs who do both of these things. the docs they work with are also on the same flight and tactical teams.

I think you highlighted the glaring issue right there... PAs had to be fortunate enough to have a like minded SP in the exact position make things happen for them. No unique arrangements interfered with the NPs. That's the point. I wouldn't have to search high and low for a physician buddy if I wanted to help out a swat team locally... I'd just go offer. What if I was a PA and wanted to do that in my city, but no MD wanted to join in? Then it's a no go. Or if I was a PA and my FP SP wasn't comfortable with my doing that? Then it's also a no go because they control the scope. How frustrating would it be to have the skills to help out and carry a call out pager only to thave to ask permission from your SP, who may or may not be willing to "let" you do it? There's really no reason why someone like you should have to jump through any more hoops than an NP to do something like that, but that kind of stumbling block is built into the PA profession.
 
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Honestly PAMAC. It's quite easy to find an SP to let you do those type of things and it also helps bring in more $ into his/her practice. Also NP independence is a scary thing, and the Physicians who preach to patients about them being totally capable of practicing medicine independently(which I have seen a few and made sure my family steered away from that practice) should IMHO retire because they honestly have forgotten the struggle of residency as well as medical school vs NP with less training and equal autonomy.
 
EMED what is that chart review policy for EM now? Haven't worked in a good bit so I am wondering.
 
EMED what is that chart review policy for EM now? Haven't worked in a good bit so I am wondering.
I practice in 2 different states. one requires 10% chart review and one requires zero chart review but that the SP have an "ongoing awareness of pa practice patterns".
the hospitals I work at, however, require 100% chart review so that is the default, although I don't think my sp's read them that closely.
 
Honestly PAMAC. It's quite easy to find an SP to let you do those type of things and it also helps bring in more $ into his/her practice. Also NP independence is a scary thing, and the Physicians who preach to patients about them being totally capable of practicing medicine independently(which I have seen a few and made sure my family steered away from that practice) should IMHO retire because they honestly have forgotten the struggle of residency as well as medical school vs NP with less training and equal autonomy.

Maybe it is easy to find an SP willing to let a PA volunteer on a tactical team, but in the examples emedpa mentioned, neither PA was functioning in their roles without their SPs being just as affiliated in the endeavor as they were, whereas the NPs I know of had no similar requirements. In the case of the NP and the tac team, no money is changing hands because it's on a volunteer basis. Any place that NP sets down can be where that NP can offer to help out on high risk activities without looking for an SP to convince to take on liability. Additionally, there isn't a zero sum nature to the NP accompanying officers, as it's a medical provider on scene that wouldn't otherwise be present (and doing so under their own liability). As for the flight company and the various ERs nearby that made the call to utilize NPs.... I guess that was the choice of the group admin based on whatever priorities they have. But even if an SP is willing to allow a PA under their supervision/sponsorship, like you said, they would understandably want a cut of the action for the risk, and in many places NPs would be free from needing those kinds of arrangements. I'm not pushing the notion that NPs > PAs, but highlighting how the system seems to offer them what I believe to be perks. I'm not endorsing that as either good or bad, but just mentioning that those facts exist. I'm also picky about what kind of provider I see (I have seen PAs and NPs, but generally if I'm in to see a provider its to address an issue that I feel like I want a physician to address).

But yes, your mention of physicians getting a cut of the cash is important in the case of the volunteer SWAT medic. I would imagine that a doctor would avoid such an activity where they have potential to gain nothing other than risk of liability for indulging a PAs sense of service. Certainly if they don't, then their malpractice insurer, practice partners, and/or spouse might. Maybe that's why emedpa's colleagues are only in those capacities with the express permission and close association with physicians.
 
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