NP vs. PA?

[MomsintheGarden]

This doesn't sound right. Where I live, PA is a master's degree program, but your bachelors needn't be in nursing, it can be most anything as long as you have the prerequisite course work (mostly biology and chemistry requirements).

 

One big factor in PA vs. NP is that PA's are required to work under a supervising physician, while in many states a N.P. can have an independent practice.

Thanks!

 

I checked out the local uni PA program, and they prefer candidates with a lot of health field experience.  The average was 2500 hours, or about a year and a half.  They listed health jobs, and nursing was included.  So it looks like you can get a bachelor's in nursing as well as in other majors as long as you have the experience.

 

The supervising physician comment is coming up often.  We will look into it, keeping in mind that a lot will probably change over the next ten years.

 

[MomsintheGarden]

I haven't read everything, but in most states NP's have more ability to open a practice on their own, without physician oversight, than PA's do.

 

Also, their knowledge is typically superior.  NP's typically work in nursing for several years before they go to grad school, and that bedside experience gives NP's a FAR SUPERIOR ability to read patients AND to have a broad overview of the most common problems and the ways different doctors treat such problems.

 

Back when I was making this choice, I chose nursing path.  At that time, a community college in Miami had a PA program there, which I would have chosen if I'd decided to go that path.  IDK if the requirements have changed, but if he's interested he should look into that program.

 

 

ETA:  Many states are moving towards making NP's get doctorates, which is another reason many nurses consider NP's superior.

The bolded is what the person I talked to said.  She said the NPs she knew understood what was going on better than PAs.  I wonder if that issue will be addressed in future PA education, or if it is a result of a different educational paradigm.  The local PA school (master's) requires health field experience, but it doesn't have to be in nursing.  You just need some kind of health-related experience.

 

[MomsintheGarden]

In my area, PA programs are at private schools and are very expensive while NP or nursing programs are at state schools and are more affordable.

 

PA is a good choice for someone who already has a bachelor's degree in another field and has been working for many years and then while homeschooling their children and working part time decides to take 1 prerequisite hard science class a semester to become a competitive applicant for a PA program whereas NP would have required taking bachelor nursing classes before prerequisites to become a competitive applicant.

 

(speaking from personal experience:)

I appreciate your experienced input.  That is good to know that PA programs can be more expensive.  Cost is important to us.  Around here, the PA master's is a 30 month program that costs about 82K.

 

Are you working on a PA or NP?  If you are, how is it going?

[MomsintheGarden]

Thank you.  We have learned so much about the health care system and so many occupations we didn't even know existed before this. Her sister is thinking she wants to be a child life specialist, which is another  job I didn't even know existed before dd got sick. I hope your son has fully recovered.  Lyme is so nasty.  My daughter's disease is chronic, life threatening, needs infusions every 14 days and genetic so any field she goes into we have to count the cost in her health.  She is doing great and stable but the pace of medical school isn't in the cards unless something dramatically changes.  She is very math and science oriented so every idea she has is related to the medical field.  She also loves art but she figures that won't pay for all her medical bills in the future.

 

Kimberly

 

I liked your post because I appreciate your input, not because I like your dd's disease.  That is just awful.  She will certainly have a deep understanding of chronic health issues and of many aspects of health care to bring into whatever field she enters.

 

Ds has recovered, but has some slight lingering neurological effects from the Lyme.  I know what you mean about art; my dd has talked herself out of an art career because of finances.

 

[MomsintheGarden]

My cousin is a PA and he was a nurse for years before he went back to school to become a PA.

 

That is good to know; nursing could be a very good career with or without NP or PA.

 

[MomsintheGarden]

This is one of the major differences that I wanted to mention. Nursing focuses on caring for the patient as a whole, while medicine diagnoses disease. It may seem insignificant, but it's actually very different. I'm a pre-nursing student and my friend is a pre-PA student and even at this stage in our education, we have different aspects that we focus on.

 

Best of luck to your son!

 

 

Sent from my XT1049 using Tapatalk

 

Allopathic vs. holistic is definitely going to be part of our conversations.  DO programs also say they emphasize the holistic approach, but I imagine it's of a different sort than that of nursing programs.

 

By pre-nursing, do you mean you are in the first year of a BSN degree?

 

Thanks!

[Mrs_JWM]

 

 

DO programs also say they emphasize the holistic approach.

 

By pre-nursing, do you mean you are in the first year of a BSN degree?

 

Thanks!

I have a friend who is a DO, and the depth of the holistic approach definitely varies by the program.

 

I'm finishing up the last of my prerequisites this year - A&P and microbiology - and then I'll start an 18-month ASN program in January of 2018. I have a previous bachelor's degree, so I'll do an additional 30 credits to get my BSN once I've worked for at least a year.

 

Now back to memorizing cranial bones... [emoji1]

 

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[bnbacademy]

Have not read all replies, but this is what I have researched. I have a son also interested in medical field, and have debated the same question. 

 

NP requires a BS of Nursing first, then further education to the Master's level currently. However, there are rumblings that this degree will soon require a PhD to practice. A NP can practice independently. Approach to illness may be more wholistic in scope.

 

    One benefit is that can practice as an RN first, then decide to further education while working.

 

 

PA would follow a similar course of study as a pre-medical student, more of a pathophysiological approach to illness, diagnosing symptoms, etc. Practices under the license of an MD, so cannot set up an independent practice.

[Katy]

The bolded is what the person I talked to said.  She said the NPs she knew understood what was going on better than PAs.  I wonder if that issue will be addressed in future PA education, or if it is a result of a different educational paradigm.  The local PA school (master's) requires health field experience, but it doesn't have to be in nursing.  You just need some kind of health-related experience.

 

 

Right, and dealing with patients directly and their medications, and observing their response to medications makes you a better provider IMO than someone whose only experience was as a hospital tech or orderly.  In most (non-complicated) situations, I actually think NP's are better primary care givers than physicians because they are more focused on the whole person and their quality of life than they are on solving a particular set of symptoms. 

 

But again, requirements are different in different states, so YMMV. 

 

Honestly if kiddo envisions living near home as an adult, I would look at every program within 250 miles or so, as well as any other state (s)he might like to live in.  It's probably best to go to school in or near the state they want to live, as requirements are so different.

[MomsintheGarden]

Have not read all replies, but this is what I have researched. I have a son also interested in medical field, and have debated the same question. 

 

NP requires a BS of Nursing first, then further education to the Master's level currently. However, there are rumblings that this degree will soon require a PhD to practice. A NP can practice independently. Approach to illness may be more wholistic in scope.

 

    One benefit is that can practice as an RN first, then decide to further education while working.

 

 

PA would follow a similar course of study as a pre-medical student, more of a pathophysiological approach to illness, diagnosing symptoms, etc. Practices under the license of an MD, so cannot set up an independent practice.

Thanks for weighing in.  We will be discussing the advantages and disadvantages of having your own practice.  It can be nice to go home every night knowing that someone else is responsible for the bottom line, but it can be also nice to be able to be in charge of things.  However, I believe the insurance companies run much of what's happening (or not) in "regular" medicine these days, for better or worse.

 

ETA - Oops, I almost forgot.  What has your son decided he wants to do and why?

Edited September 22, 2016 by MomsintheGarden

[MomsintheGarden]

Right, and dealing with patients directly and their medications, and observing their response to medications makes you a better provider IMO than someone whose only experience was as a hospital tech or orderly.  In most (non-complicated) situations, I actually think NP's are better primary care givers than physicians because they are more focused on the whole person and their quality of life than they are on solving a particular set of symptoms. 

 

But again, requirements are different in different states, so YMMV. 

 

Honestly if kiddo envisions living near home as an adult, I would look at every program within 250 miles or so, as well as any other state (s)he might like to live in.  It's probably best to go to school in or near the state they want to live, as requirements are so different.

 

Thanks for your helpful thoughts.  We will bring all of what you said into our discussion.  I agree that hands-on patient care that involves responses and results would be much better prep than hospital tech.  I was told the other day that the term "orderly" is no longer used.  Oops - I guess I am old.

 

The well-respected private uni that is 20 minutes away has PA, RN to MSN, Doctor of NP, MSN Family NP, and MSN Psychiatric Mental Health NP programs.  The also have PharmD, MS in OT, and a Doctorate in PT.  It's great to have such a fantastic resource nearby.  They are expensive, though, so we will have to think about how the savings from living at home plays out with a lower-cost option.

 

[bnbacademy]

 However, I believe the insurance companies run much of what's happening (or not) in "regular" medicine these days, for better or worse.

 

ETA - Oops, I almost forgot.  What has your son decided he wants to do and why?

 

As a BSN working in the hospital setting for the past 29 yrs, I would agree with the bolded. In fact, my son is contemplating a medical career. I found myself discouraging him from pursuing a career as a Medical Doctor for exactly this reason. He would spend years of his life training to be a critical thinker, only to have it taken away by a medical board at an insurance company dictating treatment protocols and medication regimens. Unfortunately, no matter how much you love your MD, if your insurance co. does not pay for the medicine, you will probably follow the treatment plan or medication that your insurance will pay for.   

 

Son does not know yet what he wants. We are trying to figure out what would be the most versatile degree, with minimal years in study, and least debt. He surprised me in saying that he may want to be a nurse. I see him maybe starting as a BSN, and then moving into other science fields from there, as he chooses. At least he can work his way thru post-grad education. Unfortunately, the medical field is in love with higher degrees.  I'm hoping this is just a phase...

[TX Native]

I agree too about the insurance companies setting formulas and making demands on doctors. My FIL had surgery recently and the doctor wanted to keep him overnight. The doc had to call the insurance company for approval and the insurance company said no. The doctor used to be able to choose the treatment plans and now the insurance companies choose. All people with x procedure get outpatient, all people with y procedure get 1 night hospital stay, all people who have z procedure get 3 nights. The same with orders for lab and test. If the diagnosis by the doctor doesn't satisfy the insurance company for the need for the ordered test, the insurance will not pay for what the doctor deems as thorough treatment. So people either have to pay OOP for what the doctor wants or the doctor never gets the lab or test he/she wants.

 

Here, we have a MSN program at a highly respected university (nationally known) that will allow non-medical undergraduate degrees to enter the master's nursing program for NP. The 1st year is 3 semesters preparing to take the NCLEX exam to be an RN, and the last 3 semester are NP specific training and clinicals.

Edited September 22, 2016 by TX native

[MomsintheGarden]

I agree too about the insurance companies setting formulas and making demands on doctors. My FIL had surgery recently and the doctor wanted to keep him overnight. The doc had to call the insurance company for approval and the insurance company said no. The doctor used to be able to choose the treatment plans and now the insurance companies choose. All people with x procedure get outpatient, all people with y procedure get 1 night hospital stay, all people who have z procedure get 3 nights. The same with orders for lab and test. If the diagnosis by the doctor doesn't satisfy the insurance company for the need for the ordered test, the insurance will not pay for what the doctor deems as thorough treatment. So people either have to pay OOP for what the doctor wants or the doctor never gets the lab or test he/she wants.

 

Here, we have a MSN program at a highly respected university (nationally known) that will allow non-medical undergraduate degrees to enter the master's nursing program for NP. The 1st year is 3 semesters preparing to take the NCLEX exam to be an RN, and the last 3 semester are NP specific training and clinicals.

That is terrible about your FIL.  I hope he is ok.  I dislike cookie cutter medicine and the fact that the drs' hands are tied.

 

I know an NP who did undergrad at VA Tech, which does not have a nursing program.  She must have done that kind of MSN program.  It is good to know that you can change your mind, although the process is probably more streamlined if you stick with your initial choices.

 

[kbutton]

I think some of the relative strengths in NP vs. PA come as much from clinician personality and the specific medical philosophy of the institution the student attends. Locally, we have a PA school that has a strong DO vs. MD vibe (the doctors in that larger network are largely DOs), but they also have some professors in the program (including clinical instructors) that are nurses, and the PA students from that program tend to be very strong in their history taking and physical exams. I know that someone mentioned history taking as probably stronger for NPs. This program also turns out PAs with really strong pharmacology skills, which was a frustrating thing before our state FINALLY allowed PAs to prescribe meds. There was basically no reason for denying prescriptive privileges other than local custom and the fact that our state had so few PAs that many people had never seen one in practice and didn't know what they were. (This has changed recently and rapidly.)

 

In our state, NPs and PAs fill almost identical roles, but NPs can have their own practice. We also have a very, very large number of nursing programs locally, so it's more familiar and more accessible to become a PA where we live. This is completely opposite from the state where I was born. They have lots of PA schools (second only to CA at one point), and they employ huge numbers of PAs.