[Jenniferwhnp]

As a Nurse Practitioner, I think that one must understand the real difference between the two (NP and PA) a PA is bound by guidelines that the physician places for the PA it is like giving care only based on Algorithums that he has placed for the PA to practice from. Everything that the PA does has to be signed off by the DR. Also the PA has to work with the Physician, unlike a NP who can set up her own clinic in collaboration with a physician who is no more than 30 miles away and then the DR has to do a review of charts (random) of the NP's work. The PA can write RX but only if the DR approves, and the PA is signing under the MD's number. A NP can apply for a DEA number and write for Narcotics even. A NP is an automous caregiver within their scope of practice, when the case is too complex then the patient is referred to the physician for extended care. Nurse practitioners are viewed less in the military eyes than PA so if you were wanting to do something military and stick with that then PA would be more beneficial for you. But just look at the terms PA and NP. What do they state? PA Physician's Assistant, and a Nurse PRactitioner is a Nurse that practices medicine within their scope of knowledge. I am a Women's health nurse practitioner so I can't treat any males in my scope unless they are begin seen for a sexually transmitted disease. There are only a few similarities between an NP and a PA and many differences.

[ProPA]

I want to clear up a few misconceptions that have been stated-
The PA profession is well on its way (and has been for several years) to most programs (and soon all programs) giving Masters degrees. Most students (over 75%) entering PA school have undergraduate degrees, most in a science discipline ie biology, chemistry, etc.

PA's are able to prescribe, apply for a DEA number and prescribe narcotics- we are governed by state laws- in New York PA's can prescribe as follows (from American Academy of Physician Assistants)
PA may prescribe Schedule III-V and non-controlled medications. PA prescribers of controlled drugs must register with the DEA.

(www.aapa.org)

[trier]

Hi khaki scott
If a calcium channel blocker isn't the first line for hypertension can you tell me what is?..I need the help being a student nurse it's good to know these things and you people have been out in the field and I have barely got to it. Can you also help with my query 'having a tough time'(it's in the male forum as I was replying to someone else because I need some good sound advice and I will be appreciative of all ideas to help. I need to get through this and you people probably have a lot of good answers, want to share?
thanks trier

[Sandy Jones]

I am a board certified acute care nurse practitioner. I graduated with my Master's Degree in 2003. I am still looking for employment. It was the worst decision I ever made to become an NP. I had 17 previous years of cardiology experience before being accepted into graduate school. I have lived in 5 states since graduation and still have not found a job. I have experienced everything imaginable as to why they would not hire me. I'm constantly told they want someone with experience as an NP, but how can you get experience if NOONE will hire you. I am an attractive blond haired blue eyed woman, and numerous jobs have denied me employment because the other nurses and NP I guess are intimidated by me. I worked for 3 weeks for a neurologist, but had to resign because the physician was committing medicare fraud. I relocated from another state to work for a group of 7 cardiologists, and the senior partner was constantly critical of me, and I was working at 3 hospitals, 2 LTAC facilities, and 2 offices. He told me that I was not knowledgeable enough about cardiology. He humiliated me on a daily basis as well as sexually harassed me. He told me quote " you are a medical student, you have your credentials, but you have not yet completed your residency". I resigned the next day. Becoming a nurse practitioner has been nothing but a nightmare for me. I feel I am involved in a turf war with the physicians. They challenge me and treat me horribly. I originally had planned on becoming a CRNA. The jobs are in high demand now and they make great money. I would advise ANYONE who is considering becoming a nurse practitioner to choose another path. It cost me 35K and I was gainfully employed until I became an NP now nothing is available. The physicians tend to lean more toward the PA's because they can control them, and they are not regulated by a state board of nursing. I had also considered going to law school and becoming a malpractice attorney previously, and unfortunately I did not choose that path. Don't make the mistake I did stay out of NURSING it is the WORST career that anyone could ever choose. My husband is also a nurse and hates it. EVERYONE PLEASE STAY AWAY FROM NURSING.

[Sandy Jones]

Originally Posted by ProPA

I am a PA student and while doing some research I came across this and I am ASTOUNDED to read what you have to say about PAs. I would like to point out a few things about my profession that you may not realize-
- PA's and NP's are trained in two different modes- PA's are trained in a MEDICAL model (that is, based on medical school) while NP's are trained in a NURSING model (that is, based on nursing school).
- PA's are trained as generalists (we recieve training in internal medicine, surgery, OB/GYN, peds, psych, etc etc) while NP's are trained to work in ONE special area.
- Most PA's work in SURGERY, while most NP's work in FAMILY PRACTICE.
- NP's do 200 hours of clinical work toward their degree (this info I got from a Columbia University NP student). I did more than 200 hours in my surgery rotation (enough said)
- BOTH NP's and PA's are required to have clinical experience before entering programs (Most PA programs require 2000 hrs)

Of course I am pro-pa, but I definatly think that NPs have a place in medicine as well. As far as choosing one over the other, it really depends on what field you want to work in- I've yet to see an NP in the OR or ER, but that is mostly what I see in Family Practice and geriatrics.

I'm happy to continue the discussion if intelligent comments prevails.

You obviously are misinfomred as a PA STUDENT I am an acute care nurse practitioner board certified. There were 7 graduate students in our class ALL of us had 12 + years of clinical before getting accepted into grad school. I had 17 years of critical care cardiology experience. I had over 700 hrs. of clinical with my ACNP degree. I worked in the ICU, and was on the congestive heart failure consult team, as well as 2 semesters of internal medicine in the ICU and outpatient. ALL of my general knowledge came from an Associate, and Bachelors's degrees. By the time we get into graduate school we are well trained and proficient both academically and clinically. As for your comment about intelligent conversation I have a 4.0 GPA. Something you will learn as you BEGIN in medicine is you will form your patient base by word of mouth and word travels fast. Better think before you speak.

[medi]

I dropped back by this thread to apologize because my initial reply was too flippant and given from my previous perspective as a military RN seeing how PA's were treated in the military.

My eyes have been opened by seeing the actual world reality and learning more about the differences between the two disciplines. If I can venture to answer the question again I would have to say that I would definitely choose to become a NP.

Other individuals in this thread have given excellent answers that clearly define the differences between each discipline, and it is abundantly clear that NP's have far more clinical experience, expertise, and background knowledge - the ability to practice autonomously rather than be an "assistant to" anyone, to branch into just as many specialty practice areas than PA's, and are far more educated when one considers the BSN degree earned before the MSN.

A NP is able to view patients in a holistic manner and help with all sorts of things PAs are not geared towards, such as health education of the patient and family, socioeconomic implications of their healthcare needs, etc.. being nurses a NP would provide primary care of the entire needs rather than just immediate (technical) care of the presenting problem alone.

Given the choice I would choose to be an autonomous health care provider than an assistant who has to work under the supervision of another providers license (as PAs must do).

[Cammer]

Originally Posted by medi

I dropped back by this thread to apologize because my initial reply was too flippant and given from my previous perspective as a military RN seeing how PA's were treated in the military.

My eyes have been opened by seeing the actual world reality and learning more about the differences between the two disciplines. If I can venture to answer the question again I would have to say that I would definitely choose to become a NP.

Other individuals in this thread have given excellent answers that clearly define the differences between each discipline, and it is abundantly clear that NP's have far more clinical experience, expertise, and background knowledge - the ability to practice autonomously rather than be an "assistant to" anyone, to branch into just as many specialty practice areas than PA's, and are far more educated when one considers the BSN degree earned before the MSN.

A NP is able to view patients in a holistic manner and help with all sorts of things PAs are not geared towards, such as health education of the patient and family, socioeconomic implications of their healthcare needs, etc.. being nurses a NP would provide primary care of the entire needs rather than just immediate (technical) care of the presenting problem alone.

Given the choice I would choose to be an autonomous health care provider than an assistant who has to work under the supervision of another providers license (as PAs must do).

Excellent Post Medi!

[Cammer]

Originally Posted by ProPA

I am a PA student ...

- NP's do 200 hours of clinical work toward their degree (this info I got from a Columbia University NP student). I did more than 200 hours in my surgery rotation (enough said)

A quick perusal of a local university's (University of Tampa) curriculum shows four courses that EACH require a minimum of 224 hours of supervised clinical practice. These four courses alone approximate at least 900 hours. I'm sure there is additional clinical practice required but I didn't bother to add more to this. (enough said back at ya)

You might want to check again with your buddy at Columbia. I was unable to verify clinical hour times because Columbia doesn't seem to list them on their website.

[determined]

I Read It All...ha,ha,ha,..nurse Practitioners All The Way!....like Someone Said, Physician "assistant"

[cassandra581]

Originally Posted by Henry

Let me add this little bit of knowledge to this discussion. NP's while once having their BSN followed a nursing science curriculum in their undergraduate studies. The science courses like Biology, Chemistry, Organic Chemistry, Biochemistry, Physics have two tracks one for science majors whom end result would be graduate studies in a science discipline, medical school, or PA school (you can only have science major courses in order to be accepted in an accredited program). The other track is for nursing majors where the courses in some universities are combined in multiple courses and offer only a broad overview of these subjects, or they only require the first two of each of the basics. Anatomy and Pathophysiology are not taught as combined courses in PA school or in Med School and therefore are not considered requirements for entry into these programs because of the intense degree in which they are taught in these programs.

I believe this is different for each school. In the school I'm currently in earning only an Associates Degree as an RN, this most certainly is not the case. It's required that we take anatomy, physiology, pathophysiology, and microbiology! Those are all individual in-depth courses which are not broad overviews and are in no way combined with each other. We are expected to have an in-depth understanding of these sciences. All of these plus more in-depth, non-combined courses are required by the U of MN which I paln to transfer to. They also require labs for each of these courses (some schools seem not to). So I don't see how that gives me only a braod overview! Oh, also these are the same courses required for admission to the U of MN's Medical School. A doctor does have to study even more sciences and physics (which I do not believe is required for a BSN or MSN but could be wrong). I don't plan to become a NP or a PA, I'm actually planning on becoming a Nurse Anesthetist but I think there is more opportunity for advancement as a nurse than as a PA. Not that being a PA is a bad thing but, I would rather be treated by a NP in most cases. Money-wise a PA can make more money faster but a nurse does have high paying options depending where they go with their nursing career. If high paying jobs are what your looking for you could try various branches of the nursing field. The Average wages of a PA in NY were $54,890 for entry level workers and $99,970 for experienced workers. The 2005 National Salary Survey of Nurse Practitioners shows that the average annual full-time salary for a nurse practitioner has reached $74,812. The national for a nurse anesthetis is $133,500.00! The national average for a family practice doctor was $143,000.00 So there are places you can go with a MSN that can pay quite well. I think that it depends more which job appeals to you personally.