Should I become a physician Assistant or a nurse practionner ? Is there a better or worse option ?

Question

Should I become a physician Assistant or a nurse practionner ? Is there a better or worse option ? Or are they just different. I do know that NP's have to work as a nurse first and PA's just need health expierence but otherwise I dont know which is better or which to pick !

Answer 1

There are differences in NPs and PAs, some are philosophical, and educational, some are practice related based on the state practice acts.

lovesol has given you a correct answer, for her state, but not a full perspective. In some states, NPs and PAs must have a full collaborative agreement with a physician. In others PAs require a full elaborative agreement, but as NPs are licensed as independent practitioners they can work without a physician, but must have some ability to refer patient they feel exceed their scope of practice. Also, each state regulates it's own presciptive privleges. Virtually all US states have prescriptive privleges for both NPs and PAs, in most the physicians name must appear on the PAs presciptions (this also applies to NPs in some states) in others NPs write their scipts without oversight. In many states NPs (and in some PAs) have DEA numbers and can write for narcotics, the amounts and levels vary by state.

All nurse practitioners currently educated in the US must be graduates of an MSN program. Most states require certification by the NPs national certifying board for licensure. NPs also have a BSN as a prerequisite and most programs require the RN to have some experience in the clinical setting before admission. This is the basis upon which the MSN is built. The NPs are trained to perform in specific areas, such as geriatrics, pediatrics, adult health, womens heatlh, neonatal care. The exception to this is the Family nurse practitioner, who is trained as a generalist, but the certifying board, is built from all the boards put together (except neonatal). There has been some discussion about changing the entry to NP to a doctoral program and increasing the length of the course of instruction. This has met with some resistance. NP programs are usually based on a holistic process, with the mindset of treating the whole patient, and not the current disease. Emphasis is on disease prevention and wellness, in addition to management of acute and chronic medical conditions.

PAs education process is less defined. They have an organization which sets the standards for certifyiong the programs, but there is no standard level of entry to practice, or standard prerequsite degree. There are PA programs in the US which award associates degrees, bachelors degrees, and masters degrees. There is a strong push among the leadership in the PA organizations to make the masters degree the standard, but there are reservations, by those who have previously attended associates and bachelors programs. The people entering PA programs usually are required to have some type of health care experience, but these are from various fields, a high number have been EMTs, some have been RNs from ADN programs who did not want to attend the RN to MSN program and found a bachelors PA program or BSNs who did not have NP programs available or desired to be a PA instead of an NP. There have also been noted to be many students in PA programs who majored in Pre-med as an undergraduate yet were unable or decided not to attend medical school. PA programs usually train using a traditional disease model, emphasizing treatment of the disease state. They are trained as generalist, and then often either learn on the job or take additional training in specialty areas.

The salaries for NPs and PAs in the same areas are similar, and NPs and PAs will frequently be seen working in the same clinic. In general, there is no direct competition between the two professions, and each has developed to respect the other. It is common for PA and NP conferences to invite preoviders from both diciplines to present and attend the conferences as the roles are very similar.

In general both PAs and NPs can perform approximately 85% of the functions of physicians, and both have excellent patient satisfaction and patient outcome statistics.

Now that you have seen my long winded statement of the basics, I will sya, that I chose to be a nurse, and then an NP because it allows more versatility. While PAs can perform, most of the same functions an NP can, they are not licensed to perform all the functions an RN can. NPs remains RNs and are NPs, and can work in almost any area of health care they choose. Some will say that PAs can be surgical first assistants, and NPs can't. And it is true, that surgery is not a direct component of the NP educational programs, however, as I am an RN first assistant as well as an NP, that issue can be covered.

It is really up to you, what you want to do, and where you want to go.

Where ever you choose, you will be performing a great service as a health care provider.

EDIT: Just a couple of additions:

First, I apologize for all the typos in my answers, I have a med condition, and don't feel the keyboard, it sometimes seems to type what it wants, I truely can, spell.

Second, I have never, been asked to work as a nurse, since completing my NP program, I do, however, stress, that I have known, NPs who also wanted, to work performing some tasks, which are generally under the auspices of the Nurse Practice Act of their state. It gave them versatility. Additionally, while, I did spend time learning the nursing information and skills during my undergraduate degree, at the time my goal was to be a nurse anesthetist, and not an NP, it was the ability of an RN to choose many fields, that allowed me to change, and go to the NP program.

Finally, I have found prescriptive privleges invaluable, as I often work in clinics, without physician oversight. As I have specialized and then subspecialized, I usually, work with patients, not seen by other health providers. In working with patients with severe pain issues I need the ability to write prescriptions and on occasion narcotics.

Answer 2

Your answer from the NP was great. I will add my PA 2 cents.
But first, all states allow prescriptive rights at this point (although why the ability to write an Rx seems to be such an important part of this I am not sure!). I work in California & Maryland & have my own DEA number.

I went to PA school because I did not really agree with alot of the nursing junk in nursing school, and I saw NPs who were forced to work as nurses on days nurses were short--something I did not want to do. As a PA I was always considered a "doctor type" and did not have to fill in in another capacity. I also was more interested in the medical model of education than the nursing model. I wanted to do trauma, critical care, emergency and PA was (at that time) the better route. I started out as a medical technologist (which is a BS) as well so I didn't want to add a lot of nursing years onto my training beyond what I had already done (an AA).
My BFF was a NP student at roughly the same time so we compared a lot and for what each of us wanted we made the right choices.
I went into pediatric critical care and then into the ER. I handled most of the trauma and did procedures (which I love) and which the doc's were happy to give up. I was able to pick my schedule and work what days I wanted. I was also able to pick up locum tenens (traveling) jobs which took me to Maryland for the summers (the Chesapeake bay). There really was never a time when I felt that I was being cheated out of jobs by not being a NP (except maybe those minute clinics0---but hey, those look BORING!). Salaries are overall fairly equal (some times NPs make more some times PAs--but the difference is minimal). Only big difference is malpractice--NPs get nursing malpractice (cheaper) PAs get MD--but that will change as more get sued. Also, this autonomy thing--I never would want to be completely autonomous anyway--that MD safety net is priceless in my experience.

I would shadow each for some time & decide if you want to specialize as well. Perhaps that will help your decision.

Answer 3

I struggled with the same decision and decided to go with a Nurse Practitioner. PA's have to work under a doctor's supervision and cannot write scripts. It's true that NP's must gain experience as a nurse first, but I think they have more options and a variety of work settings to choose from compared to a PA. NP's can also write scripts (except for narcotics) and I believe they have higher salaries. I wouldn't say one is better than the other, just different. Good Luck!

Answer 4

Nurse practionner make lots of money, and require lots of schooling.

Good luck with your career route.