Thoughts on NP vs PA degrees?

[cheme]

Dd is applying to college. She decided to apply mostly to direct admit nursing programs. She doesn't know if she would do an advanced degree yet, but she is thinking about it, so I'm trying to think ahead of her.

At first, we thought the BSN route would be best because it is a good degree on its own, and you can often get an NP while working (after you have experience). Also, she is more interested in preventative care or Women's Health, than in something like surgery which would favor a PA degree. But, I’ve been reading things about “diploma mill” NP programs that are diluting the degree/profession. She wouldn't choose one of those herself, but from what I have read, some people seem to be worried that the whole profession is changing because of it and PA is becoming preferred to NP? Is anyone seeing that?

At a few schools, she may be able to do the PA pre-reqs as a nursing major, but at most she wouldn’t. The nursing programs are packed with required classes, but they don’t include all of the classes that PA programs require. If PA is moving towards being more highly regarded than NP, it may help her narrow down college choices to programs where she could take the PA pre-req classes.

To give you an idea, her acceptances include Purdue, CWRU, Pitt, Marquette, Creighton, SLU, U of Utah, UCF (included for the full ride national merit scholarship she qualifies for). She applied widely - both because she isn't sure what type of school she wants and because we hoped for merit, which she has gotten a good amount of. She does have some tours scheduled for spring break.

Thanks for any advice!

[klwa]

I'm not in that field, but my niece is in school for her BSN partially due to info from her step-mom, who is a BSN. She is strongly considering going on for her NP after completion of the BSN, once again on advice from her step-mom. And I trust the step-mom. She's a great nurse and knows the area where they live & where Niece wants to work.

I'd say talk to any nurse friends you might have, especially those in the area your daughter is thinking about living in after school to see if there's any sort of an issue.

[lizzywednesday]

Definitely talk to friends who are nurses, but, based on my mother's experience (she earned a BSN) I would favor BSN over certificate because you can go multiple ways with it, from directly into nursing (whether as a floor nurse, surgical nurse, or office nurse) to pursuing other avenues, like Nurse Practitioner or even going further to MSN and teaching.

[JBaxter]

I have 2 PAs both were Respiratory Therapists before entering the program. Both had RNs in their classes. The program they did had a previous work requirement ( I forget how many hours but I think it was the equivalent to 1 yr working experience) they took the additional classes then. Different PA programs have different requirements they matched up what they had vs what they needed to take to where they applied. DS1 works in a CVT ICU he also did his Doctor of Medical Science (DMSc) which included a 10 month fellowship. DS2 is just finishing his DMSc with a fellowship in Vascular surgery. So when you are looking at PA schools check to see if they have working requirements. So unless she gets her CNA EMT or something in the related fields and works during her college she will have to work before applying / entering PA school which according to my boys is NOT a bad idea. There are a few stand alone Physician Assistant programs just fyi. I think they are 5 yr programs.

[cheme]

Thanks! Unfortunately, part of the problem is that I have no idea where dd will want to live. As you can tell from the colleges, she isn't set on one area. We have no family where we are currently, and we are already thinking we may move depending on where our kids end up.

We have talked to some friends in healthcare, but most seem to think that their field is the best, lol. Especially NP's vs PA's. A few doctor friends really pushed for med school for her, but she doesn't want to invest that amount of time or money before working. Actually, one doctor she talked to (and was likely most influenced by!) encouraged against med school because of the time/money as well as inflexible schedules once you graduate. She didn't have an NP or PA opinion though. I have looked at some of the online NP programs and I do agree that there are some (many?) that don't have a rigorous curriculum. It would be nice if they could standardize a bit more like PA has, so that some of the not so good schools don't dilute the value of an NP.

[cheme]

I have 2 PAs both were Respiratory Therapists before entering the program. Both had RNs in their classes. The program they did had a previous work requirement ( I forget how many hours but I think it was the equivalent to 1 yr working experience) they took the additional classes then. Different PA programs have different requirements they matched up what they had vs what they needed to take to where they applied. DS1 works in a CVT ICU he also did his Doctor of Medical Science (DMSc) which included a 10 month fellowship. DS2 is just finishing his DMSc with a fellowship in Vascular surgery. So when you are looking at PA schools check to see if they have working requirements. So unless she gets her CNA EMT or something in the related fields and works during her college she will have to work before applying / entering PA school which according to my boys is NOT a bad idea. There are a few stand alone Physician Assistant programs just fyi. I think they are 5 yr programs.

Thanks! That is a good point that she could always take the extra classes while working if she wanted to go the PA route. I think all PA programs have a minimum of 500 hours patient experience.

[gatorsmom]

I don’t have any experience with nursing but I know of a small 5year program with students earning their PA at Mayo Clinic in Rochester, MN. As I understand it, the internships happen at Mayo. The college affiliated is selective (but not very selective) but the program is small and competitive. PM me if you want more info. Our former babysitter is currently in the program.

[StantonHyde]

I have both PAs and APRNs in the clinic I manage. There is definitely a difference. One issue is that depending on the state, there is a difference in who can prescribe independently and who can't. You definitely want to be able to prescribe indepenently for the most job opportunities. The issue with the APRN right now is that it requires a PhD in Nursing. Honestly, its a LOT of time for not commensurate pay. The PA programs are shorter. And do NOT do medical school if you want flexible options. Advanced Practice Clinicians are totally the future of medicine. As far as which programs, you need to make sure she is in a good program at a major medical school. The University of Utah has excellent APRN and PA schools. The PA school is really top notch. I know plenty of people who did not go "straight" into PA school. One of the former dietitians at our hospital had a BS in Nutrition/Dietician (not sure the degree, but she was licensed in our state). She then went back to PA school. There probably were some catch up classes she had to take, etc.

I will say, however, that as far as difference in practice--I really don't notice that much. My clinic is a Recovery Clinic that specializes in drug/alcohol recovery. The PAs and APRNs are both very good at assessing patients and prescribing the right medications for the various issues our patients face.

[westwoodmom04]

I have a family member who was a science major undergrad and then immediately went into a 2 year accelerated rn/np program. This is at a top research university, so definitely not a diploma mill. That may be an option for your daughter if she wants more time to decide. There is currently a rn shortage but apparently the np job market is more competitive. Not sure how it compares to pas. My husband has both in his surgical group and doesn’t have a preference for one over the other. Teaching hospitals have used both to cover gaps that emerged after the 80 hour work week was adopted for residents.

[gymnbomb]

Thanks! That is a good point that she could always take the extra classes while working if she wanted to go the PA route. I think all PA programs have a minimum of 500 hours patient experience.

I'm an academic advisor for a lot of students interested in health professions, including PA. They range in requirements, but most around here want anywhere from 500-2000 hours of direct patient care experience. It is not easy to get in, and they like students who they see as having "real" experience. Many of our students work as EMTs or CNAs, either during school or for a year after finishing their BS. But it would be very reasonable to complete her BSN, work as a nurse for a while, then if needed take a couple of missing pre-req's before starting PA school if she decided she wanted to go that route.