If you could rewind and do it over again...

3 For any of you ARNP's or higher-level nursing degree nurses out there: if you could do it over again, would you still stick with Nursing, or would you jump right into being a PA? People ask me all the time, "why a nurse? why not be a PA?" I realize the first thing they are thinking of is money. I have asked the opinion of different ARNP's and have gotten a mixed bag of answers: "No, because you have to work under a Dr. and also pay more to write scripts per year", "Yes, because you can start earning really good money a lot faster"....

Just wanted to know your opinions. I haven't decided whether I want to go the PA or ARNP route yet. I'm just getting started. But right now, one of those is my ultimate goal.

Happy New Year everyone!
People who would ask why not a PA don't really understand the differences between the two. The job is exactly the same. The difference is that NP's are not as dependant on the physician for their practice. They are not regulated by physicians, but other nurses. The pay is the same also. Very little difference in pay. Have you been told that PA's earn more money faster? I don't know this to be true at all. If anything the RN's do, because their education allows them to work as RN's while in graduate school. Whereas many PA's have a degree in a field that doesn't allow them to get as good of a paying job. Also, NP programs can be done part time. There may be PA programs that are part time, but NP programs (in my opinion) are better tailored to people who work full time and/or have family obligations. There are many pro's and con's to doing either program. If your already a nurse I think it is best to do the NP path because of more flexibility, autonomy.

I am actually entering a FNP program this month. And, I chose it in part because I am a Registered Nurse and very proud of the years I spent learning and working in the profession of nursing. I would not even consider a PA program. I want to be seen as an advanced practice NURSE, not a PHYSICIAN assistant.

Quote from SarahBananaFor any of you ARNP's or higher-level nursing degree nurses out there: if you could do it over again, would you still stick with Nursing, or would you jump right into being a PA? People ask me all the time, "why a nurse? why not be a PA?" I realize the first thing they are thinking of is money. I have asked the opinion of different ARNP's and have gotten a mixed bag of answers: "No, because you have to work under a Dr. and also pay more to write scripts per year", "Yes, because you can start earning really good money a lot faster".... Just wanted to know your opinions. I haven't decided whether I want to go the PA or ARNP route yet. I'm just getting started. But right now, one of those is my ultimate goal. Happy New Year everyone!

I like the way you phrased that. Thinking of it in those terms, I guess i'm more of a puzzle person - that intrigues me more to be honest.

Quote from NYLadyThat would be an odd question for a nurse to ask but I just re-read your post and see that you haven't decided where your interest lies. It seems like you are trying to investigate the differences before you commit and that is wise. Let me say, for the record, I have never considered and would never consider being a PA. It is entirely different from nursing. I will tell you what I told a friend of mine who was struggling with the same decision - Medicine (whether MD or PA) is about the "puzzle" and nursing is about the "patient". Much of the knowledge is overlapping and some of the responsibilities but there are essential differences in the professions. I do believe that some people who should be in nursing are PAs for a variety of reasons.Take this little test for yourself and answer this question:When considering a medical issue (why someone has a fever, how to treat a sprained ankle) are you more interested in the mechanism of what caused the problem or are you more interested in knowing enough about the problem to help the individual through the crisis? Puzzle or patient?

I can see that "puzzle" or "patient" might be confusing since both are addressed. Look, for a moment, at an End of Life situation. A 95 year old frail woman with a history of advanced liver failure comes into the hospital with a chief complaint of Pre-Syncope (nearly passing out). You are assigned to her case and your level of education gives you the knowledge and expertise to make a diagnosis and order appropriate tests (MD, PA, APRN). Picture yourself now coming into her room to see her with a clear picture of the differential diagnoses and your plan of action. Patient - You are concerned about finding the reason for the Pre-Syncope but you are also well aware that the tests you would like to order may carry risks of their own and, in light of her advanced liver disease, you would like to discuss with her the nature of the tests and whether she would like to pursue this course of action. If her liver failure is far enough advanced, you may consider discussing whether she would like DNR status initiated. You may also explore whether she is ready to discuss end of life care and possibly entry into a hospice program.Puzzle - You are so focused on the finding the reason she almost passed out that your plan on entering her room is to describe to her the battery of expensive and risky tests (with additional expense) that you are planning to order for her. You will explain to her how important the tests are to find the cause of the problem.That is the type of difference I'm talking about.

Rules and regs for PA's vs ARNP's are different. In most states, ARNP's have full prescriptive authority but PA's do not. ARNP's are able to function at a more independent level. What would be the advantage of being a PA?

Quote from NYLadyI can see that "puzzle" or "patient" might be confusing since both are addressed. Look, for a moment, at an End of Life situation. A 95 year old frail woman with a history of advanced liver failure comes into the hospital with a chief complaint of Pre-Syncope (nearly passing out). You are assigned to her case and your level of education gives you the knowledge and expertise to make a diagnosis and order appropriate tests (MD, PA, APRN). Picture yourself now coming into her room to see her with a clear picture of the differential diagnoses and your plan of action. Patient - You are concerned about finding the reason for the Pre-Syncope but you are also well aware that the tests you would like to order may carry risks of their own and, in light of her advanced liver disease, you would like to discuss with her the nature of the tests and whether she would like to pursue this course of action. If her liver failure is far enough advanced, you may consider discussing whether she would like DNR status initiated. You may also explore whether she is ready to discuss end of life care and possibly entry into a hospice program.Puzzle - You are so focused on the finding the reason she almost passed out that your plan on entering her room is to describe to her the battery of expensive and risky tests (with additional expense) that you are planning to order for her. You will explain to her how important the tests are to find the cause of the problem.That is the type of difference I'm talking about.

Quote from diane227Rules and regs for PA's vs ARNP's are different. In most states, ARNP's have full prescriptive authority but PA's do not. ARNP's are able to function at a more independent level. What would be the advantage of being a PA?

As long as one has been a bedside RN in an acute care facility for more than a couple of years, I can not think of any reason going the PA route would be more enticing than becoming a NP. The only reason I can see going the PA route (if you had years of nursing experience) would be if you were interested in mainly surgery. NPs typically don't assist in surgery unless they are already RNFA's. That would be my only reason not to pursue the NP route. If as an RN you were a new grad, then I would probably encourage you to pursue the PA route (of course this opinion will vary greatly - just my take on it as a practicing NP).I guess the other thing is, though, if the area I currently lived in hired more NPs vs. PAs. Some areas of the country are more PA-friendly, while others are more NP-friendly.

Quote from SpackleheadAs long as one has been a bedside RN in an acute care facility for more than a couple of years, I can not think of any reason going the PA route would be more enticing than becoming a NP. The only reason I can see going the PA route (if you had years of nursing experience) would be if you were interested in mainly surgery. NPs typically don't assist in surgery unless they are already RNFA's. That would be my only reason not to pursue the NP route. If as an RN you were a new grad, then I would probably encourage you to pursue the PA route (of course this opinion will vary greatly - just my take on it as a practicing NP).I guess the other thing is, though, if the area I currently lived in hired more NPs vs. PAs. Some areas of the country are more PA-friendly, while others are more NP-friendly.

Because honestly (speaking from my schooling experience), I feel that NP programs tend to teach the role with the mindset that the NP student already has a few years of clinical experience under their belt (hence the term "Advanced Practice Nurse"). An RN with a few years' experience has a very workable knowledge of patho, pharm; as well as good to excellent assessment/clinical skills. An NP program builds on those essential foundations - time is not spent going over basic patho/pharm/assessment concepts - those should already be well-developed if one has been a practicing RN. It's not a bad thing, and is in no way a knock against NP programs - but they are typically modeled for someone who has already been working in the RN role.From what I've seen of PA curriculums and from friends who have gone through PA programs, they do get a more in-depth education in patho and perhaps pharm, as well as in assessment skills - because they may not have had it in their undergrad program and may not have been working in a healthcare field (remember, PA programs take applicants from various different backgrounds - they all aren't necessarily already nurses, medics, EMTs, etc.). They also spend more time in clinical rotations vs. NP programs (again, remember that NP programs were designed for those who have been RNs for a while who have years of clinical experience).Now, if you asked me if an experienced RN should choose PA school over NP school - my answer would be completely different. An experienced RN would probably be wasting their time and money to choose the PA route; and some of the info learned would probably be redundant.As for those new grads who claim they would work full-time as an RN while going to NP school so that they do have some experience prior to their clinical rotations, I wish them all the best. I think it would be very difficult (for me) to learn two new roles vs. being already knowledgeable in one and learning another.I also want to make it clear that I'm not saying new grad RNs shouldn't become NPs right out of their undergrad program - I just know that from my personal professional experience, my years of being an RN have only helped me time and again as a NP. There are many things you will see as an RN that can't be taught from a text book - and believe me, things are rarely ever a "textbook" case.