<p>My D has been interested in becoming a PA and is currently a Public Health major planning to pursue entrance to a PA school as soon after graduating as she can. Recently, though she has been thinking about nursing as an option or possible becoming a nurse practitioner. In our area, I have heard that new nursing grads are having a hard time getting positions without experience. I told my D I would do a little research for her since it is finals week.</p>
<p>If any of you are in the know as far as these fields are concerned, please weigh in. She is an excellent student, has her CNA license and will be starting some clinical experience at a heath facility next semester. We know all of the basics about the differences between the three careers but beyond that, we are interested in hearing opinions.</p>
<p>Note: She also enjoys the field of public health.</p>
<p>Public health and rural medicine would be two “ins” into the PA program. Another new and growing field is online medicine–basically you submit your symptoms online for some basic illnesses and a PA “diagnoses” you and tells you want to do. I just used our program for the first time. I have impetigo on my nose. I’ve had it before, just needed a prescription called in. I had to upload a photo of the rash. Simple, easy, but since it’s newer, there will be a need for PA’s to staff these jobs. Many of the rural programs will pay off loans, etc for people that agree to work for so many years in the area. Getting into PA school is difficult but not impossible. </p>
<p>Nursing is a good field as well. Jobs are harder to come by but certainly not impossible. It’s a well paid field in our area for hospital RN’s. There are also opportunities for RN’s to staff call in lines for insurance companies, etc. as well as being case managers with insurance companies for people with severe illnesses, chronic illnesses, etc. . </p>
<p>National Health Reform is going to create significant need for primary care physicians. There is already a shortage and this shortage will increase. PAs and Clinical Nurse Specialists will be used a lot to fill those gaps. The need for PAs is going to skyrocket. I wish I could talk my son into that field.</p>
<p>^^DD is thinking med school but we also suggested keeping the PA option open too. She wants to live in a small town somewhere and be a PCP or OB/GYN so she should have good prospects for med school too but might be even more attractive to communities like that as a PA.</p>
<p>While her first job may difficult to get as a nurse, once she has had one then she has experience. And working as a CNA will be noted. I am an RN and was hired for my first job at a hospital I had done a practicum at. One of the things they said to me was that since they knew our program was good since the students had been regularly assigned to their hospital that that was a factor in my being hired. </p>
<p>So I always suggest to Nursing students to try and go to a program where they will do their rotations at progressive notable hospitals versus a rural school.</p>
<p>I have never clearly understood the line between PAs and NPs. My sense is the NPs have the ability to form a more independent practice eg Nurse midwives, Nurse anesthetists, Diabetic practice NPs so you might want to really research how the roles are different.</p>
<p>In addition, the laws about whether a PA can practice in every state or the ones she might be interested in should be researched.</p>
<p>On nursing, all I know is this: variety is possible.
My SIL worked first as a nurse for a decade in a substance abuse teen program run by a hospital. After her children were born, she shifted to become a school nurse, which she enjoyed for a variety of reasons. One summer, she worked a summer camp with free tuition for her own kids, but felt overworked. More recently she’s gotten summer work on relief shifts at area hospitals. She also kept taking courses throughout her working career.</p>
<p>She’s been innovative at her school nurse job, for example: exercise program at lunchtime for faculty; wrote a grant for bicycle helmets and distributed them to all school families; nutrition initiatives.</p>
<p>One thing about PA to think about is many of those programs require healthcare experience to get into school. You’ll have to look at specific programs as to whether being a CNA would count…</p>
<p>Thank you all! You have already given me some good things to research and discuss with her. I think she was researching the MA General Hospital accelerated nursing program. They have one that gives you your masters in three years and I think it’s Nurse practitioner license.</p>
<p>We do know that most PA program requires some clinical experience prior to acceptance. The CNA license does apply as long as she can find a job as a nurses aid that will provide her with enough hours. The other route some applicants go is the EMT experience but that was less practical for her situation. Over winter break (she has 5 weeks at home) she is going to try to shadow a PA at a local hospital. I hope that will give her a better idea of whether she wants that or not. Knowing her as I do, my opinion is that she would rather be a better fit for a PA or Nurse Practitioner position than for a nurse. She could always go for the nursing and then decide later to pursue the other degree.</p>
<p>One of the attractive things about the PA career is that the hours are usually more regular than that of a nurse. She has expressed interest in specializing in dermatology, which would have few weekends or emergencies. Who knows! She has a while yet to decide.</p>
<p>I’m pretty sure you need some RN clinical experience before you can become a NP so you should check into that as well. Good luck to your daughter.</p>
<p>Describing the roles, schedules, and pay of PA’s or NP’s is like trying to lump drivers into one pile. Truck, bus, taxi, limo, long haul, tank, tanker, the list goes on and on. It does for PA and Nurse Practitioner as well. The most generic is likely FNP (family Nurse practitioner), but there are pediatric, emergency, geriatric, OB, etc… the list goes on. Some work Monday-Friday in a clinic, some shift work in an ER, some take call for the doctor that employs them. I’m guessing that PA’s are similar. I worked with a PA that previously had been employed a plastic surgery practice for whom he assisted in the OR and clinic, and took their call on the weekends. I also know Nurse Practitioners that do similar for OB/Gyn practices. The field is very diverse, pays well, and can be very rewarding.</p>
<p>My wife is a sixth-year hospice nurse with a two-year degree. She nets more than the average family NP in our town. (It’s a factor of NPs being salaried, whereas hospice nurses are paid hourly, and there is always a shortage.) She also has no office or insurance expenses.) Her work is also much more flexible, and she almost never sees a doctor (except to give them “orders” - the docs for the most part don’t see patients) or the inside of an office. </p>
<p>There is a shortage of RNs, ARNPs, and PAs, and that is likely to expand.</p>
<p>They’re both great fields with a difference in approach to patient care. The only thing is that your D won’t be able to become a nurse practitioner with a degree in public health. She would need to earn a BSN (there are accelerated programs for people with degrees in other fields) and spend some time practicing as a nurse before she could go back for the advanced practice degree. She might be able to get where she wants to go faster as a PA since, like med school, she call apply with any degree as long as she has the prerequisite courses.</p>
<p>She needs to figure out the pros and cons of both fields for her. There will be a need for both and they are very different in the approach to patient care. Advancing in nursing or as a physician’s assistant happens years after getting the degree- work experience at the entry level needed first. Along the way she will fine tune her interests and then it will be the time to consider advanced training/schooling for her ultimate job. Location will also be an issue- the job openings won’t necessarily be in her favored city.</p>
<p>Remember we Baby Boomers are all aging and needing more and more medical care so the job market looks good. And as a physician I totally understand the lack of interest in geriatric medicine despite the increasing needs.</p>
<p>btw- medical students evolve in their interests as well- the budding OB/GYN may discover another specialty or area to practice in. It is just as hard, or harder, to be admitted to a PA program as to a medical school- many good candidates for limited slots. It takes a different kind of person to be a physician than a PA- being a PA is not the default position for those who don’t get accepted to medical school. Hopefully students are not thinking of using other health degrees as a stepping stone to becoming a physician- it means one less nurse/PA et al filling needs.</p>
<p>I would urge her to pursue becoming a nurse practitioner. There is a definite need for them. Do not stop with your RN license. I am a RN and live in a rural area. The nurse practitioners I know function very independently in office practices - seeing pts, diagnosing and forming good bonds with pts.</p>
<p>wis75–I know she will probably change her mind but that is what she thinks at 17 years old now. I actually see her going more into immunology or maybe even a medical examiner :D.</p>
<p>So if I am understanding this correctly, to be a Nurse practitioner, you need to work as an Rn first? So she would need to go to a nursing program, then work as an RN for a period of time, then apply to program to get her license as a Nurse practitioner.</p>
<p>As far as the PA route, she would start out in a general health care area and then decide to get further training in order to specialize.</p>
<p>I agree that they are both competitive fields. A friend of mine has a D who is applying to PA school now. A very bright girl with excellent transcripts and two years experience working at hospital as a CNA. She has already been turned down by her two safeties. There are no guarantees with this which is why I am grateful that my D also enjoys the field of Public Health. She absolutely wants a grad program no matter what and will look at programs in public health if she doesn’t get accepted into a PA program.</p>
<p>One more thing to consider is the length of the training. By 2015, new Nurse Practitioners will need a doctoate (DNP) as opposed to the current master’s level degree. The program will probably be 4-5 years depending on specialty. I haven’t heard that PA school will extend beyond the current 2.5-3 years.</p>