RN or PA / Physician Assistant or Nurse Practitioner
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RN or PA: How to Choose the Right Profession for You

Finding the right healthcare career often hinges on factors like educational requirements, job duties and salary. Two popular options are registered nurses (RN) and physician assistants (PA). The RN vs PA question often arises because both choices provide the opportunity to make a difference through direct patient care. However, PAs are technically more like physicians than nurses, so there are distinct differences in education and job functions. The role an RN or PA plays is vital to patient outcomes, so compare the requirements of both options to help you make the right career decision for you.

Differences in RN or PA Education

A primary distinction between RNs and PAs is their educational backgrounds. PAs need a much higher level of education to start their careers, while RNs can enter the field with much less education but enhance their careers by pursuing advanced education.

Starting a career as an RN can take as little as two years by earning an Associate Degree in Nursing. However, you can opt to complete a four-year Bachelor of Science in Nursing degree to enhance your career options from the outset. Whichever educational path you follow, all nursing school graduates must pass the NCLEX-RN licensure exam to become registered nurses and officially enter the field of nursing. The exam is the same for both the Associate’s and Bachelor’s Degrees.

Alternately, it takes much longer to become a PA due to more extensive education requirements. You’ll begin by earning your bachelor’s degree, which typically takes four years but could take longer if you don’t complete all your PA prerequisites. To enter a PA program, you must first complete 1,000 healthcare experience (HCE) or patient care experience (PCE) hours as part of your training. Meaningful HCE can include:

Once prospective PAs complete their required training hours, they often use the Centralized Application Service for Physician Assistants (CASPA) to apply to PA schools, which all require candidates to interview. Once accepted, it takes about two years to complete a PA program and results in a master’s degree. Graduates must pass the Physician Assistant National Certifying Exam (PANCE) to become a PA.

RNs who want to align themselves more evenly with PAs can pursue a Master of Science in Nursing with a concentration in a nurse practitioner (NP) program. Becoming an NP often entails job duties similar to a PA and a higher salary that’s potentially in the same neighborhood. Another huge difference between RN→NP and PA school is that most PA programs don’t allow students to work during their enrollment. Whereas, RNs studying to become NPs can work throughout their program easily. 

RN vs PA Salaries

While you likely pursued a career in healthcare because you want to help people, salary potential is still an important factor to consider. In most cases, an RN earns much less than a PA as detailed by the Bureau of Labor Statistics. According to the Vivian Salary tool, the median wage of RNs is $37-$38/hour, and an annual RN salary based on a 40 hour work week was around $77,000-$79,000. Comparatively, per the Bureau of Labor Statistics (BLS), PAs earned a median wage of $115,390 annually, which included an average wage of $117,320 in hospitals and $128,820 in outpatient care centers.

NPs can earn close to what a PA earns, and in some settings, they can earn slightly more than they do. Their median annual wage per BLS data was $111,680. However, they earned an average of $118,210 when working in general medical surgical hospitals but only $123,850 in outpatient care centers.

Job Duties of RNs vs PAs

Your typical responsibilities can play a significant role in deciding whether you’ll be satisfied in a particular healthcare position. While both RNs and PAs provide direct patient care, their actual duties are often vastly different. Also, keep in mind, your day-to-day responsibilities in either career track can change based on your years of experience and work setting.

Despite differing job descriptions, RNs and PAs do often share similar job duties. For example, they both may assist in treatment plans, provide life support when necessary and instruct patients on their ongoing care. To help you make your decision, look at how their roles differ.

As the backbone of the healthcare system, RNs provide initial patient assessments, carefully follow patient care plans, and administer medications. However, RNs are more limited in their scope of practice compared to PAs. They can’t diagnose patients nor prescribe medications, but NPs can.

The job duties of a PA are more similar to that of a doctor and they’re much more extensive than an RN. Not only can they examine and diagnose patients and prescribe medications, but they also can create care plans instead of just following them. They may also suture lacerations, set bones and assist in surgeries.

Do Nurse Practitioners and Physician Assistants Need to Practice Under a Physician?

While PAs can perform many of the same duties as a doctor, in many states they must report to a supervising physician. This can be a big distinction between them and NPs. An NP’s duties often mirror that of a PA, including diagnosing patients, creating care plans and prescribing medications. As of January 2021, NPs are licensed to fully work independently without any physician supervision in 23 states and Washington, D.C. and need physician oversight only when prescribing medications in 16 additional states. 

Whether you decide to explore a career as an RN, PA or NP, all medical careers offer stable employment with demand increasing within all areas of the healthcare field every year. All three of these healthcare professionals also enjoy the satisfaction of making a distinct difference in their patients’ lives and the reward of helping patients live longer, healthier lives.

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Moira K. McGhee

Moira K. McGhee is Vivian’s Senior Editor & All-Around Wordsmith. As part of the Vivian Health team, she strives to help support the empowerment of nurses and other healthcare professionals in their pursuits to find top-notch travel, staff, local contract and per diem positions faster and easier than ever.

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