RN vs Physician Assistant - Lifestyle Advice

I'm not a PA or RN, but as an MD (hospitalist) I work a lot with both. Both professions are in extremely high demand so I think that if you set flexibility as a priority you'll be able to write your own ticket as far as schedule goes. The more limitations you place on the type of work setting you're in (ER vs Office vs OR vs hospital floor), and the more money you want to make, the more limited you're going to be in your schedule choices. But if all you care about is "maximize weekdays off" you'll be able to climb a huge amount in either job.

You didn't ask, but from my viewpoint the two jobs are very, very different, and I think that if you'd be happy in one of them, you probably wouldn't be happy in the other one. I'd be happy to elaborate on that in a PM if you're interested, but even better would be to ask some RN's, PA's, NP's, and MD's you know about the differences.

Good luck,
David

Marcy wrote:My goal was to become an RN, whether it was via an AS or BS degree. I was happy to get into a 2nd degree accelerated BS program as I would probably still be on the AS waiting list and the savings that I socked away to live on while being a student would be loooooong gone. Glad you got into a program and are no longer waiting. A lot of hospitals will offer tuition reimbursement for the RN to BSN program, if you eventually choose that path. Cheers! P.S. - I apologize to the OP for the thread drift

I don't see any thread drift at all ;). If anything, it is an education for the OP on this aspect.

You're right that the immediate goal is just to get into any program. I had tried to get into a degree holder's transition program like you did before with no luck and there is not one offered out here.

I too am glad I got into a program. The waiting kills you! I have been working in health care all along from registration to medical technician, so it has been an education in its own right.

Good luck in your new job. I can't wait to get out there myself.

Im an RN, I work in the Cardiovascular Labratories(CVL or "cath lab" for short) at my hospital. We perform coronary angiography, angioplasty, coronary stent placement and aortic ballon pump placement, pacemaker insertion, electrophysiology studies, cardiac ablations, and lots of other procedures that fall in the general category of "interventional radiology". I wear lead all day.
My responsibilities as a nurse with regards to patient care are pretty intense. I manage the team that performs the procedure and precedural conscious sedation, as well as any other medications we might use. I set up and operate any special equipment we might use such as ultrasound, cautery or other cutting/drilling devices. And if things go sideways, they often do in emergency surgery, its my job to run the "code", push the drugs, deliver shocks from a defibralator if needed and get the patient stable enough to finish the procedure.
As I said its intense.
I work four days a week 6am to 5pm(though I hardly ever stay that late), one night of call a week, weekends off except every fith weekend which is my call weekend. I get 5 dollars and hour just to BE on call and a special time and a half if I get called. If the ER calls me, I get two hours of call-back pay no matter how long it takes us to do the case, sometimes we're done in 40 minutes.
Cha-ching.
With this set up I am able to comfortably support a family of three in California. I also get to climb and or surf three or four days a week, I can afford to take trips as my work schedule allows, and I do a job that only a dozen or so nurses in my area know how to do.
Also, there are alot of male nurses out there and most patients dont mind being taken care of by a man, there is a brotherly connection there.
Did ya know Mark Twain was a nurse?
davi.

This is a great discussion, thank you all for giving some great opinions so far. Especially helpful having a variety of providers commenting. I have worked with both PA's (ortho,hospitalists, trauma coordinators, neuro, etc) and RNs (surg, ICU, ER) and feel that I have a good concept of the differences in both jobs. I am definitely attracted to doing more procedures and being involved in the diagnostic process of medicine. To make clear, nursing is not my "fall back plan". I have simply been indecisive between PA or RN to possibly NP,CRNA,etc.

Some great points made. The salary projections are so situation dependent though, and if is the sole focus of a career then one will likely end up miserable. I know a PA in town that told me bluntly that if you divided his salary by the hours he worked, his RN wife made far more than he did factoring in time spent and money earned.

I definitely agree that time is far more valuable than money. Although without a certain amount of money my time is generally filled with financial worries instead of enjoying the time off. And working hard for good stint of long hours makes the few days off road tripping and cragging feel all that much better. That said, my career choices have often been dictated by my need to get out. I value being able to disappear for a week here and there. Keeps me sane and can not be labeled by any monetary value.

Have the interviews in couple of weeks, which may make the decision for me whether I get in to either at all or have the luxury of having to choose. Thanks again for all of the feedback.

p.s.
Davi, you may have just swayed me big time. I remember reading an article from Johns Hopkins about the high proportion of male nurses entering cardiac positions. That sounds like an amazing job.

What great opportunities you have for both!

I'm a nurse so I'm definitely biased, though I think that being a PA would be sweet. Here is my opinion based on my own experiences..

I work in an ICU, and love the ICU environment. I like to take care of sick patients because of the amount of critical thinking involved, and I really find myself challenged. I have found the ICU to be very different from the floor, and really enjoy the added responsibility and the trust/respect/autonomy I generally receive from the physicians. I would love to someday be a flight nurse. Apart from the work itself, I enjoy the schedule. 3 days a week of work with 4 off is a pretty amazing schedule. It's very possible to take a month+ off at a time, and taking a week long vacation doesn't even require me to use any vacation time. I also like that when I am away from work, it doesn't weigh my mind. I don't have paperwork piling up on my desk, etc. I am totally free when I am off and I love it.

The money isn't amazing, but can be depending on your choices. Moving into management, or even just working for 5 or 10 years can yield a very comfortable living, depending on what your expectations are.

I also love that I could move anywhere and work in and ICU or ER and be able to take care of the same acutely ill patients.

My experience with PA's and seeing the lifestyle they lead skews me towards to nursing. If I were a PA I would want to work in and ICU, trauma service, or surgical service. But it gets tricky.. PA's are used differently in every hospital. In the larger trauma 1 teaching hopsitals they tend to be lumped in with the residents. And that sucks since they are often just as knowledgeable as the attending physicians are. If a PA chooses to work in a smaller hospital where they can have more autonomy, they seem to miss out in the higher acuity patients. My uncle is a PA, and he has had to jump from hospital to hospital looking for the work environment that he enjoys.. high acuity patients in an ER. He doesn't want the fast track patients with the sniffles, he wants the real deal. And has had a hard time finding a job that allows him to care for these sicker patients. I think this greatly reduces the flexibility you have to move.

Definitely the money is better, but from what I've seen, if you are on a high acuity service, you work similar hours to the doctors/surgeons.. which is pretty rigorous.

That's just my observation. Both are wonderful, and I'm sure you could find what you want in either. It's a great field to work in!!

Thank you all for your posts. This has been an informative read. I currently work as a CAD drafter for an architecture firm and am going crazy sitting at a computer 40hrs/week. I hope people don't mind me broadening this discussion, but I've been entertaining the thought of pursuing a career in physical therapy. Can anyone offer similar insight into the career/lifestyle of a PT with a climbing/traveling obsession?

Buff Johnson wrote:Whereas, if what you're doing is a joy and a passion regardless, you can always develop some sort of study or research that moves into doctoral work being a nurse, PA, or whatever. Einstein was a fucking patent clerk damning the opinions of lesser mortals. Someone passionate about physics that had just taken keen observations in sunlight, the ticking of a clock, and a moving boat in the water & a train to develop his epiphany into a very simple idea renown throughout the world.

It's not like he was just some patent clerk. He had the job to pay the bills while getting his physics PhD.

Regarding flexibility as a PT (sorry for the thread drift) - as in all of these professions, the amount of flexibility you have is very dependent upon the setting you are in.

I worked for years doing home health PT and raced bikes on the national circuit all through that period of my life. I was able to schedule and see patients around my training/travel schedule very effectively. On the downside, I also worked every holiday for 10 years!

As someone else mentioned, working as a traveler (whether in PT or nursing) can be fantastic as well as lucrative. I have lots of friends who would take short contracts (3 months) and then travel around climbing for long periods.

The key is to find something you are passionate about - then everything will fall into place.

Follow both and RN and PA around. I'm a nurse now on a cardiac step-down, looking to go to ICU soon. I love it. Tons of time off, and the pay is quality. I've toyed around with the idea of PA school, but I have the same fears of being stuck with belly aches and sniffles. I realize I could work in surgery, but I don't feel that I want to be that specialized. Nice thing about ICU is you learn a ton, and you get a lot of variety. My vote is for nursing.

Plus, if you work in an ICU, and kill it, you can go to CRNA school. CRNAs are much more widely accepted and utilized than anesthesia assistants. Or, you can be a flight nurse, have TONS of autonomy, work 7 shifts a month, 70k a year, and work per diem in an ICU in your home town to make extra money.

Jeff Hansen wrote:Can anyone offer similar insight into the career/lifestyle of a PT with a climbing/traveling obsession?

My experience working in the PT field is that if you want to work full time, a typical outpatient sports med practice involves ~12 hour days MWF (7am-6/7pm with a long lunch break) and 1/2 days TTh. Of course this may vary with the practice, but that outline is quite common.

If you work in other PT settings, like neuro/brain trauma stuff or inpatient, maybe the schedules tend to be better. I really don't know.

I am a surgeon and I would second the CRNA (nurse anesthetist)route. Get your RN, gain a little critical care experience in the ICU or emergency room and then go on to CRNA school. Depending on the job it is very much shift work and good money. I worked with one last night and he said he works 8 days a month.

jwrags wrote:I am a surgeon and I would second the CRNA (nurse anesthetist)route. Get your RN, gain a little critical care experience in the ICU or emergency room and then go on to CRNA school. Depending on the job it is very much shift work and good money. I worked with one last night and he said he works 8 days a month.

This

I work in a level one trauma center in LA, in trauma icu. The job is stressful a lot of the time. Like so many jobs more is asked of you each day. The work is easy, dealing with entitled families candrive you bonkers. Another career path most people dont think of is ultrasound tech. Vascular imagery is growing fast,yet you will most likely havs to work 4-10hour shifts. My job requires me to work 6 days in a 14 day pay period. If you get your month schedule right you can get 12-14 days off in a row without vacation time. You have to woklong sretches to get this and those 12- hour shifts can tucker you out .

jwrags wrote:I am a surgeon and I would second the CRNA (nurse anesthetist)route. Get your RN, gain a little critical care experience in the ICU or emergency room and then go on to CRNA school. Depending on the job it is very much shift work and good money. I worked with one last night and he said he works 8 days a month.

This is what my wife was planning on, but since we are moving to Colorado and they aren't utilized there it seems, she may go a different route. You have to check and see if there are CRNA schools near where you plan on living. I don't think Colorado has any. There is also talk of turning the CRNA license into a doctorate program.

There is one CRNA school in Colorado but it's a "satellite" school through the Univ. of Western Texas. First year needs to be in Texas after that you can be in Colorado. Not to mention the GRE's, ICU exp. ect.... Unfortunately ER experience does not count towards the CRNA requirements for some institutions. RSI a pt. in the ER and in an hour or so they leave the dept. to the CCU/ICU. There is no long term management of a sedated patient.

Some RN's work 6-12's and have 8 off. Not bad if you want to take a vacation somewhere?
PA's work a varying schedule relative to the needs of the MD's their working with. Not every institution uses PA's.

Why not become an Peace Officer? The schedule is better then any MD/PA/RN. Pays less but you make up for it arresting people. Plus there is more freedom to transfer to Federal positions including but not limited to NPS.

MTucker wrote: Pays less but you make up for it arresting people.

That is fucking sweet!

MTucker wrote:There is one CRNA school in Colorado but it's a "satellite" school through the Univ. of Western Texas. First year needs to be in Texas after that you can be in Colorado. Not to mention the GRE's, ICU exp. ect.... Unfortunately ER experience does not count towards the CRNA requirements for some institutions. RSI a pt. in the ER and in an hour or so they leave the dept. to the CCU/ICU. There is no long term management of a sedated patient. Some RN's work 6-12's and have 8 off. Not bad if you want to take a vacation somewhere? PA's work a varying schedule relative to the needs of the MD's their working with. Not every institution uses PA's. Why not become an Peace Officer? The schedule is better then any MD/PA/RN. Pays less but you make up for it arresting people. Plus there is more freedom to transfer to Federal positions including but not limited to NPS.

Cause cops suck and so does their schedule... Rotating mornings, afternoons, and nights, and 8 hour shifts. Chicago cops only get a weekend off every 3 weeks. Maybe where you're from it's easy to transfer around but not here. Doesn't matter your certifications you want to switch jobs you have to go through the whole testing process again.

-a firefighter

Personally I think firefighters have a pretty good schedule but there are drawbacks to it. This thread is RN vs PA.

Nick Mardirosian wrote: Cause cops suck and so does their schedule... Rotating mornings, afternoons, and nights, and 8 hour shifts. Chicago cops only get a weekend off every 3 weeks. Maybe where you're from it's easy to transfer around but not here. Doesn't matter your certifications you want to switch jobs you have to go through the whole testing process again. -a firefighter Personally I think firefighters have a pretty good schedule but there are drawbacks to it. This thread is RN vs PA.

You have a bad attitude towards someone offering you advice that you were asking for.

You really should consider law enforcement. There's positions in Yosemite if you want.

Marcy wrote:Just began my 2nd career as an RN. I went through an accelerated 2nd degree program in AZ. My previous career was in biomedical research (1st degree in ChemE). Great pay and benefits for 12 years until I realized I was overspecialized in an area that did not have a clear future in the current economic environment. Also, I worked a minimum of 5 days per week and often had unpaid OT or took work home with me. One thing that it took me way to long to realize is that time is more valuable to me than a big paycheck. Now, I am happily working 3 days per week and playing the other 4. I live moderately and can comfortably cover my expenses on RN wages. Something to check into for your area would be the job opportunities for new grad RNs and PAs. In AZ, there is a lot of hype about the nursing shortage, but this really applies to experienced nurses. Seems that between state universities, private colleges, and community colleges (which some say will be phased out for RN degrees) there is an imbalance between new grads and positions available. youtube.com/watch?v=tU1emGC…

I feel like a proud papa, I made this video about a year ago, not long after I finished nursing school. I finally got a job, but I stand by my initial assessment: it is damn hard to get a job as a new grad, and the "shortage: is ridiculously overhyped.

Since nursing is so broad (and I've only been in it a year) I'll refrain from too much advice, but I here's my observations from a dirtbag turned RN:

- Mostly likely you'll have to work a med surg floor out of school. Most likely you will not be fulfilled by this.
- RN's complain like crazy. They have no idea how good we have it. Most have never worked hard labor, framed houses or poured foundations. Yes, being a nurse is stressful and sometimes very hard, but so many people lack perspective.
- I can't believe I have 4 days a week to climb/ Kayak, and the money to do it just about anywhere
- There are tons of new grad nurses ready to take your job because they would love to clean up shit for $25/ hr. and climb 4 days a week. Don't lose perspective
- Best job I've ever had.

CRNA? Right. Good luck with that. How many CRNA jobs do you think there are? Guess what? They are all taken, and there are no new ones opening up any time soon, oh except in someplace where you don't want to go, like Florida.

If you are going to go the nurse route, don't bother talking about being a NP till you get through school and have your license and then some experience under your belt. I'm a nurse, I hear it every year when the new grads come, "I'm going to be a NP. I'm going to be a CRNA." I'd say about one in 20 goes on to start that program, less finish. You have to have experience on a unit to get into those programs, they don't just let new grads in.

If you want to be a nurse, just shoot for getting into a program first, and graduating. You can worry about specializing while you are in your last year's clinicals or afterward.

I work medical and high-obs on a LTAC, we take the sickest patients in the region, and they are with us for average 25 days. Lots of people on vents, everyone is on contact isolation, everyone has central lines, almost everyone has an ostomy, most people have complex wound care, about a quarter are on wound vacs. SAS patients mean lots of time to learn, and lots of opportunity to be a leader.

I work F, Sa, and Su, 4 days off in a row to climb here in NC. My climbing partners are all jealous. Last Wed at Laurel Knob, we had the place to ourselves, not a single other person there all day.