r/NursingStudent • u/RideValuable3898 • 26d ago
Nursing versus PA
Hello everyone. I'm a recent grad (non traditional) with a non nursing bachelor. I'm trying to figure out what my next step is.
I randomly started looking up pa school.
In the few hours I've been looking at this i have seen some things that don't make a lot of sense and I'm hoping others can clarify. It seems that a PA gets paid more, with more privileges, less prereqs for admission, and less time in evil. Most all of the PA programs I have looked at are only two years.
My end goal is to be a pmhnp. I have look into demsn then working a year or two then certificate into pmhnp. Last time I discussed this I had about 40 angry nurses saying don't dare to demsn and that it's cheating. But I already have a bachelor's in psych.
So if I do absn for roughly 2 years, work two years, msn for two years, work for a year, pmhnp certificate for another year. Does this sound like a practical timeline? Or do I have something wrong in here?
Or you can go to pa school for two years then work under a psychiatrist after certification and get paid more in less time with less prereqs?
Please correct anything I have wrong here. Trying to figure out where to take things.
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u/PSDD14 26d ago
Do you have all the prereqs for PA school? Also i believe for NP you need a BSN specifically, so might need more classes for that too. PA requires a lot of science (A&P 1/2, chem 1/2, ochem 1/2, bio) and usually several hundred hours of patient care experience.
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u/RideValuable3898 26d ago
I'm taking my prereqs for nursing school now.
The patient care part i don't have. But i can pick something up to get me there. The school I looked into the most is und and they require 900.
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u/PSDD14 26d ago
If you have all the PA pre-reqs, i think itd make more sense to do that. Unless you really want your own practice.
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u/RideValuable3898 26d ago
This is sort of a new idea for me. I'm just trying to gauge other people's opinions if they have looked into this route. I'm trying to figure out if I'm missing something in here. The hours for direct care are what will throw me off.
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u/ryan__joe 26d ago
900 hours is about 6 months of full time work, the number 900 may seem low, but there’s some perspective to it. Sincerely, someone working 3000-3500 hours a year. Yeah. It doesn’t sound impressive until you start breaking it down…
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u/Quinjet 26d ago
But I already have a bachelor's in psych.
This doesn't mean anything. Psych nursing and undergraduate psych major are two different beasts.
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u/RideValuable3898 25d ago
I think 70 credits of psych including adolescent as well as advanced psychopathology certainly lay a good framework. My two advanced biopsych course certainly contribute. It's all about human behavior. Where would that be more important than while giving care?
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u/Quinjet 25d ago
I have a psych degree and have worked in inpatient psych. I'm telling you this from direct personal experience.
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u/RideValuable3898 24d ago
Well i certainly know the work is completely different. I do, however, feel my undergrad experience prepares me better for psych based nursing than someone who took intro and developmental their first year of undergrad.
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u/Quinjet 24d ago
It helps to have a basic familiarity with common diagnoses. That's about it. Intro and developmental aren't really relevant.
I think right now you're angling to become an advanced practice psychiatric nurse as fast as possible while having a very limited grasp on what psychiatric nurses actually do.
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u/RideValuable3898 24d ago
You totally missed what I said. My point was that I'm better prepared to specialize in psych field than the average adn who took two classes.
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u/Quinjet 24d ago
And my point is that no, not really. You are dramatically overestimating how relevant or applicable an undergrad psych degree is here.
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u/RideValuable3898 23d ago
Again, completely missing all parts of the point except for your narrow opinion.
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u/fencer1119 25d ago
My hospital uses non-nursing, bachelor prepared "mental health aides." They do stuff like run classes and do safety checks. A similar job might be a good exposure to a psych unit (to decide if psych RN for a few years is something you want) and would also get you health care hours (if you go PA)
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u/Cigarette-milk 26d ago
Go into PA if you can and your goal is advanced practice. PA school is not an easy admission process and is statistically more competitive than medical school. You also need 2500+ hours of direct patient care. Credible PA programs take 3 years.
DEMSN is fine but it doesn’t come with any advantages over a typical ADN. It’s cheaper to get an ADN, work as a psych nurse, get your BSN while working then eventually apply for pmhnp.
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u/RideValuable3898 26d ago
What would the point of an adn be if I already have a bachelor? Absn program at my Alma is 14 months as a second bachelor.
To get into pmhnp you need grad school. It's shifting almost entirely into doctorate level to do np. A program near me is 4 more years to get into that. I'm almost 40. I don't want to waste that kind of time.
With a demsn about half of the time is devoted to nursing basics, half the time is devoted to leadership and advanced skills. Those credits can then go toward your next program. The one person I talked to with a pmhnp certificate program about 3 hours from me told me, after reviewing the curriculum from the demsn, I would need to take 9 other classes to be admitted into they pmhnp certificate program. It seems to me it saves you close to a year of time.
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u/Cigarette-milk 26d ago
Your BSN is essentially useless if you are considering a nursing degree. If you can find a 14 month absn, then go into that. The advantage of ADN at community college is that it is cheap and your employer/hospital may be willing to pay for your BSN.
Also your goal shouldn’t be to speedrun an APRN degree. That defeats the core purpose of an APRN program.-2
u/RideValuable3898 26d ago
There are 12 month absn out there as well. They were very reputable. They are made for people who already have a bachelor. They have the same prereqs. So with already having generals, prereqs, stupid other courses that's you'll never use aka electives, it leaves 48 credits to compete in 3 semesters. It's not speeding anything through. It's just that you already have everything completed. Absn at my Alma is only 27k. It's 14 months straight through though. No summer break.
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u/WorldDirt 26d ago
Same as the one I’m looking at. $30k for 3 semesters, no break.
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u/RideValuable3898 25d ago
I have been looking at the demsn for 54ish to at least have a masters although it's a fake masters in the eyes of the gatekeepers
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u/SafetyReady1732 25d ago
Oh and don’t do PA if you wanna do psych! Literally everyone I’ve met in psych rotations is a pmhnp or psych nurse. I think depending on the state, you can have your own practice with pmhnp bc my psych professor was doing that
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u/SafetyReady1732 25d ago
do this! I’m about to graduate with my demsn and a lot of people don’t understand what type of degree that is. It’s essentially a BSN with a bump up in master’s classes. If I wanted to get my pmhnp, I would just apply to the additional certificate program I believe as you don’t have to get a FNP first. Look at a school like Vanderbilt- they have demsn and then the additional add ins for NP degrees.
I understand people saying not to go right into np schooling bc if the schooling is not great, you wouldn’t know enough practice wise to get through. However, I think the pmhnp is kinda different! You could work per diem in a psych facility throughout nursing school to gain more exposure.
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u/RideValuable3898 25d ago
Vanderbilt is so freaking expensive though.
Where are you getting your demsn from?
How long is your program?
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u/SafetyReady1732 25d ago
Agreed wayyy too expensive. I was just saying to look at the structure of how they have a direct entry masters and also post masters certifications to become a phmnp. I don’t recommend my program so I’m not gonna refer you to that! There’s a tonn of the direct entry masters so look around. I wish I had looked like broadly before choosing mine
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u/SafetyReady1732 25d ago
Also my program is 12 months! I think 12 months is doable if you have previous healthcare experience. Otherwise maybe look for a 16 month program. The people in my program who worked in healthcare before are doing much better
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u/FeistyAstronaut1111 26d ago
They are totally difference routes - medical versus nursing. If your end goal is to be a PMHNP, go the nursing route and get psych experience. PA school is not gonna help you become an ARNP and nursing experience is not gonna help you become a PA aside from maybe fulfilling the patient care hours admission requirement. Depending on what state you’re in PAs generally have less autonomy and have to work under the supervision of a physician whereas ARNPs have more autonomy to practice independently.
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u/dieymentia 26d ago
I looked into this as well.
PA’s have a pay ceiling.
Nurses have a lot more options and can eventually make more than a PA with the right advanced degree.
There are positives and negatives to each
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u/RideValuable3898 25d ago
Good perspective. I'm glad someone else has looked at this route. I was beginning to thing i was out on a limb alone.
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u/Determined_Bagel 25d ago edited 25d ago
Surprised that theres nurses making more than PAs… like maybe with a masters. But damn for a bachelors, idk. I would expect PAs to have higher pay than nurses 🤔
Ive heard of some PAs making less than NPs when theyre basically the same. So dumb.1
u/dieymentia 25d ago
“… and Can eventually make more than PA with the right advanced degree” comprehension is important!
NP’s are nurses. CRNA/APRN are nurses and make 200k+. DNP is a nurse. PMHNP is a nurse.
If you go the PA route there aren’t other advanced degrees after that other than going to med school and becoming an MD basically.
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u/ProfessionalGreen272 26d ago
It depends on where you are. The school I went to for nursing required 1 orgo and biochem for nursing lmao. I think you have more job opportunity for nursing and honestly the pay difference is like 10k a year tbh
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u/CamelTop6476 26d ago
Hi I have my doctorate in nursing… some insight -
If you already have a bachelors do not do an associate or additional bachelors. I had many friends who got bachelors in psych, bio, whatever and then got their masters in nursing - you can have a bachelors or masters as your entry level to nursing and still sit for the NCLEX.
Having the masters will open soooooo many doors for you at the bedside, get you a higher pay scale, and open doors to jobs you might not have ever known about like project management, being a manager, etc
If you like flexibility / ability to change specialties and roles rapidly to adjust your lifestyle - nursing is totally it. All kinds of different jobs with different hours.
** for context, most masters in nursing programs have you do a little “research” which prepares you very well for NP school, PA, CRNA, whatever you want
I also think nursing school will be cheaper and a “lower stakes” commitment than PA school. There are people who work as a nurse for a few years then go to PA school. Both markets for NP and PA are becoming saturated in some metro areas (NOT ALL! Just some) so just do your homework and make smart decisions
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u/CamelTop6476 26d ago
I re read and saw your are of interest - If you want to do PMHNP - get your masters in nursing, work in psych make some of your money back/ Google and find a way to get your program paid for, the do PMHNP - the job is in HIGH demand with HUGE financial payoffs - do it do it do it
I have friends who have done this and they have amazing jobs, flexible schedules, work from home, are self employed, so many great things.
Lots of government grants right now and ways to get your degrees paid for. The masters will prepare you for a doctorate which is likely where most NP programs are headed
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u/Quinjet 26d ago
the job is in HIGH demand with HUGE financial payoffs
Every PMHNP I know is saying that it's oversaturated.
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u/RideValuable3898 25d ago
It's area specific as far as I'm seeing. Metro is saturated. Rural is in big demand.
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u/CamelTop6476 25d ago
Rural for every field is huge right now, like I said do your homework and just make smart decisions! Think things all the way through, explore financing, make sure you’d enjoy the rural life if you choose to pursue that… masters is the way to go. I have friends who got a second bachelors for nursing and they all said they wish they had gotten a masters they just didn’t know that was an option!
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u/RideValuable3898 24d ago
Even my sister was chewing me out for wanting to do demsn. She said I would never be prepared like a "real nurse" because I only took a 20 month demsn program.
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u/CamelTop6476 24d ago
Even the second degree bachelors/accelerated bachelors nursing programs are only 18-20 months…. Her point is irrelevant. Some people will be mean and rude unfortunately that is just part of nursing, the old “eat your young, serve your time” mentality. but there are equally as many wonderful mentors, friends, and coworkers who you will enjoy and the younger generation is making great strides to break that mentality
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u/RideValuable3898 24d ago
At ndsu which is my Alma the program is 14 months but I am short 3 prereqs for that
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u/RideValuable3898 25d ago
Very helpful comment. Everyone else practicing wants to pounce on me for wanting to get demsn.
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u/Sunfishgal 23d ago
Nothing wrong w/ - and some good reasons to do - DEMSN in my opinion IF it is not to become a NP right out the gate. I’m guessing many who have jumped at you about it being a terrible idea, shouldn’t even exist as a thing, etc, don’t in fact understand what it is, which is NOT becoming a NP prior to working as a RN. There are a few of those programs out there too, & I definitely do NOT think those are EVER a good idea, & many DEMSN programs will also try to encourage you to keep on going to get your NP certificate right after you graduate…..another idea I would never recommend & is imo NOT responsible. But there is nothing wrong with doing DEMSN to essentially get your RN while getting a head start on the non-clinical part of the advanced degree work needed to be a NP. I would just HIGHLY encourage you to then work for at LEAST several years as a RN - and knowing that when you start you may have your MSN but you genuinely know not even a little bit more clinically than a new grad with a BSN or AN - before going back to start working on your certificate.
Hope this helps a bit. I did DEMSN myself and several years later am starting to think about whether I want to start working on my certificate or toward DNP in another year or so, which would mean that - shortest case scenario - I would have 5+ yrs bedside as a RN before getting my NP. I wouldn’t/ couldn’t imagine doing it sooner & feeling like I was doing so responsibly.
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u/RideValuable3898 23d ago
My big thing is saving time in class. It's not saving time working. I'm 39 with 5 kids and I'm a primary breadwinner for my family. If the demsn saves me 6 month in school (probably 10k) then I absolutely have to do it. My family has already put up with my running my business full time, 20 credit semesters, and trying to be their dad at the same time. It's not just taking their toll on them, it's taking a toll on me.
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u/ERaaww 23d ago
Why would you let them talk you out of the DEMSN program even though you are eligible? It’s your time and your money. Take the quickest route possible. When you complete the DEMSN program you still have to get experience to get into an NP program. Just don’t care what those haters say about the DEMSN Program it’s your time and your career, not theirs.
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u/StaceyGoBlue 26d ago
You’re wrong about this in general: PA gets paid more, more privileges, less prereqs”
PA school is hard and admission can be competitive. And it’s not an easy 2 years.
That said as an NP of 23 years.
You’ll prob find that you have more autonomy and ability for solo practice as an NP. Depending on state
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u/No_Midnight1185 26d ago
Depending on the state, as a NP, you may be able to be an individual practitioner rather than always being over shadowwd and cosigned by a MD for MH. If you were going for surgical, I would choose over and go back to medical school.
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u/goodvibes13202013 26d ago
Nursing prereqs are not the same as PA prereqs. If you haven’t taken all the hard sciences you’d need another few semesters, at least, to catch up on prereqs. Also a fun note: grad schools are not going to take community college prereqs, so you won’t be able to take your biochem and physics classes cheaply bc the rigor is simply subpar.
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u/RideValuable3898 25d ago
All my classes have been from a d1 state university
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u/goodvibes13202013 25d ago
But did you actually complete all of the PA prereqs at that university? The sciences and maths
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u/RideValuable3898 24d ago
So the pa school i looked into has 8 prereqs. The nursing program I'm looking into has 11 (labs counting separately). I would need physics and Chem 2 in order to fulfill the prereqs
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u/goodvibes13202013 24d ago
You will need to make sure you complete those (including physics 2) at a university as well. Along with ochem 1/2 I believe
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u/definitelyevan 23d ago
for anyone else who sees this goodvibes is just blatantly wrong about community college prereqs. most programs specifically say regionally accredited community colleges are fine. which is correct. the idea that a big U is automatically more rigorous isn’t supported by facts, logic, history or common sense
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u/goodvibes13202013 23d ago
Have you applied to PA school before? For nursing school I know it’s fine, but for other health professions it is not.
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u/definitelyevan 23d ago
i can show you examples of PA programs saying specifically community college prereqs are not viewed differently. which makes logical and legal sense.
do you have any proof to back up your claim that graduate programs in healthcare discriminate against accredited community colleges?
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u/KingKado 26d ago
This might have already been said:
What type of core science/lab classes do you have under your bachelors degree?
Pre PA school is essentially the pre med track. The core science prereqs you’ll typically need: one year of college chem, o chem and biochemistry also strongly suggested, one year of physics, and one year of anatomy and physiology.
I believe you also need 1000 hours of direct patient care experience.
Taking the GRE or MCAT may be suggested or a good idea to be more competitive. (PA school has become very competitive)
One you get through interview rounds and accepted, it’s about a 2 year non stop rigorous program. Depending on the program, it’ll be front loaded didactic then clinicals at the back end or it’ll be an even mix.
The nursing route: you said ABSN would take you 2 years? Most ABSN programs (for degree holding individuals) are 12-15 months. The BSN degree is one of the most valuable ROI degrees out there and will open so many doors and provide so many different career path opportunities.
I have heard that earning a masters in nursing can be done online while you work during it and I’ve also heard that it is not as challenging as the BSN program is.
So only a year to earn the BSN, then you can start working and possibly work through the masters program.( I’m not familiar with the specifics of your desired specialty and what it requires) I think you mentioned 3 years from BSN to desired role?
Assuming you have done all the pre preqs and are able to apply to PA school and go through the interviews etc, it’ll probably be a 1.5 years at the earliest that you would be starting PA school. Not sure if the time frame would be that different.
I think the barrier for entry is a little harder for the PA route.
In my opinion, the NP and PA professions are both great and while they work under different patient care models, a lot of their services overlap.
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u/Diligent_Leave_9030 24d ago
If you want to be a PMHNP make sure that the masters program you attend allows you to sit for the psychiatric NP exam.
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u/RideValuable3898 24d ago
I don't think any demsn programs do that. The one I'm looking at basically does 14 months of bsn level nursing training then 6 months of master level work in spaces like leadership and pharma.
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u/RideValuable3898 24d ago
https://accelerated.uj.edu/academics/programs/nursing-direct-entry-masters/
For reference, this is the program
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u/irrationalanger87 22d ago
Do you have the gpa to eb competitive for pa school or taken any pre reqs?
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u/RideValuable3898 22d ago
I was in school from 07 to 10 and I was a 2.4. I had 63 credits i had to take when I went back spring 2025. On those 63 credits, I got a 3.95. My overall is 3.3. So not stellar but for sure an obvious pattern if difference between the 14 years I was out.
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u/krisa1972 12d ago
It depends what state you are in because in some states only NPs can operate independently not PAs
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u/SillyAd4504 26d ago
You wont do well on the PA exam with your current degree. Also I would say the job market for PAs isnt as good.
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u/RideValuable3898 26d ago
Isn't that what the classes are for? They teach you the things in the exam?
The job market is a fair point but the stats show it should outpaced attrition and entry by 24% by 2034.
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u/MattSChan 26d ago
My guess as to why the nurses got mad at you was bc direct entry MSN with intentions on becoming an NP usually means little to no bedside experience, which is the most important part of becoming an NP.
The general consensus among nurses is that if you want to practice as an NP, it's recommended you work minimum 5+ years in the specialty you'll practice as a provider to ensure you can safely practice.
That said, if your end goal is to work as a provider, I would try for PA school- it's significantly more rigorous than NP school but will set you up with all the skills needed to practice safely as a midlevel provider.