OK, but all they’re doing there is having the student go through all the coursework to become an RN first, before proceeding straight on through the master’s level/NP coursework. They’re still becoming an RN first, it’s just integrated into the program.
True of basic RNs, but not APRNs (and, yes, I’m only adding this in to further muddy the waters and make the point that none of this makes much sense) such as Psychiatric Mental Health APRNs:
Now, if someone could describe the difference between a “diagnosis” and a “nursing diagnosis” in a way that makes sense, we might get the Universe to implode.
And, of course, CRNAs are APRNs who work without an MD supervising them and can prescribe controlled substances. (Not in every state. Of course not. That might drag this closer to sensicality.) Does it make sense to prescribe without having a diagnosis? No, but I’m sure CRNAs do it, at least in a legal-regulatory sense, as opposed to a real-world sense. No, they don’t have any further supervision, because nobody else where they practice is qualified to supervise them. Yes, CRNAs very often have their own practices, complete with their own little corporations and deals with hospitals.
A (medical) diagnosis is the name of a disease or syndrome.
A nursing diagnosis is a description of how a disease or syndrome (or other physical, environmental, situational, relationship thing) is affecting the body, mind or spirit. A nursing diagnosis is often written to include a “related to” “due to” and an “as evidenced by” that help us to link symptoms with diseases.
So a medical diagnosis holds as long as the person has that disease, even when they are asymptomatic. A nursing diagnosis changes depending on their symptoms right this minute.
It’s easier with examples:
Medical diagnosis: Asthma.
Nursing diagnosis: Impaired gas exchange OR Impaired gas exchange related to ventilation perfusion imbalance due to asthma, as evidenced by dyspnea, diaphoresis and tachycardia.
If I don’t know the medical diagnosis, I can leave the “due to” out and still have a perfectly cromulent nursing diagnosis: Impaired gas exchange related to ventilation perfusion imbalance, as evidenced by dyspnea, diaphoresis and tachycardia.
There are a finite number of nursing diagnoses approved by NANDA. NANDA used to stand for North American Nursing Diagnosis Association, but it doesn’t anymore, because they’ve branched out from North America. So now it doesn’t stand for anything, it’s just a brand name. When you’re charting, you have to use NANDA approved nursing diagnoses.
Can PAs prescribe?
I do know NPs can, at least in San Diego County, but until moving here from L.A. I had never met or received any prescriptions or other treatment from an NP–indeed, I’m not sure I ever met one.
When I did meet a nurse practitioner for the first time, I was unaware of that fact until I noticed the suffix NP, appended to her name, on my prescription bottle. One of my meds is a C-II drug and she told me I’d have to come back and see the MD for that one, as she was hesitant to prescribe it herself. She didn’t say she couldn’t do it, but as I was a new patient in that office I can understand why she preferred to err on the side of caution.
Yes, PAs can prescribe meds without anyone counter signing.
Yes, but you are not required to ever work as an RN before you become a Nurse Practitioner in a program of that type even though you technically are one after the first year. That is more of an academic milestone though more than anything. If you go through a program of that type, your first academic nursing degree will be a Masters degree and not a second Bachelors degree. The one thing that they don’t make immediately obvious is that you can have a Bachelor’s degree in anything BUT you also have to have to fulfill a number (about 6 or 7) pre-med type courses before you can even apply. Most potential applicants will not have all of them if their original bachelors degree was in a non-premed type field so you have to find a way to do those on your own before you can even apply.
WhyNot: Very interesting.
Good point. To make an analogy, the Roman Catholic Church has two main ways to become a Deacon - be ordained a deacon as part of a deacons’ program where you will be expected to actually serve as a deacon for an indefinite period of time (permanent diaconate) and to be ordained a deacon as part of preparation to become a priest (transitional diaconate). The second category basically means that people already enrolled in the right programs to become a priest will officially be made a deacon at some point along the way as sort of an attaboy for making it this far and as a nod to the past where there was more of a “work your way up the ranks” attitude toward the priesthood and there was more of an acknowledgement that some people would wash out after that.