At one time it was the hospitals that had nursing schools. It was a three year course.Today it is universities and colleges and it takes four years. More book learning, more diseases, more difficult surgeries, more difficult procedures. And the big one. More paper work and computer courses.
Any part of the medical field is more difficult to enter. To become a paramedic you have to go to EMS school first. That is basically learning first aid. Get a job as EMS and work for about one year. Then you can apply for paramedic school. That is any where of 18 months to 2.5 or 3 years. Then if you want to continue on to PA, you have to have so many years under your belt as an active paramedic and a BS or Masters degree. No wonder there is a shortage of nurses and doctors.