Advanced Practice Psychiatric Mental Health Nursing

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Advanced Practice Psychiatric Mental Health
Nursing

• The American Psychiatric Nurses Association

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TITLES and CREDENTIALS

• What do they mean?
• What are the trends?
• What do I need?
• Why the confusion?
• What are the roles for APRNS
• What are major Issues?
• What patent populations (ages)?
• How does the consumer benefit?

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• Title What you will be called.
• Scope What you can do in practice.
• Role What your functional role is.

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What Do They MEAN?

• Education
• Licensure
• Certification

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A Case of The Tail Wagging the Dog?

• PROFESSIONAL ORGANIZATIONS
• CURRICULUM
• STATE BOARDS
• CERTIFYING BODIES

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EDUCATION

• MS, MSN, MN
• PROGRAM FOCUS
• CNS
• PSYCH- NP
• BLENDED ROLE
• OTHER (Two roles ANP and CNS FNP and CNS)

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Competencies

• Competencies are a combination of skills,
  abilities, and knowledge needed to perform a
  specific task (US Dept of Educ, 2002).

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• Essentials of Masters Education
• (AACN, 1996)
• Educational Preparation for Psychiatric- Mental
  Health Nursing Practice (SERPN, 1996)
• Psychiatric Nurse Practitioner Competencies
  (NONPF, 2002)
• Statement on Clinical Nurse Specialist Practice
  and Education
• (NACNS, 2004).

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Advanced Practice Licensure

• Diagnosis, psychotherapy and prescriptive
  authority are within psychiatric nursings domain
  and require an advanced license. This license
  supports and recognizes our scope of practice as
  a specialty.

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LICENSURE AND TITLING

• STATE DETERMINED
• APRN
• CNS
• ARNP
• CS-P
• RN-NP

Confusion continues because some of these titles
overlap with roles and others do not.
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Recognition that States Differ

• States function autonomously.
• Boards are comprised differently.
• NCSBN is a membership org
• so only suggests regulations, etc.
• Population health care needs in states
  differthis can drive scopes.

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What is Being Done

• Uniform Advanced Practice Act
• Advanced Practice Registered Nurse Compact
• APRN Roundtable Committee
• Professional Organizations

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THE PROBLEM TODAY

• Different Curricula
• Different Titles
• Different Scopes
• No Reciprocity
• Confusion Regarding What
• Exams for Certification
• THE TAIL IS WAGGING THE DOG !!!

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RECOMMENDATIONS

• One Title APRN
• One Scope of Practice
• Different Roles
• Clarification of Roles for Stakeholders

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APRN-PMH

• The APRNs practice is based on knowledge and
  competencies in health assessment, differential
  diagnosis, multiple treatment interventions
  including individual, group and family
  psychotherapy, and prescription of
  psychopharmacologic and related medications along
  with organization and management of complex heath
  care delivery systems

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• Historical PMHCNS roles-psychotherapist,
  educator, researcher, consultant and provider of
  treatment for acute and chronic psychiatric
  disorders
• PMHNP roles-assessment, diagnosis and management
  of health problems, and pharmacologic treatment

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HOW SHOULD THE DOG WAG THE TAIL?

• Professional Org Scope and Standards for
  Practice
• Curriculum Based on These
• States Use One Title, Scope and
• License for Advanced Practice
• Certification Tests for Excellence

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CERTIFICATION

• States excellence
• Does Not/Should Not
• 1. ensure competence
• 2. decide on curriculum
• 3. decide on standards or scope
• 4. dictate regulations for states
• 5. test functional role

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• The premise of the evidence based movement is
  that we should be teaching, testing and
  practicing those elements that are supported by a
  research base of effectiveness. Furthermore,
  educators should be preparing nurses for what
  this evidence-base suggests is needed in the
  health care system. The thrust is that education
  should drive competency testing, which then
  should drive practice.

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APNAs ROLE

• Resolving Titling Position Paper
• Lobbying States (Montana)
• Developing Scope and Standards
• from within the specialty (with ISPN)
• Conducting two role delineation studies (basic
  and advanced)
• Preparing for Certification