I am repling to my peer’s post on role and scope of practice of PMHNP

NU-664C-02-23PCS3 FamilyPsychiatric Ment.Hlth I

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  4. Week 1 Discussion 2: Role and Scope of Practice of PMHNP

Week 1 Discussion 2: Role and Scope of Practice of PMHNP

Done: Make forum posts: 1

Value: 100 points

Due: In an effort to facilitate scholarly discourse, create your initial post by Day 4, and reply to at least two of your classmates, on two separate days, by Day 7.

Grading Category: Discussions

Note: In this type of discussion, you will not see the responses of your classmates until after you have posted your own response to the question below.

Initial Post

The Psychiatric-Mental Health Nurse Practitioner (PMHNP) fills a unique space in the healthcare environment.

  • Research your state’s current scope of practice for the role of PMHNP.
  • Do these regulations present a barrier to mental health care?
  • What groups or cultures do you see most impacted by your states’ current scope of practice regulations?

Replies

Your reply posts should compare and contrast your state’s scope of practice regulations, any barriers to mental health care, and suggest a policy that would specifically address marginalized populations. Consider how regional and cultural differences play a part. Back up all arguments using scholarly resources and gray literature.

Pick out an idea from your peers’ initial post that you find most interesting and tell how you will use this information in practice.

Please refer to the Grading Rubric for details on how this activity will be graded. The described expectations meet the passing level of 80%. Students are directed to review the Discussion Grading Rubric for criteria which exceed expectations.

Your response should include evidence-based research to support your statements using proper citations and APA format.  

 

Peer’s post

 

Re: Week 1 Discussion 2: Role and Scope of Practice of PMHNP

by Bhagyshree Brahmbhatt – Monday, 1 May 2023, 1:24 PM

 

       The scope of practice for the nurse practitioner defines the rules and regulations the NP must follow in practice. Regulations vary from state-to-state regarding nurse practitioners scope of practice and level of professional autonomy. Currently, the 50 states are categorized into three groups based on NP’s practice regulations, which are Full Practice, Reduced Practice, Restricted Practice (Ortiz et al., 2018). I live in Alabama and it is a reduced practice state. Reduced practice means “State practice and licensure laws reduces the ability of nurse practitioners to engage in at least one element of ARNP practice. State law requires a career-long regulated collaborative agreement with another health provider in order for the APRN to provide patient care or, limits the setting of one or more elements of APRN practice” (Ortiz et al., 2018). This means as a NP, I cannot practice autonomously and must have a collaborative agreement with a physician to deliver care to patients. In Alabama, in regards to prescription medications, I can prescribe prescription medications, but most scheduled drugs must be co-signed by a collaborating physician (Wiesen, 2023). I believe relaxing scope of practice restrictions could help PMHNPs meet the critical demand for mental health services in rural and urban areas. Since the height of the pandemic, more and more individuals have needed mental health care services, and with reduced and restricted practice laws, it’s difficult to provide the best care. Nurse practitioners functioning at the level for which they are prepared could help to improve healthcare access disparities in areas with severe physician shortages such as rural areas, where shortages have persisted and are anticipated for the foreseeable future (Ortiz et al., 2018). Since 2018, there have been currently over 5,000 Mental Health Care Professional Shortage Areas with a population of over 115 million, an expansion of the PMHNP workforce is desperately needed to meet our nation’s urgent behavioral health needs, especially after the covid pandemic (Phoenix & Chapman, 2020). Marked differences in APRN regulation across states pose particular barriers for PMHNPs who have multiple practice sites in metropolitan areas spanning several states with differing scopes of practice (Phoenix & Chapman, 2020). APRN scope of practice restrictions and supervision requirements also impede solutions to enhance access to services in underserved areas through tele-health (Phoenix & Chapman, 2020). Given the increasing importance of tele-health to maintain services during the coronavirus pandemic, the patchwork of different state APRN regulations is an unnecessary barrier to effectively match available providers with those needing services (Phoenix & Chapman, 2020). 

 

Resources

Ortiz, J., Hofler, R., Bushy, A., Lin, Y., Khanijahani, A., & Bitney, A. (2018). Impact of Nurse Practitioner Practice Regulations on Rural Population Health Outcomes. Healthcare, 6(2), 65. https://doi.org/10.3390/healthcare6020065

Phoenix, B. J., & Chapman, S. A. (2020). Effect of state regulatory environments on advanced psychiatric nursing practice. Archives of Psychiatric Nursing, 34(5), 370–376. https://doi.org/10.1016/j.apnu.2020.07.001

Wiesen, K. (2023). Nurse Practitioner Scope of Practice By State – 2023. Nursing Process. https://www.nursingprocess.org/nurse-practitioner-scope-of-practice-by-state.html

 

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I’am repling to my peer’s post on role and scope of practice of PMHNP

NU-664C-02-23PCS3 FamilyPsychiatric Ment.Hlth I

  1. Dashboard
  2. My courses
  3. NU-664C-02-23PCS3
  4. Week 1 Discussion 2: Role and Scope of Practice of PMHNP

Week 1 Discussion 2: Role and Scope of Practice of PMHNP

Done: Make forum posts: 1

Value: 100 points

Due: In an effort to facilitate scholarly discourse, create your initial post by Day 4, and reply to at least two of your classmates, on two separate days, by Day 7.

Grading Category: Discussions

Note: In this type of discussion, you will not see the responses of your classmates until after you have posted your own response to the question below.

Initial Post

The Psychiatric-Mental Health Nurse Practitioner (PMHNP) fills a unique space in the healthcare environment.

  • Research your state’s current scope of practice for the role of PMHNP.
  • Do these regulations present a barrier to mental health care?
  • What groups or cultures do you see most impacted by your states’ current scope of practice regulations?

Replies

Your reply posts should compare and contrast your state’s scope of practice regulations, any barriers to mental health care, and suggest a policy that would specifically address marginalized populations. Consider how regional and cultural differences play a part. Back up all arguments using scholarly resources and gray literature.

Pick out an idea from your peers’ initial post that you find most interesting and tell how you will use this information in practice.

Please refer to the Grading Rubric for details on how this activity will be graded. The described expectations meet the passing level of 80%. Students are directed to review the Discussion Grading Rubric for criteria which exceed expectations.

Your response should include evidence-based research to support your statements using proper citations and APA format. 

This is my peer’s post

Re: Week 1 Discussion 2: Role and Scope of Practice of PMHNP

by William Nichols – Monday, 1 May 2023, 8:02 AM

 

Introduction

         As we have learned from some of our previous classes up to this point, the rules and regulations vary from state to state on the scope of practice from advanced practice nurses. Some states require oversight from a physician at all times, some states only require oversight for a certain number of years after a advance practice nurse becomes licensed, and some states give advanced practice nurses full autonomy. In this discussion the rules and regulations of advance practice nurses and psychiatric mental health nurse practitioner (PMHNP), what type of barriers these rules and regulations may cause, and how these regulations impact certain groups and cultures will be discussed.

States Current Scope of Practice and Barriers

          The state of New Hampshire where I hope to practice has embraced the role of the Advance Practice nurse and per the New Hampshire Board of Nursing are allowed to practice independently with full autonomy with no required oversight (Nurse, 2021). Nurse practitioners in New Hampshire can order test, diagnose and prescribe with no required oversite. This is very beneficial to the mental health community and creates no barriers to how a PMHNP can help clients with mental health needs. PMHNP’s in New Hampshire can run their own clinics, see client via telehealth to improve access among many groups and cultures. PMHNP’s are also allowed to perform medication assisted treatment medication and controlled substance as long as they are part of the New Hampshire prescription drug program where providors have to register and document controlled substances they prescribe as to prevent misuse and over prescribing of controlled substances (Prescription drug, 2023)

Groups and Cultures most Impacted

           The regulations set fourth only positive impacts for many groups such as those who have substance abuse and mental health issues. As shown by the covid 19 pandemic causing a stop to the required supervisory psychiatrist requirement, PMHNP were able to reach groups with mental health needs quicker and not having to find a willing psychiatric to oversee their practice (O’Reilly-Jacob et al., 2023). Not only lifting the requirement of needing physician oversight. lifting the telehealth restrictions has improved access to low income groups especially with Medicare/Medicaid now covering telemedicine (Harju & Neufeld, 2021). Telepsychiatry has also been found to help low income groups because it limits the transportation barrier and cost of transportation to get to an appointment (Goyal, 2021). Taking away barriers of full practice authority and telepsychiatry has also helped rural groups within the state that has some very rural areas. If a PMHNP lives in a rural area they can practice independently within that area with no oversight or other PMHNP can provide telehealth services to there rural areas. Overall New Hampshire has broken many barriers that were once present in assisting client to obtain prompt psychiatric care which could reduce the chance a client goes into crisis.

 

References

Goyal, S. (2022). Can telepsychiatry bridge the treatment gap? Journal of Mental Health & Human Behavior, 27(2), 75–81. https://doi.org/10.4103/jmhhb.jmhhb_157_22

Harju, A., & Neufeld, J. (2021). The Impact of the Medicaid Expansion on Telemental Health Utilization in Four Midwestern States. Telemedicine & E-Health, 27(11), 1260–1267. https://doi.org/10.1089/tmj.2020.0476

Nurse, advanced practice registered (APRN) – New Hampshire. (2021). https://www.nhes.nh.gov/elmi/products/licertocc/documents/nursaprn.pdf

O’Reilly-Jacob, M., Tierney, M., Freeman, P., & Perloff, J. (2023). Emergency removal of supervision requirements for psychiatric mental health nurse practitioners: A mixed-methods survey. Psychiatric Services, 74(2), 127–133.

Prescription drug monitoring program. New Hampshire department of health and human services. (2023). https://www.dhhs.nh.gov/programs-services/population-health/prescription-drug-monitoring-program

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