WK 1 NRNP
Week 1: Nurse Practitioner Professional Issues
Psychiatric-mental health nurse practitioners are committed to the assessment, diagnosis, and treatment of psychiatric disorders in individuals and groups through psychotherapy and medication. Since the role of the PMHNP carries such responsibility, it is no surprise that there is a rigorous path to obtain and maintain your PMHNP certification and licensure.
PMHNPs currently have only one choice for certification, which is through the American Nurses Credentialing Center (ANCC). The ANCC offers the “psychiatric/mental-health nurse practitioner (across the lifespan)” board certification (PMHNP-BC). In many states, board certification is a necessary prerequisite to receiving an NP license. Even if board certification is not a requirement for state licensure, it may be a requirement to receive privileges in various hospitals and other health care facilities. Malpractice insurance providers may also require board certification prior to issuing coverage to NPs.
This week, you will review your state specific PMHNP certification and licensure requirements and scope of practice, as well as prescriptive authority issues.
Learning Objectives
Students will:
- Summarize nurse practitioner certification and licensure processes
- Explain state-specific scope of practice for psychiatric-mental health nurse practitioners
- Explain state-specific restrictions or limitations for practice
- Explain nurse practitioner prescriptive authority and DEA registration processes
Learning Resources
Required Readings (click to expand/reduce)
American Association of Nurse Practitioners. (2020). State practice environment. https://www.aanp.org/advocacy/state/state-practice-environment
American Psychiatric Association. (2020). Telepsychiatry. https://www.psychiatry.org/psychiatrists/practice/telepsychiatry
Buppert, C. (2021). Nurse practitioner’s business practice and legal guide (7th ed.). Jones & Bartlett Learning.
- Chapter 1, “What Is a Nurse Practitioner?”
- Chapter 2, “Nurse Practitioner Scope of Practice”
- Chapter 3, “State Regulation of the Nurse Practitioner Practice”
- Chapter 4, “Federal Regulation of the Nurse Practitioner Profession”
- Chapter 5, “Prescribing”
Centers for Disease Control and Prevention. (2020). Using telehealth to expand access to essential health services during the COVID-19 pandemic. https://www.cdc.gov/coronavirus/2019-ncov/hcp/telehealth.html
Centers for Medicare & Medicaid Services. (2019). National provider identifier standard (NPI). https://www.cms.gov/Regulations-and-Guidance/Administrative-Simplification/NationalProvIdentStand
- This site contains information about applying for your DEA registration number. This number is required for writing prescriptions.
- After completing PMHNP Program and passing the PMHNP certification exam, complete the DEA application to request prescriptive privileges. Your DEA number will be renewable every five years.
National Panel for Psychiatric Mental Health NP Competencies. (2003). Psychiatric-mental health nurse practitioner competencies. National Organization of Nurse Practitioner Faculties (NONPF). https://cdn.ymaws.com/www.nonpf.org/resource/resmgr/imported/PMHNPcomps03.pdf
Stewart, J. G., & DeNisco, S. M. (2019). Role development for the nurse practitioner (2nd ed.). Jones & Bartlett Learning.
- Chapter 1, “Historical Perspectives: The Art and Science of Nurse Practitionering”
- Nurse Practitioner Core Competencies
- Nurse Practitioners’ Unique Role
- Chapter 13, “Quality, Safety, and Prescriptive Authority”
- This site contains information about applying for a practitioner waiver to prescribe or dispense buprenorphine under the Drug Addiction Treatment Act of 2000 (DATA 2000).
- After youobtain a Drug Enforcement Agency (DEA) number and completed 24-hour medication-assisted treatment (MAT) waiver training, you may apply to Substance Abuse and Mental Health Services Administration (SAMSHA) for MAT waiver to be able to prescribe Schedule III, IV, or V opioid drugs for the maintenance and detoxification treatment of opioid use disorders relapse prevention.
Zakhari, R. (2021). The psychiatric-mental health nurse practitioner certification review manual. Springer Publishing Company.
- Chapter 2, “The Role of the Psychiatric-Mental Health Nurse Practitioner: Regulations and Scope of Practice”
- Chapter 3, “Theoretical Foundations of Care and Nonpharmacological Therapies”
Recommended Resources
Consult these professional organization websites as needed.
American Psychiatric Nurse Association (APNA) https://www.apna.org
International Society of Psychiatric-Mental Health Nurses (ISPN) www.ispn-psych.org
National Alliance on Mental Illness (NAMI) https://www.nami.org
National Council for Behavioral Health (NCBH) www.thenationalcouncil.org
National Institute of Mental Health (NIMH) https://www.nimh.nih.gov/index.shtml
Substance Abuse and Mental Health Services Administration (SAMHSA) www.samhsa.gov
ASSIGNMENT
Discussion: Certification and Licensure Plan
Now that you are in the final course in your program, it is time to turn in earnest to preparing for certification and licensure. You will need to take and pass the national PMHNP certification exam. Once certified, you will then be eligible to apply for licensure as an advanced practice registered nurse (APRN) in the state desired. It will be up to you to ensure you are knowledgeable about the practice agreements, scope of practice, and prescriptive authority in your state.
Photo Credit: AndreyPopov / iStock / Getty Images Plus / Getty Images
Although a movement called the APRN Consensus Model is attempting to standardize NP regulations nationally, it is still the case that requirements vary state to state. In some states, NPs may establish an independent practice without the supervision of an MD. Additionally, states are currently categorized as either allowing full practice, reduced practice, or restricted practice. Full practice states allow NPs to evaluate, order diagnostics, diagnose, and treat patients. They are licensed under the exclusive authority of the state board of nursing for the appropriate state. Many states may require prescriptive authority protocols in addition to collaborative agreement.
Another important area to consider and plan for is prescriptive authority. The appropriate board, which may be the medical board, state board of pharmacy, or nursing board, grants prescriptive authority under state law for the appropriate state licensure. The federal government grants the authority to write for a controlled substance, and the Drug Enforcement Administration (DEA) verifies this action through by the appropriate state board. Drug Enforcement Agency registration is granted at the federal level and has additional requirements/fees for the registration process.
In this Discussion, you will locate and review the practice agreements in the state in which you plan to practice, identify potential collaboration requirements in your state, and understand the certification and licensing process that you will need to follow.
To Prepare:
- Review practice agreements in your state.
- Identify whether your state requires physician collaboration or supervision for nurse practitioners, and if so, what those requirements are.
- Research the following:
- How do you get certified and licensed as an Advanced Practice Registered Nurse (APRN) in your state?
- What is the application process for certification in your state?
- What is your state’s board of nursing website?
- How does your state define the scope of practice of a nurse practitioner?
- What is included in your state practice agreement?
- How do you get a DEA license?
- Does your state have a prescription monitoring program (PMP)?
- How does your state describe a nurse practitioner’s controlled-substance prescriptive authority, and what nurse practitioner drug schedules are nurse practitioners authorized to prescribe?
