Benchmark – Future Scope, Role, and Professional Obligations Paper
Advanced registered nursing graduates are entering the profession at dynamic time when roles and scope of practice are shifting based on developments in legislation and policy in response to the evolving needs of the health care system. Professional nursing organizations play an important role in making sure the perspectives of advanced registered nurses are heard, and in supporting nurse specialties in their efforts to expand their scope of practice and their full participation throughout the health care system. Benchmark – Future Scope, Role, and Professional Obligations Paper
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For this assignment, you will conduct research on the current scope of practice for your specialty and efforts that are being made to expand that scope and the role of the advanced nurse in positively influencing the health care system. Write a 1,250-1,500-word paper that includes the following:
A discussion of the scope of your future role as an advanced registered nurse, including any regulatory, certification, or accreditation agencies that define that scope.
A discussion of three professional nursing organizations that you think are most influential in advancing the scope and influence of advanced nursing. Of these organizations, evaluate the one that you would most like to join. How do its goals and mission fit in with your worldview and philosophy of care? How might membership in this organization improve your practice? Benchmark – Future Scope, Role, and Professional Obligations Paper
A discussion of a controversial or evolving issue that is most likely to affect your scope of practice or role in the next few years. How do you think this issue could influence the profession and other stakeholders, and why does it matters to the advanced registered nurse?
You are required to cite five to 10 sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and nursing content.
Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.
The Future Advanced Practice Registered Nurse (APRN): Scope of Future Practice, Role, Professional Control (Regulatory, Certification, Accreditation), Professional Organizations, and Issues of Concern
The advanced practice registered nurse or APRN position has steadily grown in importance in the United States. This is because the role that they play in plugging the gap between physicians and the population is immense. It is a common fact that the number of physicians practicing is virtually inversely proportional to that of the population they are supposed to be serving. To become an advanced practice nurse, one must complete a rigorous accredited postgraduate course in their specialty. This postgraduate degree is currently recommended to be a PhD as the entry level to practice. After meeting these educational requirements, the psychiatric-mental health nurse practitioner (PMHNP) for instance has then to be certified by the American Nurses Credentialing Centre (ANCC) (ANCC, N.D.) and receive licensure to practice from the State in which they intend to practice. The role APRNs have come to play has become quite significant, given the fact that many communities that are socio-economically deprived are not able to access the expensive health services offered by the country’s physicians. What these populations need is affordable healthcare brought to them where they can easily access it, conveniently. This is primary health care (PHC), and the frontline clinicians that are going to champion it going forward are the APRNs. This paper will look at the future roles of the nurse practitioner (in this case a PMHNP) and their scope, the regulatory framework governing their practice, accreditation and credentialing, nursing professional organizations they can join, and one controversial matter related to the practice of a PMHNP. Benchmark – Future Scope, Role, and Professional Obligations Paper
Scope of Future Role as a PMHNP, Regulation, Accreditation and Credentialing
At present, the role of the nurse practitioner and its scope are very much a factor of the state legislation and regulations that govern nurse practitioner practice. In states that guarantee full autonomy of practice (full practice authority or FPA), the PMHNP evaluates mentally ill patients, diagnoses, orders investigations and interprets them independently before ordering appropriate treatment and making follow up (Maryville University, 2019). This is the full scope of the role that the PMHNP will be practicing in the future, because the movement to have universal full practice authority across states is unstoppable. Regulation of practice of PMHNPs and by extension all other APRNs is done through state legislation. Different states have different regulatory structures for APRNs (AANP, 2018). Across the fifty states, there are those whose regulatory structure is that of full practice authority. However, other states still have a regulatory structure of either reduced practice or restricted practice (AANP, 2018). These last two regulatory structures are restrictive and prohibitive to the nurse practitioner, preventing them from exercising their knowledge and training to the full extent of their abilities. As stated above, full practice authority regulatory structure permits the nurse practitioner to practice without any supervision or hindrance. Reduced practice, on the other hand, requires that the nurse practitioner enters into a collaborative agreement with a practicing physician so that they can effectively practice under them. Lastly, the worst regulatory framework is the restricted practice arrangement. In the states with this kind of APRN regulation, the nurse practitioner is only allowed to do a few things which also have to be done under the supervision of a physician (AANP, 2018). There are a total of 23 states that have a full practice authority regulatory structure as at 2017. These include Idaho, Iowa, Maryland, Hawaii, Washington D.C., New Mexico, and so on. The remaining are either reduced or restricted practice. Reduced practice states for APRNs include Ohio, Illinois, Wisconsin, Utah, Louisiana, and so on. Lastly are the worst states to practice in as APRNs. These have licensure laws that only allow restricted practice which give the APRN very little room to flourish. These states include Florida, Texas, Michigan, Georgia, and California, amongst others (Maryville University, 2019; AANP, 2018).
The future of the PMHNP and other APRNs however looks bright and their traditional role as seen above is definitely set to expand. This is because there is a shortage of physicians as they move to the super specialties leaving disciplines like family medicine with severe shortages of manpower. APRNs are the cadre that will fill this vacancy (Maryville University, 2019). After education and training the PMHNP is expected to get certification before applying for a practicing licence from the state in which they intend to practice. In the case of the PMHNP, the agency tasked with this certification is the American Nurses Credentialing Centre or ANCC (ANCC, n.d.). All that the graduated nurse practitioner needs to do is to sit for a competency examination that tests for clinical acumen, knowledge, and skills. After passing the examination and the board certification (BC) is awarded, the official title of the nurse practitioner changes to PMHNP-BC (ANCC, n.d.). The certification lasts for five years, after which it needs to be renewed.
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On the matter of accreditation, it is the particular course that the PMHNP does at the university that needs to be accredited. Accreditation of courses and institutions takes place both at the regional level and the national level (EDsmart, n.d.). There is preference, however, for the regional accreditation of courses as it is easy to transfer credits to another institution this way. Some of the regional accreditation bodies include the Higher Learning Commission (which is recognized by the US Department of Education) and the Northwest Commission on Colleges and Universities. In summary, the process therefore starts with enrolling in a duly accredited postgraduate course. After completion of the course, the nurse practitioner applies for board certification and sits for the competency examination. If successful, they then apply for a practice license as per the state’s licensure laws. The licence that they will then get will depend on the state as discussed above and will be for full practice autonomy, a reduced practice, or a restricted practice. Benchmark – Future Scope, Role, and Professional Obligations Paper
Three Professional Nursing Organizations
Professional organizations are an important component for the advance practice nurse professional. This is especially true considering the challenges with the disparate regulatory structures seen above. Policies and their formulation by their very nature are political processes. Political processes require masses and one voice, if anything is to change. This is the reason why PMHNPs must come together in professional bodies so that they can champion their professional causes. Therefore, professional organizations provide a platform and forum on which psychiatric-mental health nurses can stand and articulate their issues (Catallo et al., 2014). These issues include lobbying state legislators for policy changes towards the granting of full practice authority in the states that still do not have it. Professional bodies also help in the exchanging of professional ideas for better and improved practice.
Three of the most prominent professional organizations for the PMHNP are the American Psychiatric Nurses Association (APNA), the International Society of Psychiatric-Mental Health Nurses (ISPN), and the American Association of Nurse Practitioners (AANP). The ISPN builds capacity by way of mentorship and sharing of ideas, while at the same time helping with sharing professional ideas. The APNA fosters knowledge dissemination and professional support for its members (Adams &Black, 2016). For instance, by the year 2016 it had come up with a short online course to help its members seal some identified knowledge gaps. The program was titled American Psychiatric Nurses Association Transitions in Practice (ATP) (Adams & Black, 2016). The American Association of Nurse Practitioners (AANP) on its part provides professional support and encouragement by conferring Fellowship status to those members that have done something remarkable to the profession. The Fellowship status is only by nomination. Thus those who have received this prestigious recognition carry the title of Fellow of the American Association of Nurse Practitioners (FAANP) (Rossiter et al., 2017). Benchmark – Future Scope, Role, and Professional Obligations Paper
The most important controversial issue for a PMHNP at the moment is the matter of evidence-based practice. It is only psychiatry and mental health that is lacking behind in implementation of evidence-based practice in all of medicine. This is because of long-held traditions that have proved hard to drop completely (Alzayyat, 2014).
Adams, S.M., & Black, P. (2016). American Psychiatric Nurses Association –Transitions in practice certificate program: Bridging the knowledge gap in caring for psychiatric patients within the general nursing workforce. Nursing Administration Quarterly, 40(3), 225-236. Doi: 10.1097/NAQ.0000000000000168
Alzayyat, A.S. (2014). Barriers to Evidence-Based Practice Utilization in Psychiatric/Mental Health Nursing. Issues in Mental Health Nursing, 35, 134-143. Doi: 10.3109/01612840.2013.848385
American Association of Nurse Practitioners [AANP] (2018). State practice environment. Retrieved 14 September 2019 from https://www.aanp.org/advocacy/state/state-practice-environment
American Nurses Credentialing Centre [ANCC] (n.d.). Psychiatric-Mental Health Nurse Practitioner (Across the Lifespan) Certification (PMHNP-BC). Retrieved 14 September 2019 from https://www.nursingworld.org/our-certifications/psychiatric-mental-health-nurse-practitioner/
Catallo, C., Spalding, K. & Haghiri-Vijeh, R. (2014). Nursing professional organizations: What are they doing to engage nurses in health policy? SAGE Open, 1-9. Doi: 10.1177/2158244014560534
EDsmart (n.d.). Regional vs. national accreditation – there’s a huge difference. Retrieved 14 September 2019 from https://www.edsmart.org/regional-vs-national-accreditation/
International Society of Psychiatric-Mental Health Nurses [ISPN] (2019). International Society of Psychiatric-Mental Health Nurses. Retrieved 13 September 2019 from https://www.ispn-psych.org/
Maryville University (2019). States granting NP full practice authority. Retrieved 14 September 2019 from https://online.maryville.edu/nursing-degrees/np/states-granting-np-full-practice-authority/
Rossiter, A.G., Sabol, V.K. & Hicks, R.W. (2017). So you want to be a Fellow in the American Association of Nurse Practitioners: Navigating the Fellowship process to ensure your success. Journal of the American Association of Nurse Practitioners, 29, 501-505. Doi: 10.1002/2327-6924.12508
Benchmark – Future Scope, Role, and Professional Obligations Paper