Shaping the Advanced Practice Psychiatric-Mental Health Nursing Role: A Futuristic Model

Abstract

As advanced practice psychiatric-mental health nursing has transitioned from earlier models of practice, elements of clinical specialist and psychiatric nurse practitioner roles are being blended to produce a new type of practitioner. The challenge of preserving mental health expertise while expanding advanced practice primary and primary mental health care competencies is addressed in several nursing education models. At New York University's Division of Nursing, faculty have designed a program around elements identified as essential to the autonomy demanded of the evolving role, knowledge, and skills basic to broad based health care and mental health care delivery with quality patient care outcomes and the competencies necessary for accountability as care providers in a changing health care delivery system. Essential elements, resources to identify them, and strategies to attain them are discussed. Approaches that promote student, clinician, and faculty development and maximize education affirm the specialty's capacity for innovation and the profession's capacity for new direction and futuristic change.

Clinical Outcomes of Depressed Clients: A Review of Current Literature

“…The APPN has always been prepared to provide both individual and group psychotherapy. Now the role has expanded to include prescriptive authority and an increased focus on the psycho-neurobiological aspects of treatment (Naegle & Krainovich-Miller, 2001). In today's health care arena, both psychiatrists and APPNs typically prescribe medications to treat mental illness.…”

The work and values of mental health nurses observed

“…The willingness of CMHNs to undertake work in primary care should not be mistaken for an ability to do it, as Stockler (1986) and Brooking (1985) have pointed out. The observations of Naegle & Krainovich-Miller (2001) that the educational basis of mental health nursing needs to be strengthened should also be taken into account. Both male and female participants expressed dissatisfaction with their current 'own' and 'shared' caseloads, apparently finding them either too onerous or the mix too difficult.…”

“…Low levels of educational support combined with poor role definition mean that nurses can play only a limited role in multidisciplinary teams. Naegle & Krainovich‐Miller (2001) call for a vigorous attempt to rediscover the professional identity of mental health nurses, and Peplau (1994) agrees that nurses must review their practice in order to have a say in the future direction of services. The price to be paid for having no say is that nurses will be forced to assume subordinate roles and face increasing professional obscurity.…”

Community psychiatric nursing: focus on effectiveness

“…Brooker & White (1997b) concluded from their census that CPNs have increased the number of more severely ill people on their caseloads. There is also movement to expand the role of the CPN and highly graded consultant nurses are now being introduced in many areas (Naegle & Krainovich‐Miller 2001).…”