How did the Advanced Practice Psychiatric Nurse (APRN) role begin?
The first clinical nurse specialist (CNS) program began in 1955 at Rutgers University. Dr. Hildegard Peplau initiated it with a grant from the National Institute of Mental Health. The goal was to prepare nurses with expert theoretical and practical knowledge, to improve patient outcomes, and impact systems to promote quality care. Psychiatric mental health advanced practice nurses (PMH-APRNs) were then prepared to link nursing practice and nursing science.
Ten years later in 1965, more than 30 programs were preparing PMH-APRNs for practice. By the early ‘90s, as other specialties and nurse practitioners were determining their roles in the advanced practice nursing industry, leaders in psychiatric nursing established and implemented the nurse practitioner roles for PHM-APRNs.
Care is provided by PMH-APRNs for people with psychiatric disorders such as depression, bipolar disorder, anxiety, schizophrenia, and substance use and with mental health issues such as adjustment problems from loss, grief or difficulty coping with resulting physical health problems.
PMH-APRNs also focus on therapeutic milieu, which are activities and interactions in a setting supported by positive outcomes for patients and psychotherapy which covers family, group, and individuals.
Is an APRN the same as a nurse practitioner?
APRN is an umbrella term for nurses with an advanced degree —Master’s of Science Nursing (MSN) or doctorate. Nurse practitioners, certified nurse specialists, midwives, and nurse anesthetists are all considered an APRN.
What is the difference between a psychiatric nurse practitioner/certified nurse specialist vs psychiatrist?
Psychiatric nurse practitioners and certified nurse specialists can do most things a physician psychiatrist can do. PMHNPs receive education specialized in psychiatry and mental health. They are required to become board certified in order to practice in the field of psychiatry/mental health and to have either a master’s or doctorate to receive a license from their practicing state. In addition, they are required to complete continuing education and renew their state license as well as their board certification. Most APRNs have years of experience as a nurse prior to becoming an APRN. An APRN is able to evaluate, diagnose, test, and treat patients, prescribe all medications that a physician can, unless it requires a special certification that APRNs are unable to obtain.
What is a PMHNP? Are they APRNs?
PMHNP refers to a psychiatric mental health nurse practitioner. They are considered APRNs, as APRN is the umbrella term for nurses with advanced degrees and training.
What is a clinical nurse specialist (CNS)? Are they APRNs? How are CNSs different then PMHNP?
CNSs are APRNs. There are fewer programs now than previously existed to become a CNS.. Typically, CNSs and PMHNPs are hired for similar APRN positions.
The Differences Between a Nurse Practitioner and Clinical Nurse Specialist
Understanding the role of a nurse practitioner (NP) and the difference of a clinical nurse specialist (CNS) is important in determining which of the two positions an advanced practice nurse chooses.
Both certifications, NP and CNS, require a Master’s of Science in Nursing (MSN) to practice. Once a MSN and/or Doctor of Nursing Practice (DNP) degree has been acquired the expected responsibilities are still very different. For example, an NP is able to prescribe medications in most states and a CNS is often not.
Technically, a CNS is an advanced nursing clinician focused on expert practice, improvement of bedside care, and intertwining roles as clinician, consultant, researcher, educator, and manager. As the role of a CNS has grown the scope of practice now includes direct patient care services, staff education, macrosystem management of a specialized population—including nursing or a system model, instead of a medical model of care. In the beginning, the NP practice was focused on the individual at the direct care level, while the CNS practice was to be both individual and macro-level, using nursing diagnoseis, management, systems assessment and synthesis of improved approaches to nursing care.
In summary, both NPs and CNSs are highly educated and skilled, driven to work hard , and provide the very best patient care available. Finding the right role for each person is totally dependent on what type of work environment best suits each person’s interests and personality.
Can a psychiatric nurse practitioner prescribe medication?
Yes. Each state varies on specific rules and regulations.
What kind of continuing education is needed?
An APRNs education does not stop after graduation. They are required to take ongoing continuing education contact hours in areas such as diagnosis, psychotherapeutic treatment, or psychopharmacology.
What is the APNA?
The American Psychiatric Nurses Association (APNA) is the largest national professional society representing psychiatric nurses. Founded in 1987, APNA has chapters in most US states, the District of Columbia and the federal services. APNA is the unifying voice of psychiatric-mental health nursing. A professional organization of more than 11,000 members, we are committed to the specialty practice of psychiatric-mental health nursing, health and wellness promotion through identification of mental health issues, prevention of mental health problems and the care and treatment of persons with psychiatric disorders. APNA pursues these goals through alliances with stakeholders, research publications, and continuing education programs.
Is there a shortage of psychiatric APRNs?
Yes, in fact, a recent report stated that only 3% of nurse practitioners decide on psychiatry for employment. In recent years, the number of available positions across the country has risen by 17%. The employment growth for nurse practitioners is projected to rise 31% between now and 2024.