Explanation Of The NP/PMHNP

Explanation of the Role of the NP/PMHNP

History and Background

Towers (2011) identifies nurse practitioners as “the most modern of the four advanced practice roles (APRN) – arose against the backdrop of the 1960’s in response to changes needed in the healthcare environment and the education of graduate nurses” (Towers, p.19). The sociopolitical situation at the time and the concern about maldistribution of health resources and health promotion, “made it a good time for change in the nursing profession, the window of opportunity was clearly open” (Towers. P.20). Consequently, from the onset of advance practice roles in nursing, “the aim of the clinical content model was not only to prepare graduate students for clinical specialization, but

12; Towers, p. 20). The original model developed by Ford, based on health promotion, disease prevention, and well-child care established a historical connection between the role of the NP and the health of populations. While most NP programs were originally certificate programs, many had moved to nursing schools that provided graduate degrees. The recommendation, by the National League for Nurses (NLN), in 1979 moved that all NPs be prepared at the graduate level. Since that time, the “NP has continued to expand into new settings and new specialty areas as needs, demands, and opportunities have increased” (Towers, p. 22). “The breadth of the role has expanded from a 9-to 12-month formal preparation beyond the basic nursing program to a master’s level and now to doctoral preparation in family health, pediatrics, gerontology, adult health, women’s health, neonatal

When PMHNPs entered into the workforce in the early 1990’s, they were faced with many challenges around licensure, certification, and scope of practice. There was no national certifying exam for the PMHNP and PMHNP’s were not qualified to sit for the existing ANCC CNS certification exam. Consequently, new graduates of NP programs, in some states, were unable to practice in their state, “Several states refused to grant PMHNP full scope of practice because there was no national certification exam” (Wheeler & Haber, p. 131). After development of the ANCC exam for NPs in 2000, other challenges developed around practice for PMHCNSs who were already practicing in their states with prescriptive authority. Additionally, “educators who had developed the PMHNP programs and those who taught the courses in these programs were in the unique position of being ineligible to take the exam for which they were preparing their students”(Rice, 2000; Wheeler & Haber, p. 132). As a consequence, post-masters PMHNP programs were developed to assist PMHCNSs in transitioning to the