Writer’s Professional/Policy/Practice issue for Psych NP to provide care for 32 y/o schizophrenic patient
Psychiatric Nursing Practice
Legal Mandates That Impact the Ability to Provide Primary Health Care
Other than meeting the authorized educational requirements, it is necessary that the PMHNP undergo certification, which is, according to Johnson and Vanderhoef (2013), “the process by which a professional organization or association certifies that an individual licensed to practice as a professional has met certain predetermined standards specified by that profession for specialty practice” (Johnson & Vanderhoef, 2013). This gives assurance to the public that PMHNPs have a mastery of their respective specialty. Presently, according to Johnson and Vanderhoef (2013), the American Nurses Credentialing Center (ANCC) is the only certifying agency for advanced practice psychiatric nursing.
Professionals that Would Be Involved in Providing Care
The PMHNP role is performed in various settings. Thus, consultation and collaboration with other disciplines is necessary to provide a successful psychiatric and biopsychosocial treatment for the patient. PMHNPs will often work as members of an interdisciplinary team, and play a vital role in coordinating care, including referrals to specialists (ANA, APNA, & ISPN, 2014). A complex case of PTSD may necessitate a referral with a psychiatrist, and a foreign-language speaking patient may need the assistance of interpreter services. Additionally, the PMHNP would work with other nursing staff to develop a plan on how to maintain the safety of a patient with suicide risk.
Potential Barriers to Practice
In medical practice, especially with respect to psychiatric practice, all communications between RNs and patients are private and RNs are expected to observe the confidentiality of the patient. According to The Scope and Standards of Practice: Psychiatric-Mental Health Nursing, 2nd Edition and the code of ethics, all information regarding the schizophrenic are intended to be private and confidential including the identity of the patient. Confidentiality in the field of psychiatric treatment is essential partly because of the special characteristics of the field. PMHNPs are only released confidential information with the authorization of the schizophrenic patient in the circumstances that they are compelled by the law. This is a huge barrier as many schizophrenic patients highly value their privacy and being diagnosed with schizophrenia or any other mental disorder could mean being prevented from continuing his or her employment, and could discourage future patients from seeking medical attention.
Legal Regulations Determining Scope
State law, rules, and regulations govern the practice of nursing. Nurses are covered by their state’s Nurse Practice Act, where one can determine which actions they are allowed to do without stepping out of bounds and into the domain of medicine. However, nursing is a dynamic science, and its evolution may likely compel the nurse practitioner (NP) to perform additional functions not explicitly stated in their state’s Nurse Practice Act. That is why the state of California, for example, has standardized procedure guidelines in place to legally permit the nurse to perform standardized procedure functions under the conditions developed by an organized health care system and upon provision of satisfactory evidence that the nurse meets its experience, training, and education requirements to perform such functions (California Board of Registered Nursing [CBRN], 2011). Nonetheless, it is important for the PMHNP to know their scope of practice as malpractice insurance does not protect NPs from charges of practicing outside their legal scope of practice.
An important and necessary standardized procedure function of the PMHNP is the furnishing and ordering of drugs and devices. This function should be by standardized procedures developed by the NP and the supervising physician (CBRN, 2013). This is conditional upon the issuance of a furnishing number by the board and as for controlled substances, upon registration with the United States Drug Enforcement Administration, including a completion of a course regarding Schedule II controlled substances (CBRN, 2013).
Appropriate Standards to Follow
The Scope and Standards of Practice: Psychiatric-Mental Health Nursing, 2nd Edition guide the PMHNP in the application of their professional skills and responsibilities. The book entails the fundamentals of psychiatric-mental health nursing in all practice stages and circumstances. It expresses what is required of all psychiatric-mental health RNs, identifying the “who, what, where, when, why and how” of their occupation. It expresses the fundamental conventions and features, concerns matters of surroundings and backgrounds in addition to education and teaching needs, and addresses key concerns and developments and the moral and theoretical basis of the field. Furthermore, it identifies the proficiencies for the nursing profession and specialized conduct of all psychiatric mental health registered nurses.
Available Financial Services
Financial resources are also available for veterans suffering from schizophrenia. Aside from the federally-financed Medicaid program and California’s Medi-Cal that provides health care coverage for certain eligible low-income and needy populations, veterans who are California residents may also be qualified for the California Department of Health Care Services’ Veterans Benefit Enhancement Project, which helps veterans obtain federal benefits they are entitled to (California Department of Health Care Services, 2014). If the patient does not qualify for any of the above resources, there are other ways to obtain financial help. First, the patient must ask his primary care provider whether bills can be discounted, and if not, inquire for free or low-cost clinics in his area. The social worker would be of great assistance in helping the veteran find the appropriate avenue to address the financial need. Other additional resources are the federal benefits guide from the Department of Veterans Affairs which informs veterans and their dependent relatives of the diversity of federal assistances available and the Coming Home Project, a non-profit organization dedicated to offering care and provision for Iraq and Afghanistan veterans suffering from schizophrenia (Moore & Penk, 2011).
American Nurses Association, American Psychiatric Nurses Association, & International Society of Psychiatric-Mental Health Nurses, (2014). Psychiatric-mental health nursing: Scope and standards of practice.
California Board of Registered Nursing. (2011). Professional issues in nursing: Challenges & opportunities. Baltimore, MD; Philadelphia, PA: Wolters Kluwer Health/Lippincott Williams & Wilkins.
California Board of Registered Nursing. (2013). Contemporary Nursing: Issues, trends, & management. Baltimore, MD; Philadelphia, PA: Wolters Kluwer Health/Lippincott Williams & Wilkins.
California. (2014). California Department of Health Care Services: Weaknesses in its Medi-Cal Dental Program limit children’s access to dental care.
Johnson, K., Vanderhoef, D., Guess, K., & American Nurses Credentialing Center, (2013). Psychiatric-mental health nurse practitioner review manual. Silver Spring, MD: American Nurses Credentialing Center.
Moore, B. A., & Penk, W. (2011). Treating PTSD in military personnel: A clinical handbook. New York: The Guilford Press.
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