PMH-APRN
a nurse with graduate-level training who provides psychiatric-mental health care and
promotes mental health across the lifespan
-assess, diagnose and treat individuals and families who have psychiatric and/or
substance disorders
-work in a variety of health care settings and practices and are eligible for
reimbursement through private insurers, HMOs, PPOs, Medicare and Medicaid
ANA Code of Ethics: anticipatory guidance competency
ANA Standards and Scope: Standard 5B: Health Teaching & Promotion
-An educated professional nurse is aware of normal developmental and situational
threats to wellness and can educate healthcare consumers to avoid them.
• Example: Moving a toddler from a crib to a bed can prevent injury associated with
climbing out of the crib at that developmental age.
ANA Code of Ethics: the art of nursing is based on?
caring and respect for human dignity
ANA Code of Ethics: the fundamental principle of and attitude that the
professional nurse must have as outlined in Provision 1
ANA Code of Ethics: Provision 1
-"the nurse practices with compassion and respect for the inherent dignity, worth, and
unique attributes of every person" (ANA, 2015b, p. 1).
ANA Code of Ethics: How should the nurse respond to the discovery of human
trafficking in his or her practice?
ANA Code of Ethics: Provision 8
-Nurses must "bring attention to human rights violations in all settings and contexts. . . .
The nursing profession must respond when these violations are encountered" (ANA,
2015b, p. 33).
Dr. Edward Cowles created in 1882
the first organized training school within a hospital for the insane
1913, Effie Jane Taylor developed
,the first nurse-organized training course for psychiatric nursing at Johns Hopkins
Hospital
(before early psychiatric nurses were trained by physicians)
Following WWI, the National League for Nursing Education added:
"nursing in nervous and mental diseases" to curriculum guides
In WWII, many potential military recruits deemed unfit for service due to
psychiatric concerns, while many veterans experienced combat-related
neuropsychiatric conditions. Laura Fitzsimmons recommended:
standards of training for psychiatric nurses, which led to improved education and
standards of care.
National Mental Health Act (NMHA) of 1946
-psychiatric nursing was recognized as one of the four core disciplines in psychiatric
care and treatment
-The act increased funding for psychiatric nursing education programs and contributed
to a growth in university-based nursing education.
1954
-the first graduate program in psychiatric nursing was established at Rutgers University
by Hildegarde Peplau
• to prepare nurse therapists.
-The first advanced practice nursing role was the psychiatric-mental health clinical nurse
specialist (PMHCNS) role.
The Community Mental Health Centers Act of 1963
(1950s brought a transition towards deinstitutionalization in care for those with mental
illnesses, which led to an increase in the number of psychiatric clients receiving care in
the community rather than hospitals)
-The Community Mental Health Centers Act of 1963 allowed for the expansion of the
PMHCNS role into community and ambulatory settings as they helped those who had
been deinstitutionalized adapt
1965
Loretta Ford, RN and Henry Silver MD introduce the nurse practitioner role.
1973 ANA first published:
, Standards of Psychiatric-Mental Health Nursing Practice
1980s states began to grant:
prescriptive authority to advanced practice registered nurse (APRN), adding medication
prescribing and management to the traditional therapy role of the psychiatric mental
health (PMH) APRN.
2000s these exams were developed:
Certification exams for adult and family psychiatric mental health nurse practitioner
(PMHNP) developed.
-These exams were retired in 2015 when psychiatric certification exams were combined
to a single Psychiatric-Mental Health Nurse Practitioner (Across the Lifespan)
Certification (PMHNP-BC).
The 21st Century Cures Act of 2016:
-resulted in the creation of the U.S. Department of Health and Human Services (HHS)
Interdepartmental Serious Mental Illness Coordinating Committee (ISMICC)
-group is charged with compiling a summary of advances in serious mental illness (SMI)
and serious emotional disturbance (SED) research, evaluating federal programs and
treatment services related to SMI and SED, and making specific recommendations to
better coordinate the administration of mental health services
present:
Current trends in care focus on integrated treatment of those with co-occurring medical
and psychiatric diagnoses and co-occurring psychiatric and substance use disorders,
leading to a need to add content in advanced health assessment, pharmacology,
pathophysiology, and the diagnosis of psychiatric illness to graduate psychiatric nursing
curricula.
-Primary care has become the point of entry to psychiatric care for many clients.
-PMHNPs are helping to address the growing need for primary mental health services
and mental illness prevention.
-Though the number of advanced practice psychiatric nurses has increased, there are
still limitations in access for many clients, which has led to disparities in mental health
treatment.
PMHNP scope of practice