Nurse Practitioner Professional Issues

 

Psychiatric-mental health nurse practitioners are committed to the assessment, diagnosis, and treatment of psychiatric disorders in individuals and groups through psychotherapy and medication. Since the role of the PMHNP carries such responsibility, it is no surprise that there is a rigorous path to obtain and maintain your PMHNP certification and licensure.
PMHNPs currently have only one choice for certification, which is through the American Nurses Credentialing Center (ANCC). The ANCC offers the “psychiatric/mental-health nurse practitioner (across the lifespan)” board certification (PMHNP-BC). In many states, board certification is a necessary prerequisite to receiving an NP license. Even if board certification is not a requirement for state licensure, it may be a requirement to receive privileges in various hospitals and other health care facilities. Malpractice insurance providers may also require board certification prior to issuing coverage to NPs.

Assignment:

Review the state of Colorado and Texas specific PMHNP certification and licensure requirements and scope of practice, as well as prescriptive authority issues. Don’t combine information while answering these questions. Treat the state of Colorado separate from the state of Texas.

• Summarize nurse practitioner certification and licensure processes
• Suggest a way to advocate for the profession in each of the above states.
• How does the states of Texas and Colorado define the scope of practice of a nurse practitioner?
• What is included in the state of Texas and Colorado practice agreement?
• How do you get a DEA license in the two states?

 

Sample Solution

Nurse practitioners (NPs) will play a vital role in improving health outcomes for a variety of populations as healthcare reform progresses. Nurses should be change advocates through caring for communities within complicated healthcare systems, according to the Institute of Medicine’s (IOM) 2011 report, The Future of Nursing: Leading Change, Advancing Health. “Advanced practice registered nurses (APRNs) should be able to practice to the full extent of their education and training,” according to the IOM report (IOM, 2011, s8). Existing hurdles in the healthcare industry, however, hinder APRN activity. This post will go through a few of these roadblocks and offer advice for how to overcome them.

Exposure Therapy (ET) targets learned avoidant behaviours in response to situations that someone with PTSD might associate with the reason for their trauma. The aim of the therapy is to “expose” a client to what they fear or avoid in a safe way in order to decrease the fear and reduce avoidance by desensitization (Craske, Treanor, Conway, Zbozinek & Vervliet, 2014). Due to ET targeting learned behaviours, it is used regularly in conjunction with CBT (Foa, Rothbaum & Furr, 2003). A more modern take on ET is using Virtual Reality, and it is mainly used with veterans of war, as the scenes they were exposed to are easier to recreate than other forms of trauma, such as sexual assault, and is an alternative to imagination exposure (Rothbaum et al., 1999). Miyahira, Folen, Hoffman, Garcia-Palacios and Schaper (2010) conducted a case study of a Vietnam veteran that had completed 18 months in Iraq over two deployments. In this study, the soldier was treated with Virtual Reality Exposure (VRE) over 6 sessions. The participant reported that the VR headset made him feel as though he were back in Iraq and helped him to remember events of what happened more clearly. This is encouraging as the point of ET is to enable participants to re-live their trauma to be able to process it properly and therefor begin the healing process and to prevent sufferers of PTSD from developing long-term psychological damage (CITE). Difede and Hoffman (2002) also found promising results. Their case study consisted of administering VRE to survivors of the 9/11 terrorist attacks. The participant’s symptoms were measured using the Beck Depression Inventory and the Clinically Administered PTSD Scale. It was seen that there was a 90% reduction of symptoms of PTSD and an 83% reduction in symptoms of depression after completion of the therapy. Another treatment that works in similar ways is Eye Movement Desensitization and Reprocessing (EMDR).

This therapy is designed to target and treat the symptoms of trauma and is especially used to treat symptoms of PTSD and is recommended by NICE as a primary treatment (NICE, 2018). It is seen as a cognitive-behavioural treatment combined with aspects of exposure therapy (Boudewyns & Hyer, 1996) and it works by the participant recalling the traumatic events that they experienced whilst simultaneously having their attention directed to a physical bilateral stimulation they are receiving, such as hearing tones in alternating ears, moving eyes rapidly from side to side, or tapping sensations of either side of the body. Similarly to ET, this therapy works by allowing the mind to safely experience traumatic events, letting the mind process them fully in order to heal appropriately (Shapiro, 1996). A systematic narrative review was carried out on the effectiveness of EMDR for PTSD from four randomized control trials and two meta-analyses. It was found that the therapy was ab

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