Academic journal article Perspectives in Psychiatric Care

Letters to the Editor

Academic journal article Perspectives in Psychiatric Care

Letters to the Editor

Article excerpt

What's in an acronym?

I read the editorial ("The Future of Advanced Practice Psychiatric Nursing," PPC, January/March 2001) with much interest, and yet it left me confused. It has been my belief that the initials PNP referred to Pediatric Nurse Practitioner and the acronym NPP was for Psychiatric Nurse Practitioner. Please clarify this for me.

Another issue: How is the Board certification listed, or is it listed at all? I am board certified in the area of Psychiatry and Mental Health as both an NP and a CS.

Iris M. Simon, MS, APBC-RN, NPP, CS
Hewlett, NY

The Editor responds:

According to Mary Smolenski (ANCC), the official ANA position on the title and certification credentials for both clinical specialist and nurse practitioners is currently "APRN, BC" (Advanced Practice RN, board certified). Nurses are bound by state law to use whatever credentials their BRN dictates. Each state has certification criteria for nurse practitioners, and those criteria may or may not include national certification. For instance, California and New York do not require a nurse to have certification through ANCC. PNP can refer to either a pediatric or a psychiatric nurse practitioner, which is confusing to nurses, other disciplines, and the public. I have not seen NPP used so am unaware of how common this is. I don`t believe there is a national consensus about what initials to use. Some nurses are using APPN (Advanced Practice Psychiatric Nurse), others are using APRN-PMH (Advanced Practice Registered Nurse-Psychiatric Mental Health).

I am interested in knowing what is happening in different states with these issues. Only then can we come up with a title and an acronym that is agreed on and used by all advanced practice psych nurses. Right now, it is confusing and divergent.

Therapist and/or medication manager?

I am writing in regard to your editorial, "The Future of Advanced Practice Psychiatric Nursing" (PPC, January/March 2001). You indicated you have "strongly suggested that UBH open its provider list to CNS therapists and at the same time invite PNPs to provide medication evaluation." I am a CNS (child/adolescent) who has prescriptive authority. I live in Indiana and graduated from IU with a MSN. My course work included psychopharmacology. In my current position my main responsibility is medication management. Consider asking UBH to open the provider list to advanced practice psychiatric nurses who work according to their state practice laws. Let's not define that the CNS is the therapist and the PNP is the medication manager.

Pamela Pepper, MSN, RN, CS
Newburgh, IN

What the law allows

Thanks to Dr. Paquette for her comprehensive comments (Editorial, January/March 2001). Here is a brief update on the two states where I practice.

* Georgia: "CNS/PMH" is the GA Board of Nursing (GBON)-authorized title. CNS/PMHs perform all functions of the ANA Standards and Scope of Practice for APPNs and "order meds in a physician's name ... utilizing Protocols" as Georgia law states. CNS/ PMHs often have independent private practices providing psychotherapy. PMH-NPs in Georgia are included in the generic NP authorization and NPs in Georgia do not provide psychotherapy, according to the current GBON Rules and Regulations.

* Michigan: CNS/PMHs are authorized as "Certified Nurse Practitioner Specialists." The term psychotherapist is a title protected in Michigan for use by psychiatrists and PhD-level psychologists. CNS/PMHs provide psychotherapy, and a few managed care companies will reimburse them. Most of the companies are successfully refusing to reimburse, stating one or more of the following reasons: (1) they're confused, (2) their underwriters only include MDs and PhD psychologists, and (3), from a recent e-mail, "We don't reimburse NPs for mental health care ... they have to have at least a social work degree"!!

Until recently, ANPs and FNPs in Michigan have been hired to do medication management with OJT provided by the dwindling number of psychiatrists rather than hiring CNS/PMHs who have years of experience providing psychotherapy and prescribing meds. …

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