FAQ _Frequently Asked Questions_

							FAQ Psychiatric Nurse Practitioner


  FAQ (Frequently Asked Questions) about USA’s Online Postmasters
                       Psych NP Program:
Q:
I have some questions about the Advanced Practice Psychiatric Nurse Practitioner
program. I am a board certified (ANCC) psychiatric nurse currently working in a state
hospital. I am in graduate school and will have my master’s as a Family Nurse
Practitioner in two more semesters. I very much enjoy working in mental health and am
interested in continuing in this field after I graduate this December.

I saw on your web site that you have a Post Master’s Certificate program. If I already
had my MSN/FNP what courses would be required for postmasters in psych?

My other question is about when the classes begin. Is it only in the fall or are there other
times of the year?

A:
To sit for the ANCC certification exam and obtain NP certification as Psychiatric-Mental
Health Nurse Practitioner requires completion of a formal Psych NP online program
(USA/CON program is fully accredited). ANCC stipulates that students must complete a
formal postmasters program in order to sit for certification.

Post Masters students begin the formal program in the fall with CMN 551 but would
begin their clinical practicum in the spring semester (depending on the courses that apply
following receipt of transcripts).


Q:
I have an MSN and am a psychiatric clinical nurse specialist, having practiced about 15
years. I have APRN, BC status and APN status in my state. I have read the info on the
program but am confused as to length and requirements for someone who has been
practicing.

A:
It will require a minimum of four semesters, even though you have been
practicing because our postmasters program is four semesters long.


Q:
How many credits would that be each semester? I would need health assessment and
pharmacology as well as pathophysiology. What would the other courses look like?

A:
Please review the postmasters sample curriculum at:
http://www.southalabama.edu/nursing/psynp/pmPSYCH2004.pdf
FAQ Psychiatric Nurse Practitioner


Q:
I am an adult psychiatric clinical nurse specialist with MSN. I am ANCC credentialed.
I have been told I only need 3 courses to take another credentialing exam as a psych NP.
A coworker took her courses online with your school and recommended I do so you were
"user friendly." How would I know how many courses I would need to take?

A:
If you already have an MSN in psychiatric nursing, you still need to have completed a
formal postmasters Psych NP program in order to sit for the ANCC psych NP
credentialing exam. See the following sample curriculum:
http://www.southalabama.edu/nursing/psynp/pmPSYCH2004.pdf


Q:
I thought I only needed to take the 3 courses and then take the NP exam. By the response
above, I need a NP degree and more clinical hours. At your school, would you review my
courses from my CNS program and then consider giving me credit for all the courses and
hours I did and then grant me a new degree?

A:
The requirements today are that you do the four semesters for the NP program. The
ANCC requirements in the first year the PMH-NP test was out (2001) allowed those who
had a CNS in psych AND advanced assessment and pharmacology to take the test. The
following year the requirement was for two or three semesters and now they require
completion of a formal program. Depending on your transcripts, it would take you a
minimum of four semesters.

Below are ANCC requirements copied and pasted from the ANCC web site:


 Adult Psychiatric and Mental Health Nurse Practitioner (exam #34)--
 Family Psychiatric and Mental Health Nurse Practitioner (exam #35)--
 Description of Practice and Eligibility Requirements

 The Psychiatric and Mental Health Nurse Practitioner (PMHNP) is a registered nurse
 with a graduate degree in nursing who is prepared to administer advanced primary
 mental health care throughout a patients life, in accordance with ANAs scope and
 standards of psychiatric and mental health nursing. The PMHNPs practice includes
 independent and interdependent decision making and is directly accountable for
 clinical judgments. The PMHNPs role includes comprehensive physical assessment,
 diagnosis, and medication management, in addition to psychotherapeutic
 interventions. Graduate preparation allows the PMHNP to expand into the use of
 research, development and implementation of health policy, leadership, education,
 case management, and consultation in his or her practice.
FAQ Psychiatric Nurse Practitioner


 Specific Eligibility Requirements

   1. Have graduated from of an accredited masters or post-masters program prepared
      to practice as either an Adult Psychiatric and Mental Health Nurse Practitioner
      (PMHNP), an Adult Advanced Practice Psychiatric and Mental Health Nurse, a
      Family Psychiatric and Mental Health Nurse Practitioner, or a Family Advanced
      Practice Psychiatric and Mental Health Nurse, which includes:
           Advanced health assessment to include both physical and mental health
              (pediatric and adolescent physical and mental health assessment is
              required for the PMHNP-Family exam)
           Pathophysiology (or neurophysiology/biophysiology)
           Pharmacology or psychopharmacology*
           Diagnosis and medication management of psychiatric illness (clinical
              practicum); and

   1. Clinical training at the graduate or post-graduate level in at least two
      psychotherapeutic treatment modalities.

 *Pharmacology preferred; both Pharmacology and Psychopharmacology are ideal,
 however Psychopharmacology alone is acceptable. All PMHNP candidates are
 expected to have a broad understanding of basic pharmacologic principles, along with
 a strong background in psychopharmacological agents. An understanding of the
 major drug categories and drugs, the drug's purpose, its specific actions, and how
 drugs interact and affect psychiatric and mental health problems is required. Please
 note: prescriptive authority may require a general pharmacology course depending
 on the state in which you are licensed. ANCC recommends that you contact your
 appropriate state board of nursing for more information.


ANCC FAQ from the web site:

 Psychiatric and Mental Health Nurse Practitioner

 Q1. How many Psychiatric and Mental Health Nurse Practitioner examinations will
 there be?


 A. There are currently two exams developed. One for the Psychiatric and Mental
 Health Nurse Practitioner - Adult and one for the Psychiatric and Mental Health
 Nurse Practitioner - Family.

 Q2. I heard that the PMH-CNS exams will no longer be offered once the PMH-NP
 exams are phased in. If I'm not eligible to take the PMH-NP exams, am I out of luck?
FAQ Psychiatric Nurse Practitioner


 A. This is simply not true. We will continue to offer both the CNS and NP psychiatric
 mental health exams. Although some states look at the PMH advanced practice nurse
 the same whether that person went to a clinical specialist or a nurse practitioner
 program, others regulate these two roles differently and still require separate national
 exams. ANCC will continue to offer them until there is no longer a reason to do so.

 Q3. What are the criteria to qualify to sit for the Adult or Family Psychiatric Mental
 Health Nurse Practitioner Exam?


 A. Scenario 1: Graduate from an accredited Adult or Family Psychiatric Mental
 Health Nurse Practitioner Program (PMHNP).
     Scenario 2: If you are a Psychiatric Clinical Nurse Specialist: You must have a
 post masters as an Adult or Family Psychiatric Mental Health Nurse Practitioner from
 an accredited University. Take your transcripts to an accredited PMHNP program for
 evaluation by a program director. At a minimum, you will be required to have 120
 hours of post-masters clinical in the specialty to sit for this exam and physical
 assessment (with a clinical component), pathophysiology, pharmacology and
 diagnosis and medication management (this is the "role" component for the PMHNP).
 These courses must all be on the graduate level--undergraduate courses are not
 accepted.
     There is not a "waiver" associated with this exam, nor do we accept contact hours
 or experience in lieu of graduate credit.
     You must formally apply if you wish ANCC staff to review your transcripts for
 eligibility.

 Q4. Can any nurse practitioner qualify to take the PMH-NP exam?


 A. No. A Nurse Practitioner must have graduated from a PMH-NP program or post-
 master's program or have the PMH-CNS program with the four components
 mentioned above. Individuals in dual programs must show evidence of all of the same
 requirements.

 Q5. If I'm already a PMH-CNS, why can't I be "grandfathered" into the PMH-NP
 role, rather than sit an exam?


 A. ANCC does not grandfather individuals into particular roles or specialties. The
 nurse practitioner eligibility criteria require specific course work to gain the nurse
 practitioner skills in advanced health assessment and diagnostics. Even when the
 nurse practitioner role first evolved, faculty teaching in nurse practitioner programs
 had to return to school to take those courses considered to be essential to the nurse
 practitioner education.
FAQ Psychiatric Nurse Practitioner


 Q6. I took my MSN-Psychiatric program years ago and it did not have 500 hours of
 clinical. Why are you only taking new graduates and punishing the experienced
 nurses by not accepting less than 500 clinical hours?


 A. In 2000, ANCC started to accept CNS candidates right out of school for initial
 eligibility to sit the CNS exams, as long as their educational programs provided 500
 faculty supervised clinical hours. This was to provide advanced practice entry level
 for clinical nurse specialists comparable to the nurse practitioners. If a CNS became
 certified as a PMH-CNS under the old criteria which did not require the 500 hours,
 we would not make them go back to get these additional hours to comply with the
 new CNS or nurse practitioner clinical requirements.

 Q7. I have been working in a psychiatric setting for a number of years and I meet
 your criteria through work experience and continuing education. Why can’t I take the
 PMH-NP exam?


 A. ANCC no longer accepts experience or continuing education toward eligibility to
 sit its advanced practice exams.

 Q8. There is no need for the PMH nurse practitioner role since CNSs are already
 functioning as advanced practice PMH nurses. Adding the nurse practitioner role just
 makes things more confusing for the public and for payors.


 A. In the ANA Scope and Standards on advanced practice nursing there are four roles
 identified: the nurse practitioner, the clinical nurse specialist, the nurse midwife and
 the nurse anesthetist. Although the PMH advanced practice nurse comes closest to
 merging the nurse practitioner and clinical nurse specialist than any of the other
 specialties, there are still states that do not see those two roles as the same and
 regulate them differently. Educational programs educate the PMH-NP and the PMH-
 CNS differently although the programs are getting more alike than not over the last
 five years. Although one role is certainly a possibility for the PMH advanced practice
 nurse in the future (more so than any other nurse practitioner/clinical specialist
 specialty group), there are still two distinct advanced practice roles. ANCC is
 responding to the needs of the PMH-NPs and states that are looking for a way to
 provide advanced practice recognition for these NPs.
    The ANA Scope and Standards for PMH Nursing have just been updated. In the
 previous version, the CNS was referred to as the "Advanced Practice Psychiatric and
 Mental Health Nurse." The new standards speak of the advanced practice PMH nurse
 (APRN-PMH) as either a nurse practitioner or a clinical specialist. It is also stated
 that "Each individual APRN-PMH is not expected to perform every function
 identified within the scope of practice for advanced-mental health nursing. All nurses
 are accountable for practicing in accordance with state law and within the limits of
 their knowledge, skills and abilities, taking into account what is therapeutic for each
FAQ Psychiatric Nurse Practitioner


 individual patient. Even though a function is within the nurse's s scope of practice, the
 nurse may decide to refer that aspect of care to another clinician." (Scope and
 Standards of Psychiatric-Mental Health Nursing Practice, ANA, 2000, pg 19)

 Q9. Will the CNS-PMH lose their current status and the ability to be reimbursed for
 services?


 A. Both CNS and NPs are written into the current HCFA language regarding
 reimbursement. There is no reason to believe that they will rewrite language and
 eliminate the CNS. ANCC is not the one who created the PMHNP role or the
 education programs or combined /dual track CNS/NP programs. Educators responded
 to the needs of the community. Educators in PMH-NP programs however, do need to
 evaluate their curricula for consistency of course work across programs, especially in
 relation to assessment and pharmacology. PMH CNS and NPs need to work together
 with their State Boards of Nursing and their legislators to educate them on the unique
 roles of both the CNS and the NP in PMH, their evolution and future.