Bjorklund Pamela
College of St Scholastica, Duluth, MN 55811-4199, USA.
Arch Psychiatr Nurs. 2003 Apr;17(2):77-87. doi: 10.1053/apnu.2003.50002.
During the decade of the 1990s, health care reform, market forces, population needs, new knowledge in neuroscience and changes in advanced practice regulation provided the impetus for the development of the role of the psychiatric nurse practitioner. Debate about issues of role, scope of practice, educational preparation, titling, and credentialing for the advanced practice psychiatric nurse (APPN) of the future intensified as the American Nurses Credentialing Center (ANCC) proceeded with its controversial decision to develop a certification examination for the psychiatric nurse practitioner-in advance of consensus among advanced practice psychiatric nurses about those widely debated issues. Ironically, now that the ANCC adult and family psychiatric nurse practitioner (PMHNP) examinations exist, with test content outlines that clearly identify the professional standards and scope of practice relevant to the role of the certified psychiatric nurse practitioner, those contentious issues of role, scope of practice, educational preparation and credentialing (if not titling) seem considerably less thorny. In fact, by credentialing the role of the psychiatric nurse practitioner sooner rather than later, ANCC may have saved advanced practice psychiatric nursing for psychiatric nurses. This article proposes to (1). explain that assertion, (2). clarify what the scope of practice relevant to the newly certified role means in terms of credentialing requirements for existing types of psychiatric nurse practitioner, and (3). identify some of the controversies that linger with the debut of the PMHNP certification examination(s).
在20世纪90年代的十年间,医疗保健改革、市场力量、人群需求、神经科学新知识以及高级实践监管方面的变化为精神科执业护士角色的发展提供了动力。随着美国护士认证中心(ANCC)做出有争议的决定,即在高级实践精神科护士就这些广受争议的问题达成共识之前,为精神科执业护士开展认证考试,关于未来高级实践精神科护士(APPN)的角色、实践范围、教育准备、职称和认证等问题的争论愈演愈烈。具有讽刺意味的是,既然ANCC的成人及家庭精神科执业护士(PMHNP)考试已经存在,其考试内容大纲明确界定了与认证精神科执业护士角色相关的专业标准和实践范围,那么那些关于角色、实践范围、教育准备和认证(如果不是职称)的争议问题似乎就不那么棘手了。事实上,通过尽早而非推迟对精神科执业护士角色进行认证,ANCC可能为精神科护士挽救了高级实践精神科护理领域。本文旨在(1)解释这一论断,(2)根据现有类型精神科执业护士的认证要求,阐明与新认证角色相关的实践范围意味着什么,以及(3)确定随着PMHNP认证考试首次亮相而仍然存在的一些争议。