The role of the psychiatric nurse practitioner.

Policy, organizational management, and research roles have received little attention in this article because the focus has been on the practice role. It must be noted, however, that psychiatric nurse practitioners often assume these roles. Many psychiatric nurse practitioners have discovered that their expertise in communication and systems assessment prepares them well for policy and management positions. The influence of public and private policy on practice and the lives of mentally ill persons has led psychiatric nurse practitioners to become active in the public policy arena. Similarly, psychiatric nurse practitioners' grounding in practice and training in research allows for participation in planning and conducting studies that will inform policy makers as the mental health reform process continues. The psychiatric nurse practitioner title and role have evolved in response to regulatory desire for consistent titling of advanced practice nurses and community need for practitioners with the skills in assessment, psychotherapy, psychopharmacology, and care management. Nursing academic institutions are working to develop new programs to prepare the psychiatric nurse practitioners of the future in the wide range of skills needed for this role. Practice subspecialties and settings vary, but in all instances the psychiatric nurse practitioner offers a blend of nursing and psychiatric specialty care that, in many cases, is substitutive for that of a psychiatrist. In the current era of health-care reform, fiscal constraint, and burgeoning health-care technology, the practice, research, and policy roles available to and occupied by psychiatric nurse practitioners are many. The primary threat to full actualization of the psychiatric nurse practitioners' potential is that advanced practice nursing will choose to be wedded to anachronistic ideologies regarding nurse practitioners and clinical specialists.