Preparing for prescriptive privileges: a CNS-physician collaborative model. Expanding the scope of the psychiatric-mental health clinical nurse specialist.

Advanced practice nurses throughout the United States have been successful in securing prescriptive privileges and the related accountability for independent practice. As their authority for the medication management of patients increases, opportunities for practice in expanded nursing roles also increase. When the clinical nurse specialist (CNS) is able to undertake medication management of patients in addition to providing specialized nursing care, continuity is enhanced and cost is reduced. Assuring that the CNS is prepared to provide comprehensive patient services and has the competence to efficiently assess the need for medication, prescribe specific drugs, implement patient teaching, and monitor patients' responses to the medication regimen are key factors if this extended role is to be successful. This article focuses on the CNS in psychiatric mental health nursing. It outlines a collaborative CNS-physician model that addresses the challenges of developing the necessary knowledge and skills to manage patients' medication.