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National certification opportunity leads to confusion for advanced practice psychiatric nurses
Journal of the American Psychiatric Nurses Association
Policy and Politics
National Certification Opportunity Leads to Confusion for Advanced Practice Psychiatric Nurses Judith Haber, APRN, CS, PhD, FAAN
I
n response to a request from the American Psychiatric Nurses Association (APNA) at their March 2001 meeting, the American Nurses Credentialing Center (ANCC) Commission on Certification voted to grant a one-time waiver for advanced practice nurses who currently hold ANCC certification as clinical nurse specialists (CNSs) in psychiatric–mental health nursing and who are currently authorized for advanced practice/prescriptive authority in psychiatric–mental health nursing by their state boards of nursing, to sit for the Psychiatric and Mental Health Nurse Practitioner–Adult and Psychiatric and Mental Health Nurse Practitioner–Family examinations for a limited time. These nurses may be referred to in their state as advanced registered nurse practitioners (ARNPs), advanced practice registered nurses
Judith Haber, APRN, CS, PhD, FAAN, is a professor and director of the Master’s and Post-Master’s Programs in the Division of Nursing at New York University. Reprint requests: Judith Haber, APRN, CS, PhD, FAAN, 111 New England Dr, Stamford, CT 06903. J Am Psychiatr Nurses Assoc (2001). 7, 169-70. Copyright © 2001 by the American Psychiatric Nurses Association 1078-3903/2001/$35.00 + 0 66/1/118767 doi:10.1067/mpn.2001.118767
October 2001
(APRNs), advanced practice nurses (APNs), nurse practitioners (NPs), or the equivalent title, with prescriptive authority. This decision temporarily waives the academic credit requirement of the following four courses required of CNSs to sit for the psychiatric–mental health nurse NP examinations: 1. Advanced pathophysiology 2. Advanced pharmacology 3. Advanced physical assessment 4. Differential diagnosis and medication management (clinical practice component) The ANCC Commission on Certification agreed to allow continuing education courses to be accepted for the four courses needed to apply for the NP examinations. Evidence of completion of the four courses as continuing education offerings must be provided. The nurse also may have a combination of continuing education offerings and academic credit courses that meet the eligibility requirements for these four courses. The waiver does not apply to CNSs with prescriptive authority who are still considered and titled as CNSs by their respective states. CNSs who are concerned that the psychiatric NP certification examinations signal the devaluing of the CNS and the demise of the adult, child, or adolescent CNS certification examinations are erroneous in their thinking; there are no such plans in the near or distant future. Rather, CNSs are challenged to demonstrate the continuing value of
their roles and the positive effect on patient/client outcomes to consumers, third-party payors, legislators, and policy makers. The rationale for granting the one-time waiver included the recognition that some psychiatric–mental health CNSs are already authorized by their states to diagnose, prescribe, write prescriptions, and conduct psychotherapy in their states. The waiver recognizes the value of the nurses who pioneered these advanced practice functions at a time when academic credit courses were not available to the psychiatric–mental health CNSs whose roles were expanding to include prescriptive authority and related role competencies. Finally, the waiver highlights the value of the existing CNS credential and the recognition that CNSs have from their state boards of nursing, state boards of medicine, and third-party payors. For example, in the state of Connecticut, psychiatric–mental health CNSs who are nationally certified in adult psychiatric nursing and who have passed a psychopharmacology course (which could be a continuing education course recognized by the Connecticut Board of Nursing) are titled APRNs and have prescriptive authority. In New York, a significant number of the original psychiatric–mental health NPs achieved their NP status through a continuing education option. Because the New York State Board of Nursing does not require national
APNA Web site: www.apna.org 169
Haber
Journal of the American Psychiatric Nurses Association
certification to practice as an NP, national certification was never a practice issue. However, eligibility for reimbursement as a psychiatric–mental health NP from Medicare and other third-party payors requires the national certification credential. As such, these New York NPs who were credentialed through the original pharmacology continuing education option are now very interested in and should consider taking advantage of this one-time waiver by completing the additional requirements either through other continuing education or academic credit courses. Candidates should be aware that if a nurse becomes certified as a psychiatric NP under the conditions of this waiver and moves to another state, that state may or may not recognize their certification as an NP because of the continuing education variance (American Nurses Credentialing Center, 2001). Nurses who wish to establish their eligibility to take the adult or family psychiatric–mental health NP examinations should: • provide evidence of ARNP, APRN, APN, NP, or the equivalent status (copy of license). • determine whether she or he has completed the four course requirements. ANCC will accept what the state required of the nurse in applying for advanced practice status. There is no minimum number of didactic hours for any of the courses and no maximum limitation regarding how long ago the contact hours were earned or the course work was completed. • complete any hours necessary to sit for the examination. For example, if the state in which the nurse practices did not require one or more of the four courses previously identified, candidates who wish to complete the courses before the end of 2001 to be
170 APNA Web site: www.apna.org
able to sit for the examinations must complete the following hours: —at least 45 didactic hours of hands-on experience for the advanced physical assessment. —at least 45 didactic hours for the advanced pathophysiology (or neurophysiology) and pharmacology courses. —120 hours of clinical practice (not supervision hours) in diagnosis and medication management overseen by a collaborating or supervising individual (certified peer [CNS or NP]), licensed and practicing psychologist, and/or psychiatrist eligible to prescribe psychotropic medications. Evidence that these hours have been completed can be provided in a letter that describes the clinical setting in which the practice took place, the types and diagnoses of patients seen, and the medications prescribed. • mail complete application materials, postmarked no later than December 31, 2001, to qualify; each application is reviewed individually. Questions regarding eligibility should be directed to Dr. Mary Smolenski, Director of Certification, at ANCC (202-6517000). Once the nurse’s application is reviewed and deemed eligible, her or his name is forwarded to the testing agency. • candidates make a date to take the certification examination via computer-based testing through March 31, 2002 (American Nurses Credentialing Center, 2001). A significant number of advanced practice psychiatric–mental health nurses (referred to as ARNP, APRN, APN, NP, or the equivalent in their state) who are missing one or more of the course requirements want to meet the December 31, 2001 dead-
line. APNA members should note that various state nurses associations or specialty organizations are developing continuing education offerings this fall that meet the ANCC requirements. For example, the New York State Nurses Association plans to offer an advanced physical assessment course equal to 45 hours on October 6 and 7 and October 20 and 21, in combination with independent study. Potential candidates should also contact geographically convenient graduate programs to determine which continuing education and academic courses are available through special student or nonmatriculated status. The APNA List Serve (http://www.apna.org/list. htm) also contains multiple continuing education and academic course offerings of interest to concerned members. APNA members will have an opportunity to talk about this issue and other credentialing issues with the new ANCC executive director, Jeanne Floyd, RN, PhD, at the Advanced Practice Interactive Session on Thursday, October 18, 2001, from 10:30 AM to 12:00 PM at the APNA Annual Conference in Reno, Nevada. APNA members should feel confident that the leaders of the organization are on the cutting edge of credentialing discussions with other psychiatric nursing organizations, ANCC, and the National Council of State Boards of Nursing. Good luck to all advanced practice psychiatric nurses in their efforts to establish their eligibility to take the ANCC adult or family NP examinations. Remember to pass along any tips that other APNA members might find helpful so they can maximize their opportunities for success.
REFERENCES American Nursing Credentialing Center (2001). Psychiatric mental health waiver in effect only until December 31, 2001. Retrieved July 27, 2001, from http:// www.nursingworld.org/ancc/certify/cert/ anwaiver.htm
Vol. 7, No. 5
Policy and Politics
National Certification Opportunity Leads to Confusion for Advanced Practice Psychiatric Nurses Judith Haber, APRN, CS, PhD, FAAN
I
n response to a request from the American Psychiatric Nurses Association (APNA) at their March 2001 meeting, the American Nurses Credentialing Center (ANCC) Commission on Certification voted to grant a one-time waiver for advanced practice nurses who currently hold ANCC certification as clinical nurse specialists (CNSs) in psychiatric–mental health nursing and who are currently authorized for advanced practice/prescriptive authority in psychiatric–mental health nursing by their state boards of nursing, to sit for the Psychiatric and Mental Health Nurse Practitioner–Adult and Psychiatric and Mental Health Nurse Practitioner–Family examinations for a limited time. These nurses may be referred to in their state as advanced registered nurse practitioners (ARNPs), advanced practice registered nurses
Judith Haber, APRN, CS, PhD, FAAN, is a professor and director of the Master’s and Post-Master’s Programs in the Division of Nursing at New York University. Reprint requests: Judith Haber, APRN, CS, PhD, FAAN, 111 New England Dr, Stamford, CT 06903. J Am Psychiatr Nurses Assoc (2001). 7, 169-70. Copyright © 2001 by the American Psychiatric Nurses Association 1078-3903/2001/$35.00 + 0 66/1/118767 doi:10.1067/mpn.2001.118767
October 2001
(APRNs), advanced practice nurses (APNs), nurse practitioners (NPs), or the equivalent title, with prescriptive authority. This decision temporarily waives the academic credit requirement of the following four courses required of CNSs to sit for the psychiatric–mental health nurse NP examinations: 1. Advanced pathophysiology 2. Advanced pharmacology 3. Advanced physical assessment 4. Differential diagnosis and medication management (clinical practice component) The ANCC Commission on Certification agreed to allow continuing education courses to be accepted for the four courses needed to apply for the NP examinations. Evidence of completion of the four courses as continuing education offerings must be provided. The nurse also may have a combination of continuing education offerings and academic credit courses that meet the eligibility requirements for these four courses. The waiver does not apply to CNSs with prescriptive authority who are still considered and titled as CNSs by their respective states. CNSs who are concerned that the psychiatric NP certification examinations signal the devaluing of the CNS and the demise of the adult, child, or adolescent CNS certification examinations are erroneous in their thinking; there are no such plans in the near or distant future. Rather, CNSs are challenged to demonstrate the continuing value of
their roles and the positive effect on patient/client outcomes to consumers, third-party payors, legislators, and policy makers. The rationale for granting the one-time waiver included the recognition that some psychiatric–mental health CNSs are already authorized by their states to diagnose, prescribe, write prescriptions, and conduct psychotherapy in their states. The waiver recognizes the value of the nurses who pioneered these advanced practice functions at a time when academic credit courses were not available to the psychiatric–mental health CNSs whose roles were expanding to include prescriptive authority and related role competencies. Finally, the waiver highlights the value of the existing CNS credential and the recognition that CNSs have from their state boards of nursing, state boards of medicine, and third-party payors. For example, in the state of Connecticut, psychiatric–mental health CNSs who are nationally certified in adult psychiatric nursing and who have passed a psychopharmacology course (which could be a continuing education course recognized by the Connecticut Board of Nursing) are titled APRNs and have prescriptive authority. In New York, a significant number of the original psychiatric–mental health NPs achieved their NP status through a continuing education option. Because the New York State Board of Nursing does not require national
APNA Web site: www.apna.org 169
Haber
Journal of the American Psychiatric Nurses Association
certification to practice as an NP, national certification was never a practice issue. However, eligibility for reimbursement as a psychiatric–mental health NP from Medicare and other third-party payors requires the national certification credential. As such, these New York NPs who were credentialed through the original pharmacology continuing education option are now very interested in and should consider taking advantage of this one-time waiver by completing the additional requirements either through other continuing education or academic credit courses. Candidates should be aware that if a nurse becomes certified as a psychiatric NP under the conditions of this waiver and moves to another state, that state may or may not recognize their certification as an NP because of the continuing education variance (American Nurses Credentialing Center, 2001). Nurses who wish to establish their eligibility to take the adult or family psychiatric–mental health NP examinations should: • provide evidence of ARNP, APRN, APN, NP, or the equivalent status (copy of license). • determine whether she or he has completed the four course requirements. ANCC will accept what the state required of the nurse in applying for advanced practice status. There is no minimum number of didactic hours for any of the courses and no maximum limitation regarding how long ago the contact hours were earned or the course work was completed. • complete any hours necessary to sit for the examination. For example, if the state in which the nurse practices did not require one or more of the four courses previously identified, candidates who wish to complete the courses before the end of 2001 to be
170 APNA Web site: www.apna.org
able to sit for the examinations must complete the following hours: —at least 45 didactic hours of hands-on experience for the advanced physical assessment. —at least 45 didactic hours for the advanced pathophysiology (or neurophysiology) and pharmacology courses. —120 hours of clinical practice (not supervision hours) in diagnosis and medication management overseen by a collaborating or supervising individual (certified peer [CNS or NP]), licensed and practicing psychologist, and/or psychiatrist eligible to prescribe psychotropic medications. Evidence that these hours have been completed can be provided in a letter that describes the clinical setting in which the practice took place, the types and diagnoses of patients seen, and the medications prescribed. • mail complete application materials, postmarked no later than December 31, 2001, to qualify; each application is reviewed individually. Questions regarding eligibility should be directed to Dr. Mary Smolenski, Director of Certification, at ANCC (202-6517000). Once the nurse’s application is reviewed and deemed eligible, her or his name is forwarded to the testing agency. • candidates make a date to take the certification examination via computer-based testing through March 31, 2002 (American Nurses Credentialing Center, 2001). A significant number of advanced practice psychiatric–mental health nurses (referred to as ARNP, APRN, APN, NP, or the equivalent in their state) who are missing one or more of the course requirements want to meet the December 31, 2001 dead-
line. APNA members should note that various state nurses associations or specialty organizations are developing continuing education offerings this fall that meet the ANCC requirements. For example, the New York State Nurses Association plans to offer an advanced physical assessment course equal to 45 hours on October 6 and 7 and October 20 and 21, in combination with independent study. Potential candidates should also contact geographically convenient graduate programs to determine which continuing education and academic courses are available through special student or nonmatriculated status. The APNA List Serve (http://www.apna.org/list. htm) also contains multiple continuing education and academic course offerings of interest to concerned members. APNA members will have an opportunity to talk about this issue and other credentialing issues with the new ANCC executive director, Jeanne Floyd, RN, PhD, at the Advanced Practice Interactive Session on Thursday, October 18, 2001, from 10:30 AM to 12:00 PM at the APNA Annual Conference in Reno, Nevada. APNA members should feel confident that the leaders of the organization are on the cutting edge of credentialing discussions with other psychiatric nursing organizations, ANCC, and the National Council of State Boards of Nursing. Good luck to all advanced practice psychiatric nurses in their efforts to establish their eligibility to take the ANCC adult or family NP examinations. Remember to pass along any tips that other APNA members might find helpful so they can maximize their opportunities for success.
REFERENCES American Nursing Credentialing Center (2001). Psychiatric mental health waiver in effect only until December 31, 2001. Retrieved July 27, 2001, from http:// www.nursingworld.org/ancc/certify/cert/ anwaiver.htm
Vol. 7, No. 5