Career Goals
As a Psychiatric Mental Health Nurse Practitioner, I am trained to provide advanced specialty medical care with a dual emphasis on intervention through psychotherapy and psychopharmacology. I am proficient in the art and science of psychotherapy and physical assessment, and my role allows me to intervene with vulnerable populations and promote mental health across the lifespan. Additionally, I am able to work with children, adolescents, adults, and older persons in a variety of settings, including community mental health clinics, public health departments, hospitals, outpatient mental health clinics, health maintenance organizations, government facilities, schools of nursing and independent private practice. As I continue to develop my skills and earn a Doctorate of Nursing Practice (DNP) , I plan to utilize my education by providing education in evidence-based practice, quality improvement and systems thinking in other key areas. As a DNP, I will provide the highest level of nursing practice. Over the next decade my professional goals include developing my clinical practice as a Psychiatric Nurse Practitioner and completing my Doctorate of Nursing. Additionally, I plan to participate in committees that enhance the Nurse Practitioner role in the healthcare system, as well as become an advocate for comprehensive and evidence-based care in the area of mental health while disseminating research that will support both causes.
Advanced Practice Registered Nurse Role
Excerpts from APRN Joint Dialogue Group Report, July 7, 2008
The definition of an Advanced Practice Registered Nurse (APRN) is a nurse:
(CNM), clinical nurse specialist (CNS), or certified nurse practitioner (CNP).
Advanced practice registered nurses are licensed independent practitioners who are expected to practice within standards established or recognized by a licensing body. Each APRN is accountable to patients, the nursing profession, and the licensing board to comply with the requirements of the state nurse practice act and the quality of advanced nursing care rendered; for recognizing limits of knowledge and experience, planning for the management of situations beyond the APRN’s expertise; and for consulting with or referring patients to other health care providers as appropriate.
All APRNs are educationally prepared to provide a scope of services across the health wellness-illness continuum to at least one population focus as defined by nationally recognized role and population-focused competencies; however, the emphasis and implementation within each APRN role varies. The services or care provided by APRNs is not defined or limited by setting but rather by patient care needs. The continuum encompasses the range of health states from homeostasis (or wellness) to a disruption in the state of health in which basic needs are not met or maintained (illness), with health problems of varying acuity occurring along the continuum that must be prevented or resolved to maintain wellness or an optimal level of functioning (WHO, 2006). Although all APRNs are educationally prepared to provide care to patients across the health wellness-illness continuum, the emphasis and how implemented within each APRN role varies.
The definition of an Advanced Practice Registered Nurse (APRN) is a nurse:
- who has completed an accredited graduate-level education program preparing
him/her for one of the four recognized APRN roles;
- who has passed a national certification examination that measures APRN, role
and population-focused competencies and who maintains continued competence as evidenced by recertification in the role and population through the national certification program;
- who has acquired advanced clinical knowledge and skills preparing him/her to provide direct care to patients, as well as a component of indirect care; however, the defining factor for all APRNs is that a significant component of the education and practice focuses on direct care of individuals;
- whose practice builds on the competencies of registered nurses (RNs) by demonstrating a greater depth and breadth of knowledge, a greater synthesis of data, increased complexity of skills and interventions, and greater role autonomy;
- who is educationally prepared to assume responsibility and accountability for health promotion and/or maintenance as well as the assessment, diagnosis, and management of patient problems, which includes the use and prescription of pharmacologic and non-pharmacologic interventions;
- who has clinical experience of sufficient depth and breadth to reflect the intended license; and
(CNM), clinical nurse specialist (CNS), or certified nurse practitioner (CNP).
Advanced practice registered nurses are licensed independent practitioners who are expected to practice within standards established or recognized by a licensing body. Each APRN is accountable to patients, the nursing profession, and the licensing board to comply with the requirements of the state nurse practice act and the quality of advanced nursing care rendered; for recognizing limits of knowledge and experience, planning for the management of situations beyond the APRN’s expertise; and for consulting with or referring patients to other health care providers as appropriate.
All APRNs are educationally prepared to provide a scope of services across the health wellness-illness continuum to at least one population focus as defined by nationally recognized role and population-focused competencies; however, the emphasis and implementation within each APRN role varies. The services or care provided by APRNs is not defined or limited by setting but rather by patient care needs. The continuum encompasses the range of health states from homeostasis (or wellness) to a disruption in the state of health in which basic needs are not met or maintained (illness), with health problems of varying acuity occurring along the continuum that must be prevented or resolved to maintain wellness or an optimal level of functioning (WHO, 2006). Although all APRNs are educationally prepared to provide care to patients across the health wellness-illness continuum, the emphasis and how implemented within each APRN role varies.
Psychiatric Mental Health Nurse Practitioner Scope of Practice
Psychiatric Mental Health Nurse Practitioner, ANCC
Selected competencies related to Assessment, Diagnosis and Treatment.
Health Promotion, Health Protection, and Treatment Assessment
1. Obtains and accurately documents a relevant health history, with an emphasis on mental health history, for patient relevant to specialty and age.
a. Performs a comprehensive physical and mental health assessment.
b. Performs a comprehensive psychiatric evaluation that includes evaluation of mental status, current and past history of violence, suicidal or self-harm
behavior, substance use, level of functioning, health behaviors, trauma, sexual behaviors, and social and developmental history.
2. Analyzes the relationship between normal physiology and specific system alterations associated with mental health problems, psychiatric disorders, and
treatment.
3. Collects data from multiple sources using assessment techniques that are appropriate to the patient’s language, culture, and developmental stage,
including, but not limited to, screening evaluations, psychiatric rating scales, genograms, and other standardized instruments.
Diagnosis of Health Status
1. Orders and interprets findings of relevant diagnostic and laboratory tests.
2. Identifies both typical and atypical presentations of psychiatric disorders and related health problems.
3. Differentiates psychiatric presentations of medical conditions from psychiatric disorders and arranges appropriate evaluation and follow-up.
4. Develops a differential diagnosis derived from the collection and synthesis of assessment data.
5. Diagnosis of psychiatric disorders.
Plan of Care and Implementation of Treatment
1. Develops a treatment plan for mental health problems and psychiatric disorders based on biopsychosocial theories, evidence-based standards of care, and
practice guidelines.
2. Conducts individual, group, and/or family psychotherapy.
3. Treats acute and chronic psychiatric disorders and mental health problems.
4. Plans care to minimize the development of complications and promote function and quality of life using treatment modalities such as, but not limited to,
psychotherapy and psychopharmacology.
5. Prescribes psychotropic and related medications based on clinical indicators of a patient’s status, including results of diagnostic and lab tests as appropriate,
to treat symptoms of psychiatric disorders and improve functional health status.
Selected competencies related to Assessment, Diagnosis and Treatment.
Health Promotion, Health Protection, and Treatment Assessment
1. Obtains and accurately documents a relevant health history, with an emphasis on mental health history, for patient relevant to specialty and age.
a. Performs a comprehensive physical and mental health assessment.
b. Performs a comprehensive psychiatric evaluation that includes evaluation of mental status, current and past history of violence, suicidal or self-harm
behavior, substance use, level of functioning, health behaviors, trauma, sexual behaviors, and social and developmental history.
2. Analyzes the relationship between normal physiology and specific system alterations associated with mental health problems, psychiatric disorders, and
treatment.
3. Collects data from multiple sources using assessment techniques that are appropriate to the patient’s language, culture, and developmental stage,
including, but not limited to, screening evaluations, psychiatric rating scales, genograms, and other standardized instruments.
Diagnosis of Health Status
1. Orders and interprets findings of relevant diagnostic and laboratory tests.
2. Identifies both typical and atypical presentations of psychiatric disorders and related health problems.
3. Differentiates psychiatric presentations of medical conditions from psychiatric disorders and arranges appropriate evaluation and follow-up.
4. Develops a differential diagnosis derived from the collection and synthesis of assessment data.
5. Diagnosis of psychiatric disorders.
Plan of Care and Implementation of Treatment
1. Develops a treatment plan for mental health problems and psychiatric disorders based on biopsychosocial theories, evidence-based standards of care, and
practice guidelines.
2. Conducts individual, group, and/or family psychotherapy.
3. Treats acute and chronic psychiatric disorders and mental health problems.
4. Plans care to minimize the development of complications and promote function and quality of life using treatment modalities such as, but not limited to,
psychotherapy and psychopharmacology.
5. Prescribes psychotropic and related medications based on clinical indicators of a patient’s status, including results of diagnostic and lab tests as appropriate,
to treat symptoms of psychiatric disorders and improve functional health status.
Implementation of the Advanced Practice Role
As the role of the APRN continues to be defined, both professionally and in the eyes of the public, I anticipate a number of personal and professional challenges while implementing my skill set into clinical practice. I believe that the challenges can and will include perfecting my new skill set, educating clients, fellow clinicians and the general public about the role of an advanced practice nurse and continuing to promote autonomy and reimbursement rates for APRN’s. First, with regard to personal challenges, I anticipate having to make a concerted and consistent effort to transition from a Novice Psychiatric Mental Health Nurse Practitioner (PMHNP) to and Expert PMHNP. That is, I will have to take advantage of each and every client interaction as an opportunity to learn, grow and better educate myself.
Next, in support of educating clients, fellow clinicians and the general public about the role of an advanced practice nurse, I believe that it is quite important to disseminate detailed information to help people better understand and appreciate the training and core competencies of an advanced practice nurse. Once they gain a greater understanding and appreciation of the advanced practice nurse, they will be able to share their perspective with other clinicians, clients and the general public. Their second hand dissemination of information can and should reinforce the educational material that health professionals provide to the public. Last, but certainly not least, I believe that I will have to work to promote the removal of arbitrary barriers that restrict the nurse practitioner practice. This may involve personal advocacy or continued support of political action committees and/or professional nursing associations that support continued growth within the profession.
Although I appreciate that fact that I will face a number of challenges while implementing my role and skill set into clinical practice, I believe that I will be successful in doing so because of my “grit”. The definition of grit is a firmness of mind or spirit – an unyielding courage in the face of hardship or danger. This term is used in positive psychology as a way to describe an individual’s passion and powerful motivation that allows him or her to achieve their respective objective. This perseverance of effort promotes the overcoming of obstacles or challenges that lie within a individual’s path to accomplishment and serves as a driving force in achievement realization. As previously mention, I believe that grit is my greatest personal strength.
My other strengths include optimism, curiosity, teamwork and self-motivation. An optimistic and positive attitude not only promote personal actions, it allow also allows me to recognize achievements in others, thus exciting fellow team members and making it easy to successfully work together as a team. My curiosity allows me to seek out new opportunities for learning, as well as provides me with the spirit to volunteer for new roles or participate in new projects. With regard to being self-motivated, once co-workers have an opportunity to get to know me, they quickly gain confidence in me and trust that the final product I deliver to them or their client will be quality and completed in a timely manner. When combined with grit, these traits allow me to better related to co-workers and clients, thus creating strong personal connections over a brief period of time.
In an effort to successfully implement the APRN role into practice, I believe that I must first demonstrate my knowledge and expertise while caring for clients. In doing so, I hope to do away with the preconceived notions that many health care professionals and clients have about APRN’s. Additionally, I hope that by demonstrating my knowledge and professional expertise, I will gain the confidence of clients who can then help to further promote the profession by sharing their positive experiences with other members of the community. During this same time I plan to utilize professional resources and scholastic resources, as afforded to me by the University of Virginia, to disburse educational material to co-workers, clients and members of the community through community outreach programs – (i.e. public health department, local urgent care centers, hospitals and the local chamber of commerce.). Last, but certainly not least, I plan to immediately become an active participant with professional associations and political action committees so as to promote autonomy and reimbursement rates for APRN’s.
Next, in support of educating clients, fellow clinicians and the general public about the role of an advanced practice nurse, I believe that it is quite important to disseminate detailed information to help people better understand and appreciate the training and core competencies of an advanced practice nurse. Once they gain a greater understanding and appreciation of the advanced practice nurse, they will be able to share their perspective with other clinicians, clients and the general public. Their second hand dissemination of information can and should reinforce the educational material that health professionals provide to the public. Last, but certainly not least, I believe that I will have to work to promote the removal of arbitrary barriers that restrict the nurse practitioner practice. This may involve personal advocacy or continued support of political action committees and/or professional nursing associations that support continued growth within the profession.
Although I appreciate that fact that I will face a number of challenges while implementing my role and skill set into clinical practice, I believe that I will be successful in doing so because of my “grit”. The definition of grit is a firmness of mind or spirit – an unyielding courage in the face of hardship or danger. This term is used in positive psychology as a way to describe an individual’s passion and powerful motivation that allows him or her to achieve their respective objective. This perseverance of effort promotes the overcoming of obstacles or challenges that lie within a individual’s path to accomplishment and serves as a driving force in achievement realization. As previously mention, I believe that grit is my greatest personal strength.
My other strengths include optimism, curiosity, teamwork and self-motivation. An optimistic and positive attitude not only promote personal actions, it allow also allows me to recognize achievements in others, thus exciting fellow team members and making it easy to successfully work together as a team. My curiosity allows me to seek out new opportunities for learning, as well as provides me with the spirit to volunteer for new roles or participate in new projects. With regard to being self-motivated, once co-workers have an opportunity to get to know me, they quickly gain confidence in me and trust that the final product I deliver to them or their client will be quality and completed in a timely manner. When combined with grit, these traits allow me to better related to co-workers and clients, thus creating strong personal connections over a brief period of time.
In an effort to successfully implement the APRN role into practice, I believe that I must first demonstrate my knowledge and expertise while caring for clients. In doing so, I hope to do away with the preconceived notions that many health care professionals and clients have about APRN’s. Additionally, I hope that by demonstrating my knowledge and professional expertise, I will gain the confidence of clients who can then help to further promote the profession by sharing their positive experiences with other members of the community. During this same time I plan to utilize professional resources and scholastic resources, as afforded to me by the University of Virginia, to disburse educational material to co-workers, clients and members of the community through community outreach programs – (i.e. public health department, local urgent care centers, hospitals and the local chamber of commerce.). Last, but certainly not least, I plan to immediately become an active participant with professional associations and political action committees so as to promote autonomy and reimbursement rates for APRN’s.