In the United States the PMHNP environment differs from one state to another. It is therefore important that psychiatric/mental health nurse practitioners understand their own state’s restrictions and limitations. This paper will highlight any limitations or restrictions for the PMHNPs in California. After describing the PMHNP practices in California, I will compare it with a state neighboring California: Nevada.
Practice Environment for PMHNPs in California
California Board of Registered Nursing, California (BRN), licenses PMHNPs to practice as advanced-practice registered nurses. PMHNPs can provide mental health care, such as assessment, diagnosis and treatment, and they may also prescribe medication. PMHNPs are required to complete a post-graduate program in psychiatric mental health nursing, and then pass a certification test in order for them to be licensed as APRNs in California.
A California PMHNP is restricted in their practice if they do not have a collaboration agreement with physicians. A physician isn’t required to be in the room, but must be available for consultations if necessary. In rural areas with limited access to doctors, this can pose a problem for PMHNPs.
Another limitation for PMHNPs in California is that they are not authorized to certify patients for disability benefits or workers’ compensation claims. This can limit the scope of practice for PMHNPs, as these certifications may require a physician’s signature.
Practice Environment of PMHNPs in Nevada
Nevada’s State Board of Nursing licenses PMHNPs as APRNs. PMHNPs may provide medication prescriptions and a variety of mental services. This includes assessment, diagnosis, treatment and management of mental illnesses. Nevada PMHNPs do not need to sign a collaboration agreement with a doctor to prescribe medication. This is an advantage to PMHNPs who work in remote areas and may only have access to a few physicians.
Nevertheless, PMHNPs are restricted in Nevada from performing electroconvulsive (ECT), a therapy option that is used to treat severe depressions and mental illnesses. It limits their practice in Nevada, and they may have to refer patients to physicians or other health care providers.
Comparing PMHNP practice environments
Nevada is less restrictive than California in terms of PMHNP practice. This includes prescribing medicines. However, Nevada’s restriction on ECT limits the scope of practice for PMHNPs. PMHNPs need to know the current practice environment of their state and neighboring states to make educated decisions regarding their careers.