Nursing is the largest healthcare profession in the USA, but there are only about 12,000 Psychiatric Mental Health Nurse Practitioners (PMHNP), and America experiences a shortage of professionals in this field.
Two leading authorities regulate nurse practitioners’ work in the USA – The Joint Subcommittee of the Medical Board and the Board of Nursing. Every nurse has a supervising physician obligated to sign a collaborative practice agreement and regularly provide support, ongoing management, feedback, and consultations. For North Carolina specifically, it is typical that all PMHNP notes and prescriptions must always be co-signed, as well. There are also specific regulations as to how often the practitioner and the supervisor shall meet up and have the feedback sessions – once every month in the first six months and then once every six months. If the supervisor changes, the process starts over (AMA, 2017). These kinds of rules add more bureaucracy to the process, which slows essential healthcare-providing services down.
The political activism of PMHNPs in North Carolina might improve practitioners’ work conditions, reduce the amount of stress and pressure specialists are under, and ensure patient advocacy. According to Arizona Nurse Publication, there are several stages of political activism of nurses: apathy, buy-in, self-interest, political sophistication, and leading the way. Apathy and buy-in stages are the most common ones (Jaurigue & Schmidt, 2020). And it’s no surprise – to be able to do their job, PMHNPs spend a lot of time aiming to meet all the basic requirements. In my opinion, it is essential to ensure nurse practitioners’ awareness of the stages by teaching them at the universities or special courses and leading the students to take practical steps, e.g., writing a letter to an elected official (Jaurigue & Schmidt, 2020). But the choice to follow the path of political activism or not should be up to the practitioner because it requires a lot of time and investment. On the other hand, being politically engaged means advocating for oneself and the patients’ interests.
PMHNPs’ role is often underestimated, but a greater understanding of it and addressing barriers might improve and contribute a lot to health care access and patient advocacy. It might also have an impact on healthcare economics. Nurse practitioners provide high-quality care being cost-effective at the same time. If given a chance to work more freely, PMHNPs will contribute to lowering outpatient and prescription drug costs significantly. Current legal restrictions prevent both sides – healthcare providers and patients from benefiting. And also make the PMHNPs profession unattractive in general, resolving in high demand for specialists, which leads to more work for the already accredited specialists. This might lead to the overall lowering of the provided healthcare quality due to the number of tasks PMHNPs are forced to perform and the lack of balance between work and personal life.
There are moral obligations to participation using nurses’ “sphere of influence.”The main commitment of any nurse should be to the patients. By contributing to the system’s development, sharing the professional experience, and suggesting insider ideas, practitioners will contribute to the patients’ advocacy and their own professional satisfaction. However, the working circumstances in North Carolina should be considered to be eased in order for the practitioners to be able to concentrate on healthcare rather than bureaucracy. The more aware and supported the PMHNPs’ are, the more significant their impact on the healthcare system nationwide can be.
References
American Medical Association. (2017). State law chart: nurse practitioner practice authority.
Chapman, S. A. & Phoenix, B. J. (2020). Effect of state regulatory environments on advanced psychiatric nursing practice. Archives of psychiatric nursing, 34(5), 370–376.
Jaurigue, L. & Schmidt, C.(2020). Political activism: Preparing future nurses to impact healthcare policy. Arizona Nurse.