In the journal article, “Family nurse practitioner scope of practice issues when treating patients with mental health issues,” Balestra (2019) examines the challenges which family nurse practitioners (FNPs) encounter when providing care for patients with various mental health conditions. These nurses attend the clients presenting different mental health problems and often find themselves acting as the primary health care providers, especially in rural hospitals due to staff shortages, which characterizes these contexts. They are responsible primarily for diagnosing and treating a wide range of mental health conditions, such as depression and anxiety disorders. Balestra (2019) attributes their increased involvement in the delivery of mental health care to the growing demand for these services in the United States, with a large number of young people and adults suffering from various disorders.
Some complex situations expose the FNPs to ethical dilemmas which might lead to the breach of their scope of practice (SOP). SOPs are defined by the state licensing boards and refer to “the procedures, actions, and processes which NPs can perform as part of their professional licensure” (Balestra, 2019, p. 479). These guidelines provide specific boundaries within which the practitioners are expected to practice. Thus, the nurses cannot perform tasks that do not fall within their mandate. For instance, they are not expected to treat patients with certain complex mental problems due to inadequate training and preparation for handling such illnesses. Those instances could lead to violations of their SOPs, which vary across the states. For example, failure to monitor patient outcomes and refer patients who need special care to a relevant specialist may constitute misconduct. Other potential breaches include failure to report clients who refuse to adhere to the treatment regime or show unsatisfactory progress and assuming family members’ concerns regarding the patient (Balestra, 2019). Therefore, FNPs must recognize areas that are not within the scope of their responsibilities to mitigate potential breaches of their SOPs.
In conclusion, the growing staff shortages in the nursing profession, coupled with the growing number of mental health problems, increase NFPs’ responsibilities in this population. Despite their valuable contributions to the management of these conditions, they encounter challenging situations that enhance the risk of breaching their SOPs. Therefore, the nurses need to stay abreast of the state guidelines to provide the appropriate level of care. Embracing the best practices may allow them to deliver safe patient care and protect their licenses.
Balestra, M. L. (2019). Family nurse practitioner scope of practice issues when treating patients with mental health issues. The Journal for Nurse Practitioners, 15(7), 479-482.