PMHNP vs PHMCNS murky waters scope of practice

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    Hi, I graduate from an adult pmhnp program next year. I also have colleagues who will be in pmhcns tract. I understand that in some states the cns can not prescribe. What is the difference between scope of practice?
    Is is mostly the managment of med for the NP's. It seems that CNS's in massachusetts do the same as well.

    Some people say the adult scope is 13-85+ others 18-85+. I have also been told by a FNP professor that as a PMHNP I may have to do an emergency physical and that would be in my scope due to the NP training. Seems strange? Is is up to us to determine our scope? The state of massachusetts is not clear on the board site as to the ages for treatment.The ANCC site indicates 13+. Mass BON also separates NP's and CNS's however doesnt include the Psych NP because it is a fairly new speciality.

    Is anyone else as confused as me with this? I know that Psych is a crazy field, however it shouldn't be this difficult to navigate.

    Any light shed would be wonderful. How is the job Market in Mass for psych NP's newly graduated, but with RN experience?

    Many Thanks,
    Delphinium
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  3. 10 Comments so far...

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    I think it all depends on your state BON. I trained as a PCNS years ago and the focus was not on meds or physicals. I'm now a PMHNP student doing my preceptorship at a military base. Psychiatrists here do their own physicals, which means I also crank them out. Once you get them down it's no big deal, although I doubt I'll be doing them in the civilian world.
    delphiniumRN likes this.
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    I am a psych NP........I went thru an adult NP program.........I mostly do med management. the CNS's that I work with do that too, but they also do therapy which I do not.
    also some insurances are funny, like blue cross blue shield.........if the patient is new on our service, I cannot be the first one to see them, they won't pay for an NP only CNS, but after the first visit I can see them.

    the CNS's I work with also do the guardianship stuff, I do not do that.
    delphiniumRN likes this.
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    Quote from Bonosgrrl
    I am a psych NP........I went thru an adult NP program.........I mostly do med management. the CNS's that I work with do that too, but they also do therapy which I do not.
    also some insurances are funny, like blue cross blue shield.........if the patient is new on our service, I cannot be the first one to see them, they won't pay for an NP only CNS, but after the first visit I can see them.

    the CNS's I work with also do the guardianship stuff, I do not do that.
    What age range can you treat?
    harmonizer likes this.
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    Thanks, it seems that it depends on your training. I think the Federal Govt dictates it's own scope and I will be at the VA for training. Makes sense
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    Quote from zenman
    I think it all depends on your state BON. I trained as a PCNS years ago and the focus was not on meds or physicals. I'm now a PMHNP student doing my preceptorship at a military base. Psychiatrists here do their own physicals, which means I also crank them out. Once you get them down it's no big deal, although I doubt I'll be doing them in the civilian world.
    Zenman, I have been paying attention to your posts. Your apparently an active-duty grunt and doing your clinicals in a military setting. I have ten years prior service and will be in the strap program program soon and be a reservist. I anticipate being deployed eventualy as an NP. My question is what are the active duty Psych NPs doing? Have you seen them in practice? How broad is there scope? I'm in the FNP program, but am interested in a psych post masters being as I have more than a little experience there. vAs I'm sure your aware, the Army is mucho hungry for both specialties.
    Last edit by t2krookie on May 23, '10
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    Quote from t2krookie
    Zenman, I have been paying attention to your posts. Your apparently an active-duty grunt and doing your clinicals in a military setting. I have ten years prior service and will be in the strap program program soon and be a reservist. I anticipate being deployed eventualy as an NP. My question is what are the active duty Psych NPs doing? Have you seen them in practice? How broad is there scope? I'm in the FNP program, but am interested in a psych post masters being as I have more than a little experience there. vAs I'm sure your aware, the Army is mucho hungry for both specialties.
    I'm a civilian now but wanted a site close to home in Bangkok. Originally I was going to have a Navy NP for my preceptor but he was deployed before I arrived. I wound up with a Navy doc who has been great. He's being deployed also right at the end of this quarter so I'm heading for the states for my final quarter. If I had my original preceptor I could tell you a great deal about their scope. There is one other PMHNP in the outpatient clinic but I've spent all my time inpatient. Basically, I do everything the doc does. I will also consider a civilian job with the military when I finish.
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    Sure wish to hell I was free to live where u r. Great diving in your region!
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    I have a question regarding PMHCNS VS PMHNP. I know that the scope of Psych CNS & NP varies significantly from states to states.

    Some schools offer either PMHCNS or PMHNP that have 'identical' curriculum, including psychopharm, assessment, and patho & physio etc. My state only recognizes CNS so most people who can percept me will be CNS. Their scope of practice is identical to NP. Ok, I can choose to go for PMHCNS route and get certified.

    However, NP is more recognized nationally.
    Can I go back to NP route later without going back to school and take all those classes and practicum again?
    It is quite ridiculous to spend money and time to repeat the identical courses for post-bac at other schools? or I just need to do the practicum all over again?

    My local state school have dual CNS/NP program but I won't be able to go there because of other commitment.

    Do the certification agency look at the actual courses taken or the name of the degree offered? I think they should realize that curriculum for PMHCNS curriculum in many school includes all the courses offered in NP program. I am VERYconfused about the transportibility between CNS & NP.

    Thank you for your help!!
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    Sorry digging out the old thread. I graduated from a program have more clinical hours and courses, which allow me to sit for "both" PMHNP and PMHCNS. I just passed PMHNP exam.

    Since we all know that PMHNP will replace PMHCNS cert in the future, it is worth paying another $395 to get PMHCNS license. Any benefits or it is just a cool thing to have two license? Is the reimbursement different for psychotherapy? Anything that PMHCNS can do more than PMHNP in any states? The laws may not be catching up with the change in nursing profession soon in the future.

    In Massachusetts, PMHCNS is mentioned in the APRN scope for practice regarding developing a practice guidelines with supervising physician. However, I did not notice PMHNP mention separately from other NPs.


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