DNP vs APN with MS in "other"

[jfailla]

I am looking at an online (or primarily online) program that will give me my Adult or Family NP credential. I am an RN with an MS in Psychology and therefore am eligible for an APN license as a psychiatric CNS but want to expand my scope in both clinical practice as well as obtain my prescription privilages. What is the best way to go about this? Anyone else in this rather unique boat?

Frustrated shrink & NP wanna-be.

Jon

[zenman]

I'm confused. What do you mean you're eligible for APN license as a psychiatric CNS? In order to be a PCNS you have to complete a masters program in psychiatric nursing, not in psychology. I'm also a PCNS but get little credit for that in a psych NP program.

[Corey Narry, MSN, RN, NP]

I was wondering the same thing. Be aware that although some states recognize CNS' as providers who can bill and prescribe, the requirements for being credentialed as a CNS includes national certification by a credentialling body such as ANCC which one achieves by attending a formal CNS program at least at the master's level.

You basically have 2 options:

1. Attend a MS or DNP Psych CNS program and be certified as a Psych CNS. However, you will be able to obtain the ability to bill and prescribe only in states that recognize the CNS as a non-physician provider. Find out how your state defines the CNS role if you plan on staying where you are.

2. Obtain a MS or DNP degree from a Psych NP program.

It would obviously take you longer to finish in a DNP program as you would in a master's degree program.

[jfailla]

Nope, each state may be different but our state's Board of Nursing provides for nurses (RN's) who have a Master's Degree in a "nursing specialty" such as psychology, can apply for an advanced practice credential but without prescriptive authority until additional classes are taken that satisfy that requirement. I am taking the NCLEX in the next few weeks and will be applying for my CNS/APN credential right afterwards. Anyway, I was able to find two programs that would consider an RN with a master's degree in another field to apply for their DNP program. UMass at Amherst is one of them.

Jon

[core0]

Nope, each state may be different but our state's Board of Nursing provides for nurses (RN's) who have a Master's Degree in a "nursing specialty" such as psychology, can apply for an advanced practice credential but without prescriptive authority until additional classes are taken that satisfy that requirement. I am taking the NCLEX in the next few weeks and will be applying for my CNS/APN credential right afterwards. Anyway, I was able to find two programs that would consider an RN with a master's degree in another field to apply for their DNP program. UMass at Amherst is one of them.

Jon

One little problem with this. Medicare. The medicare rules are as follows:

• Hold an active license as a registered nurse, authorized to perform the services of a clinical nurse specialist, in the state where he or she practices;
  
• Have a master's degree in a defined clinical area of nursing from an accredited educational institution; and
  
• Hold current certification as a clinical nurse specialist from an appropriate certifying body.

Your degree is not in a defined clinical degree of nursing. It is not a nursing degree. In addition ANCC requires:

Hold a master's, post-master's, or doctorate from a clinical nurse specialist in adult psychiatric and mental health program accredited by the Commission on Collegiate Nursing Education (CCNE) or the

National League for Nursing Accrediting Commission (NLNAC). A minimum of 500 faculty supervised clinical hours in the Adult Psychiatric & Mental Health CNS role and specialty must be included in the educational program. The Adult Psychiatric & Mental Health CNS graduate program must include course work in:

> advanced health assessment

> advanced pharmacology

> advanced pathophysiology

> clinical training in at least two psychotherapeutic treatment modalities

Since your psychology degree is presumably not from a CCNE or NLNAC accredited program you would not be eligible for certification (which is required for Medicare billing).

Notice that the Medicare rules are different from your state requirements. So presumably you could get a state license but reimbursement is going to be difficult if not impossible.

The DNP may or may not help things. Currently a DNP without a Masters cannot be reimbursed by Medicare. There is a proposed emergency rule in January to fix this but it will probably be challenged. The law currently reads you must have a Masters in nursing for NP. It doesn't say anything about higher degrees.

David Carpenter, PA-C

[jfailla]

Thank you for your reply.

Medicare states a "defined clinical area of nursing" not defined degree in nursing. My master's degree is a defined area of nursing, mental health. Now, yes, the board has stipulated that I must take the three classes you mentioned, Advanced pharm, advanced health assessment, and advanced pathophys. I also may be required to do the 500 hours. However, I am, according to the board, able to be a clinical nurse specialist while fullfilling these additional requirements but without prescriptive authority.

Jon

[jer_sd]

Thank you for your reply.

Medicare states a "defined clinical area of nursing" not defined degree in nursing. My master's degree is a defined area of nursing, mental health. Now, yes, the board has stipulated that I must take the three classes you mentioned, Advanced pharm, advanced health assessment, and advanced pathophys. I also may be required to do the 500 hours. However, I am, according to the board, able to be a clinical nurse specialist while fullfilling these additional requirements but without prescriptive authority.

Jon

That is correct you can function in an advaced role if you have state licenseure/registration, but you may have a hard time billing for services... In order to bill medicare you would need a recognized certification from ANCC (multiple fieldsoffered), onc, hospice, critical care, are the only CNS exams that I can think of off the top of my head.

It is good to see your ambition, I woudl get teh advanced practice licensure even if you have a hard time getting reinbursed you could always work strictly outpatient under incident to rules..... But work to get recognition from medicare it will open more doors for you, even if it means getting another masters or post masters certificate.

Jeremy

[DelilaNP]

Seriously consider the DNP. Schools with a DNP PMH concentration that would lead to certification eligibility will prepare you for the future of PMH advanced practice. Research the legislation that is coming down the pike regarding prescribing psychoactive medication and the doctoral degree requirement.

[patrick1rn, MSN, RN, NP]

Go to FNP school.