PMHNP in an ACNP/FNP position?

[B52Bomber]

Hello,

So this may be a simple question... or maybe not! I recently obtained my DNP degree with a focus in psych-mental health nursing - taking my PMHNP boards soon!! My first 3 years of RN experience were in a Neurotrauma ICU and I'm still fond of the neurological/neurosurgical environment. As many of you know our fellow MD/DO's are board certified in neurology and psychiatry. I wonder if this could apply to PMHNPs who have experience in acute care/outpatient neurology yet wish to practice without being an ACNP or FNP?

Thanks!

[Jules A, MSN]

I believe it depends on your state. In Maryland it is my understand that NPs need to be certified in the specialty they are practicing in. COMAR 10.27.07.02C A nurse practitioner may practice only in the area of specialization in which certified.

Why did you do a psych specialty when your background and interest is acute care?

[B52Bomber]

Well, to be more specific I have an interest in neuropsych (disorders associated with TBI, neurodegeneration, neuroimmunology, etc) rather than treating S/p neurosurgery (craniectomies, endovascular, spinal). My clinical inquiry project for my DNP degree was "implementing and evaluating a depression screening protocol among post-stroke patients in the outpatient setting." Interestingly enough we don't focus on the psych consequences of neurotrauma or disorders.

[PG2018]

Nah doesn't look like you'd have adequate curricular backing and credentialing for that. You could do it but be out of scope and lose your ass.

[NicuMurse]

I am in my first semester of grad school to obtain my PMNHP. To answer your question, from what I know, absolutely not.

[Psychcns]

maybe you could look into,a geripsych or medpsych unit. I think psychiatry evolved from neurology so there is an overlap.

[Corey Narry, MSN, RN, NP]

You'll have to be more specific with what the role entails. As a PMHNP, are you going to be doing neuropsychological evaluations and recommending psychotropic medications? Then, that's within your scope regardless of whether this is in an ICU or not.

You mentioned that the fellows in your Neurotrauma ICU have Neurology and Psychiatry backgrounds. You'll have to be more specific about what fellowships these guys are under. I've never come across a Neurocritical Care fellowship that admits fellows from a Psychiatry residency. Most programs do admit applicants from broad medicine backgrounds (IM, Neurology, Anesthesiology) but never Psychiatry. The neurointensivist role requires broad knowledge of critical care concepts of sedation, mechanical ventilation, hemodynamics, line placements, etc that a Psychiatry residency graduate would not transition well into.

BON's are typically not specific about what roles various kinds of NP's can do. There are some that are starting to delineate the differences, however, so you'll have to check with your state. In the absence of BON regulation, the default is national standards. I've sat in an ACNP national task force to define the ACNP role and the push is for NP's who train in acute care perform acute care roles. Experience as an RN in acute or critical care is not a substitute for the appropriate NP training. That's at least what the national certifying body is pushing for.

There are legal repercussions of practicing outside the scope based on state and national standards.

[traumaRUs, MSN, APRN]

Also need to consider credentialing at your hospital. I know at the hospitals where I'm credentialed they want my specific training to line up with my hospital role

[LessValuableNinja]

...you could always do a postgraduate ACNP cert and become a psych acute power ranger Optimus prime Batman with me.

[Skippingtowork]

Hello,

So this may be a simple question... or maybe not! I recently obtained my DNP degree with a focus in psych-mental health nursing - taking my PMHNP boards soon!! My first 3 years of RN experience were in a Neurotrauma ICU and I'm still fond of the neurological/neurosurgical environment. As many of you know our fellow MD/DO's are board certified in neurology and psychiatry. I wonder if this could apply to PMHNPs who have experience in acute care/outpatient neurology yet wish to practice without being an ACNP or FNP?

Thanks!

Check with your board of nursing and local hospitals. Your specialty in clinics that see TBI, stroke ex-preemies, etc. is greatly needed. Psychiatrists are consulted in hospitals all the time and so their NPs also follow. Whether or not you'll be consulted in the area you like is another question. See if you can get a clinic with a neurologist, even for a week or so, if permitted by your school.