Blending Specialist and Practitioner Roles in Psychiatric Nursing: Experiences of Graduates

Abstract

BACKGROUND: Blended roles in advanced practice nursing have generated much discussion but little study. As role modifications emerge in nursing, there is a need to explore their implementation. OBJECTIVE: This descriptive study examined the experiences of nurses who were implementing blended roles as psychiatric clinical specialists and adult nurse practitioners. DESIGN: Four master of science in nursing and 10 postmasters nurses who had been practicing in blended roles for 1 to 2 years were interviewed about their experiences in implementing their roles. Interviews were tape recorded, transcribed, and content analyzed. RESULTS: Respondents believed they were practicing holistically, were able to appropriately integrate physical and psychological care of the patient, and found chronic psychiatric patients to have more complex physical illnesses than they had anticipated. In addition, the advanced practice nurses were satisfied with their roles, felt supported by their physician preceptors, and described cross-consultation with physicians and nonpsychiatric nurse practitioners. CONCLUSIONS: There are roles for advanced practice nurses who blend clinical specialist and adult nurse practitioner skills in the care of psychiatric and primary care patients.

Applying Benner's Model to Psychiatric Mental Health Nurse Practitioner Self-Ratings of Role Competence

“…In summary, published literature includes descriptions of advanced psychiatric nursing practice, entry-level competencies, and the evolution of PMHNP practice, education, research, and policies (Bjorklund, 2003;NONPF, 2003;Wheeler & Haber, 2004). Research has been conducted on practice patterns and the blending of clinical specialist and nurse practitioner roles in psychiatry (Campbell, Musil, & Zauszniewski, 1998;Scharer, Boyd, Williams, & Head, 2003). However, no research reports were located examining the development of advanced practice psychiatric nurses beyond career entry, as they progress through stages of knowledge and skill acquisition engendered through practice.…”

Peer Consultation: A Unique Experiential Model for P/MHNP Students

“…Changes in the educational programs preparing Psychiatric Advanced Practice Nurses, and the controversy surrounding the development of the Psychiatric/Mental Health Nurse Practitioner (P/MHNP) have been described by many authors (Bjorklund, 2003; Delaney, 2005; Edmands, Hoff, Kaylor, Mower, & Sorrell, 1999; Puskar, 1996; Scharer, Boyd, Williams, & Head, 2003; Wheeler & Haber, 2004). The shift in Psychiatric Mental Health graduate nursing education in the last decade reflects the need to prepare nurses to function in a primary mental health care role in a variety of settings (Delaney, 2005).…”

“…The shift in Psychiatric Mental Health graduate nursing education in the last decade reflects the need to prepare nurses to function in a primary mental health care role in a variety of settings (Delaney, 2005). One aspect of the controversy included concerns that some of the valuable aspects of the Clinical Nurse Specialist (CNS) role would be lost in the educational programs, such as the consultant role (Edmands et al; Scharer et al).…”

Geropsychiatric Nursing Education: Challenge and Opportunity

“…Indeed, more recent literature has addressed the concept of, and debate regarding, a blended role for the advanced practice psychiatric nurse (Cotroneo, Kurlowicz, Outlaw, Burgess, & Evans, 2001;Naegle & Krainovich-Miller, 2001;Scharer, Boyd, Williams, & Head, 2003;Williams et al, 1998). A frequent topic concerns blending the nurse practitioner (NP) and CNS roles.…”

“…Students could elect to focus on a particular population (subspecialty) during their 2nd year, with one of the options being older clients. Scharer et al (2003) discussed a blending of the CNS and NP roles designed to bridge the boundaries of advanced practice specialties. From this perspective, a graduate student would complete courses for both the PMHN specialty and a nonpsychiatric NP specialty, such as the adult NP.…”