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Lindert, Jessica C.

Nursing

2011

MS

Articlulating and understanding the unique nature of advanced practice psychiatric nursing has been of ongoing interest and lively exchange for the past two decades (McCabe, 2000, Perraud et al, 2006, Thomas, 1999). Historically grounded in interpersonal practice as developed by Peplau (1997), psychiatric-mental health advanced practice registered nursing (pMH-APRN) demands the integration of physiological knowledge, including the appropriate place and use of psychotherapeutic medications as a primary treatment modality, while maintaining a nursing focus on the human response within the spectrum of illness and wellness. The PMH-APRN role remains one of the smallest specialities in advanced practice nursing. The paucity of providers stands alongside the increasing need for mental health treatment.
Given the ability to offer responsive and flexible multi-dimensional care, PMH-APRNs stand in strong position to assume a central role in the provision of mental health treatment. This study provides an initial description of the contours of PMH-APRN practice from the perspective of eight practitioners across a range of treatment settings in Vermont. Thematic analysis of the resulting transcripts reveals three interwoven aspects of practice: the body, relationship, and the practitioner. The true nature of this practice, however, is one of interwoven multidimensionality with each domain considered and incorporated into each element of treatment. Practitioners additionally describe structural aspects of practice including autonomy and availability of collaboration within the specialty and across disciplines as crucial factors for full enactment of PMH-APRN. The interviews yield a rich depiction of the challenges to the full realization of this role with suggested areas for continued research.