The practice agreements for PMHNPs Essay Paper.

State Practice Agreements

The practice agreements for PMHNPs Florida

PMHNPs in Florida State are required to practice under the supervision of a medical doctor. According to Phillips (2020),  Both the APRN and the supervising medical doctor determine the method and degree of supervision and are explicitly outlined in a written protocol The APRN might order occupational therapy, physical therapy, and diagnostic tests according to the written protocol. The practice agreements for PMHNPs Essay

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APRNs are permitted by the supervising physician under the protocol to order dispense, administer, or prescribe medications, including scheduled drug (schedule II-V) as under the approval of a  board of nursing- adopted controlled substances formulary. Also, PMHNs who are certified by the board might prescribe psychotropic controlled substances.The practice agreements for PMHNPs Essay Paper.

Two physician collaboration issues that I identified

The first physician collaboration issue I identified is that collaboration with a physician prevents nurse PMHNPs from practicing at the top of their training, education, experience, licensure, and competency. According to Chapman et al. (2028), PMHNPs have graduate-level training in mental health and their practice, and that os psychiatrists is same and includes evaluation of physical health conditions and diagnostic assessment and pharmacological and psychotherapeutic management of mental disorders. However, state regulation of nurse practitioners influences the availability of services provided by PMHNPs. In states where nurse practitioners are needed to be in the same geographic region as the supervising practitioner, PMHNPs are unable to provide their services and to increase access to health services, particularly in rural regions. Physicians  are usually concentrated in suburban and urban regionsThe practice agreements for PMHNPs Essay Paper..

The second physician collaboration issue I identified is that PMHNPs are not able to provide services if the collaborating/ supervising physician is unavailable. According to Barnes et al. (2017), the requirement for a collaborative agreement negatively impacts the number of nurse practitioners available to deliver care because t NPs are unable to offer services without a collaborative agreement.  Additionally, if the collaborating physician decides to relocate or terminate the agreement, the NP cannot render any services.The practice agreements for PMHNPs Essay Paper.

The barriers to PMHNPs practicing independently in Florida

Restrictive scope of practice laws, reduced reimbursement rates are key barriers to PMHNPs practicing independently in Florida. Florida laws require nurse practitioners, including PMHNPs to work under the supervision of a medical doctor who is licensed in Florida. Peterson(2017) indicates that despite the vast amount of evidence and support in support of the independent practice, Florida continues to deny NPs authority to practice autonomously to the full level of their education, training, and licensure. Physician supervision limits nurse practitioner’s practice opportunities, including the capability to seek reimbursement. According to Phillips(2020), in Florida, APRNs are reimbursed by Medicaid at eighty-five percent of the physician rate if the supervising physician is not on the site where the APRN is practicing and fails to countersign the chart within twenty-four hours.The practice agreements for PMHNPs Essay Paper.

Opposition from physicians and physician organizations, including Florida Medical Association is another barrier PMHNPs independent practice in Florida.  Physicians and national and state medical organizations view PMHNPs as insufficiently educated and trained to provide quality and safe care. Kraus and DuBois (2017) indicate that medical organizations explicitly contest the majority of the reforms that nurse practitioners have worked toward to gain independent practice. They argue that nurse practitioners have a lesser number of years of training and education compared with physicians, which might put patients at risk.The practice agreements for PMHNPs Essay Paper.

A plan for how you might address PMHNP practice issues in Florida

Address PMHNP practice issues in Florida by advocating for the amendment of the restrictive scope of practice laws to permit PMHPs to practice without physician supervision. I might also recommend Congress to reform both the private and public reimbursement services to permit independent and equitable reimburses for PMHNP delivery of care in all settings, permitting direct reimbursement from private and Medicare payers for the care that PMHNPs provide. I would encourage physicians and physician organizations to acknowledge PMHNPs as professionals with qualifications and capability to deliver quality, safe, and less costly care and who greatly contributes to healthcare teams. The practice agreements for PMHNPs Essay Paper.