I am currently ANCC certified as a CNS in Adult MH Nursing. I am licensed in DE and PA, however, in DE I am able to practice with prescriptive authority but am unable to do so in PA because I am not board certified as an NP.  I live in PA and would like to open a private practice but am really frustrated about the prescriptive authority.  Any suggestions?  Should I go back and get another post-graduate certificate as a psychiatric NP or maybe an adult NP?  I really don't want to do that but it seems like the only option.  Please help.  Thanks.

I am caught in the same situation, I practiced in Florida as an ARNP with Rx authority because Florida licensing rules recognized my ANCC CNS certification- and with a few additional courses-Health Assessment,and  Pharmacology -in my case, I then qualified to apply for the ARNP license.  This was all prior to the development of the psych NP cert exam. When I moved to Virginia-which has regs that address transfer of NP licensure-all that changed because I did not have the psych NP cert exam....when I spoke with the BoN...they essentially said, sorry don't blame us..it was your profession that developed the psych NP cert exam!!! Talk about a catch 22!!  I wrote to APNA-Anerican Psychiatric Nurse Association-and they agreed this was never the intended outcome and now they are engaged in diaglogue with the State Boards of Nursing-essentially pointing out that the two advanced mental health degrees are the same content...and should be interchangeable.  I encourage you to look at their website www.apna.org for the latest information on this.....

It really is outrageous that in this time of acute mental health and professional nursing shortages, that our own colleagues become our biggest detriment to practice...particularly since we have always played a vital role in moving advanced practice forward. 

One possible interim move for you would be to partner with a physician for Rx support only.  I know that with the shortage of mental health providers here, primary care groups are very interested in partnering...especially in the rural areas. At University of Virginia, there is a telemedicine rural health clinic that provides mental health services throught the dept of psychiatry, and they are recruiting for a clinical specialist to do psy evals, med mgt, etc with the PCP at the rural clinic providing the Rx...and the psychiatry dept has some kind of clinical supervision mechanism in place.....so it is not impossible to negotiate a contract doing everything but writing the prescription.....

I hope other CNSs can give some thoughts and suggestions...I will say however, I have no intention of sitting for a 2nd certification exam ...best to you in your decision making process.....

I am currently looking for a list of states that provide prescriptive authority to the CNS.  Have you found out anything?

Well its certainly not Alabama.  I'm a CNS in psych mental health since 1988; board certified with the ANCC since 1992; 30 years of experience; DON; published; etc...   My official title:  APRN,BC.  Blue Cross/Blue Shield runs this state and the physicians OWN Blue Cross/Blue Shield of Alabama.  We do have title protection, but that is it. We do not receive 3rd party reimbursement from BCBS (just about a monopoly) for anything.  I'm leaving Alabama for just this reason.  I was hoping Pa [birthplace] was more progressive.

To answer your question, we are light years away from precriptive authority for the CNS.

Hello, I did find a list of states that allows CNSs to prescribe, however, the article the list is from is from 2003, so not sure if it is current.  The websight is www.medscape.com/viewarticle/455980_3 it is from Clin Nurse Spec 17(3):163-169, 2003.  Hope this helps.  I am able to prescribe in WI.

Julie Nigh

Hi Janet,

As a CNS for pmh, you can indeed have a private practice providing therapy and can refer to a physician or psychiatrist for med management.

They can also refer to you which makes a nice arrangement for both of you while providing the patient with the care they need. Also a great way to build and expand your business.

Do you practice independently in DE? I practice in NJ, currently as an adult health NP in pain mgmt with several years as psych rn, still active in that role. 

By the way, I'm facing the ANCC pmh CNS exam soon and would like to know how you prepared for it; did you go to their review course,

which books did you devour, etc etc.

Thanks,

Carolyn.Kostera@atlanticare.org

 

 

Ann,

Go to the APNA site.

Carolyn 

Ann,

Have you tried the APNA site?

Carolyn 

New Jersey offers a CNS prescriptive authority. I  have been a CNS since 1986, and I am ANCC certified in Advanced Diabetes Management.

 

Hi,  I am an adult CNS practicing in Ohio and I have prescriptive authority. 

 

I too am stuck in this catch 22.  Did you find a list of states that grant prescriptive authority?  To my knowledge every state does except for Ga. but Ga. also does with the collaboration of an M.D.  Other states vary based on whether you can prescribe narcotics. Florida does not allow NP's to prescribe narcotics currently. 

Did you go to school in Ohio?  Do you have full prescriptive authority in Ohio?  I am very interested, if you could reply and let me know.  Thanks,  Dianne Beauchamp

Carolyn, I was scheduled and studied to take the CNS for PMH in Florida and via the ANCC until I found out that the new legislation in Feb. this year says that a CNS is no more than a glorified RN.  My option was to not take it or take three more classes and 360 hours more of clinicals to get the NP in Psych.  Have you taken the exam yet?  I used the online study program and there is a lot of information.  I am now trying to decide if I want to go ahead and take the exam to get national certification and then move to some other state to work that recognizes CNS as Advanced Practice Nurses and to have prescriptive authority.  Dianne Beauchamp

I am a CNS in the state of Iowa where CNS's are included in the Nurse Practice Act in the same category as NPs, CRNA, and Nurse Midwives.  We are obligated to take our scope of practice seriously.  Some of us have increased out education related to medication management and some have not. We also have legislated the right to offer controlled substances to our clients.  I treat patients with ADHD and have a DEA number that allows me to use stimulant medications such as Concerta and Adderall.  ARNPs in Iowa have worked hard within the legislative process to establish these opportunities to have an exceptional scope of practice.  What is your legislative support in this area?