On Becoming a PMHNP

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Hildegard Peplau, the founder of advanced practice psychiatric nursing, was a nurse theorist and educator, and her development of the theory of interpersonal relations revolutionized nursing care.¹ Peplau collaborated with Harry Stack Sullivan, MD, renowned for his contributions to interpersonal approaches to treatment and his publication of The Interpersonal Theory of Psychiatry.² Peplau developed and implemented the first master’s-level role for advanced practice nurses to provide direct care to psychiatric patients.¹ The advanced practice role shifted from clinical nurse specialist to advanced practice registered nurse in the early 1990s.³ Today, students who have successfully completed an accredited program are eligible to sit for the board certification exam through American Nurses Credentialing Center to obtain PMHNP certification.

Education is an ongoing process, however, and does not end with board certification. Board-certified PMHNPs are required to renew national certification every 5 years and must complete 75 continuing education units. In addition, nurse practitioners maintain certification by remaining active in clinical practice and completing additional renewal requirements in domains that demonstrate continued competence.⁴ Additionally, all PMHNPs must meet specific state-level requirements for maintaining state licensure as both a registered nurse and a nurse practitioner; many states require renewal of these licenses every 2 years.

PMHNPs also have years of experience as professional nurses, which serve to hone their clinical judgment and assessment skills. The hands-on clinical experience of interacting with patients during prelicensure education, clinical practicum, and subsequent practice is a valuable asset. Therapeutic communication is a core skill, and the therapeutic relationship with patients is a central tenet throughout all levels of training, especially within psychiatric nursing.

Practice authority for nurse practitioners varies from state to state, ranging from full practice to reduced or restricted practice.⁵ Many states require collaboration, supervision, or consultation with a physician for nurse practitioners to practice. Even in states without a collaborative requirement, many nurse practitioners choose to participate in formal and informal supervision with physician colleagues. Massachusetts recently joined the rest of the New England states by passing legislation to grant nurse practitioners full practice authority, becoming the 23rd state to do so.⁶

Ms Robinson is a psychiatric mental health nurse practitioner in the Seacoast, New Hampshire area; and clinical assistant professor and program director of the Post-Masters Psychiatric-Mental Health Nurse Practitioner Certificate Program, Department of Nursing, University of New Hampshire, Durham.

References

1. Callaway BJ. Hildegard Peplau: Psychiatric Nurse of the Century. Springer Publishing Company; 2002.

2. D’Antonio P, Beeber L, Sills G, Naegle M. The future in the past: Hildegard Peplau and interpersonal relations in nursing. Nurs Inq. 2014;21(4):311-317.

3. Drew BL. The evolution of the role of the psychiatric mental health advanced practice registered nurse in the United States. Arch Psychiatr Nurs. 2014;28(5):298-300.

4. American Nurses Credentialing Center. 2017 certification renewal requirements. June 1, 2016. Accessed March 24, 2021. https://www.nursingworld.org/~4ac164/globalassets/certification/renewals/RenewalRequirements

5. American Association of Nurse Practitioners. State practice environment. Updated January 1, 2021. Accessed March 24, 2021. https://www.aanp.org/advocacy/state/state-practice-environment.

6. Massachusetts Coalition of Nurse Practitioners. Massachusetts NPs granted full practice authority! January 1, 2021. Accessed March 24, 2021. https://mcnp.enpnetwork.com/nurse-practitioner-news/212292-massachusetts-nps-granted-full-practice-authority- ❒