State Practice Agreements

State Practice Agreements

Students will:
Analyze state PMHNP practice agreements
Analyze physician collaboration issues
Analyze barriers to PMHNP independent practice
Create plans for addressing state PMHNP practice issues
**Assigned in Week 9 and submitted in Week 10
To Prepare for this Practicum Journal:
Review practice agreements in your state.
Identify at least two physician collaboration issues in your state.
For this Practicum Journal:
Briefly describe the practice agreements for PMHNPs in your state.
Explain the two physician collaboration issues that you identified.
Explain what you think are the barriers to PMHNPs practicing independently in your state.
Outline a plan for how you might address PMHNP practice
issues in your state. State Practice Agreements


State Practice Agreements
A brief description of the practice agreements for PMHNPs in Texas
Prescriptive authority is the capability of advanced practice registered nurses to order or prescribe without limitation. According to Potera (2013), nurse practitioners presently practice without the supervision of a physician in several states and recent legislation within numerous states has reverse outdated laws, permitting nurse practitioners to expand their scope of practice. In Texas, a PMHNP may get into a prescriptive agreement and be able to prescribe or order devices or drugs unless her or his license is revoked, delinquent, inactive , surrendered has been willingly given up or if the PMHNP is under a disciplinary order which forbids entrance into the agreement.
Two physician collaboration issues that I identified
The first issue was that physicians’ lack of understanding of PMHNPs scope of practice, their educational level and what was essential to their work Schadewaldt et al (2013) claim that physicians often concerned about legal responsibility and consider themselves accountable for the care that nurse practitioners provide. The other issue was that successful collaboration was successful for PMHNPs who had previous experience working with a physician. Development of an excellent collaborative relationship improved when the physicians and medical practitioners got to be acquainted with one another, which also assisted in the establishment of trust amid the professionals
What I think are barriers to PMHNPs practicing independently in Texas
The two barriers to PMHNPs practicing independently in Texas are restrictive legislation and lack of acknowledgment from both public and private health professionals on their preparation. According to Duncan and Sheppard (2015), that several states restrict the capability of nurse practitioners to independently prescribe narcotics and required them to be in possession of a written collaborative agreement for them to be able to perform these activities. Additionally, there is limited distance amid the primary office of the nurse practitioner and the overseeing physician which reduces access to people requiring care in rural regions.
A plan for how I might address PMHNP practice issues in Texas
I might address barriers to full authority practice by recognizing PMHNPs as providers of primary care in all healthcare programs and plans. During their training, PMHNPs must be offered the diagnostic, prescribing and treatment tools essential to offer superior care to patients. Gutchell et al (2014) argue that in order to be able to practice independently, it is crucial that nurse practitioners be perceived as autonomous and feel confident and empowered in their competencies, roles and responsibilities in providing care to patients. State Practice Agreements

Duncan, C., & Sheppard, K. (2015). Barriers to Nurse Practitioner Full Practice Authority (FPA): State of the Science. International Journal of Nursing Student Scholarship, 2(1): 1-12.
Gutchell, V., Lazear, J., & Idzik, S. (2014). An Evidence-based Path to Removing APRN Practice Barriers. The Journal for Nurse Practitioners, 10(4): 255-261.
Potera, C. (2013). NPs Continue to Break Down Practice Barriers. American Journal of Nursing, 113(9): 14.
Schadewaldt, V., Mclness, E., Hiller, J., & Gardener, A. (2013). Views and experiences of nurse practitioners and medical practitioners with collaborative practice in primary health care- an integrative review. BMC Family Practice, 14 (1):131.  State Practice Agreements


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