title: Psychiatric nurse practitioner versus clinical nurse specialist: moving from debate to action on the future of advanced psychiatric nursing.
abstract: The psychiatric nursing literature recently has included a proliferation of discussions regarding the nature and direction of change impacting the future of advanced practice psychiatric nursing. The debate has focused most commonly on the role of the clinical nurse specialist versus the role of the nurse practitioner. The debate has produced little in the way of outcomes other than an entrenchment of positions. The stalemate in psychiatric nursing is producing a slow but steady surrender of the boundaries of psychiatric nursing to other fields of nursing. Although advanced practice psychiatric nurses disagree on what to become and what to be called, people with conditions such as depression, anxiety disorders, and other psychiatric disorders are being treated increasingly by family nurse practitioners. The time for debate has ended. Unless consensus regarding what constitutes the domain of psychiatric nursing is reached soon, the discussions will be moot because few clients will remain to be treated. This article began as a discussion between colleagues. The two authors teach at a regional state university, but they share diverse opinions regarding the substance and nature of advanced practice psychiatric nursing. These diverse views led to discussions that have implications not only for faculty practice, but for curricular design, and for decisions regarding how to best educate future nurses. The discussion developed into a presentation at the 20th Southeast Conference of Clinical Nurse Specialists. It was presented as a point-counterpoint discussion regarding this debate; one author advocated the perspective of traditional clinical nurse specialist and one advocated the perspective of a psychiatric nurse practitioner role. We conclude with a projected model of a merged role, with delineation of traditional clinical nurse specialist and nurse practitioner that must be blended for the new role.
authors.affiliation: Mental Health Nursing Department, East Tennessee State University, Johnson City 37614-70658, USA.
authors.forename: S
authors.initials: S
authors.lastname: McCabe
authors.forename: S
authors.initials: S
authors.lastname: Grover
mesh_terms: D002568:Certification; D003479:Curriculum; D005544:Forecasting; D006801:Humans; D007587:Job Description; D019359:Knowledge; D016294:Models, Nursing; D009720:Nurse Clinicians / Q000193:education / Q000458:organization & administration*; D009722:Nurse Practitioners / Q000193:education / Q000458:organization & administration*; D009936:Organizational Innovation; D010687:Philosophy, Nursing; D011568:Psychiatric Nursing / Q000193:education / Q000458:organization & administration*