title: Barriers to practice and impact on care: an analysis of the psychiatric mental health nurse practitioner role.
abstract: This paper is a retrospective review of the literature analyzing the role of the psychiatric mental health nurse practitioner in the community. Presented here is an appraisal of national and state mental health initiatives. Professional nursing regulations are reviewed, focusing on New York State advanced practice nursing. Barriers to practice are assessed with discussion on how barriers, such as statutory collaboration, impede access to treatment in the community for mentally ill psychiatric patients. The current New York State legislative agenda is featured. Clinical vignettes from a nurse practitioner's private community practice are presented to introduce and conclude how clinical practice barriers impede autonomous practice.
authors.affiliation: Wegman's School of Nursing, St. John Fisher College,Rochester. NY, USA.
authors.forename: Heather
authors.initials: H
authors.lastname: Muxworthy
authors.forename: Nancy
authors.initials: N
authors.lastname: Bowllan
mesh_terms: D000328:Adult; D003156:Community Mental Health Services; D005260:Female; D018166:Health Care Reform; D006801:Humans; D008297:Male; D008875:Middle Aged; D009518:New York; D009722:Nurse Practitioners / Q000331:legislation & jurisprudence / Q000600:supply & distribution; D017009:Professional Autonomy; D011568:Psychiatric Nursing / Q000331:legislation & jurisprudence; D014481:United States; D000078329:Workforce