When using the free-cash flow model, cash flows are discounted at the weighted average cost of capital (WACC) and when using the dividend discount model, dividends are discounted at….
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Psychiatric mental health nursing is the chosen nursing specialty within the MSN program. Psychiatric-Mental Health Nurse Practitioner (PMHNP), currently called Psychiatric Nurse Practitioner, is an advanced role in nursing that entails working with individuals, groups, families, and communities to assess and meet their mental health needs. Specifically, Psychiatric Mental Health Advanced Practice Registered Nurses (PMH-APRNs) play an instrumental role in ensuring that the psychiatric-mental health population have access to comprehensive primary care services (Butryn, Bryant, Marchionni, & Sholevar, 2017). Interest in the nursing specialty piqued while volunteering in a program for homeless persons with co-existing mental and behavioral health problems. Working with the vulnerable population group offered invaluable insights about the lived experiences of patients with mental/behavioral health problems. Clinical rotation in a psychogeriatric unit reinforced the desire to pursue the psychiatric mental health nursing specialty. Two factors gleaned from the past experience influenced the decision to specialize in psychiatric mental health nursing.
First, mental health problems are a growing and significant public health concern in the United States. The Centers for Disease Control and Prevention (CDC) reports that one in five 46.6 million Americans experience a mental health problem in a given year (CDC, 2018). According to de Nesnera and Allen (2016), the current opioid crisis has worsened the state of mental health problems in the US. The scope of opioid misuse and severe mental illness was clear while working with older adults and homeless persons with mental health disorders. Second, the severe shortage of mental health providers is another issue that influenced the decision to pursue psychiatric mental health nursing specialty. More than 75% of counties in the US have a chronic shortage of mental health prescribers (Butryn et al., 2017). For example, patients seeking care at the psychogeriatric unit could wait for more than three months before accessing a prescribing psychiatrist. The situation was dire for the homeless and ethnic minority populations who did not have comprehensive health insurance coverage.
The increasing prevalence of mental/behavioral health problems and a shortage of mental health prescribers had a profound influence on the choice of the nursing specialty. However, making the choice has not been easy. The first challenge is deciding whether I am mentally and physically prepared for the heavy workload and emotional burnout associated with the job (Bodenheimer & Bauer, 2016). Nesnera and Allen (2016) have found that VA psychiatrists report high burnout rates. Therefore, I have had to weight the benefits and costs of pursuing the psychiatric mental health nursing specialty. The second challenge is deciding whether I am ready to work in an underserved and rural communities. According to de Nesnera and Allen (2016), the shortage of psychiatrists is severe in rural and underserved communities across the US. Thus, a difficult decision is about the willingness to accept challenging conditions associated with working in underserved and rural areas. Despite these issues, commitment to patient care is a professional responsibility that overrides the prevailing challenges. Working in rural, underserved communities and with vulnerable populations will enhance practical skills in advanced leadership and advocacy.
In conclusion, the American Nurses Association (ANA); the American Psychiatric Nurses Association (APNA), and the American Association of Nurse Practitioners (AANP) are prominent professional organization affiliated with the chosen nursing specialty. ANA is a nursing regulatory agency recognizes nursing specialties, specifies the scope of nursing practice, acknowledges standards of practice, and affirms practice competencies. The American Psychiatric Nurses Association (APNA) is a professional organization that offers membership, continuing education, and other resources for psychiatric-mental health nurses. Third, the American Association of Nurse Practitioners (AANP) is also a national professional organization that offers membership to NPs of all specialties. As such, affiliation with the three organizations is necessary for professional growth and development, as well as mentorship. The first step of membership will entail reviewing the registration requirements for each of the organization. The next step is to complete the registration process, including paying the membership fees and licensure exams, to become a fully-pledged member.
Bodenheimer, T., & Bauer, L. (2016). Rethinking the primary care workforce: An expanded role for nurses. New England Journal of Medicine, 375, 1015-1017. doi: 10.1056/NEJMp1606869
Butryn, T., Bryant, L., Marchionni, C., & Sholevar, F. (2017). The shortage of psychiatrists and other mental health providers: Causes, current state, and potential solutions. International Journal of Academic Medicine, 3(1), 5-9. doi: 10.4103/IJAM.IJAM_49_17
Centers for Disease Control and Prevention. (2018). Learning about Mental Health. Retrieved from https://www.cdc.gov/mentalhealth/learn/index.htm
de Nesnera, A., & Allen, D. E. (2016). Expanding the role of psychiatric mental health nurse practitioners in a state psychiatric system: The New Hampshire experience. Psychiatric Services, 67(5), 482–484. doi: 10.1176/appi.ps.201500486
Lake, J. (2017). Urgent need for improved mental health care and a more collaborative model of care. The Permanente Journal, 21, 17-24. doi: 10.7812/TPP/17-024