Practicum Journal Entry

Practicum Journal Entry

Psychiatric and Mental Health Nurse Practitioner (PMHNP) in Texas is an advanced practice nurses that includes registered nurses who hold Doctoral degree in nursing (DNP) or master’s Degree in nursing. The level involves advance holistic care in line with psychiatry and mental illness. In Texas, a fully accredited PMHNP is charged with management of acute, chronic mental conditions while promoting preventive care. Texas Nurse Practitioners, Texas Board of Nursing, East Texas Nursing Practitioners Association and America Academy of Nurse Practitioners are among recognized nurse practitioner agencies in Texas.

For several years, the nursing practitioners have been required by the legal practice guidelines to collaborate with physicians in practice and prescriptions of medications. The practice guidelines may vary from one state to another throughout United States (Barton Associates, 2017). The paper seeks to describe the PMHNP in Texas, compare the practice to those of other neighboring states, address new licensure and credentialing issues then wrap up with a checklist for national certification exams (Kuo et al., 2013).


Describing the Psychiatric and Mental Health Nurse Practitioner (PMHNP)    

practice environment in my home state (Texas), and highlighting restrictions or limitations for practice

The PMHNP in Texas has continued to grow over the years. The nursing specialty seeks to advance nursing practice skills in the care and management of patients with psychiatric and mental illness. The program constitutes of practicum and course work that focus on wide range of health care needs of patients. There is certain limitation in the practice outlined by American Association of Nurse Practitioners (AANP). The state restricts the nurses to engage in at least more than aspect of Nurse Practitioner practice. The practice is restricted by supervision by supervisory physicians. A larger part of the program is offered by the State’s regulation online.

In provision of the program, the Texas University System usually signs affiliation agreement with other states. Signing of such academic and operational treaty comes with certain advantages. These include convenient credit transfers for students and relocation or inter-university state transfer among others. Currently, Texas has no such affiliation agreements with Florida, California, Louisiana and Massachusetts.

For PMHNP in Texas, the prescriptive authority, supervisory body and Practice Act are three vital components. The prescriptive authority defines the process, ethical and legal guidelines of practice. This includes the supervisory process, control of prescriptions, registration and Control of controlled substances. The governing body in Texas TX Board of Nursing guided by the TX Practice Act (American Psychiatric Association, 2016).


Comparing the PMHNP practice environment in my home state (Texas) with a 

neighbouring state (Louisiana) or a state in which you would like to practice.

The PMHNP environment in Texas varies in some noticeable ways with that of other states in United States. Like other states, Texas has a legal Board of Nursing called the TX Board that supervise the admission process. The main role of the board is to ensure that interested nurses meet the course requirement. The Nursing Practitioners are guided by TX Practice Act that defines the scope of practice and the ethical legal issues binding the successful nursing practitioners. The PMHNP environment provides a professional atmosphere for the program. These issues vary from state to state. In Louisiana, the prescriptive requires a defined Collaborative Practice Agreement (CPA) between the nurse practitioner with the physician. The collaborative agreement plays an oversight role on the medical prescriptions and use of controlled substances.

However, the current Texas regulations. In Texas, the prescriptive authority calls for a separate prescription delegation to the nurse by the supervising politician. Unlike Louisiana, Texas abolished the requirement of on-site supervision of the nurse practitioners by the supervising physician. This creates a difference as far as practice environment for the two states is concerned. Currently, the nurse practitioners in Texas have a greater degree of practice freedom than most U.S states.


 Describe a professional and/or clinical practice issue a new PMHNP will need to 

 consider and address with the certification, licensure, credentialing, or relocation 


There are certain clinical practice and professional issues that a new PMHNP student should understand. Professionally, there are binding legal terms associated with relocation and credit transfers for Students. Every state has its own guidelines affecting their practice. For instance, Texas has a different prescriptive authority. A learner may have individual views in this and this affect their choice of nursing school.

In terms of university transfer, the ease only comes when a given university has signed affiliate treaty with such universities. Therefore, there is need to make an informed decision about the school you need to enroll in to avoid future inconveniences. Additionally, a new student should understand the practice restrictions in PMHNP program. For example, on should know that having an NP certificate does not mean you can practice in any state in America. This is due to diversity in practice guidelines in these states.


Develop a checklist for passing the national certification exam, including a 

detailed timeline that includes academic preparation (study plan), registration, financial preparation, etc.

In preparing for the certification exams, adequate preparation is sensitive. This entails course requirements, personal preparation and financial preparation. Applicants should ensure that the application is complete and timely. The success of the application depends on whether one has met the admission requirements. Usually the application is done through the national exam licensure board through website link. After the approval, examination fees will be paid as part of financial preparation. The examination board then releases the official examination timetable available at their website. Depending on whether one is part time or full-time student, one develops a convenient study plan. The study plan should allow adequate coverage of the

examinable course work covered to satisfy the board of examiners. Preparing such flowing study plan is essential in passing the certification exams (Butts & Rich, 2013).



Ideally, the Texas PMHNP has faced series of transitions over the years. The support of practitioners’ agencies in Texas has promoted the growth of nursing practitioners. Texas has guiding academic requirements and practice regulations for nurse practitioners. The Texas Nursing Board defines the relationship between Nurse Practitioners and supervising physician.

Texas practice environment has various similarities and contrast with other states. Future advancement in the PMHNP guidelines will improve the system of the nursing program.



American Psychiatric Association (2016). Practice Guidelines for the psychiatric evaluation of adults. Retrieved from web on March 25, 2018.

Barton Associates. (2017). Nurse Practitioner scope of practice laws. Retrieved from web on March 25, 2018.

Butts, J.B., & Rich, K.L. (2013). Philosophies and theories for advanced nursing practice. Jones & Bartlett Publishers.

Kuo et al. (2013). States with the least restrictive regulations experienced the largest increase in patients seen by nurse practitioners. Health Affairs, 32 (7), 236-1243.

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