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Is collaborative practice still needed?
I would like to express my concerns for Louisiana citizens’ access to mental health care. Statistics show most of Louisiana parishes are underserved in the areas of mental health.1 Individuals who experience mental health issues are one of the highest risk groups in health care today.
I am a psychiatric nurse practitioner with 17 years of experience and provide care to over 600 active patients. This number does not include my services in acute care hospitals, emergency departments (EDs), psychiatric facilities, or outpatient behavioral health facilities. Psychiatric nurse practitioners cover for area shortages due to limited psychiatric providers.
My psychiatrist has 7 psychiatric NPs because he is one of the few psychiatric providers who will collaborate. If something happens to him, the loss of care for over 5000 patients would be devastating to an already fragile mental health care system. The loss would result in a lack of psychiatric services for area drug rehabilitation centers both inpatient and outpatient, EDs, inpatient acute care hospitals, acute psychiatric care facilities, and other behavioral service centers. Some facilities would be forced to scale down services, decrease bed space for patients, and possibly close due to lack of providers. Patients would face month-long waits for provider services due to lack of available resources. Patients who have developed relationships with previous providers might refuse to seek treatment with new ones. The risk of suicide would exponentially increase.
The removal of collaborative practice, allowing nurse practitioners to give care without a doctor’s supervision, was pulled from vote in senate. This move could adversely affect many in Louisiana—including voting senators and their families.
I find it noteworthy that Veterans Affairs (VA) already allows nurse practitioners to work without collaboration.2 The VA recognizes the importance in access to care and the lack of available psychiatric providers, and it has moved to afford veterans access to psychiatric care.
The lack of psychiatric services trickles down to unnecessary hospitalizations, arrests because of psychotic behaviors, and jail time for issues that need mental health—not incarceration.
Louisiana citizens need our support.
Ms Davis is a nurse practitioner in Monroe, Louisiana.
1. Stokowski LA. APRN prescribing law: a state-by-state summary. Medscape. January 4, 2018. https://www.medscape.com/viewarticle/440315
2. US Department of Veterans Affairs. VA grants full practice authority to advance practice registered nurses. December 14, 2016. Accessed August 9, 2021. https://www.va.gov/opa/pressrel/pressrelease.cfm?id=2847