Master of Science Degree in Psychiatric Nursing Family Psychiatric Nurse Practitioner Certificate. Certificate Family Psychiatric Nurse Practitioner

Transcription

1 Binghamton University Letter of Intent A. Program Identity A1 Proposed Title A2 Proposed Award Master of Science Degree in Psychiatric Nursing Family Psychiatric Nurse Practitioner Certificate Master of Science Degree in Psychiatric Nursing Certificate Family Psychiatric Nurse Practitioner A3 Proposed Beginning Date Spring 2009 A4 Program Description The Master of Science Degree /Family Psychiatric Nurse Practitioner program is a 48 credit, 4 semester program designed to prepare advanced practice nurses for psychiatric settings. Family Psychiatric Nurse Practitioners are prepared to provide assessment and intervention for patients of all ages within the mental health system. Using accepted protocols, graduates will be able to diagnose mental illness and provide behavioral and psychotropic interventions. Students who enroll in the program with a Bachelor of Science Degree in Nursing will complete the entire 48 credit program and will be awarded both the Master of Science Degree and the Certificate. Students who already possess a Master of Science Degree in Nursing will complete 21 to 32 credits, depending upon their area of preparation, and be awarded a post masters Family Psychiatric Nurse Practitioner Certificate. Both the Certificate and the Masters Program include 11 credits of supervised clinical practice. Students may enroll for part time study which will allow them to complete the program in 6 to 8 semesters. Graduates will be eligible for certification in New York State as a Family Psychiatric Nurse Practitioner and will be eligible to take the American Nurses Credentialing Center Examination for national certification as a Family Psychiatric Nurse Practitioner. B. Planning Factors B1 Relationship to Mission The development of a Psychiatric Nurse Practitioner Program at Binghamton University is consistent with the strategic plan for the University. In the Roadmap to the Future which describes ways of implementing the University s Strategic Plan, it states that the University needs to respond rapidly to educational needs resulting from the work world. The document supports educational programs for individuals who could benefit from new courses, certificates and other thoughtfully designed educational experiences. The Strategic Plan of The Decker School of Nursing stresses the role of the School in addressing the health care needs of the region with a special emphasis on the needs in rural areas. The Plan suggests that a Psychiatric Nurse Practitioner Program is an area for growth for the School.

2 B2 Existing Similar Campus Programs The proposed program is unlike any other program on the Campus of Binghamton University. The Psychology Department offers the most similar program, a doctoral program which is clinical in nature; graduates are prepared to provide behavioral therapy and testing for individuals in psychiatric settings and in outpatient care. These graduates, however, are not able to prescribe psychotropic medications. The proposed program should have no effect on the Psychology Program since it is a program designed specifically for nurses seeking an expanded advance practice role, B3 Similar Programs at Other Institutions There are four programs in Upstate New York that prepare Psychiatric Nurse Practitioners. These are: The Sage Colleges School of Nursing in Albany, The University of Rochester School of Nursing in Rochester, The State University at Buffalo School of Nursing, and SUNY Upstate at Syracuse (a newly developed program that will enroll its first students in Fall 2008). There are two programs in the metropolitan New York City area, one at Hunter College and one at New York University. Stony Brook has had a program, however, it is currently not listed on their website. It is unlikely that graduates of programs in the metropolitan area would relocate to the rural Upstate Region that the proposed program is intended to serve. The proposed program at Binghamton differs from these programs in that there will be a strong emphasis on rural mental health. The Decker School has a long standing commitment to preparing advanced practice nurses for rural areas. Rural content is infused throughout the existing programs in family, community health and gerontological nursing. The proposed new program will have the same emphasis on rural issues and recruitment of students from rural areas will be a priority. Our experience demonstrates that this recruitment strategy leads to increased employment of graduates in rural areas. B3 Clinical Placements All local psychiatric facilities (Binghamton General Hospital, Greater Binghamton Health Center, Elmira Psychiatric Hospital, Broome County Mental Health and Broome Developmental Center) have agreed to provide clinical experience for students. Placement of students for the proposed program should not impact clinical placements for any existing programs, except perhaps for Stony Brook should local residents be enrolled in the online program. Since Psychiatric Nurse Practitioners are scarce in the local area (see C Need and Demand) some of the clinical supervision will need to be provided by psychiatrist preceptor. C. Need and Demand C1 a. New York State Need Currently there is a national shortage of psychiatrists. Only 4.3% of practicing physicians are psychiatrists. In the 1950s, 7% of physicians were psychiatrists, but that number has been steadily declining to a low of 4.3% in Between 1999 and 2005, the average number of psychiatric residents per year dropped from 6,078 to 5,754 (5% decline). Although New York State has the highest number of residents in psychiatry and the third highest percentage of physicians that are psychiatrists (8.1%), there is a shortage in the upstate area. In Broome County and the surrounding rural region, the shortage has reached a near crisis state. Every facility in the Southern Tier indicated that they have not been able to hire sufficient numbers of psychiatrists to meet the needs of their patient population. One facility reported that it was necessary to have a psychiatrist fly into the region from Boston every three weeks to 2

3 see patients. Further every facility reported that the need for psychiatric care for children and adolescents in the region is even more extreme. Nurse practitioners have been found to provide effective, cost efficient and acceptable care in a number of health care settings including primary care, hospitals and nursing homes. A psychiatric nurse practitioner working in concert with a psychiatrist using accepted protocols is an effective way of addressing the mental health needs of the region s population. Representatives of every facility in the Southern Tier report that they have openings for psychiatric nurse practitioners but that hiring these individuals is extremely difficult. The Decker School of Nursing has a long history of placing graduates of its nurse practitioners in rural and/or medically underserved regions (30 to 60% of each graduating class). In the late 1990 s, the Surgeon General s Report on Mental Illness (1999) increased the awareness of the mental health needs of Americans, highlighting the prevalence of mental illness as the second leading cause of disability and the second leading cause of premature death in the U.S. However, the report did not focus on rural America, which makes up 90% of the landmass and has approximately 25% of the U.S. population (Bureau of the Census, 2001). The New Freedom Commission on Mental Health, convened to investigate problems in the current mental health system, found that despite the vast proportion of rural America, rural issues are often misunderstood, minimized, and not considered in forming national mental health policy. Too often, policies and practices developed for metropolitan areas are erroneously assumed to apply to rural areas. (Commission Report, 2003). Recent research indicates that rural areas, which are characterized by low population density, limited and fragile economic base, cultural diversity, high level of poverty, and limited access to cities, have cases of serious mental and behavioral health problems, such as substance abuse, depression and suicide, that are equal to or greater than urban areas. There is a significant shortage of behavioral health professionals and specialized behavioral health services; the turnover rate for service providers is high; and the remaining providers often express feelings of isolation from other health professionals. These conditions are exacerbated in areas with concentrations of poverty and migrant and seasonal farm workers (Sawyer, Gale & Lambert, 2006), such as central NYS. The Family Psychiatric Mental Health Nurse Practitioner Program at the Decker School of Nursing will help to remedy the shortage of psychiatric practitioners by developing specialized nurse practitioners who can assess, diagnose, treat (including prescribing medications), and prevent mental illness. Family Psychiatric Mental Health Nurse Practitioners (FPMHNP) promote the mental health for individuals, families, and groups across the lifespan with a nursing focus that involves education, research, and practice directed at the treatment of mental illness and optimizing mental health. FPMHNPs are advanced practice nurses who work in partnership with clients to provide care for the whole individual using nursing science and psychological theory to understand how mental health affects overall health. The Family Psychiatric Mental Health Nurse Practitioner Program at the Decker School of Nursing is unique in that it focuses on the needs of rural populations, so that its graduates can understand and intervene with issues specific to this population, such as barriers to mental health care delivery, the 3

4 development of mental health models that are effective for rural populations, policy issues in rural mental health, and the use of technologies such as telemedicine/health in rural areas. This unique focus will better prepare practitioners to work with the rural populations of central NYS, and will aim to better the recruitment and retention of FPMHNP in this rural area. References President s New Freedom Commission on Mental Health (2003), Achieving the Promise: Transforming Health Care in America, Washington, D.C., United States. Sawyer, D., Gale, J., and Lambert, D. (2006). Rural and Frontier Mental and Behavioral Health Care: Barriers, Effective Policy Strategies, Best Practices. A report prepared for the National Association of Rural Mental Health, Contract Number P. Accessed from the National Association of Rural Mental Health on at: U.S. Department of Health and Human Services (1999), Mental Health: A Report of the Surgeon General, U.S. Department of Health and Human Services, National Institutes of Health, National Institute of Mental Health, Washington, D.C. C1 b. Effect on Other University Institutions The proposed program should not have an effect on other University institutions. C2 Educational or Economic Need The need for nurses to be educated as psychiatric nurse practitioners has been documented above. By providing a program which prepares these practitioners to provide care across the lifespan mental health needs of children, adolescents, adults and elders can be addressed. C3 Student Demand Student demand is expected to be high and steady. It will be assessed more precisely through the use of a formal questionnaire that will be distributed to health care agencies and baccalaureate programs in the region. Part of the assessment will include educating potential students to the opportunities and need for this kind of degree and certificate, especially in rural areas. C4 Employment Needs The following agencies have requested the establishment of the proposed program; Broome County Mental Health Department, Greater Binghamton Health Center, Binghamton General Hospital, Elmira Psychiatric Center and Broome Developmental Center. Each agency indicated that they would hire several practitioners. In addition, State Senator Libous has requested that The Decker School consider such a program and has provided some planning funds. United Health Services, the parent organization of Binghamton General Hospital, has set aside two scholarships to support students enrolled in this program. 4

5 D1 and 2 Headcount Enrollment Full Time Part Time D3 and 4 The proposed program will result in an increase in graduate enrollment in the Decker School of Nursing by approximately 5% in Year 1 and 10% in Year 5. This increase is in keeping with the goals of both the University and The Decker School to increase graduate enrollment. The projected enrollment is based on both an analysis of need and interest in the program. Currently there are six potential students waiting for this program. As stated above, there are agencies and facilities waiting to hire graduates of this program. D5 Cost Requirements and Sources of Funding Cost Requirements Operating $76, , , , ,095 Capital Cost requirements for the program are based on the need for one faculty member in Year 1. Currently the Decker School has one Psychiatric Nurse Practitioner and 3 Psychiatric Clinical Nurse Specialists on the faculty to support the program. As the enrollment grows to a steady state of sixteen students an additional faculty member will be needed to teach the courses and provide clinical supervision for the program. The figures above reflect a 3% annual salary increase. Source of Funding Internal Reallocation Incremental Funding 76, , , , , Funding will be through a combination of grants and internal reallocation of funds. In anticipation of this program, The Decker School has prepared a grant proposal to The Division of Nursing of Health Resources and Services Administration (HRSA). There is an annual request, in the Fall, for proposals from this agency to support advanced practice nursing program. The grant can be submitted once approval is secured for the proposed program. August 20,