CONSTRAINTS TO ADVANCED PSYCHIATRIC MENTAL-HEALTH NURSING PRACTICE

Constraints and barriers to advanced practice psychiatric nursing were reported by respondents of the Primary Mental Health and Advanced Pra ctice Psychiatric Nursing survey of certified psychiatric clinical nur se specialists. Primary data (N = 507) were the qualitative responses to a survey item about constraints and secondary data were the literat ure and theoretical memos. Methodology was based on principles of qual itative data analysis and procedures for manifest and latent content a nalysis. Findings resulted in eight themes that explained both constra ints and barriers to advanced practice: (1) reimbursement, (2) prescri ptive authority, (3) admitting privileges, (4) bureaucracy, (5) practi ce environment, (6) colleagues, (7) image, and (8) personal. Themes we re interpreted within the context of regulatory, market-based, and int er/intraprofessional constraints and barriers that led to suggestions for organizational and individual strategies for action, The survey wa s funded by the Society for Education and Research in Psychiatric-Ment al Health Nursing with technical support from the Center for Mental He alth Services, Copyright (C) 1997 by W.B. Saunders Company.