Does the recommendation that future PMH-APRN be educated in the NP role mean that APNA / ISPN are abandoning existing PMH-CNS?

Absolutely not! APNA and ISPN remained committed to existing PMH-CNSs and view them as an essential component to PMH advanced practice nursing. The recommendation that all new PMH-APRNs will be educated in the NP role is more a recognition of the current state of affairs than a recommendation. Data from ANCC shows the number of candidates passing their CNS exam has been steadily declining over the last decade. Over the past ten years there has been an average decrease in the number of CNSs taking the exam for the first time of 41% per year. At this rate, the data suggests that by 2015 that there will be zero new CNS certificates awarded. See the attached graph which is based on data from the ANCC website on number of new certificates awarded in all PMH APRN roles.

The recommendation is one that affects the future education and does not apply to any of the existing certified CNSs. Both APNA and ISPN recognize that currently certified and licensed CNSs have the appropriate credentials to practice and teach. Furthermore, we have received assurance from ANCC that it will continue to offer recertification to all ANCC certified CNS for as long as those certified CNSs continue to practice. (Even if there are no new applications for the PMH-CNS exam.)

The other nursing organizations outside of PMHN support existing PMH-CNSs as being able to continue to function in their role since the Consensus Model states that as part of each state’s foundational requirements for licensure that the Boards of Nursing:

“…institute a grandfathering clause that will exempt those APRNs already practicing in the state from new eligibility requirements.”

Grandfathering is defined in the Consensus Model as:

“Grandfathering is a provision in a new law exempting those already in or a part of the existing system that is being regulated. When states adopt new eligibility requirements for APRNs, currently practicing APRNs will be permitted to continue practicing within the state(s) of their current licensure.
However, if an APRN applies for licensure by endorsement in another state, the APRN would be eligible for licensure if s/he demonstrates that the following criteria have been met:

  • current, active practice in the advanced role and population focus area,
  • current active, national certification or recertification, as applicable, in the advanced role and population focus area
  • compliance with the APRN educational requirements of the state in which the APRN is applying for licensure that were in effect at the time the APRN completed his/her APRN education program, and
  • compliance with all other criteria set forth by the state in which the APRN is applying for licensure (e.g. recent CE, RN licensure).

Once the model has been adopted and implemented (Date to be determined by the state boards of nursing. See proposed timeline on page 14-15), all new graduates applying for APRN licensure must meet the requirements outlined in this regulatory model.”

The Task Force recommendation that “Currently licensed and certified PMH APRNs who demonstrate their competency by continuing re-certification, should be permitted to continue practicing under their current license and certification” speaks directly to the grandfathering provisions in the Consensus Model. The Task Force feels strongly that APNA and ISPN must take a strong position to assure that this provision in the model is implemented and enforced.

Under the Consensus model no one who meets current eligibility criteria is required to go back to school. For those CNSs that elect to do so, APNA and ISPN will convene a coalition on advance practice education to help those who seek to become certified as NPs to find the appropriate educational opportunities to achieve NP certification.
If you additional comments or questions please forward them the Task Force via APNA Executive Director, Nicholas Croce Jr, at ncroce@apna.org.