review the following post and provide a reply as a DNP student of at least 250words, NO AI use, REferences different from post from 2020-2026

 

Advocacy competencies constitute one of the roles of DNP leaders. Within an outpatient behavioral health setting, access to care is complicated by stigma associated with mental health illnesses, fragmentation of care models, and lack of insurance parity for psychiatric disorders. At the organizational level, a leader within R&C Psychiatry may support advocacy efforts at multiple levels to optimize systems of care. One nursing leader can help shape organizational policy to create protocols that promote access including advocating for the expansion of telehealth access or shortening patient wait times via expedited intake procedures. A nursing leader may also advocate for warm hand-offs and individualized patient follow-up care protocols to improve long-term outcomes for psychiatric patients at high risk of hospitalization. Standardization of evidence-based protocols within treatment facilities may also be established by nursing leadership to ensure timely access to pharmacological therapies and evidence-based psychotherapy interventions for patients with complex psychiatric illnesses.

Systems-level advocacy could also occur at the governmental level through DNP-prepared nurses voting, supporting mental health-related legislation, and joining professional organizations to advance mental health policies and procedures. Governmental advocacy may include legislation around mental health parity laws, increased Medicaid coverage of behavioral health services, and interventions designed to mitigate social determinants of health that may negatively impact psychiatric populations. Legislative change aimed at these targets is necessary to close gaps in care and mental health disparities (Holly et al., 2022; Trautman et al., 2023).

This week, I completed my leadership hours by observing the leadership practice within R&C Psychiatry. Using the American Organization for Nursing Leadership Nurse Executive Competencies, I observed numerous nursing leadership skills throughout my clinical day.

The first competency, communication and relationship building, was exemplified by this nurse leader building rapport with patients and colleagues alike. Communication involves not only talking but active listening, empathetic statements, and being culturally congruent. This is particularly important in psychiatry as gaining trust from patients can be challenging but promotes treatment adherence.

Knowledge of the healthcare environment was another competency that was fully demonstrated by this nurse leader. They demonstrated working knowledge of outpatient psychiatry regulations including payer restrictions, state Medicaid laws, clinical documentation standards and privacy compliance when navigating the ICANOTES electronic medical record system. Resource stewardship, clinical workflow, and regulatory expertise were vital in providing safe and efficient patient care in this environment.

Leadership was another competency displayed when providing consultation to the provider regarding disposition recommendations for this patient. The patient’s symptoms were complicated by co-morbid medical issues that impacted her mental status, and this nurse knew when to lead and follow during patient care. Accountability and support were promoted by this nurse as she encouraged her staff to seek out answers to clinical questions. Team delegation was also observed during peak productivity times.

Professionalism was another competency this nurse leader exhibited throughout patient care. From holding the patient’s confidentiality to providing emotionally supportive presence, this nurse displayed an exemplary amount of professional behaviors during her shift.

Lastly, business skills were displayed by this nurse leader through her skills in optimizing clinic schedule, productivity during the day, and revenue cycle management. As outpatient psychiatry can be very reimbursement-challenged, balancing productivity and low session fees were vital to allowing patients access to psychiatric services.

From the DNP Essentials lens, I can relate several competencies to this experience. In particular, organizational and systems leadership, population health, and interprofessional collaboration and teamwork. Advocacy can be integrated into all levels of leadership and incorporated into advanced nursing practice to address healthcare disparities and improve access, quality, and equity of care.

References
American Association of Colleges of Nursing (AACN). (2021). The essentials: Core competencies for professional nursing education.

Heinen, M. M., van Oostveen, C. J., Peters, J. W., Vermeulen, H., & Huis, A. (2019). An integrative review of leadership competencies and attributes in advanced nursing practice. Journal of Advanced Nursing, 75 (11), 2378–2392.

Holly, C., Salmond, S., & Saimbert, M. (2022). Comprehensive systematic review for advanced nursing practice. Springer.

Trautman, D. E., Idzik, S. R., & Hammersla, M. (2023). Advancing health policy through nursing leadership. Nursing Administration Quarterly, 47 (1), 12–18.