Nurse prescribing: what do other professionals think?

April 10, 2009 by admin 

What are the views of other healthcare professionals - doctors and non-prescribing nurses - on nurse prescribing? This is an important question because, if nurse prescribing is to reach its potential, the support and cooperation of other professionals is crucial. Two recent studies have sought to address this and related issues.

In one [1], 12 doctors (seven dermatology specialists and five GPs) and six non-prescribing nurses, all of whom worked with nurses prescribing for patients with dermatological conditions, were interviewed about their views on nurse prescribing in the light of this experience. They were positive about the prescribing practice of the nurses with whom they themselves worked and about the benefits, but they continued to have reservations about nurse prescribing in general and particularly about the importance of extensive experience before nurses start prescribing and about prescribing within limits of competence.

The authors point out that the parameters within which nurses prescribe are not always understood and some of the participants expected negative opinions about nurse prescribing to shift as more healthcare professionals gain direct experience of how it works in practice. The authors then recommend that the standards for nurse prescribing are promoted widely and adhered to.

In the other study [2], a questionnaire survey of all 200 qualified psychiatrists working in two UK mental health trusts, the results from the 149 that were returned suggested that senior doctors had fewer concerns about new nursing roles than their junior colleagues.

Although just over half the consultants felt that mental health nurses should be able to prescribe independently, 80% of junior doctors thought that they should not, although many thought they had a role in out-of-hours prescribing. The junior doctors suggested consistent supervision and limited access to mental health drugs. The senior doctors also had strong ideas about which drugs nurses should be prescribing.

The authors discuss these interesting results in terms of role change and implications for the future. It is possible that the consultants know the senior nurses who are prescribing better than their junior colleagues do, and therefore have had more chance to gain confidence in their abilities. It is also possible that the junior doctors are concerned about their roles in future. The concerns of junior doctors about nurse prescribing need addressing, to avoid conflict and to safeguard the quality of care that patients receive; more research is also needed in this area. Links between nurse prescribers and pharmacists could be a valuable means of support and development, given the importance participants attached to regular practice review for nurse prescribers, but the authors point out that there are few specialised mental health pharmacists in England and that not all mental health trusts have dedicated pharmacy support.

[1] Stenner K, Carey N and Courtenay M. Nurse prescribing in dermatology: doctors’ and non-prescribing nurses’ views. J Adv Nursing 2009; 65(4): 851-859.

http://dx.doi.org/10.1111/j.1365-2648.2008.04944.x

[2] Rana T, Bradley E and Nolan P. Survey of psychiatrists’ views of nurse prescribing. J Psychiatr Men Health Nursing 2009; 16(257-262).

http://dx.doi.org/10.1111/j.1365-2850.2008.01351.x

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