Nurse prescribers resisting ‘mini-doctor’ role

Nurse prescribers were resisting becoming ‘mini-doctors’, striving instead to maintain a holistic, patient-centred nursing style while adopting prescribing, in this small, interview-based study of nurses who prescribe for people with diabetes and their colleagues.

The nurse prescribers wanted to retain the nursing focus – including holistic assessment, health promotion and patient-centred care – that they see as particularly important in the care of people with diabetes; doctors interviewed concurred that this style of consultation was important. Flexibility over consultation times is therefore vital and had been the subject of discussions in some settings. Interestingly, it is not the introduction of prescribing by nurses that threatens this model but the drive for greater service efficiency.

Perceived approaches to decision-making provided some interesting contrasts: nurses in general practice were seen as tending to make decisions within current guidance or protocols, referring to a doctor where necessary; diabetes specialist nurses (DSNs), however, reported that their roles involved the higher levels of decision-making skills traditionally associated with doctors – using clinical judgement to prescribe outside standard protocols. In general practice, nurses’ prescribing decisions were often monitored by doctors, perhaps because they were prescribing a wide range of medications including those for comorbidities. DSNs were highly specialised, prescribing from a narrow range of diabetes medications.

Stenner K, Carey N and Courtenay M. How nurse prescribing influences the role of nursing. Nurse Prescribing 2010; 8(1): 29-34.