Patients ‘confident’ about nurse prescribing

In diabetes care, patients were confident about nurse prescribing and reported improved access to medicines and greater efficiency, in this interview-based study. The 41 patients with diabetes were under the care of a seven nurse prescribers – some general practice nurses and some diabetes specialist nurses.

Interestingly, the patients were able to demonstrate specific improvements in efficiency and access – for example, being able to get an appointment with a nurse at short notice. Nurses were seen as more flexible than doctors but doctors’ time was also perceived as more important! So, nurse prescribing had contributed to improving the service in ways which patients noticed and cared about.

Patients expected teamwork among health professionals, preferring to see doctors for conditions perceived to be more serious or undiagnosed, and expected nurses to have had the necessary training and experience, as well as specialist diabetes knowledge, if they were to prescribe. Confidence in their ability to prescribe was inspired by these attributes and also patients’ direct experience, nurses’ willingness to refer to doctors or others when unsure, good communication skills, and attention to detail.

Patients of the diabetes specialist nurses expected the nurse prescriber to prescribe new medication or equipment but only that related to diabetes. In contrast, some patients of the general practice nurses saw the role as monitoring and continuing to prescribe medication initiated by the doctor although others were happy for the nurse to prescribe medicines for co-morbidities – there was a varied range of views among these general practice patients.

The authors conclude that workforce planners need to include services provided by nurse prescribers alongside those of doctors.

Courtenay M, Stenner K and Carey N. The views of patients with diabetes about nurse prescribing. Diabetic Medicine; published online 8 June 2010.