Practice nurses and prescribing

What is the experience of prescribing for practice nurses, how do they feel about it, and what has its impact been on their role? These were some of the issues explored in a small, qualitative study using semi-structured interviews with eight prescribing practice nurses. Their experiences were mainly positive, but some tensions with medical colleagues in particular remain.

Many or all of the nurses felt that there were benefits for patient care through prescribing, that there were misunderstandings among practice staff about their role, that it is both ‘imperative and intuitive’ to follow appropriate guidance, that their role had changed as a result of prescribing, and that they were unwilling to prescribe outside their competence or boundaries. Some felt that workload had increased. It emerged during the interviews that minor illness is increasingly being incorporated into the role of these nurses. Although some GPs welcomed the change and were supportive, others were less happy about it and lacked understanding about the nurse prescriber’s role and competency.

The authors make some recommendations: all staff working with prescribing nurses should get full explanations of the circumstances in which they can prescribe; after the initial mentoring period, doctors or experienced nurse prescribers should provide a further period of mentoring and supervision, to further mutual respect and understanding; and a continued learning or system of monitoring could be introduced to help nurse prescribers demonstrate their credibility – as nurses’ roles extend, something like the GP performance monitoring system may become more appropriate. Clearly, as the authors point out, this is a small study and further work is needed.

Daughtry J. and Hayter M. A qualitative study of practice nurses’ prescribing experiences. Practice Nursing 2010; 21(6): 310-314.