What barriers to nurse prescribing remain?

It is clear that despite the rapid growth in nurse prescribing, some obstacles remain, particularly in certain clinical areas. Two recent articles discuss some of these issues.

In one [1], the author traces the recent development of nurse prescribing and how it is now being implemented and argues that although it is now mostly supported by doctors, and there has been much progress, some barriers remain.

As predicted, the proportion of nurses qualified to prescribe independently who use supplementary prescribing has fallen since the formulary was opened up. According to Professor Molly Courtenay, that figure is now 20%, down from 40% in 2006, and she points out that some nurses prefer to use supplementary prescribing, to help build confidence and skills, or because their patients have complex conditions.

Some trusts are, however, requiring nurses to practice as supplementary prescribers for a period after qualifying, for a variety of reasons. These policies have their critics and can be seen as frustrating obstacles. Other restrictions include a lack of training and support once nurse prescribers have finished the course, as highlighted by recent research.

Another article [2] discusses nurse prescribing in mental health in Scotland, which has been slow to take off, and shows that evidence about what the barriers are is lacking, concluding that there is an urgent need for research in this area.

[1] Lomas C. Nurse prescribing: The next steps. Nursing Times 2009; 14 July.

[2] Ross J. Researching the barriers to mental health nurse prescribing. Nurse Prescribing 2009; 7(6): 249-253.