Why aren’t mental health nurse prescribers prescribing?

A lack of support for the prescribing role was one of the main barriers to independent prescribing identified in this study of nurse prescribers working in mental health, with more than half wanting more support from their managers. Another major barrier was seen to be the lack of recognition, in terms of both status and pay, of the extra responsibilities that come with prescribing.

The authors point out that the sample of mental health nurse prescribers in Scotland in this questionnaire and focus group study was small, and that the research was carried out in 2008, when independent nurse prescribing was relatively new in the mental health area. Sixty per cent of the prescribers were not prescribing

They conclude that although further research is needed, possible barriers may be identified from this work, some of which have been articulated previously and some of which are new. One barrier discussed that is specific to mental health nurse prescribing is the impact on the therapeutic relationship and whether there is a potential role conflict between prescribing and mental health nursing. Other issues included delays between qualification and prescribing, the generic nature of the prescribing course and need for pharmacological updates, difficulty in getting medical supervision, and lack of a clear prescribing policy and guidance.

Ross JD and Kettles AM. Mental health nurse independent prescribing: what are nurse prescribers’ views of the barriers to implementation? J Psychiatr Mental Health Nursing 2012; published online ahead of print 1 February.