Non-Medical Nurse Prescribing

Topics: Medical prescription, Nursing, Nurse Pages: 9 (2878 words) Published: February 12, 2011
This paper will demonstrate the author’s ability to prescribe safely from the Nurse Prescribing Formulary (NPF 2009-2011). A prescribing situation undertaken by myself while supervised by my mentor will be discussed. The patients name, address, date of birth and GP details have been changed to ensure patient confidentiality in accordance with the Nursing and Midwifery Council (NMC)(2004). The patient therefore will be referred to under the pseudonym Prince Charming. Nurse prescribing was first suggested by the Royal Collage of nursing (RCN) in 1980, it was to take another six years for it to become part of the government’s agenda with the Cumberlege Report in 1986 (Department of Health and Social Security (DHSS)(1986). These two report as well as the Crown report (DH 1989), Prescription by Nurses Act, (1992) and the Medical Prescription by Nurses Act (1994), lead to The Nurse Prescribing Formulary being introduced nationally in 1998. These acts give community nurse like myself the opportunity to improve their skills and improve patient’s access to care. The patient a 32 year old man attended the district nurse clinic with a laceration to his right shin. Within my practice I assess patients with the use of the Neighbours (1987) consultation model. By using this model i feel that I can build a therapeutic relationship with my patient which helps gain an understanding and concordance with their treatment. I introduced myself informing him of my name and asked him to explain what the current problem was in his own words. Timmins (2007) believes that by introducing yourself warmly and welcoming you begin to build a good rapport with your patient, thus building a good nurse-patient relationship which is an important aspect of patient concordance Latter (2010). I used open questions to help my patient divulge as much information as possible and then close questions to extract specific information. With any patient a full holistic assessment is needed, the skill of assessment is more important, however with the introduction of nurse prescribing. While (2002) suggest that nurse need to become more efficient at these skills if they are going to prescribe. I asked Prince Charming if he had any allergies he replied “None that he knew off” I asked if he had experienced any reaction to drugs/dressings in the past he again replied “None that he knew off”. He advised me that he was not taking any prescription medication from his General Practitioner (GP) and that he did not take any over the counter medication apart from ibuprofen occasional for back pain. He also advised me that he did not use any herbal or homeopathic remedies, Greener (2009) claims that a nurse prescribing any item for a patient should always enquire if they take over the counter, herbal or homeopathic medication as Otway (2004) considered this safe practice Brookes (2007) also agrees with this. He did not have any medical conditions and was normally fit and healthy. Due to Prince charming answering “None that he knew off” I contact his GP to confirm that there was no record of allergies/reactions that he wasn’t aware off, when prescribing for a patient it is good practice whenever possible to access patients records NMC (2006). Anderson (2002) states that patient’s records should clearly record any allergies or reaction they have had in the pass so mistakes cannot be made. Royal Collage of Nursing (RCN) (2005) would agree and considers accurate record keeping a key issue in limiting misunderstandings and improves communication between GP and Nurse. Bradley et al (2007) study found that relationships between nurse prescribers and other medical professionals improved greatly with the use of the NPF (2009-2011). However Fisher (2005) disputes this as he feels that GP’s sometimes expect too much of nurse prescribers refusing to prescribe for patients if they know they are, or can be seen by a nurse prescriber. Fisher (2005) also suggests that prescribing complicates...
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