Nurses To Prescribe Medicine

ShandyLynnRN, BSN, RN · Nov 29, 2002

No WAY!!! There was nothing in my training about prescribing. Granted, it would be nice to not have to call the doc to get tylenol or dulcolax....but then again, well... just no way!!!

**canoehead, BSN, RN** · Nov 29, 2002

Nursing does everyone else's job, without extra pay, they just pawn off "this one little thing" Seems like this could be another of those. Although I don't argue that we have the ability to appropriately prescribe some meds I like the definite dividing line between what we can and can't do. And the same result of convienence and fast response to pt needs can be accomplished with standing orders from a physician.

nurseman · Nov 29, 2002

Outpost nurses can prescribe limited medication in Canada without being a NP.

We got isolation pay but nothing extra.

http://www.hc-sc.gc.ca/fnihb/ons/nursing/resources/clinical_guidelines/index.htm#Introduction

A class drugs are those that a nurse is authorized to prescribe independently.

B class drugs are drugs that may be prescribed only by a physician.

C class drugs are drugs that a nurse may prescribe for one course of treatment.

D class drugs are drugs that a nurse may administer for one dose only, in an emergency situation; any subsequent doses must be authorized by a physician.

**SKM-NURSIEPOOH, BSN, RN** · Nov 29, 2002

...to have rns without advance practice degrees prescribe medication...even if it's only on an one-time basis or not. the only way to allow this to happen is have rns go through a specific course & become certified in order to prescribe certian or limited medication from certain classes. but then again, they would end-up being an advance practice nurse in the us right??? so what's the point???

originally posted by nurseman
outpost nurses can prescribe limited medication in canada without being a np.
we got isolation pay but nothing extra.

http://www.hc-sc.gc.ca/fnihb/ons/nursing/resources/clinical_guidelines/index.htm#introduction

a class drugs are those that a nurse is authorized to prescribe independently.
b class drugs are drugs that may be prescribed only by a physician.
c class drugs are drugs that a nurse may prescribe for one course of treatment.
d class drugs are drugs that a nurse may administer for one dose only, in an emergency situation; any subsequent doses must be authorized by a physician.

nurseman · Nov 29, 2002

A bit of clarification as to what an outpost is. The hospital wing I worked at was in a s a fly in only community of about 1700 people. You could drive a truck up on the ice road two months a year. The rest of the year we were surrounded by swamp. When we were lucky we had 11 nurses working and a doctor who flew in on Tuesday and out the next day. The rest of the week we were on our own. In the year and a half I work there I saw one NP who stayed 3 months. Turnover at the hospital was around 40% for RNs.

My scope of practice was far greater up there then it is here in civilization. Of course here I can walk to a clinic and see a doctor, up there I would have to be flown 200 KM to one.

http://www.jamesbayhospital.org

flowerchild · Nov 29, 2002

This article link is found on this BB "Latest Nursing News", I thought that was what this thread was about when I saw it. I'm posting the article for those who missed seeing it.

Pharmacists will prescribe a limited range of drugs

New powers allowing pharmacists and nurses to prescribe drugs from early next year have been finalised.

The move should allow patients with asthma, diabetes, coronary heart disease and high blood pressure quicker access to medicines.

Under the scheme, after diagnosis, patients will no longer need to re-visit their doctors for prescriptions.

This development means that pharmacists will make fuller use of their five years training and expert knowledge in medicines

Marshall Davies

Instead, patients would be able to get medicines prescribed by a pharmacist or nurse, with agreement from a doctor.

Staff will undergo comprehensive training before becoming 'supplementary' prescribers.

The aim is to have up to 1,000 pharmacists and up to 10,000 nurses trained by the end of 2004.

Training for pharmacists will begin in the spring, and new courses for nurse prescribing will be available from early in the new year.

Health Minister Lord Philip Hunt said: "This move has real potential to provide better and quicker patient care, and to make much better use of highly skilled pharmacists and nurses, by giving them delegated powers to prescribe drugs to patients in partnership with GPs or hospital doctors."

Pharmacists pleased

Marshall Davies, president of the Royal Pharmaceutical Society of Great Britain, said: "Our profession welcomes supplementary prescribing.

The current antiquated arrangements are insulting to the many highly trained nurses

Professor David Haslam

"The ability to prescribe will allow pharmacists to take a more active role in delivering care to the benefit of patients.

"This development means that pharmacists will make fuller use of their five years training and expert knowledge in medicines."

Sarah Mullally, Chief Nursing Officer for England said: "This type of prescribing will be a very useful addition to the practice of nurses, many of whom already manage a variety of long term conditions and health needs for their patients.

"Nurses often advise doctors on prescribing decisions in their specialist area, and the introduction of supplementary prescribing will allow nurses to write many of those prescriptions themselves."

GP reaction

Professor David Haslam, Chairman of the Royal College of General Practioners, welcomed the initiative.

He said: "The current antiquated arrangements are insulting to the many highly trained nurses who already effectively make prescribing decisions, particularly in areas like diabetes or asthma management, but who then have to find a doctor to sign the prescription.

"With the right safeguards in place, this will be of benefit to nurses, doctors, and particularly patients - saving everyone time, and increasing teamwork, skillmix, and efficiency."

The proposals for prescribing stem from the recommendations of the Review of Prescribing, Supply and Administration of Medicines, published in 1999.

The Department of Health plans to issue guidance on supplementary prescribing early next year.

donmurray · Nov 29, 2002

Re UK nurse prescribing. It took 20 years, and three "pilot studies" to get it off the ground, and past the obstruction of the medical profession.

OC_An Khe · Dec 1, 2002

Why not? Most medication changes and additions that are done in the Hospital setting are done based on the RN's assessment of the patients condition. Many MDs just ask the RN what the patient needs/ or asks what was forgotten and then tells the RN to write it. Granted there is a check and balance here , but it goes both ways.

No matter who prescribes the drug, if it is wrong and the RN gives it, the RN has liability.

Home Health Columnist / Guide · Dec 1, 2002

BBC News reports:

Nurse prescribing role expands

http://news.bbc.co.uk/hi/english/health/newsid_675000/675582.stm

Nurses 'frustrated' at prescribing limits

http://news.bbc.co.uk/hi/english/health/newsid_1312000/1312232.stm

RCN(Royal College of Nursing) Policy briefings :

Extension of Prescribing Rights for Nurses

http://www.rcn.org.uk/professional/professional_policybriefings_prescribing.html

Extended Prescribing of Prescription-Only Medicines by Independent Nurse Prescribers

http://www.rcn.org.uk/professional/professional_policybriefings_medicines.html

Sense a BIG OPPORTUNITY here... see no reason why experienced RN's (say over 5 years) with an addtional pharmacy course shouldn't be allowed to prescribe commonly used meds from an approved classification list.

fab4fan · Dec 1, 2002

In the ED where I work, the docs don't care if we go ahead and give kids with temps tylenol/advil (drug/dose approp. for wt. and temp.), or ntg sl for someone who has just come through the door with CP (we get the EKG first, and I throw a hep well in, too, before I give the ntg.).

In my area, there are just some drugs that you KNOW you'll wind up giving for certain dx., but I feel that actually prescribing should be limited to AP nurses.

mattsmom81 · Dec 1, 2002

If it is done in limited protocol form I might support this move. ( proper safeguards and guidelines in place etc)

Since protocols and standing orders are already in common use...I see this as only one half step farther IMO.

I would not support the granting of prescription privileges to all nurses in all situations, but in special circumstances limited powers for nurses could be a godsend...particularly in rural, underserved areas.

Peeps Mcarthur · Dec 1, 2002

I don't think nursing educators would be willing to include the sciences in anything more than the prerequisites. A little chem101 in prerequisites, then they forget about it and learn some side-effcts in a class called "pharmacology" and think that's enough to pass meds safely.

Nursing schools are not prepared to educate in anything more than the psychosocial aspect of dispensing medication:rolleyes:

It would take a complete overhaul of curicculum and instructors to simply teach pharmacokinetics. The mechanisms by which chemicals interact with each individual is beyond understanding in this soccer-mom-psychology curicculum that nursing will never let go without a fight.

The masters level programs don't look like they teach much more than that either, with exception of an MSNA. I've looked at NP programs and they don't seem to make-up for lower level nursing's anti-medical-model curicculum.

Nursing has worked hard to separate themselves from anything resembling medical science, and having them dispensing medications after training in psychology would be an unfair burden on the licenses of nurses with too much to do now.

It would be a complete disaster, given what I have seen of the curicculum.

Nurses To Prescribe Medicine

(Under limited conditions) Should nurses be allowed to prescribe medicine?