Community Nurse Prescribing
This paper aims to explore the role of the V100 nurse prescriber. The development of nurse prescribing will be outlined, followed by a reflective case study in which ethical and legal implications will be discussed and finally a reflective conclusion will be drawn. Where appropriate the paper will be written in the first person (Webb 1992).
Nurse prescribing was first recommended, by the RCN, in 1980 and became part of the government’s policy agenda in 1986 with the Cumberlege Report (DH 1986). Further, the Crown Report (DH 1989) advocated prescribing by trained community nurses from a limited formulary. Legislation was introduced in 1992 -The Medicinal Products: Prescription By Nurses Act, 1992 followed by secondary legislation,
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Accountability is at the core of nurse prescribing and the NMC (2006) states that practitioners should only prescribe within their level of experience and competence. It is appropriate to prescribe treatment in Jane’s case as, in line with the RCN (2006) and local guidelines (appendix 3); I have undertaken the specified training and am competent in this area of nursing practice. As well as being accountable to the patient and the NMC, practitioners are also accountable to their employer (Dimond 2004) and should prescribe in conjunction with employers guidelines and formulary, whilst at the same time ensuring that decision are based on best available evidence (NMC 2006). Therefore, following assessment and diagnosis the Local Leg Ulcer Formulary was utilised (appendix 4) to guide appropriate treatment and prescribing, as well as the Local Trust’s Non-Medical Prescribing Guidelines (appendix 5). It is also essential to be familiar with the DH document “Medicines Matters” which gives guidance on the mechanisms available for prescribing and the supply and administration of medicines (DH 2006) as well as “Organisation with a Memory” (DH 2001) which encourages the reporting of errors to enable learning from mistakes, a change from the traditional culture of blame.
Before prescribing treatment it is important to have an open discussion with the patient, regarding all options, to achieve concordance. Concordance is