The Power to Prescribe

# 46

Posted: 21/12/2011 14:03

Anon, I don't know about the medical definition but the common understanding of active ingredient usually refers to whatever ingredient hasan action on the illness. For example the active ingredient in a Lemsip capsule  would be paracetamol and a small amount of ascorbic acid (vitamin c), it would not be fillers, sugar or starch.

Badger, I cannot imagine why anyone's "hair would go on fire at the thought of nurses prescribing" It sounds like a commonsense approach. Unless of course you mean the complaint of vested interests. While removing the ward shift component from nursing training would be a retrograde step (afterall this is a requirement for junior doctrs as well), I think including a prescribing course as well, would be entirely positive this time instead.

# 45

Posted: 22/05/2011 04:17

The main impetus driving nurse prescribing should be to improve patient care and limit healthcare costs. Most prescribing should still be done by doctors. Nurses in Ireland would need a lot of training before being able to prescribe extensively. NCHDs are becoming thin on the ground due to the removal of training funding, the lack of career advancement  and the issues with overtime not being paid. Patients often suffer while waiting for overworked NCHDs to arrive to prescribe medication. Nurses could prescribe a limited number of medications such as paracetamol, stemetil, senna, lactulose and IV fluids and they could follow rigid protocols like robots to reduce the chances of everyone's hair going on fire at the thought of nurses actually being allowed to take responsibility for a clinical decision without having millions spent on a by-the-numbers nurse prescribing program. Seeing as the 4th year of a nurse's degree involves 9 months of ward shifts, surely some provision could be made for nursing students to do a nursing prescribing course at this time instead? (I am an NCHD.)

# 44

Posted: 03/01/2008 17:43

Anonymous, Why are you so hooked on 'active ingredients'?
What do you mean by 'active ingredients' anyway?
Do you mean chemicals?
All 'ingredients' in all things are active in some way otherwise we would have no drugs whatsoever. To think that most drugs come from a herbal/plant source originally does not make them any less active.
They are just as 'active' in their original format. The only difference is that the Pharmo comps have hijacked them simply for financial gain.

# 43

Posted: 19/12/2007 10:33

The argument regarding legislation is perfectly valid. Just becuase other areas are not governed by legislation doesn't not make homoepathy's lack of governance any more right.
There are not homeopathic hospitals in this country
Given that homeopathics cannot contain any active ingredient, by law, how then can their effect be any thing more than a placebo?

# 42

Posted: 18/12/2007 16:25

Anonymous,
There are no regulations governing a vast amount of areas in this country. Your argument is irrelevant in this case.
There are homoepathic hospitals, there are homoepaths that treat people.
There are people who respond to this treatment.
Whether you believe that or not is not the point.
It works for lots of people where sometimes allopathic medicine does not.

# 41

Posted: 18/12/2007 12:54

Simply declaring someone to be wrong does not make them so or your argument any stronger.
Under EU law, homeopathics cannot contain any active ingredient. I didn't pass the law, I'm only stating what it is.
There are no regulatory State or statutary bodies governing or regulating those who describe themselves as homeopaths in Ireland. If you have information that suggests otherwise, please tell us.

# 40

Posted: 18/12/2007 08:24

You are wrong, on both counts. :)

# 39

Posted: 14/12/2007 09:03

Again, homeopathics cannot by law contain any active ingredient (as in any ingredient actually designed to have an effect on the illness it is trying to treat - you cannot treat people with an active ingrediatn which,, in homeopathics, does not exist) so I don't know how you can qualify them as medicines.
There are no regulatory bodies (state or otherwise) governing or regulating those who describe themselves as homeopaths in this country.

# 38

Posted: 13/12/2007 19:12

Oxford English Dictionary: Medicine: 2. Any drug or preparation used for the treatment or prevention of disease, esp. one taken by mouth.

I believe that allopathic and homoeopathic treatments work best in tandem. Homoeopathic medicine can often help where medical doctors have been unable to.

As to regulation, etc., if you are thinking of using homoeopathy why not investigate these for yourself and only proceed if satisfied?

# 37

Posted: 13/12/2007 10:45

Given that homeopathics cannot by law contain any active ingredient I don't know how you can qualify them as medicines.
There are not regulatory bodiues (state or otherwise) giverning , inspevcting or regulating those who describe themselves as homeopaths in this country.

# 36

Posted: 12/12/2007 15:25

The word is 'homoeopath,' not 'homeopathist.'

By way of correction to the recent post about homoeopathy, homoeopaths have their own association and regulations. There are many medically qualified homoeopaths, and these are obviously qualified to prescribed pharmaceutical medicines as well as homoeopathic medicines. There are five National Health homoeopathic hospitals in the UK. Nonmedical homoeopaths only prescribe homoeopathic medicines.

# 35

Posted: 12/12/2007 10:46

Homeopathists perscribing?????

Sure they have no medically approved or scientific training at all and they don't even have a recognised standard.

# 34

Posted: 11/12/2007 20:19

To Anonymous Posted: 08/12/2007 17:29
You have a severe attitude problem and an obvious problem with nurses.
You study pharmacology for 5 years so you should know your subject inside out. Where were you when the country was on aulin?
None of the nurses on here have even attempted to suggest that they know all about pharmacology. Surprise Surprise, neither do Doctors. That is why they rely SO HEAVILY on MIMS!
Nurses and Doctors do a broader and more complicated training.
Using your logic we should dispense with Pharmacists altogether and get Homeopathists in the hospitals instead. After all they do 7 YEARS training.

# 33

Posted: 08/12/2007 17:29

It's typical of the Nurses who post here to get the detail wrong, Pharmacists do not train for 4 years THEY TRAIN FOR FIVE YEARS!.

If you are stupid enough to try and compare the vast knowledge (and much more difficult degree) Pharmacists' have in such subjects such as Pharmacology and Pharmacokinetics with the woeful Knowledge Nurses have in these areas - there is no hope.

I sincerely hope nobody here falls victim to the basic errors I have witnessed on wards such as nurses that didn't know the difference between grams and milligrams.
Once that idiot Liam Doran wakes up, and stops this dangerous behaviour from his "profession" I will rest easier.

# 32

Posted: 04/07/2006 17:30

Strange Sioban but nurses in the UK have had limited powers to perscribe for years and there has been no \"disaster\" in fact it has improved patient care quite commendably.
Medicaid patients are not subjected to nurses playing the role of the \"pseudo doctor\" but are treated (as are other caegories of patients, where appropriate by Nurse Practitioners. These are not Drs and have never claimed to be.
The high rate of litigation in the US is in the field of consultancy not Nurse Practitioner.
There is already a process in place to deal with medical error. Perhaps is Nurses had perscribing power less mistakes would be made in perscribing by junior D\'s, past the point of exhaustion, after their 3rd 24 hour shift that week.

# 31

Posted: 04/07/2006 13:52

What is the matter with Mary Harney and anyone to do with the world of medicine? Her, the nursing lot and the doctors seem to be on some sort of crusade to annihilate the general public. Giving nurses power to prescribe is a recipe for disaster. There is no way a crash course in pharmacology can match the depth of knowledge a doctor possesses or indeed that of a pharmacist. Has anyone noticed this great and wonderful report was produced by a nursing body? The above article stated \"The review was carried out by An Bord Altranais (the Nursing Board) and the National Council for the Development of Nursing and Midwifery.\" So what are the odds of this lot turning around and finding fault with such thinking? It doesn\'t work, take America for example where Medicaid patients are subjected to an awful lot of exposure to nurses playing the role of the pseudo doctor. By no coincidence these people have a rather high rate of litigation. I wonder why? Could it be due to a lack of interaction, consultation, and appropriate prescribing from a more suitably qualified person? This more active role thing is something I can only suggest nurses and doctor\'s practice on each other. If the general public had wanted such a disastrous idea I\'m sure we\'d have petitioned for it a long time ago. Just because something is the done thing in certain other countries doesn\'t mean it\'s the right thing. Clearly these great and wonderful self-regulating people have not done their homework right. Or if they did they chose not to finish the story.
If we must be forced to endure such appalling practices then I would like to see some legislation introduced to allow me full access to free Legal Aid. I would also like tax free compensation for any blunders this lot commit and separate courts to deal with the matter of medical error.

# 30

Posted: 22/12/2005 11:02

Well done Olive. Nursing is more than a job. It is a vocation. I hope to apply for nursing as a mature student myself in 2006. Fingers crossed I will get a place.

# 29

Posted: 19/12/2005 10:43

I would like to clarify a few points please.
Firstly nurse prescribing is not either new or will it be an ad.hoc arrangement. This had be piloted and monitored closely by An bord Altranais and by the Health Service Executive. It will not lead to nurse diagnosing and then prescribing just any medication.
Prescribing will be within appropiate guidelines and protocols and specific medications.
I feel the reason why some nurses are reluctant to take this on, is because with all additional responsibilities that have been taken on over the years, nurses have not received that appropiate pay increment to reflect this responsibility,although the An Bord Altranais and Indemnity fees continue to rise.
I have been a nurse for 16 years and my patient care has been my top priority despite poor hospital conditions and high stress levels that will continue to be my remit and the reason why the profession is more that just a job it is a vocation!

# 28

Posted: 19/12/2005 09:47

"healthcare workers " - could be anyone from Dr's who would hate to see any shred of their power taken away, to admin staff who know absolutely nothing aobut drugs and their interactions.

# 27

Posted: 17/12/2005 23:29

I think it's interesting that those above who have identified themselves as other healthcare workers tend to be the people who are against nurse prescribing. What does that say?

# 26

Posted: 14/12/2005 13:54

Anon 11:55 - if you read John Williams posting above yoyu will see that this is precisely the trainign the nurses undertake at a senior level.

# 25

Posted: 14/12/2005 11:55

If nurses are given the right to prescribing, then I believe PHARMACISTS should be allowed to play a bigger role than nurses purely because pharmacists spent most of their time studying about drugs!
However, if nurses are to prescribe, I think they must undergo extensive training and appropriate education regarding prescribing.

# 24

Posted: 13/12/2005 23:03

I am afraid many of the comments on this topic are coming from people who don't understand the subject. Firstly, only certain catagories of nurse specilaist will have prescribibing rights and the formulary to be used will be restricted to the speciality within which the nurse works. I do know that in diabetic clinics and in asthma clinics specialist nurses are very clued in to the management of these diseases. All this will be carefully planned so many of the posters above can cool down a bit.

# 23

Posted: 13/12/2005 18:42

as a nurse specialist in emergency care, I have to aggree with most of the posts above. I personally think the advent of nurse prescribing particulary in specialist fields such as emergency care, respiratory, diabetes,community based practice and other areas of care which contain clinical nurse specialists or advanced nurse pracctitioners will be of great benefit to both patients and nursing as a profession alike. The education needs of a clinical nurse specialist consists of 4 years undergraduate training a minimum of 2 years experience and then a minimum of 1 year at higher diploma level, which is 7 years in total training in oder to qualify as a CNS. The training of an advanced nurse practitioner is at masters level and takes a minimum of 7 years to complete. the arguement then by lcollins is inaccurate. The pilot programme which was run by An Bord Altranais consisted of a further year of education which focused intensely on pharmacology and issues surrounding medication management(I have undertaken this course). So to put peoples' minds at rest any nurse who will be granted prescribing powers will be more than qualified to undertake this role. The implementation of nurse prescribing will also take place in collaboration with other key stakeholders, namely medical practitioners and pharmacists, and as with any extension in the role of nurses over the last few years will be very tightly monitored. To Priya, I urge you to call into an emergency department and spend some time with an advanced nurse practitioner to see just how far nursing practice has evolved since Florence Nightengale used to make beds.

# 22

Posted: 13/12/2005 08:12

Priya - you are very clearly completely and utterly ignorant of modern nursing practise and cureent Nurse Practitioner training.

# 21

Posted: 12/12/2005 20:16

I don't think we should start flinging personal insults. This is supposed to be a discussion about whether we think nurses should be allowed to prescribe medicines. I think we are all aware that nurses do far, far more than merely make beds. The question is whether their very intensive training should be extended to take in drug prescription. I presume that only senior nurses would be doing this, and I see advantages for the patient, but also disadvantages. I would prefer to have my drugs prescribed by a doctor, with nurses being able to write return prescriptions for those which I am well used to using.

# 20

Posted: 12/12/2005 15:54

four years training to learn how to make a bed?!
what a laugh

# 19

Posted: 12/12/2005 14:50

pHARMACISTS TRAIN FOR FOUR YEARS BUT NURSES ALSO train for four yars and oftentimes know a patient better than dR'S, MANY OF WHOM DON'T BE BOTHERED TO COME AND LOOK AT THE PATIENT FOR HOURS.

# 18

Posted: 12/12/2005 12:04

linz, of course not all of you are dizzy blondes, i never said that. but there are some very irresponsible nurses out there hence the bad reputation. I'm sure there are plenty of very professional nurses out there who should have the power to prescribe more so than some doctors out there but in my opinion i don't think it'd be a good idea simply from my experience of some nurses.

# 17

Posted: 12/12/2005 12:02

While working in a Hospital I saw countless errors being made by nurses administering drugs eg giving penicillin to the wrong(allergic!) patient. if they were given prescribing powers there would be more deaths in Irish hospitals. Is this what you really want? All because you can not be bothered to wait for a properly quailified doctor?

# 16

Posted: 12/12/2005 11:52

actually i am a doctor and have worked with plenty of irish nurses, many of whom are clueless. if they make mistakes the chances are its the doctors who will pay the price.
last time i checked, nurses had no proper pharmacology training...would you let a nurse fix your car? then why would you want them to prescribe medication for you?
if it was so simple you wouldnt have to train for 6 years to be a doctor or train for 4 years to be a pharmacist, would you?

# 15

Posted: 12/12/2005 11:25

Liam, you are completely and utterly wrong. A nurse is not doctors aid not is she or he a lay persons version of a doctor but a totally different role altogether.
Nurses as part of their job are the first medial professionals to evaluate a patient and are perfectly qualified to do so.

Anonymous 17:35, clearly, you do not kno the vast majority of
Irish nurses.
I would prefer a nurse with limited powers of perscribing looking after me, than waiting in agony for 6 hours to see a Dr., who frequently will first ask the nurses opinion - as she or he also has the appropriate knowledge of human physiology and pharmacology.

# 14

Posted: 11/12/2005 17:35

i dont think many irish nurses would be bothered taking any sort of responsibility so i dont think nurse prescribing will happen in practice.
i certainly wouldnt want a nurse prescribing for me. i would prefer someone with appropriate knowledge of human physiology and pharmacology to decide what drugs i can have

# 13

Posted: 10/12/2005 01:42

a nurse is not a doctor, period, a nurse is a doctors aid, period. a nurse is not qualified to evaluate , administer, or evaluate the need to administer drugs .
a nurse is a laymans version of a doctor. a professional helper only, 4 years only, not 7 years or more.

# 12

Posted: 09/12/2005 11:32

I have spent much time in hospitals in the last two years and have met some wonderful nurses and have met some idiots and cruel ones. Many nurses have no idea what half the medications I take are. I am frequently asked to spell them and tell the nurses what they are for and what they do. It is a dismaying experience to be the expert when you are the patient. However many nurses actually do read journals etc and are up to date on all medical matters. I say give them the power but it must be limited as per experience - just like doctors. How many doctors have you met that are jerks? I have had many a doctor and even a few pharmasist give me the wrong drugs and wrong combinations. Only for the fact that I read up on all my drugs things could have turned out worse. In every profession there are people that are easy riders, take life too easy and this applies to nurses, doctors, teachers, lawyers, engineers - of which I am one of the above but am not telling which one.

# 11

Posted: 09/12/2005 11:03

I was under the impression that pharmacists are pursuing the the objective to have limited prescribing power.

# 10

Posted: 09/12/2005 09:51

The power to prescribe drugs is not something nurses should accept without due consideration of the implications for patients, themselves and the legal system .
As a nurse specialist I can identify times when prescribing powers would certainly have proved beneficial.e.g. when patients were admitted under the care of a general physician rather than a specialist who asked our advice anyway and acted upon it. However I am reticent to accept independent prescribing powers if this brings additional personal costs to bear in the purchasing of public liability insurance. Nurses don't earn a phenomenal salary as it is. Further the approval of a Consultant/ Specialist Registrar re your decision making in prescribing is essential for the protection of all parties involved.

Two Questions: What is the Pharmaceutical Society's response to nurse prescribing? Pharmacists have a wealth of knowledge in this regard, why are they not pursuing prescribing rights?

Not all nurses are dizzy blondes! Nor are we stealing medications from our employers to supply family and friends. It is objectionable to suggest otherwise. Most of us are hard working, conscientious individuals who do our utmost to provide optimal patient care with oft times scant resources.

# 9

Posted: 05/12/2005 15:08

Of course they shouldbe aloowed perscribe and they are in the bUK, US, Sweden and Australia.
Afterall, they know the patients better and this will help aleviate pain, and trauma for the patient

# 8

Posted: 05/12/2005 10:06

I agree and i also think they should be aloud administer intervenis at home to patients in contact with Doctors. That would also free up some bedspace as you cannot receive IV in Ireland unless you are in Hospital.

# 7

Posted: 04/12/2005 16:30

Yes i think nurses shoulb be let prescribe drugs they are with patients on the ward's for 14 hour shifts and know their patients while the doctor only visit's the patients on his rounds and ask's the nurses all about their sickness so give them the power