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Why the push for nurse prescribing?

I am concerned at the effort NZNO is making in support of nurse practitioners (NPs) gaining prescribing rights. As far as I am aware, there is already a group of health professionals diagnosing and prescribing medication: doctors. Why do we need another profession taking over a role, which, to me, is one of the fundamental differences between nursing and practising medicine? The arguments in Favour of nurse prescribing just don't seem logical. Why have someone who can only prescribe in a defined clinical area, pay them roughly what you would pay a doctor when you could actually have a doctor who could prescribe to everybody?

One of the main reasons offered in support of nurses prescribing is that they would be able to prescribe in the rural setting. How many NPs do we actually have working in a rural setting? From what I understand there are very few. I also understand there are very few GPs wishing to work in these areas. Is this a nursing problem? Shouldn't we look at the bigger picture and see why doctors choose not to work in these areas?

An example given in last month's Kai Tiaki Nursing New Zealand (Nurse prescribing a reality at last, p10-11) is of an NP being able to "treat Chlamydia without referring young clients on to GP care". The test for Chlamydia is a laboratory procedure that nurses can order. Why would a nurse spend at least a further three years' study to write a prescription themselves, when a two-minute phone call to a GP will achieve the same outcome?

Why does NZNO continue to spend members' money on promotion, advisory groups and magazine space for something that only affects a tiny percentage of the nursing workforce? Even with the best will in the world, the number of NPs is never going to be huge and their effect on communities' well-being, in my opinion, will never justify the current over-the-top lobbying for this position.

What is the real need for nurses prescribing? Is it realty that we want to help people access health care? Or are some nurses driven by a deep envy of doctors, wanting to be just like them, or as close as they can? I am proud to be a nurse, and see no reason to take on a role done by another profession for centuries. There are many things nurses do that doctors will never be able to do.

Garth Edwards, RN, BN, Hastings

The co-editors reply: International evidence shows that nurse prescribing is safe and effective for patients and improves access to care. Nurse practitioners (ALP), unlike medical practitioners, will only be able to prescribe within their defined clinical areas of practice, with those prescribing conditions placed on their annual practising certificates.

NZNO, as the country's largest professional nursing organisation, has contributed expertise and advice on the development of the NP role and on nurse prescribing. While there are just 17 NPs at present, more than 100 nurses are seeking endorsement as NPs, so the pool of NPs will continue to grow. Kai Tiaki Nursing New Zealand has simply reported on this significant development within the profession.
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Author:Edwards, Garth
Publication:Kai Tiaki: Nursing New Zealand
Article Type:Letter to the Editor
Date:Nov 1, 2005
Previous Article:Nurses must learn to care for themselves.
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