Prescribing medicines gives status

In the Netherlands, nurse specialists (Masters Advanced Nursing Practice) were recently granted the authority to prescribe medicines. In a number of other Western countries, nurses already had this authority. NIVEL researchers asked medical- and nursing associations in these countries about their views on this development. Their study was published in the International Journal of Nursing Studies.

In Australia, Canada, Finland, Ireland, New Zealand, Sweden, the United Kingdom and the United States of America, nurses are allowed to prescribe medicines. Since January 1 this year, nurse specialists in the Netherlands are also allowed to prescribe medicines and it is expected that later this year diabetes,- COPD- and oncology nurses will follow. In most countries, nurses’ scope of prescribing practice is rather limited and legal responsibility lies mainly with the doctors. The exception is formed by the United Kingdom, where every nurse is allowed to prescribe a wide range of medicines after completing a three month prescribing course.

The researchers asked professional nursing and medical associations in the countries concerned about their views on nurse prescribing of medicines. That proves to be diverse. Medical associations primarily look upon nurse prescribing as an inevitable development because of the shortages of medical personnel, for example in rural areas. They state that if a nurse prescribes a medicine, the doctor should have ultimate responsibility. Nursing associations, on the other hand, emphasize that nurse prescribing fits the expertise and possibilities of, for example, nurse practitioners. Therefore, they mostly state that nurses should have the legal authority to prescribe medicines.

NIVEL programme coordinator prof. dr. Anneke Francke: “The reasons that professional nursing and medical associations bring up when it comes to nurses’ prescriptive authority, have consequences for the scope of this authority. In those countries where nurses are only allowed to prescribe medicines because of a shortage of qualified personnel, their authority is limited. However, if you emphasize that nurses are allowed to prescribe medicines because of their expertise, then that gives the profession a higher status. This can be important for the attractiveness of the nursing profession.”