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Nurse prescribers are not novices

From Debbie Hilton

Independent nurse prescriber Guildford, Surrey

I am alarmed by the story about nurse prescribing (News, 5 October). You make us sound like gung-ho novices and not professional and experienced people.

I have worked in general practice for over 20 years. I have done one course after another over the last 14 of those years and am considerably more up to date clinically than many doctors in primary or secondary care. I am currently doing an MSc in advanced clinical practice.

In the time I have been working in primary care, I have over the years, as many others will have done, generated prescriptions for the patients I have seen, diagnosed and treated – which GPs have then signed and very rarely changed.

I have been an extended nurse prescriber and now independent for the past three years and I value and respect this qualification, as indeed do my patients. It allows me to take responsibility for the decisions I make, which is how I feel it should be. I wish to enhance my patients' care and practice, not to compromise or commit harm by it.

Your description of the training as 26 days only, does not take into account several aspects: the training we have done over the years, the experience we have and our professionalism. A nurse is far less likely to prescribe inappropriately, or dangerously, than a doctor. We abide by our code of practice and prescribe within our levels of competence and confidence.

• From Ghislaine Young

Nurse practitioner, Bradford

GPs' view of nurse prescribing is based on nothing but prejudice, with not a shred of evidence.

When is the medical profession going to stop feeling threatened by the new nursing roles and begin to realise that developing nursing is good for patients and doctors? Doctors will be freed to see patients of a different complexity who need their specific skills and education.

The strange thing is that when some doctors are asked to comment on nurse practitioners, their knee-jerk response is negative. But then if you asked this group of doctors the same question once they have worked with a nurse practitioner, then the response is wholly positive. They even encourage their colleagues to include nurse practitioners in their clinical teams!

Nurses and doctors should acknowledge that they need each other to fulfil their roles to the best advantage of their patients. Nursing and medicine has always been a symbiotic relationship, and when we work in partnership and make an effort to communicate effectively the outcome is win for the patient, win for the nurse and win for the doctor.

• From Dr Kate Simpson and

Dr Rod Sutcliffe (GPs) and

Angela Barrow, Catherine Gill and Wendy Iles (nurse practitioners)


The doctors who responded to your survey clearly know very little about nurse prescribing. No examples of patients being endangered were quoted.

Nurse prescribers are usually more experienced clinicians than GP registrars and have undergone an education module at first degree or masters level involving up to 400 hours of study, supervised clinical experience, and rigorous clinical and academic assessment.

How many doctors have studied prescribing at masters degree level? How many are familiar with every drug in the BNF? Nurses prescribe, like doctors, within the limits of their professional competence.

We have extensive experience of teaching, supervising and assessing nurse prescribers. They are knowledgeable, skilled, careful, responsible and professional in their prescribing. Doctors are not professionally responsible for nurses' prescribing.

Some GPs need to wake up to the benefits for patients and for themselves of professional development and interdependent working, of which nurse prescribing is a good example.

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