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Prescribing is an art nurses can't master

I read with interest your story about medical bodies' concerns over nurse prescribing (News, 21 December).

It takes more than 18 months of learning about the pharmacological action of drugs during medical training.

I was alarmed to read that nurse prescribing is to be extended to issuing scripts for the use of drugs about which nurses have limited knowledge.

To gain appropriate experience, non-medical people should go through an intensive pharmacology course to learn about the mode of action, interactions and side-effects of drugs.

The Government has acted irresponsibly by giving the green light to non-medical prescribing. Prescribing multiple drugs is an art and even after 35 years I make sure I keep abreast of new drugs and their mode of action.

Dr J Dhillon, Folkestone, Kent

I read with interest Dr Anila Reddy's views on nurse prescribers and practitioners (Letters, 14 December).

Along with many nurse practitioners (NPs), I share his frustrations at the lack of regulation of the NP role. The Royal College of Nursing, Nurse Practitioner Association and others have campaigned for many years to have the role registered.

This principle has now been accepted and taken forward by the NMC. Standards and competencies for the role have been agreed, and the proposal is now with the Privy Council – where it has unfortunately been for many months.

The NMC is unable to act until it receives the agreement of the Privy Council. Many of us are increasingly frustrated by the unexplained delay.It seems many GPs and NPs share similar concerns. Perhaps we need to work together to lobby the Privy Council.

Anne Baird, nurse practitioner, Sheffield

The overwhelming lack of support from various medical bodies for the rolling out of nurse prescribing to enable appropriately trained nurse prescribers to prescribe from the full formulary (News, 21 December) is depressing, ill-considered and ill-informed.

What the various medical critics of this advance in patient care seemingly fail to realise is that no nurse is going to prescribe any drug other than one on which the nurse has performed a stringent checklist and been rigorously taught and examined on a degree-level prescribing course.

The fact the full formulary is available does not mean that a nurse will prescribe any or every drug but rather that there is the possibility to prescribe any drug in that nurse's area of competency or expertise.

In many cases – for example, in palliative care or other clinical nurse specialist roles – an experienced nurse will know far more about her specialised area of prescribing than most junior doctors.

What the various medical bodies similarly ignore are the standards set out by the Nursing and Midwifery Council, drilled into nurse prescribers during their training.

These emphasise among other core values the paramount principles of patient safety, clinical competency and accountability. These should preclude the major prescribing disasters they seem to envisage.

Deborah Stevens, nurse practitioner, Surbiton, Surrey

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