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| Author | Comment |
Simon Higgs
 Oct 25, 07 - 9:44 AM |
Nurse prescribing in Acute Pain
I am interested to know if many people working in Acute Pain are prescribing and what are you able to prescribe. Are you able to prescribe PCA's or epidural solutions? |
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Glenn
Oct 25th, 2007 - 9:54 AM |
Re: Nurse prescribing in Acute Pain
The option to look at nurse prescribing is one that we have debated in our Trust. We personally took the line that nurse prescribing was a route that we did not want to take, as we see our role as an educational and supportive one (and put simply if we go in and prescribe the F1's will never learn to do so effectively) It's a difficult one, certainly from a day to day point of view our job would be quicker and easier if we prescribed - but we feel that our current practice will have a longer term benefit. |
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Wendy G
Oct 25th, 2007 - 10:09 AM |
Re: Nurse prescribing in Acute Pain
I have to agree with Glen, if we do it, the medics will not bother to review analgesia, or consider their own prescribing habbits. It takes a lot of effort to convince prescribers that regular analgesia is different to PRN (which rarely gets given as often as it is needed) If I were to alter it the junior docs would never get the message! |
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Ros
Oct 25th, 2007 - 2:31 PM |
Re: Nurse prescribing in Acute Pain
I agree. It's easy to get prescriptions written and to be able to suggest medication and doses and support junior doctors as an acute pain nurse. I see nurse prescribing as being more useful in the community where there are fewer people able and available to prescribe. Ros. |
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Dawn
Oct 26th, 2007 - 12:46 PM |
Re: Nurse prescribing in Acute Pain
I have been a nurse prescriber since 2005, and it has helped my role immensely. We recieve acute pain referrals on a regular basis and queries with regards to problems with PCA's and Epidurals. Obviously if an epidural fails then we can prescribe the alternative medication or change the patient onto a PCA with it's accompanying adjuvants, without having to rely on the doctors arriving to do this. If the surgeon's/medics ask us to see patients with an acute pain problem, traditionally we assessed them, diagnosed the pain problem and then transcribed or suggested what treatment should be given. This can create some time delays and it seems only reasonable, considering that they have asked our expert opinion, that we should then be responsible for prescribing the suggested treatments. This has helped our role immensely and although we document everything in the patients notes, we also tend to verbally inform the medics/surgeons what we have prescribed and the reason's for this (which ultimately acts as an education session for them). The formularly is still restrictive in terms of controlled drugs at present but this is due to change in the new year. 
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Dee
Oct 26th, 2007 - 2:42 PM |
Re: Nurse prescribing in Acute Pain
There are 4 nurses in our team and we are doing the NMP course one after the other.One has already completed NMP, one has just started the course and the other two will follow. We do mixed acute and chronic pain so as well as the ability to prescribe in the acute situation, we envisage being able to adjust medication at nurse-led patient follow-up clinics in the future. We feel that the ability to prescribe will enhance, not detract from the educational aspect of our role as we will still be discussing the plan with staff and recording plan and rationale in notes. The benefit will be for the patient who will actually get the appropriate treatment on the day we see them :-) |
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Sarah P
Oct 28th, 2007 - 4:05 PM |
Re: Nurse prescribing in Acute Pain
I think nurse prescribing will, as has been pointed out, make the 'day-to-day' role much easier, but I have to go along with the train of thought that suggests that we should be teaching the F1's to prescribe well, rather than bailing out their poor analgesia choice/prescribing by being able to prescribe for their patients. |
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Sue Carter
Oct 28th, 2007 - 4:59 PM |
Re: Nurse prescribing in Acute Pain
I think the simple fact is that, like many 'extended roles' nurse prescribing would be a great idea if it were an adjuct to sytems that already exist. Sadly, however, I think it is likely to be seen as an easy way of reducing house officers workload (and, therefore, their education) |
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Charly
Oct 30th, 2007 - 11:55 AM |
Re: Nurse prescribing in Acute Pain
We have just had our PGDs passed so can prescribe one dose of co-codamol, diclofenac, ibuprofen, bupivacaine and cyclizine. We are also, one at a time, undertaking the nurse prescribing course. We will, of course, continue to nag F1's into prescribing correct dosages etc! 
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