The Nursing Council is taking time out to refine its proposal for lower-level ‘community’ nurse prescribing but pushing ahead with ‘specialist’ nurse prescribing.
The decision was made at the Council’s meeting in late September after considering sector feedback to its proposal to introduce two levels of registered nurse (RN) prescribing in addition to nurse practitioner (NP) prescribing.
Council chief executive Carolyn Reed said it remained committed to both the ‘community’ and ‘specialist’ RN prescribing levels “but we’re ready to go ahead with one and not the other” at the present time.
She said most of the nearly 200 submissions were “really positive” but there had been quite a lot of feedback about the proposed education requirements for community prescribing being inadequate and highlighting complexities around the proposed list of drugs for community prescribing.
The council has decided to do further work on developing the community nurse prescribing proposal, particularly engaging an expert advisory group to provide council with further advice on the proposal’s drug list.
“We’re going to take a little bit more time on that but going to try and move the other proposal forward.”
She said the council was starting to develop a formal request to Health Workforce New Zealand to go ahead with the ‘specialist’ nurse prescribing proposal and it was also seeking another title for that level of RN prescribing. The move follows the rolling out of diabetes nurse specialist prescribing after a successful demonstration project in 2011.
Reed said the consultation feedback on ‘community prescribing’ had backed the council’s belief that there was a need for that level of RN prescribing as ‘specialist’ RN prescribing would not solve the problems of patients in rural and remote areas and for nurses working out in the community.
“The consultation responses actually enhanced that thinking even more, as people gave examples of patients not getting health care in a timely manner because nurses were not able to prescribe.”
After considering the analysis of the consultation feedback, the council has also decided to develop guidance for nurses on standing orders and prescribing by proxy.
The initial consultation document proposed that community prescribers needed to have a minimum of three years nursing and a community prescribing course of up to six theory days and three days supervised practice with a GP or NP to be able to prescribe medicines for minor ailments and infections. The specialist nurse prescriber proposal requires nurses to have a postgraduate diploma in prescribing and 150 hours supervised prescribing experience with a medical mentor so they can treat common conditions in their specialty area.
