Opinion  

Since May 2006, independent nurse prescribers have been able to prescribe from the full formulary. Nurses are expected to prescribe within their competence, and there are some other restrictions. They can only prescribe a small number of controlled drugs independently (although legislation is due to address this), and they cannot prescribe unlicensed medicines.

The area of unlicensed medicines can be confusing. For example, a product may be unlicensed, despite another product containing the same drug having a licence. Meanwhile, mixing two licensed products in a syringe driver creates a new, unlicensed medicine and it seems that this is causing problems for many palliative care nurses.

The use of supple-mentary prescribing and clinical management plans would address this, but it is worrying that many nurses seem to be unaware of this problem, or its legal implications. There is very little specific guidance available and, what's more, it would be difficult for individual nurses to track down expert advice on the matter.

When Independent Nurse spoke to the RCN it was unable to provide advice that would help nurses worried about this situation.

Earlier this year, the college controversially reduced the number of its professional advisers. One of the posts to go was the nurse prescribing adviser, meaning RCN members no longer have access to an individual with specialist knowledge about prescribing practice. This is very short sighted.

The number of nurse prescribers is rising steadily and there will therefore be many more issues like this, or other issues specific to trusts or practices, that nurse prescribers need advice and support on. Surely the UK's largest nursing union should make such a resource available to its members.

Emma Bower, editor, Independent Nurse, emma.bower@haymarket.com

Comment below and tell us what you think