Nurse prescribing in the UK – where did it start?

In the beginning

It sounds unbelieveable, but Nurses could not always precribe. It was in 1998 that they were given access to a limited formulary. It was only due to loobying by Baroness Cumberlege and the RCN that this took place. Presumably Doctor’s groups were unimpressed with this development.

Where are we now?

Nurse prescribing is now well established. According to the NMC there are over 55,000 nurse and midwifery prescribers in the country. Over 13 million items a year are prescribed by Nurse prescribers according to the NHS prescription authority.

What’s the difference?

Nurse Independent Prescribers

They are allowed to prescribe any drugs within their clnical competence. Since the ruling in 2006 they have been able to prescribe any drug within the BNF. This has sometimes caused friction with Doctors ! Since 2012 they have also been able to prescribe controlled drugs.

Community Practitioner Nurse Prescribers

These fall under the NIPs, but are restricted to prescribing only from the Nursing Formulary for Community Practitioners. This group includes health visitors, district and school nurses.

Nurse Supplementary Prescribing

This a form of a voluntary prescribing partnership between a doctor and a nurse where the supplementary nurse prescriber has the ability to prescribe any drug listed in a patient-specific clinical management plan. The patient must have a definite diagnosis given by the doctor.

How can I qualify as a nurse prescriber?

A NMC accredited prescribing course through a UK university must be done. All nurses who complete the NMC qualification can prescribe independently as well as in a supplementary capacity.

How do I train or qualify to be a nurse?

Training to be a nurse requires a pre-registration nursing degree. Once you have this you can register with the NMC. This will then allow you to practice. The great thing is you won’t pay any university fees. As the degree is funded by the NHS.

Choosing your branch of nursing

There are four branches of nursing that the pre-registration nursing degrees are offered in.

Adult
Children (paediatric)
Learning disability
Mental health

You will need to decide which branch you would like to train in. Some universities allow you keep your options open. Others might give allow you to have two specialties under your belt.

The pre-registration degree or course

These are offered by universities. Entry requirements vary depending on the the university you choose. Generally they are quite flexible. However, some top universities require a ABB in A-levels.

The course leads to a BSc (bachelors of Science). It can also be a BN (Bachelor of Nursing). It can be full time, or part time. The full time degree will take three years for a single field. If two branches are chosen then it can take four years. Part time courses will take longer. Degrees generally take a year more in Scotland.

Students will obtain the foundations they need to follow this challenging, responsible and valuable vocation.

Nursing is diverse and has many demands. Degree courses aim to instil and diffuse all of these skills which include: academic and technical skills. A good sense of humour, being patient and compassionate.

Foundation year

The foundation year or first year of the nursing course is which is common to all who study to be a nurse. Basic knowledge in biochemistry, anatomy and physiology, and communication is imparted. Other subjects in this year include skills to do with nursing and caring.

2nd and 3rd year

In these years, nurse students study the specialisation they have chosen.

Ongoing practical teaching and experience – participatory learning

Nurse placements in clinical settings such as hospitals as well as other settings are plenty during the course of the degree. They are fundamental to providng the basics of Nursing. Observing the patient journey can provide an insight into the workings of the health service.

Once you graduate as a nurse

Nurse graduates will have to apply to the NMC for registration. Once approved they are given an NMC pin number which will then allow them to work anywhere in the UK. Obviously, working in the NHS is the first port of call for many. However, private healthcare and working abroad are common.

Don’t forget nurse revalidation and CPD

Being a nurse is very much becoming like being a Doctor. Life long learning and reflection for self improvement. Remember that once you graduate, learning does not stop. Document any courses or CPD you do. Reflect on at least 5 of those in 3 years. Gather feedback about your practice. And every three years apply for revalidation.

All posts by Julie Spencer

Nurse prescribers in the UK