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RCN defends prescription training

The Royal College of Nursing (RCN) has defended the amount of prescriptions handed out by nurses after an academic called their diagnosis skills "pathetically poor".

The magazine Pulse compared figures from May 2006 with figures for May 2007 and found the number of prescriptions issued by "independent nurse prescribers" increased by 49%.

Professor Hugh McGavock, visiting professor of prescribing science at the University of Ulster, said he has "serious concerns" over the data.

He said: "Nurses' knowledge of diagnosis is pathetically poor.

"It takes medical students five years to be competent to make a differential diagnosis. Only a country with not enough doctors would go down this cheapy line."

But RCN general secretary Dr Peter Carter said: "Nurse prescribing has been a historic move for the nursing profession, and it is one of the most successful parts of the current NHS reforms.

"Far from being the problem Professor Hugh McGavock suggests, nurse prescribing has proved itself to be an important part of the solution in improving access to medicines and cutting waiting times for patients.

"Research shows that the majority of nurses who prescribe have at least 10 years' nursing experience before starting their prescribing training, and must have either degree or masters-level education."

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Your comments: (Terms and conditions apply)

"I am a respiratory nurse specialist, having trained for over 30 years, with a vast backround of acute and chronic disease management. I have worked autonimously for over 10 years, and have proven on many occasions to possess diagnostic skills, and effective management, according to the approved guidance and within my competencies. Having worked with doctors for many years as well, it is a shame that they are not all keeping up to date with treatment changes and effective chronic disease managment. In fact I have worked with a consultant who it seems cannot even write a correct prescription, either the doseage is wrong, the spelling of the drug is wrong or worse still, it is not the approved and best treatment for the individual  patients. Perhaps the professor has not had a wide enough experience of working with able nurses, who are trained and have worked using varied skills, and have proven to their own clinical leaders their competencies, and even better, those nurses who know when to refer onto a clinician, as they are sure the patients needs further input from a colleague who may be a doctor or another professional. However, I do feel that 'junior' nurses should not be prescribing unless they are limited to their own speciality. You cannot put an old head on young shoulders. The experienced nurses usually have at least three to five years postgraduate experience in my opinion, not one year" - Name and address supplied

"Having read the comments of Professor McGavock what annoyed me the most was that as he feels we are 'pathetically poor' at making a differential diagnosis he is in effect questioning our professional accountability as nurse prescribers. A major component of the course focuses around the legal, ethical and professional accountability of nurse prescribing. As previously stated, nurse prescribers are very experienced nurses often working in specialised areas with a lot more knowledge than a newly qualified doctor. To say that we are the 'cheapy option' is very offensive to nurse prescribers who are justifiably proud of our qualification - Anna Taylor, Practice Nurse, Ipswich

"I agree with the previous comments. What the Professor forgets is that we have many years experience and have developed advance clinical skills. The training I had and the assessment process I went through to become an independent prescriber was far more robust than the training our medical students have (their words not mine). Throughout the training I had a GP mentor and my mentor continues to be my clinical prescribing supervisor. As nurse prescribers we only prescribe within our field of practice and contrary to what the Professor says my medical colleagues are delighted that we have these skills and are taking on new roles" - Irene Taylor, Community Matron, Newcastle PCT

"Nurses are taking on more advance roles and these have been evaluated positively by both patient satisfaction rates and outcomes. It will be interesting to note that the prevalence of skin conditions have risen and of course more are treated in the community as opposed to the hospital. Therefore it should not come as a surprise that the numbers of prescriptions have risen. We could of course ask patients to buy treatments including antibiotics etc like they do in the EU. Which method would the Professor [McGavock] advocate? Welcome to the 21st Century professor" - Name and address supplied