The palliative care nurse who ran the workshop with me Michele Kent, gave a moving case study of 'Rachel' - a 42-year-old woman who was up until an OOH contact unknown to her, suffering with brain metastasis and whom she visited over the weekend with the district nurse.
Rachel had suddenly deteriorated following radiotherapy and Michele had some very challenging decisions to make regarding careand prescribing decisions. Listening to Michele deliver the case study reminded me of the amazing assessment skills we have as nurses.
Not only did Michele assess the present situation, but through asking the family for a recent photograph of Rachel, she took into account the contrast between when the photo was taken and the Rachel's current condition, which was almost unrecognisable. She explained her reasons for her prescribing decisions, some of which were challenged by people attending the course. Michele explained each point, giving valid reasons why she chose the particular decision, all of which those challenging ultimately agreed were good choices.
Michele explained to delegates that she had initially been unwilling to undertake prescribing training, but that her organisation had demanded prescribing as part of her role. She is now an advocate of non-medical prescribing having realised its benefits for patients, herself, the organisation she works for and the NHS as a whole: patients have faster access to medicines; crises can be avoided; there is usually more time than OOH doctors are able to give for discussion and explanation with family - in this example Rachael was able to stay in her preferred place of care and died comfortably at home 2 days later.
In short, Michele has a greater sense of job satisfaction and is able to give complete episodes of seamless care. Being able to prescribe is certainly challenging, but is also liberating and motivating, and is proving to be most beneficial in so many areas and for so many patients.
Fiona Peniston-Bird has arranged 3 Non Medical Prescribing, Continued Professional Development events which will be held in London during 2008. The first on 9 April is for those working in primary/community care, the second being held on 20 May is for mental health and the third, on 10 July, is for secondary care.