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Blog: Palliative care and the benefits of nurse prescribing

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I have just done a non-medical prescribing workshop for Macmillan Cancer Support staff. I was asked to do the workshop to provide information and advice for those professionals working for Macmillan who might want to consider undertaking the Non Medical Prescribing training and subsequently a prescribing role.

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.

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Readers' comments (1)

  • I am a CNS in community specialist palliative care and undertook the second NMP course in manchester. i have been an advocate of this extra skill...particularly in my field and feel it is shortsighted of nurses not to undertake this for the very reasons stated in this article. We can provide seamless care in the community, and have far more experience than most medical staff. we also spend far more time with our patients and families. i do , however, feel that it is a great responsibility, and feel that we should be financially rewarded for this extra the buck now stops with us !!

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