I thought this went without saying, but after reading the comments on a story about nurses, it apparently still needs to be said out loud.
Yes, nurses study pharmacology. That’s why we’re the people who administer all the medications in hospitals. We also study pathophysiology so that we know why people need those medications.
Last week, the media reported on an approved plan for Registered Nurses to do further study and training to become medication prescribers, not just medication givers.
This elicited some peculiar responses along the lines of “do nurses even study pharmacology?” and “no offence nurses, but I’m not comfortable with that”.
Offence taken, Janet. Please know, they don’t just let anyone loose in the medication room with opioids and chemotherapy drugs.
The idea that nurses blindly follow orders is one of the misrepresentations that stubbornly lingers about a highly educated and skilled profession.
Nursing is already a job that requires continuous education and training. That can be as simple as the annual study requirements to keep your registration and job, including medication and drug calculation tests; or post-graduate study to work in specialty areas, such as critical care or oncology; or Masters and Doctorate programs to work in clinical leadership roles.
Nurse Practitioners, who hold Masters Degrees, are already qualified to prescribe medications.
For experienced nurses to be able to diversity even further and become medication prescribers is not a stretch when you know what we already have to study and then do on the job.
In terms of medications specifically, there is something called the Seven Rights of Medication Administration. To be able to give a patient any medication, you have to accurately tick off seven rights: right patient, right medication, right dose, right route, right time, right reason, right documentation.
In terms of knowledge, the big one on this list is “right reason” – that’s where your pharmacology and pathophysiology knowledge comes into play.
You have to know how a medication acts on the body at a cellular level and why the patient needs it. You have to able to do patient assessments and know if medications are safe to be given.
For example, it’s not safe to give a patient their usual medications for hypertension if they’ve deteriorated with sepsis. Or blood thinners to someone who fell over and potentially has a brain bleed.
The clinical judgements that nurses make day in day out, and the reasons we escalate to nurses-in-charge and doctors, are based on years of study and experience. And we are constantly referring to medical/pharmacology resources for things we don’t know.
Where I work in ICU, a patient’s regular medications change drastically once a life-threatening, critical illness changes their whole physiology.
We have to know all the medications of Advanced Life Support; the doses, how to prepare them and how they work; what can be given in a small peripheral vein versus a large central vein; and how to assess the response.
A nurse’s knowledge is extensive and our primary role is always to advocate for our patients.
The new accreditation that will allow qualified nurses to prescribe medicines is an extension of that and something the Australian Nursing and Midwifery Federation has spent many years advocating for.
Last week it was approved by Australia’s Health Ministers and will come into effect in mid-2025. It’s called the Registration standard: Endorsement for scheduled medicines – designated registered nurse prescriber (the standard).
To apply for the endorsement, experienced nurses must complete a post-graduate qualification and a clinical mentorship program.
Once approved, those nurses will be able to prescribe Schedule 2, 3, 4, and 8 medicines (which includes pharmacy only medicines and opioid analgesia) in partnership with an authorised health practitioner.
The landmark reform is considered especially important for people living in rural and remote areas to be able to access timely healthcare.
The ANMF has played a key role in developing the new standard and says it will improve the quality and efficiency of Australia’s healthcare system.
“This is a game changer for the nursing profession, and it will lead to improved health outcomes for people requiring care,” ANMF Senior Federal Professional Officer Julianne Bryce said.
“Experienced RNs are well placed to prescribe medicines in a safe, effective and timely way that leverages their expertise, allowing them to work to their full scope of practice whilst providing responsive, efficient, person-centred care.”
I remember first starting out in nursing school and the panic I felt in our first anatomy and physiology lecture when I thought the study material was for the whole first semester. Nope. It was the first week.
I remember being gobsmacked at the degree of difficulty to become a Registered Nurse because the human body is so incredibly complex, and I took it very seriously because patients deserve nurses who have as much knowledge as possible.
It took six years to become a qualified Critical Care Registered Nurse and it’s not a job where you can ever phone it in.
For nurses to become qualified to prescribe medications will no doubt follow the same standards of academic rigor and clinical expertise as every other part of the job.
LEARN MORE HERE:
Registered nurses given green light to prescribe medicines starting mid-2025 – ANMJ
Looks like you had a fantastic trip!