Community Nurse Prescribing

2348 Words Apr 25th, 2010 10 Pages
This paper aims to explore the role of the V100 nurse prescriber. The development of nurse prescribing will be outlined, followed by a reflective case study in which ethical and legal implications will be discussed and finally a reflective conclusion will be drawn. Where appropriate the paper will be written in the first person (Webb 1992).

Nurse prescribing was first recommended, by the RCN, in 1980 and became part of the government’s policy agenda in 1986 with the Cumberlege Report (DH 1986). Further, the Crown Report (DH 1989) advocated prescribing by trained community nurses from a limited formulary. Legislation was introduced in 1992 -The Medicinal Products: Prescription By Nurses Act, 1992 followed by secondary legislation
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Jane presented with a wound to her lower left leg which, following a holistic assessment (appendix 2), was diagnosed as a venous leg ulcer. The assessment was conducted in accordance with Local PCT Leg Ulcer Guidelines (appendix 3) as well as RCN Guidelines (RCN 2006) to rule out other possible aetiology such as arterial ulceration, diabetes or malignancy (Moloney and Grace 2004). Although traditionally considered uncommon, recent studies suggest that malignant ulcers are more prevalent than previously thought (Miller et al 2003, Taylor 1998) therefore even though initial assessment suggests an uncomplicated venous ulcer, if Jane’s wound fails to heal following appropriate treatment then specialist advice will be sought. Between 17% and 65% of people with a leg ulcer experience severe or continuous pain with a major impact on quality of life (Briggs and Nelson, 2003) and effective pain relief is important to maximise quality of life, to enable mobilisation and improve appetite to facilitate wound healing. Fortunately, Jane experienced no pain from the leg ulcer prior to or at the time of assessment. However, careful review and monitoring of any pain will be important throughout the treatment process as the first line of treatment for uncomplicated venous leg ulcers are compression systems (RCN 2006) and although compression counteracts the harmful effects of venous hypertension and…