There are things called something like Patient Prescribing Directives available.
they have to have a clear way of selecting patients, and doses etc. With these
and the appropriate back-up from the hospital authorities including signitures,
a doctor can take responsibility for Nurse prescribing. Tis allows ENP's in
MIU's to do all the things they do so well. The only perk I have found that
applies because I am registered with the GMC is that I can take responsibility
for prescribing whereas someone who isn't can't.
----- Original Message -----
>From: "Dr. Tudor Codreanu" <[log in to unmask]>
>To: <[log in to unmask]>
>Sent: Friday, February 08, 2002 11:43 AM
>Subject: Nurse delivered analgesia
>
>
>> I wonder if other A&E Centres have a different approach to Nurse
>> administerd analgesia.
>> In our department, I am told, nurses cannot prescribe simple analgesia (ie
>> paracetamol) to the patients while waiting to be seen, unless at the
>> doctor's request.
>
>politics pure and simple
>
>Nurses except for some District Nurses and Health Visitors cannot
>'presecribe' at present, most of the arrangments outside of some ENPs and
>Walk in centres which is supply of a limited quantity of medication, are
>supply and adminster single doses, and then these arrengements are in my
>experiernce mainly about event cover - as a Nurse on duty with SJA at
>present i can supply and adminster four different drugs ( aspirin in chest
>pain, paracetamol , oxygen and entonox, five if you count oral glucose as a
>'drug') , which is the same as the ambulance crews and a good proportion of
>the first aiders and unless i can convince my county Nursing officer and
>county medical officer this won't change - although i understand London SJA
>has a more formalised system beyond individuals making agreements with the
>CNO and CMO)
>
>> As pain is a major triage criteria to me it seems illogical for fully
>> qualified A&E nurses (even at ENP status) to be forbidden the
>> administration of a couple of paracetamols when they are freely available
>> from the across the street filling station.
>
>liability, pure and simple, plus Nurses are quite conservative as a
>professional about exposing themsleves to risk, so they might not push as
>strongly for it themsleves, it all depends on the Nurse managers and the
>trust head of shed of nursing.
>
>> The other illogical thing to me is that if a patients phones A&E asking
>for
>> advice, it is often suggested analgesia/antiinflam. in form of products
>> available freely to the public. So, it is OK to suggest analgesia over the
>> phone but not to actual give it in the patient's hand?
>>
>you haven't supplied it then, you have only suggested it, it is still the
>patient's own choice to act on that advice and therefore it is hoped that
>liability is reduced.
>
>> Are we isolated in doing this?
>> Thanks for your comments.
>>
>> Dr. Tudor Codreanu
>> SG A&E
>
>Martyn Hodson
>[log in to unmask]
>Registered Nurse
>SJA Ambulance Attendant
>writing for myself, views expressed are entirely my own,
>and may not reflect those of my employer or St. John Ambulance , Nationally
>or locally
>-Duct tape is like the force, it has a light side and a dark side,
>and it holds the universe together.
>
>
>
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