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Dear all

The prescribing debate has been around a while and I would agree with Diane
that it does seem to be more of an issue for the NHS than non NHS - which
leads me to the question, why?

Why should the NHS be different to non NHS?  There are enormous differences
in the environments we all work in.  There is a huge difference between
manufacturing engineering and an investment bank,  between regulatory
organisations and a healthcare setting.  BUT, without fail, all these places
have the following
-    an employee population who usually require some sort of assessment
before they start working there
-    employees who sometimes need regular health assessment as they might be
exposed to damaging substances or work in safety critical situations - even
investment banks can have facilities and catering staff.
-    have an HR and management community that require advice because some
employees go off sick for a variety of reasons
-    have a whole range of other issues which we advise about in relation to
health and work.

Having worked in NHS and non NHS, I can't see a reason why we should
prescribe anything, because I can't see a reason for us to treat anything
other than the most basic condition which should be covered by PGDs. At
present, our skills lie elsewhere.

In order to prescribe,  we would be crossing a fundamental line in our role
from adviser to provider of treatment.  If (god forbid) we are going to be
the first line providers of sicknotes in the future, then it could be
logical step for us to provide treatment to combat the reason for the
sickness. But this is taking us into the realms of the GP and is a huge step
to take.  When viewed in terms of clinical value to an employee and clinical
competence of the nurse prescriber, it may be right to develop our skills in
this direction. When viewed in economic terms, particularly regarding the
level of OH resource in the UK, it is a massive issue.   However it should
be an issue for either all of us, or for individual organisations, not neces
sarily just for certain sectors of industry and commerce.

Thanks

Lindsey Hall
Head of Nursing Services
AXA PPP Healthcare

----- Original Message -----
From: "Diane Romano-Woodward" <[log in to unmask]>
To: <[log in to unmask]>
Sent: Saturday, October 23, 2004 6:51 AM
Subject: nurse prescribing


> I get the feeling this is more of an issue for NHS OH department than
> elsewhere.
> I did note that one of the job requirements for the Nurse Consultant post
in
> Stoke on Trent was the posession of ,or willingness to undertake the Nurse
> Prescibing  Course.
>
> I know I attended a lecture by Jan Maw at the AOHNP Synposium in 2003
where
> this was dicussed thouroughly-and I think the general  consensus there was
> that PGDs could cover pretty well everything that most OH nurses needed,
and
> that one would have to learn and maintain expertise about a lot of drugs
> that  one would not be likely to prescibe(except perhaps for  personnal
> use!)
>
> I think for many of us ther would be difficulty in having the appropriate
> medical support while undertaking the training (am I correct in saying
that
> one has ot identify a medic to oversee/asssit during the course)
>
> Having said that I would find it quite a challenge and think that
employers
> might perceive it to be of benefit. I would like to hear what was involved
> and if you found it relvant. My concern is that there would be pressure
from
> management (in the non-nhs sector) to be a mini GP and prescribe for the
> coughs and colds, to reduce sickness absence..or to reduce absence by
> reducing the need to visit GP  by providing prescriptions for on going
> treatments.
> An interesting topic-
>
> And with  regards to skin .. where i am currently working (a university)
we
> can refer directly to a skin specialist , however I had not considered
that
> we might set up a PGD for skin care products..
>
> With regards to the varicella PGD- try the drug rep- i got a disc last
year
> with a lot of PGDs on, but i am not sure if the was one for varicella...
>
> BW
>
> Diane
>
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