The benefits are massive: Why nurse prescribers are the way of the future

24 May 2022
The benefits are massive: Why nurse prescribers are the way of the futureMegan Holmes, Tairāwhiti child health nurse and RNPCH.

Applications for the next annual Midlands Collaborative Registered Nurse Prescribing in Community Health (RNPCH) programme are now open, and nurses working in the Pinnacle network are being encouraged to consider the Nursing Council of New Zealand (NCNZ) RN recertification. 

In the past two years the majority of enrolments for the Midlands RNPCH programme have been Pinnacle nurses from community settings, including school-based, general practice and outreach teams. 

With 35 RNPCHs now working in Pinnacle roles across the network, practices and communities are seeing the benefits of this extended nursing role*.

Barriers, benefits and building on existing expertise

Tairāwhiti Child Health Nurse and recently qualified RNPCH, Megan Holmes, says the programme is a great thing for nurses to do, and should be encouraged. 

“Being a nurse prescriber breaks down barriers for patients, takes pressure off practices, and increases the scope of nursing practice. 

“It builds on the work nurses do every day in the community. We may not be prescribing every day, but we are assessing and making plans with patients, so prescribing is extra support.” 

Pinnacle MHN nursing director, Jan Adams, agrees saying a qualified RNPCH works at the top of their scope, with the ability to use their skills and experience in a different way. 

“Prescribing ability gives nurses immediacy of care and widens their relationships with patients. It’s an important part of reducing barriers to access and improving health equity.”

Extending nursing in the community

Megan sees a lot of children with skin conditions in her work. She says that, for various reasons, whānau at times find it difficult to access practices. That means people often wait until they have a bad flare-up to see a GP, which can cause other complications and delayed healing. 

“For patients with conditions like eczema where maintenance is important, they can regularly see me in the community and I can prescribe creams and adjust treatment to support the plan the practice has given them,” says Megan. 

“I’m an extension of the practices. I can be there to see the different stages their skin is at, and suggest to them when they need to go back in and see the GP.” 

Similar feedback comes from other recently qualified nurse prescribers. They say the ability to prescribe more common medications, such as paracetamol, reduces both the time patients have to wait for a prescription, and extra workload for GPs and Mātanga Tapuhi in their practice.

Support and encouragement from GPs

Pinnacle MHN medical director Dr Jo Scott-Jones says it’s a “no brainer” for GPs to encourage nurses in their practice to consider the RNPCH programme, and support them to complete it. 

“It’s about increasing everyone’s capacity to do more. The benefits that flow onto the clinical team and patients are well worth the commitment,” says Jo. 

He says GPs can promote the programme and ensure nurses are aware of the support that’s available to them. 

“That might be providing some protected work time to complete coursework, or finding out a bit more about being a supervisor yourself. 

“If patients understand and use the expertise of nurses to the fullest, then they’re not bringing everything through the doctor. Our nurses are fantastic, they can do so much.”

Megan says support from other nurses completing the RNPCH programme and Pinnacle colleagues made a big difference while she completed the programme. 

“Once we understood what the paperwork requirements were for the programme, it was easy to complete because we were documenting our everyday work. 

“Our learning enhanced our everyday roles to include the ability to prescribe medications, not just share our understanding of them. It helped solidify my knowledge.”

Working smarter, not harder

Feedback from another recently graduated RNPCH accurately sums up the benefits of the programme. 

“Our GPs are so overworked which is only increasing. The delivery of healthcare is also changing within the primary and secondary services. 

“I would love to see all nurses I work with completing the RNPCH course. The positive impact this would have for ourselves, our patients, and our GPs would be substantial. We would be working smarter, not harder.”

*Qualified RNPCHs can prescribe from a limited list of medicines to support healthy patients/whānau who are experiencing minor health ailments. They work collaboratively within their community health setting, which includes clinical supervisors who must be authorised prescribers (for example, a GP or Mātanga Tapuhi). A named clinical supervisor is essential to support the required learning and development.