The Change from Practice Nurse to Nurse Prescriber

I have worked as a Practice Nurse since 2001 and at Students’ Health Service (SHS) since 2003, completing various courses over these years – minor illness/injury, contraception, sexual health and travel health. As a result of this experience and knowledge, I felt the next step was to be able to prescribe for certain conditions that I felt competent in; to complete episodes of care and to help reduce the number of doctors’ appointments within these specialities at SHS.

Therefore in 2011 I qualified as an Independent Nurse Prescriber, which involved undertaking a recognised Nursing and Midwifery Council (NMC) accredited prescribing course through a UK university.

Legislation to allow nurses to prescribe from an initially restricted list was introduced in 1986, and gradually nurses were given more autonomy, eventually culminating in Nurse Prescribers having full access to the British National Formulary (BNF) which has put nurses on a par with doctors in relation to prescribing capabilities. Although we have access to the BNF, this does not mean we can prescribe everything in there – we only prescribe within our own limitations and scope of competence. So, for example, I feel competent to prescribe antibiotics for certain conditions, and contraception methods, but I do not feel competent to prescribe anti depressants or diabetic medications.

Before the Change – Scenarios I would see in Practice…

“I feel REALLY terrible… I can hardly swallow as my throat is so sore, I can’t seem to get warm, but feeling freezing cold and sweating and I have painful swellings around my neck. I’ve come to Student Health and after waiting to see the nurse and having been assessed, I have been diagnosed with Tonsillitis. I’ve been given a leaflet with information about medicines I should take from the pharmacy to help with my symptoms, but I need to see the doctor for a prescription for antibiotics. I have to sit and wait now for my appointment. The waiting room is full, too much noise and I just want to go home and back to bed…”

“Oh… the nurse is running late… I’ve a lecture in 15 minutes. I just want to start the pill. My friends are all taking it and now I’m with Tom, I don’t want to repeat that episode with the split condom and having to take the emergency pill last month- how stressful was that… Hooray! I’ve been called in… after a few checks and lots of questions looks like I’m ok to take the pill- but the nurse cannot prescribe it and I now need to see a doctor… I’ll have to book an appointment on another day for my prescription as I need to go to my lecture…”


After the Change…

Advantages for me as a Practitioner

Being a Nurse Prescriber has increased my autonomy and independence at work leading to greater job satisfaction, especially in my specialised field of travel health medicine, which here at Students’ Health is now entirely nurse-led.This independence provides more streamlined care that is patient-focused.

Advantages for you as a Patient

Continuity of care, with particular reference to the scenarios as above – these are consultations I see fairly frequently and can complete independently in one appointment without the need for referral to a doctor for a prescription. This ensures timely access to medicines and treatments, increasing convenience for you.

Advantages for Students’ Health

Nurses being able to prescribe at SHS increases service efficiency by freeing up our doctors’ time to care for patients with more complex health care needs. We have three Nurse Prescribers at SHS.

Advantages for Secondary Care (Hospitals)

Evidence has shown that Nurse Prescribing helps to avoid unnecessary A&E and hospital admissions and improves access to treatment.

So please, when booking your appointments at SHS, check to see if a Nurse Prescriber can help you with your health care need – we are here to help you.