LETTERS

While the sarcastic response from the British Medical Association to our bid for enhanced prescribing rights was predictable (news, page 10, 18 January), I feel duty bound to explain once again to our medical colleagues that incompetent nurses are not going to run riot with prescription pads, causing untold problems for patients, nor set out to pinch their jobs.

Hundreds of specialist nurses are well able to make effective prescribing decisions for clinical areas in which their expertise is undoubted. At present these nurses have to pester a doctor, who may know less than they do, to take responsibility for a prescribing decision which is not theirs.

To say that nurses of this level of experience should be given a medical degree and be called 'doctor' misses the point. We choose to be nurses because nursing is what we want to do, not practise medicine. Nursing has moved on, and we now have the preparation and skills to make effective prescribing decisions.

But that is not much good when access is only to a stick-on, stick-up and slap-on formulary with half a dozen prescriptiononly medicines thrown in for good measure. The 20,000 existing nurse prescribers have made good use of this, but expert nurses need more to provide the best care to their patients.

Giving specialist nurses access to a wide formulary with most POMs at their disposal is the only sensible option as regulating access to varying ranges of medicines for certain conditions would be a logistical and legalistic nightmare.

Doctors should realise that just as we would hope GPs would not prescribe a drug with which they were not familiar, nurses would not prescribe willy-nilly beyond their competence or where their patients' needs do not require it.

If BMA members cast their minds back to junior doctor days, they will remember that friendly ward sister whispering the correct dose of a drug in their ear as they pondered over the hospital formulary only to sign the drug chart without question. That is what friends are for, docs - sometimes you will know more than us, sometimes we more than you, now and again we will know the same.

Our patients do not care, so it has to be teamwork.

Mark Jones Primary care policy and practice adviser Royal College of Nursing