Analysis of interviews to uncover the effects of nurse prescribing on the doctor-nurse relationship

Abstract

Objective: The introduction of nurse prescribing has had a profound effect on how patients obtain a prescription. Yet very little has been researched about the effects of nurse prescribing on the professional relationship between nurses and doctors since its introduction. It was this lack of enquiry that led to this research study to see if this relationship has changed since the introduction of the nurse prescriber. Design methods: A purposeful sample approach was chosen, interviews were undertaken using a semi-structured method and interpretative phenomenological analysis was used to analyse the data. Setting: A large teaching hospital in the north west of England. Subjects: Four nurse prescribers and four doctors working in orthopaedics, breast surgery or urology looking after adult elective surgery patients. Main outcomes: What emerged from this study is a complex pattern of readjustment within this relationship. The power once enjoyed by the medical profession is now challenged by the introduction of the nurse prescriber. A number of themes emerged around the topics of prescribing, relationship, educational and communication. Each help to focus how this change manifests itself in the relationship and how it needs to evolve if the maximum benefit from nurse prescribing is to be achieved. Conclusions: What has emerged from this research is how complex the relationship between the nurse prescriber and doctor really is. The power to prescribe medication that was once the sole preserve of the medical profession is now shared with the nurse prescriber. But this shared authority remains unequal; the medical profession remains at least unwilling to give up its position of control just yet, but the dialogue has begun.