Conference Proceedings - School of Nursing & Midwifery - Trinity ...

School of Nursing & Midwifery, Trinity College Dublin: 8 th Annual Interdisciplinary Research Conference
Transforming Healthcare Through Research, Education & Technology: 7 th – 9 th November 2007
Conference Proceedings
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Community Mental Health Nurse Prescribing: The Results of
a Preliminary Study
John Wells, PhD, MSc, BA(Hons), PGDip (Ed), RNT, RPN
Michael Bergin, MMedSc, Bsc(Hons)RPN, RGN
Martina Gooney, PhD, BSc(Hons)
Background
An Bord Altranais and the National Council published a final report
in 2005 that recommended further use of medication protocols and
extension of prescribing authority to nurses. This was followed by
the passage of the Irish Medicines Board Act (2006), which gives
limited powers of prescribing to nurses who have undergone
specialist post-registered training.
Doctors and nurses in mental health services have been criticised
for inflexibility in relation to adherence to rigid role boundaries that
impede rapid response to patient crises, especially as it affects
control of psychotic arousal. A Vision for Change (2006) emphasises
a person centred recovery model to operate within the CMHT but
has little to say about the breaking down of boundaries. Prescribing
authority has the potential to be a source of tension within the
CMHT, particularly as this relates to professional boundaries. This
paper reports the first stage results of a study of community mental
health nurses and issues of team boundaries within a new
prescribing context
Aim of the study:
To describe the views of community mental health nurses in Ireland
on prescribing authority as this relates to clinical supervision and
professional boundaries.
Methodology
A 13 item questionnaire adapted from work by Nolan (2005) was
administered to 120 community mental health nurses, with a
response 89%. Questions included both closed and open-ended
items which were analysed through SPSS v14 using descriptive
statistics and category analysis respectively. Qualitative data was
analysed for recurring themes and categorized accordingly.
Summary
Analysis of the data identified that whilst many nurses agreed that
their knowledge base was sufficient to engage with a prescribing
role concerns were expressed about the potential for conflict in
relation to communicating prescribing decisions.
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