Writing Prescriptions by Nurses and Midwives in Poland
- 1. Department of Medical, University of Rzeszow, Rzeszow
Citation
Binkowska-Bury M, Wi?ch P (2016) Writing Prescriptions by Nurses and Midwives in Poland. Ann Nurs Pract 3(2): 1045
DEAR EDITOR,
I wish to draw your attention to a specific revolution which is going to take place within the community of nurses and midwives. From January 2016 they will be given the authority to write prescriptions. Such competence will be acquired due to the amendment to Act on Professions of Nurse and Midwife passed in July 2014. The proposed changes qualify nurses and midwives who hold master’s degree to write prescriptions to medications autonomously. Nurses and midwives with a bachelor’s degree will be able to write repeat prescriptions, as a continuation of treatment ordered by the physician.
Such changes are a compliment to patients for whom the new competence will bring the improvement, effectiveness and better accessibility of health care. In terms of Polish health care which happens to be overloaded by omnipresent queues and which struggles with the necessity of a long wait for health services [1], each initiative which could change this state of affairs would be greeted with approval. Enabling the continuation of treatment and a more rapid diagnosis without waiting for the doctor’s appointment, which is expected from the changes, are considered as a process of continual improvement of health care standards, especially for regional and rural communities.
Changes are a signal directed at community of Polish nurses and midwives as obtaining wider qualifications and competence is an opportunity to change their occupational status and prestige. It is vital to entrust the nurses/midwives with wider authority connected with ordering certain diagnostic tests, medications and foodstuffs for particular nutritional uses as well as medicinal products
Despite the fact that writing prescriptions by nurses and midwives is a new solution in Poland, it already functions successfully in many countries, especially in the EU member states. These qualifications differ according to health care system, distribution of population and occupational status of a nurse and midwife in a certain country, however, they result in benefits for both, patients and the whole health care system
The patients follow therapy orders; they have accessibility to subsequent consultation with a nurse or midwife who are seen as professionally trained and who are effective in communicating with the patient. This rational management of health care resources is reflected in economical effects, satisfaction of nurses and midwives, as well as patients themselves, and in saved time.
The legislative changes that deserve mention which were passed in July 2014 by the Polish parliament introduce new solutions based on articles: 15a and 15b According to the draft regulations, nurses and midwives who hold a master’s degree will be authorized to independently prescribe particular medicines as well as order particular medicinal products. Thus, completing specialist course will be required.
However, nurses and midwives who hold a bachelor’s degree will be able to write prescriptions on particular medicines necessary to continue treatment ordered by the doctor. The required condition for this will also be completion of a specialist course
The matter of payment for the courses has not yet been established. In the explanatory statement of a bill which expands authority of nurses and midwives, it is estimated that an average cost of such course will amount to 450 PLN ($200). Additionally, it could be financed by the employer or individuals interested in obtaining qualification subject to the bill.
At the same time, according to the amended act, nurses and midwives will be authorized to write referrals for specific diagnostic tests as well as laboratory diagnostics, excluding tests which require diagnostic and treatment methods posing a risk to a patient.
I would like to emphasize that the above-mentioned regulations do not oblige nurses and midwives to obtain the authority of writing prescriptions or issuing referrals for particular diagnostics tests. It is their decision whether to undertake action to receive them.
It is rather different for students of Nursery and Midwifery. The amendments result in necessity to introduce into the curriculum content referring to medicines prescription.
In the explanatory statement to amendment to the bill it is indicated that changes that will come into force, apart from nurses and midwives, will affect:
1) Recipients of health care (33011012 people –central list of beneficiaries (centralnywykazubezpieczonych) on 31 December 2012) who due to expanded authority of nurses and midwives will gain accessibility to health care services, especially to primary health care (POZ) and outpatient specialist services (AOS),
2) Organizers of postgraduate training for nurses and midwives (239 organizers – according to the Centre of Postgraduate Training of Nurses and Midwives (Centrum Kszta ?ceniaPodyplomowegoPiel?gniarekiPo?o?nych). The organizers will be able to conduct specialist trainings in medications prescription, and treatment continuation as well as to enrich their training offer,
3) Higher education facilities which provide undergraduate and graduate programs in Nursing and Midwifery (73 in Nursing and 15 in Midwifery – according to the Polish Ministry of Health). The change will be of an organizational character and will result in necessity of modernizing educational standards in undergraduate and graduate programs in Nursing and Midwifery.
What is more, in the explanatory statement it was indicated that the nurses and midwives are expected to issue 20% of prescriptions for medications in chronic diseases in primary health care and 10% in outpatient specialist services all of which were issued solely by doctors. It is estimated that about 10% of visits to nurse or midwife may end in issuing the referral to diagnostic tests including laboratory diagnostics.
As an organizer of the training in undergraduate and graduate programs in Nursing and Midwifery in one of the leading universities in Poland from which about 250 nurses and midwives graduate every year, I would like to arouse interest of international nursing community in recent events that took place in our country. All who wish to receive more information on this topic are more than welcome to share their experience and to take part in the discussion.
Communities of doctors, nurses, and open population approach the proposal with reservation. However, from the standpoint of an academic teacher, I perceive this proposal as another quantum leap in the development of Polish nursing
