Exploring the Benefits of Prescribing Medications by Iranian Nurses Based on the Status Quo: A Letter to the Editor

AUTHORS

Hamid Taghinejad 1 , Gholamreza Noori 2 , Elham Mohammadyari 3 , Hamed Tavan 4 , *

1 Department of Nursing, Faculty of Nursing and Midwifery, Ilam University of Medical Sciences, Ilam, Iran

2 Department of Medicine, Faculty of Medicine, Ilam University of Medical Sciences, Ilam, Iran

3 Department of Cardiology, Faculty of Medicine, Ilam University of Medical Sciences, Ilam, Iran

4 Department of Nursing, Psychosocial Injuries Research Center, Ilam University of Medical Sciences, Ilam, Iran

How to Cite: Taghinejad H, Noori G, Mohammadyari E, Tavan H. Exploring the Benefits of Prescribing Medications by Iranian Nurses Based on the Status Quo: A Letter to the Editor, Iran Red Crescent Med J. 2017 ; 19(10):e14169. doi: 10.5812/ircmj.14169.

ARTICLE INFORMATION

Iranian Red Crescent Medical Journal: 19 (10); e14169
Published Online: October 10, 2017
Article Type: Letter
Received: April 30, 2017
Revised: May 28, 2017
Accepted: July 29, 2017
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Keywords

Nurses Prescribing

Copyright © 2017, Iranian Red Crescent Medical Journal. This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/) which permits copy and redistribute the material just in noncommercial usages, provided the original work is properly cited.

Dear Editor,

In Iran, nurses do not have the authority to prescribe medications and only physicians have such an authority. However, due to the development of societies and enrichment of knowledge, other health groups such as nurses can also prescribe medications consistent with their knowledge and acquired experiences. In the developed countries such as America and Australia, prescribing medications by nurses is permitted, but because of some reasons, it has not been permitted in Iran yet. Prescribing medications by nurses shortens the time of taking effective medications by the patients for their treatment (1). It is obvious that nurses are considered as the largest group providing services to the patients in hospitals, spending most of their time (more than 40%) on administering medications to the patients. Moreover, they communicate with patients more than other medical staff members and are the first members of the treatment group who are present at the patient’s bedside in times of trouble (2, 3). However, in Iran, even in emergencies when the patient’s life is in danger, nurses do not have the right to prescribe medications without obtaining physicians’ order, so they should certainly obtain the permission of the physician to do so. The majority of nurses know which medications they have to give the patient in case of emergencies, but doing so is legally wrong. Moreover, if something bad happens to the patient even though the nurse has done his/her best for the patient, he/she will be legally guilty; thus, if he/she acts contrary to his/her duties, he/she will be considered guilty and liable to punishment (4, 5).

In this paper, we decided to express the benefits of prescribing medications by nurses. In the current qualitative study, we attempted first to scrutinize this condition by considering the current situation, educational system, and medical science system governing the education and health in Iran and second to answer the question whether prescribing medications by Iranian nurses can be helpful or not.

In the qualitative study conducted through interviews, the interviewed people consisted of 40 Iranian nurses with degrees at various levels, typically including bachelor’s degree, master’s degree, and PhD degree. The interview form was totally about 4 domains regarding the consequences of prescribing medications by nurses for patients, nurses, physicians, and health promotion so as to realize whether medication prescriptions by Iranian nurses considering the status quo can be beneficial or not (6). The related date was collected by the Delphi method during 3 rounds with the participation of experts in nursing.

The results showed that prescribing medications by nurses had some consequences for patients including having instant access to the treatment, being exposed to less damages and risks due to not delayed treatments, being provided by low-price and cost-effective nursing services rather than physicians’ services, enjoying economic advantages in terms of costs, and consequently avoiding paying for several appointments which are costly for the patients. Moreover, currently most diseases all over the world need care more than treatment and thanks to the fact that more care is provided by nurses, so prescribing medications by nurses is in the best interest of patients.

Prescribing medications by nurses have several consequences for nurses themselves. Nurses can practically use their knowledge by gaining access to new tools like prescribing medications. Therefore, first, this issue may increase the nurses’ knowledge and motivation; second, the nurses can use the learned knowledge; and third, prescribing medications by nurses can change the attitude of people and nurses who make decisions towards the nursing profession. Furthermore, prescribing medications by nurses enhances their knowledge, so it is both to their benefit and to the benefit of the community. Another useful consequence is that the hidden prescriptions of medications for patients will be prevented and in some ways, law enforcement can be performed, as well.

Prescribing medications by nurses has several consequences for physicians including reducing their workload to a satisfactory level, avoiding unnecessary appointments and increasing the quality of the required appointments for the patients, and saving physicians’ time.

Additionally, the scope of consequences of prescribing medications by nurses for the health care system has been well presented so far through serving the patients, nurses, and physicians who are the members of the health care system. Some other consequences consist of reducing insurance deductions by nurses, reducing the economic costs of the system, and considerable saving in the health care system. These are all due to the permanent presence of nurses in hospitals.

Although the benefits of prescribing medications by nurses are discussed in 4 domains (i.e., patients, nurses, physicians, and the health care system), prescribing medications by nurses has not yet been applied in Iran; therefore, this issue causes several problems in Iran such as:

• prolonging the patients’ treatment process,

• being reluctant to nursing profession in Iran,

• examining and taking medical histories of patients with low qualities by physicians because of having not enough time,

• paying additional costs such as fees for several appointments, and

• causing the income gap due to the high fees paid to physicians in contrast to those paid to other medical care providers such as nurses

However, in some other countries, there is not such a gap because nurses have the authority to prescribe medications. Nurses in the developed societies are paid for the services they provide, so not only their quality of life is enhanced but also the quality of services they render to patients is increased. Although drug prescription by nurses establishes legal responsibility for nurses, other procedures performed by nurses have the same condition. Of course including drug prescription in the nurses’ duty forms is necessary (duty forms approved by the ministry of health).

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