Mental health nurse prescribing: using a constructivist approach to investigate the nurse–patient relationship

Abstract

Nurse prescribing has been embraced in many areas of nursing, but less so in mental health. Relatively few studies have been published in this field with even fewer asking clients who have their medication prescribed by a mental health nurse about their views. This paper reports findings concerning the mental health nurse prescriber-patient relationship. It draws on data from a qualitative study, which was undertaken in one mental health National Health Service Foundation Trust in England to ascertain the views of clients and other stakeholders (nurse prescribers, pharmacist prescribers, nurse managers and doctors) about nurse prescribing. Data were collected by interview (either face to face or telephone) or focus group. Following Framework analysis, findings revealed that clients liked to have their nurse prescribe for them as they valued the pre-established relationship. They also valued the consistency of seeing the same person and the relative ease of access to appointments. Doctors and nurse managers were aware of positive feedback from clients. Nurse prescribers believed that nurse prescribing provided an enhanced service to clients.

Mental health nurse prescribing: A qualitative, systematic review

“…This perspective was reflected across stakeholder groups in studies within the present review (Dobel-Ober et al 2013;Harrison 2003;Ross 2015), although role conflict was of minimal concern. Patients generally perceived that the nurse prescriber role strengthened their therapeutic relationship, as well as their level of comfort and trust, with the nurse (Ross et al 2014), although others were concerned about whether or not nurses had the requisite skills and expertise in prescribing (Harrison 2003). These findings are consistent with other published research (Chaston & Seccombe 2009;McCann & Clark 2008;Patel et al 2009).…”

“…Overall studies demonstrated consensus across the studies reviewed in support of the nurse prescriber role. Nurse prescribers adopted a patient centred, evidence-based approach to their practice (Jones et al 2007;Ross et al 2014), consistent with views expressed in the literature .…”

“…Two were mixed methods (Jones et al 2010;Ross & Kettles 2012); however, only qualitative data are reported in the present review. We identified two examples where authors reported results from a single dataset in multiple (n = 2 in both cases) manuscripts (Ross 2015;Ross et al 2014;Snowden & Martin 2010. All studies were from the UK, and included perspectives from nurses, doctors, allied health staff, and patients/clients regarding their attitudes about, and experiences of, nurse prescribing.…”

“…Patients generally perceived that the nurse prescriber role strengthened their therapeutic relationship, as well as their level of comfort and trust, with the nurse (Ross et al . ), although others were concerned about whether or not nurses had the requisite skills and expertise in prescribing (Harrison ). These findings are consistent with other published research (Chaston & Seccombe ; McCann & Clark ; Patel et al .…”

Mental health nurse prescribing: the emerging impact

“…The word 'client' is used throughout this paper, other than when referring to the 'nurse-patient relationship'. A previous paper (Ross et al 2014) reporting the same study focuses solely on the nurse-patient relationship aspect of the data. This paper will focus on all five findings including the relationship, concordance, power, treatment approach and 'unprescribing'.…”