Fraudulent qualifications
18% of nurses using the Nurse Practitioner title do not have the qualificationAsk yourself carefully why no one is bothered.
The Health Care Republic also reveals that
13 per cent of nurses who are prescribing do not have the prescribing qualification.It is scary enough when they do have the "qualification". It's all about professional standards, I suppose. Real professional standards. How many of these nurses will be struck off? Don't hold your breath.
Labels: dumbing down, fraud, nurse practitioners
10 Comments:
Thanks for bringing this to a wider audience. It has long been a bone of contention amongst those of us qualified as nurse practitioners that the title is not protected by statute. We were near to a definition of the nurse practitioner role and regulation of the role fairly recently. However the re-appraisal of the regulation of health-care professions, including medicine, brought about by the review into Dr Shipman's shenanigans has caused this to become mired down.
You may be surprised to hear this doctor C, but all those of us who have trained as nurse practitioners, gaining BSc and/or MSc in this area of practice, positively welcome the regulation of the title. Indeed we have pressed for it, over a considerable period of time. The confoundng factor, as always, has been the government/DoH.
As for prescribing, the figures reported are absolutely inexcusable. Those without a prescribing qualification should not prescribe. Pharmacists should not dispense against their prescriptions and doctors/nurse prescribers should not collude with them.
As I have stated previously, I am seriously concerned that these 'cowboys/girls' undermine the good work that some of us nurses in advanced roles do.
Dr C.
So tyhe nurses that work in your practice, do they run chronic disease clinics? Do they adjust the doseage of patients medications? Do they print off scripts and wave them under the nose of a partner to get them signed?
Cornishgiant
You just don't get it. Being a real professional includes policing your own profession to make sure that no one misrepresents their skills.
If doctors behaved like this, they would be struck off.
John
And to take your points in order:
So tyhe nurses that work in your practice, do they run chronic disease clinics?
Yes - and they have done courses in Asthma/COPD etc
Do they adjust the doseage of patients medications?
Not without clearing it with the doctor
Do they print off scripts and wave them under the nose of a partner to get them signed?
No they don't. They do come and see us and say that the think a patient should have X Y and Z and then we, if we agree with the suggestion, issue the prescription. This is called TAKING RESPONSIBILITY. If I issue a prescription, I am responsible for it.
John
It would be interesting to see a more in-depth analysis of these figures.
For example, what counts as a nurse practitioner qualification? As others have stated, this is not a protected title and so anybody can legally use it - some do use it when clearly they are not suitably knowledgable and skilled, but it may be the case that there are those using it who haven't taken a degree with "nurse practitioner" in the title, but have nevertheless got the requisite skills. For example, whilst there are several "nurse practitioner" degrees available, you also see degrees for example in "minor injuries and ailments" (ideal for nurses working in A&E), did this survey include those?
As for prescribing - I don't think it gets much simpler than if they haven't got the qualification there's absolutely no way they could prescribe: FP10s are usually regarded as controlled stationery, and pharmacists should be checking who's written the prescription and ensuring they're qualified.
What's slighly more tricky is the issue of assessing the patient yourself and getting others to sign the prescription. Is that prescribing? As Dr C has demonstrated there's a fine line.
Having said all this, I do know there are 'nurse practitioners' out there who are woefully inadequate. I once spent an afternoon as a 1st year student nurse working with one who had completed her NP course but didn't want to do the prescribing course. Instead, she had a list on her desk of 10 of the most common medications she needed and their dosages etc., when she thought they were needed she'd consult her list and write the script then get one of the doctors to prescribe it. That was bad enough, but she clearly didn't understand what she was doing - even as a 1st year student I knew she was wrong, for example, in prescribing a non cardioselective beta blocker to an asthmatic 23 year old who'd been found to have a BP of around 145/80 on one occasion. Thankfully the doctor who did sign the script realised what was going on and prevented her from making this mistake, which was lucky for me who was sat there trying to think of ways to stop the script being issued without obviously undermining her and failing the placement!
Dr C,
Thanks for the reply. You might one of the few practices that work this way then. Proxy prescribing is rife in General Practice, and whilst you might me whiter than white, many are not.
Because of proxy prescribing I would bet that far more than 13% are, in effect, prescribing. It is this proxy prescribing that is the most dangerous due to the difficulty with accountability/responsibility.
And by they way, I do get the point. And I agree with it. And it bothers me too. For the record, I have an intimate knowledge of non-medical prescribing (of which I am sure you have some very strong opinions) and I was curious to see in this instance if your practice matches your chat.
And if you are to be believed, which I am sure you are, you have no problems. Other GP practices might not be so well "sorted" in this regard.
Student nurse - how do I get myself one of those minor injury & ailment degrees? Is it easier than FRCA?
I didn't realise that you needed a qualification to call yourself a nurse practitioner, do you need one to call yourself a Clinical nurse specialist or a modern matron?
e.
technically you do not, therefore, technically noone is doing anything wrong.
It is not a title protected by statute, just a mere job description/title.
About time the government and the NMC get their collective acts togethr and tightened up this one methinks
"Do they print off scripts and wave them under the nose of a partner to get them signed?
No they don't. They do come and see us and say that the think a patient should have X Y and Z and then we, if we agree with the suggestion, issue the prescription. This is called TAKING RESPONSIBILITY. If I issue a prescription, I am responsible for it.
John"
Quite right too. Some while back I read a crazy comment made by Dr C about "air hostesses being allowed to fly planes". Being an aviator, I was somewhat offended by the suggestion that the role of air hostess/pilot was in some way analogous to that of doctor/nurse. In reality it's the nurses who do the "hands-on flying" in the health service leaving the air traffic control to the doctors. At least that's how it should be.
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