The debate is not new, but those responsible for the Health Care Committee of recent creation within the Ministry of Health: the body coordinated by Alda Recasin its eagerness to adapt the National Health System (SNS) to a healthcare context marked by aging and chronicity, raises the question of whether the medication indication guides for the Nursing or if, on the contrary, it is necessary to modify the current regulations to regulate the nurse prescriptionjust as the doctor already is, something before which the Medicine He has never hidden, at least, his skepticism. consulted by Medical Writingthe profession today oscillates between caution, approach and rejection.
The truth is that in the General Nursing Council (CGE) are in no hurry to regulate the power of the professionals they represent to prescribe medications. “We are aware that, given the current parliamentary instability, now is not the time,” he assures this newspaper. Jose Luis CobosVice President III of the CGE.
Cobos is committed, for now, to continuing to agree on specific protocols for the indication, use and authorization of dispensing of medicines with the current mechanisms, based on which the autonomous communities those competent to accredit their nurses for the indication of drugs.
In any case, the head of the CGE is clear: “We have to evolve towards prescription.” “We, beyond the Health strategy, already said that regulation had to continue improving to incorporate nurses into prescribing in their field of competence,” he adds.
It is the same thing that, in essence, was announced by the director of the Care Committee, Mayte Moreno, in the presentation of that roadmap of the Department of Health. Monica Garcia. “It is a path that we want to walk hand in hand with everyone to do well,” says Cobos, who denies that this should be linked to the achievement of professional nursing reclassification to group A1.
“Dialogue” in pursuit of a generalization model of prescription
There is part of the medical professional spectrum willing to pick up that gauntlet. “We are open to any improvement that results in patient care,” he says. Lorenzo Armenterosspokesperson for the Spanish Society of General and Family Physicians (SEMG).
The doctor advocates a kind of Solomonic decision: neither to continue expanding the current indication guidelines, nor to regulate nursing prescription, but to articulate a “generalized model” whose elaboration “is discussed in a broader way than until now”, that is, including in conversations scientific societiesin addition to professional associations.
The basis for the success of this approach would be, for Armenteros, not only “a lot of dialogue”, but also the “elimination of bureaucracy that harms attendance, always in patient benefit”. However, like Cobos, he is somewhat cautious about this: “When this issue is raised every year, we do not see that it is a priority concern for Nursing.”
More pharmacological training in Nursing
The president of the General Council of Official Medical Colleges (Cgcom), Thomas Cobo; and its counterpart from the Spanish Society of Primary Care Physicians (Semergen), Jose Polo, agree on their greatest reluctance to undertake legislative changes in this regard. “The prescription is the last part of a process that involves a diagnosis and a treatmentand that is the responsibility of the doctor,” emphasizes Cobo.
“It makes no sense to continue insisting on a non-existent concept,” concludes the president of the Cgcom, who, despite this, affirms that “there is no conflict” between the medical profession and nurse. “The SNS is the best gift that we Spaniards have given ourselves and in which the two professions can collaborate in the most efficient way possible with a common objective: patients,” he says.
Hence, the doctor advocates, instead of moving towards nursing prescription, for “optimizing joint work” between both healthcare branches: “Anyone who doubts that patient care does not have to be multidisciplinary, understands absolutely nothing. But those who don’t understand that these teams must be led by a doctor won’t either.”
Cobo assures that his point of view is not based on the “corporatist advantage”, but on the “burden of responsibility derived from an eleven or twelve year career training.” Along these lines, Polo recalls that “a high percentage” of Nursing training plans do not include Pharmacology.
“They are great professionals, but the prescription is a medical act, unless there is a change in their previous training,” analyzes the president of Semergen, who does not close the door to this last possibility in the case of future new graduates.
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