Critical Reflection in Prescribing
Subject Area-Professional: for example, you have undertaken the prescribing course that will change your practice, the delivery of your service, or impact on patients.
Topic- Prescribing in the acute medical unit
Introduction
Nurse prescribing is the practice of ordering treatment for a patient. In the past, prescribing was done by medical professionals only. Today, nurses are authorized to prescribe treatment or in other words, they have entered into advanced practice roles where they perform different advanced nursing roles. Common drivers to nurses performing advanced practice roles are physician's shortages, an increase in chronic conditions, and the need for an inter-professional team. The purpose of this reflection is to focus on how the prescribing course will bring about change in acute medical unit. I will use the analysis model from the Gibbs' reflective cycle to explore how nurses prescribing will help meet the needs of patients with acute medical illness. Today, patients' needs are changing and hence nursing roles. Chronic diseases and healthcare costs are on the rise and this means that chronic disease management and cost-effectiveness are needed. Having undertaken the prescribing course, I will now have the prescribing authority to prescribe medications to patients with acute medical illnesses.
According to Jones (2009, p.14), there is a development in the nursing health system since many countries have adopted nurse prescribing to meet the health services of patients. Factors for extending the nursing roles include access problems, disparities, fragmentation, and more (Salmond & Echevarria, 2017, p. 12). I count myself as an agent of the transformation since I will contribute to the change by providing patient-centered care. According to Jones & While, A (2011, p. 120) the United Kingdom has extended nursing roles in all settings. This means that independent prescribers no longer have a sole responsibility of prescribing. What happens is that there is a shared responsibility where the supplementary prescriber is helping patients’ access medicines (Pittman, P., 2019, p. 22). Thus, prescribing is a multi-professional practice where non-medical healthcare professionals are performing the role.
De Oliveira Toso et al (2016, p. 171) puts it clearly that functions carried out by doctors have been transferred to nurses. For example, nurses are now prescribing or offering treatment to patients with acute illness such as heart diseases. Asthma, and more. In general, a group of doctors are working together to combat the high prevalence of acute disease (Alharthi et al 2019, p. 50). As healthcare providers in the acute medical care unit, I need knowledge about clinical management. The latter means that I must effectively and efficiently meet the complex health care needs. Thus, my prescribing course will enable me gain skills in case management that will enable me in caring for patients with asthma, hypertension, diabetes, and other illnesses. Note that in the prescribing course, I will receive special training not only to perform consultations but also to prescribe medicines. For example, suppose I have a diabetic patient in the acute medical unit, I will prescribe insulin. If a patient is a smoker and wants to quit, I will prescribe tablets to stop smoking. In short, I will not be restricted from prescribing but professionally, I will practice with competence
According to Jones et al (2007, p. 488), since 2006, the United Kingdom has developed the health care system and now nurses are providing service effectively through prescribing. However, The British Medical Association is against nurse prescribing and argues that nurses should not prescribe drugs and the practice is 'absolute idiocy' (Jones et al., 2007, p. 488). Despite these arguments, the USA established the Physical Assistance Programs in 1965 after realizing there was a shortage of medical providers and hence patient dissatisfaction (Zaman et al. 2018, p. 2015). I highly support the physician assistant programs not only in the USA but also in other countries like the UK. My interest as a healthcare provider in the medical unit is promoting patients' satisfaction through providing a 'time investment' service.
Sabin et al. (2016, p. 330) says that patient safety is critical in the acute medical unit. Hospital staffing is an important concept in that for healthcare providers to manage acute hospital care, they must work as a multi-disciplinary team. Note that in the past, a junior doctor performed roles such as taking patient history, taking blood samples, among other simple roles. However, today, once a patient is admitted, seniors' doctors provide diagnosis and management immediately and this means that there is a great transformation. My prescribing course is a path to progress and I will have the ability to work in medical admission where I will perform supporting tasks like prescribing. The Robert Wood Johnson Foundation (2011, p. 163) found that nurses should be allowed to gain education and training for them to improve quality, access, and value. The need for advanced practice is to manage acute illnesses. Olayiwola (2015, p. 4) says that health care providers meet inevitable changes while working in primary care settings. Patients’ present different diagnoses yet some healthcare providers lack the experience to handle the medical problems. My prescribing course is a path to advanced practice nursing and where I will gain knowledge and skills needed in the acute care unit.
Conclusion
There are sound reasons why my prescribing course will change my practice, service delivery, and make a difference in patients' life. The prescribing course will provide prescribing competence where I will develop knowledge and skills about the assignment and diagnosis. An extended formality is a significant development that will enable me to address community acute illnesses. Nurses need competency in nursing practice. Likewise, competence is important in prescribing as it allows nurses to make a diagnosis and prescribe treatment. I feel that with my prescribing course, I will be competent to make assessment, diagnosis, and provide the appropriate treatment.
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