Department of Health Sciences, Liverpool Hope University, Liverpool, UK.
Fam Pract. 2012 Apr;29(2):223-7. doi: 10.1093/fampra/cmr077. Epub 2011 Sep 28.
Studies examining the impact nurse prescribing have largely focused on the efficacy of the service. It was suggested in pro-prescribing policy arguments that extending the nursing role to include prescribing would increase job satisfaction. This assertion has not been fully explored.
To investigate the impact of independent prescribing for experienced nurse practitioners (NPs) working in general practice.
In-depth interviews were conducted with six NPs who each had at least 3 years experience of independent prescribing in a busy inner city general practice.
Analysis of interview data yielded two main themes: as independent prescribers NPs experienced increased levels of both job satisfaction and work-related stress. Increased satisfaction was associated with having greater autonomy and being able to provide more holistic care. Increased work-related stress emerged from greater job demands, perceived insufficient support and perceived effort-reward imbalance that centred upon the enhanced role not being recognized in terms of an increase in grade and pay.
Independent prescribing increases job satisfaction for NPs in general practice, but there is also evidence of stressors associated with the role. It is important that NPs in general practice are encouraged and supported towards providing the effective patient-centred care in the community envisaged by current UK government. We acknowledge that the results presented in this paper are based on a sample limited to one city; however, it provides information that has important implications for the well being of NPs and ultimately patient care.
研究护士处方对服务效果的影响居多。在支持处方的政策论证中提出，扩大护理角色以包括处方将提高工作满意度。这一说法尚未得到充分探讨。
调查经验丰富的执业护士（NP）在全科医疗中独立处方的影响。
对六名 NP 进行深入访谈，他们在繁忙的市中心全科医疗中均有至少 3 年的独立处方经验。
对访谈数据的分析得出了两个主要主题：作为独立处方者，NP 经历了更高水平的工作满意度和与工作相关的压力。满意度的提高与更大的自主权和提供更全面的护理相关。工作相关压力的增加源于更大的工作需求、感知到的支持不足以及努力-回报不平衡，其中心是增强的角色在薪酬和职级方面没有得到认可。
独立处方增加了全科医疗中 NP 的工作满意度，但也有证据表明该角色存在压力源。重要的是，要鼓励和支持全科医疗中的 NP 提供当前英国政府所设想的以患者为中心的社区有效护理。我们承认，本文介绍的结果基于一个仅限于一个城市的样本；然而，它提供了对 NP 的福利以及最终对患者护理有重要影响的信息。
