Lim Anecita Gigi, North Nicola, Shaw John
School of Nursing, Faculty of Medical and Health Science, The University of Auckland, Level 2, Building 505, 85 Park Road, Grafton, Auckland, New Zealand.
School of Population Health, The University of Auckland, Tāmaki Campus, Glen Innes, Auckland, New Zealand.
Nurse Educ Pract. 2017 Nov;27:1-6. doi: 10.1016/j.nepr.2017.08.009. Epub 2017 Aug 8.
Non-medical prescribing is now well established in a number of countries. Because prescribing has traditionally been viewed as a medical role, there are inevitable interprofessional boundary tensions when non-medical prescribing is introduced. In New Zealand, enabling legislation has allowed nurse practitioners to apply for prescriptive authority after undertaking appropriate educational preparation. This study explored the experiences and perspectives of one of the first cohorts of nurse prescribers and their strategies in establishing the role and negotiating the associated professional boundaries. Semi-structured interviews were undertaken with ten newly registered nurse-prescribers. Two broad categories, each comprising three themes, were identified: 'shifting professional boundaries' and 'navigating boundaries of practice'. Participants described how they were faced with the challenge of an unprepared environment as they began to prescribe and how they built trust in their prescribing practice among their colleagues and patients. They also related how they determined their personal prescribing boundaries in this new environment. They described the new professional relationship between nurse prescribers and doctors as collaborative, but with the crucial difference of it being interdependent, not dependent. The study offers insights into the challenges associated with the establishment of new professional roles such as prescribing.
非医疗处方如今在许多国家已得到充分确立。由于处方开具传统上被视为医疗职责，所以引入非医疗处方时不可避免地会出现跨专业边界紧张的情况。在新西兰，相关授权立法允许执业护士在接受适当的教育准备后申请处方权。本研究探讨了首批执业护士处方者群体之一的经历与观点，以及他们在确立该角色和协商相关专业边界方面的策略。对十名新注册的执业护士处方者进行了半结构化访谈。确定了两大类，每类包含三个主题：“转变专业边界”和“应对执业边界”。参与者描述了他们在开始处方时如何面对准备不足的环境这一挑战，以及他们如何在同事和患者中建立对其处方业务的信任。他们还讲述了在这个新环境中如何确定自己的个人处方边界。他们将执业护士处方者与医生之间的新专业关系描述为合作关系，但关键区别在于这种关系是相互依存而非依赖的。该研究为与确立诸如处方开具等新专业角色相关的挑战提供了见解。
