PRESCRIPTION FOR CARE? An exploration of the experiences of nurse and midwife prescribers in the maternity setting

Introduction and Background: Nursing/midwifery practice are continually evolving and the introduction of prescriptive authority for nurses/midwives in 2007 is one of the most significant changes in recent years. Nurses/midwives in Ireland can engage in prescribing decision making within their scope of practice following educational preparation and with support from their employer. Though prescriptive authority brings benefits for patients and practitioners, questions have been raised about how caring and nurse/midwife identity may be affected. Given prescribing was once the sole remit of doctors within healthcare, nurse/midwife prescribing raises issues in relation to role boundaries which can affect identity. This research aims to explore the experiences of nurse/midwife prescribers (RNPs) in order to generate practitioner-based knowledge with the potential to inform education and research, policy and practice. Methodology: This qualitative study is influenced by hermeneutic phenomenology. Ethical approval and permission to access the research sites was obtained and a gatekeeper forwarded study information to potential participants. 16 participants from 2 maternity hospitals participated in one to one semi-structured interviews which were audio-recorded and transcribed. Interviews were coded and codes categorised, allowing themes to emerge. Results: Findings suggest that the introduction of prescriptive authority was an important point in the professionalisation of nursing/midwifery. Prescriptive authority contributes to the empowerment of nurses/midwives but factors which influence the extent to which this happens have been identified. Prescriptive authority enhances nursing/midwifery identity and compliments nursing/midwifery practice, facilitating a more agentic practitioner, though challenges to this have also been identified. Conclusion: This study provides a rich account of the practice and experiences of RNPs in the maternity setting, developing knowledge directly from those experiences. Findings from this research can inform those with direct responsibility for the regulation of prescribing practice and those responsible for education and research in the context of nurse/midwife prescribing

Name dc:type.qualificationname

phd

Level dc:type.qualificationlevel

doctoral

Grantor dc:publisher.institution

National University of Ireland Maynooth

Year dc:date.issued

2020

Author dc:creator

• Watson, Chanel Louise

Language dc:language

en