Uncertainty in nurse prescribing

Abstract

An editorial that analyses the legal and professional insecurity generated by the regulation of nurse prescribing in Spain, with special attention to the field of mental health. After reviewing the regulatory path from Law 29/2006 and its amendment by Law 28/2009 to the entry into force of Royal Decree 954/2015, the author sets out the limitations it imposes: nurses cannot indicate medicines subject to medical prescription without a prior diagnosis, prescription and protocol recorded in the clinical history, and the protocols and guidelines must be validated by the Ministry of Health, something that had not happened to date. The restricted validity of verbal orders to life-threatening emergency situations is underlined, and the ethical conflict this poses in frequent situations in mental health (dystonia, anxiety, insomnia, agitation of a psychotic patient), where nursing assessment is crucial. The author concludes that, despite the insecurity, current regulations must be complied with, and that their strict application may highlight the need to recognize nursing as a prescribing profession within its area of competence.