Specialist Areas Being Adopted by Nurses

Nursing
Student’s name:
Institutional:

The nursing profession has encountered a significant evolution over the recent years with
new roles, especially in specialist areas being adopted by nurses (Hoeve et at. 2014).
Independent prescribing (IP) has been figured out to be among the roles and skill being taken
up as the changes unfold. According to Hoffmann, & Del Mar, (2015), IP is not the only
recommendation of treatment but also a choice of prescription and a treatment plan that take
into consideration the patients’ values, beliefs, preferences, expectations and diversity. With
the IP, the nurse is accountable and responsible for the decisions concerning the management
of the patients in the clinical setting including prescribing and also the assessment of patients
(National Institute for Health and Care Excellence (NICE), 2018).
The IP concept seeks to achieve modernization of service, enusure delivery of quality care
and considers the choice of the patient without compromising safety guidelines. IP work to
tranform the traditional compliance model, which involved the patient being guided by the
prescriber’s directions to a change in culture of concordance, where prescription is made and
medicine taken depending on a well-established collaboration between the professional and
patient. As a result, the delivery of quality care and proper management of diabetes has been
noted by several care givers and even individuals as being critical (American Diabetes
Association, 2013). The people living with diabetes have reported IP to have led to an
improvement in the case management (Courtenay et al. 2010).
About 463 million people have been diagnosed diabetes globally, hence showing that it is at
epidemic levels (International Diabetic Federation (IDF), 2019). Wylie et al. (2019) has
shown that individuals diagnosed with diabetes feel left out when making a decision relating
to their health. They, therefore, feel that this limited involvement frustrates them. Tabesh et
al. 2018 illustrated that most of the cases are managed in the primary care level, where the
key role players are nurses who have elaborate skills, for example, non-medical. Therefore,
there has been advocacy for alteration in the primary care where a patient centred model for

care should be used and also the non-medical staff have to improve their skills. This,
however, can only be achieved through combined efforts working together for better health.
The author is in a primary care setting as a practice nurse, engaging nurse-led clinics in baby
vaccinations, chronic disease management, travel vaccinations, complex care management
which includes type 2 diabetes management. Being a practice nurse provides a perfect
opportunity to deliver patient-centred care which entails establishing a rapport and
assessment of the individual needs. The author looks forward to being an independent nurse
prescriber upon successful completion of the non-medical prescribing course, which is
pursuing currently. The practitioner will, therefore, be able to provide care that is holistic to
the patients and also gets to focus on conditions that are more complex (McArdle, 2017).
Compared to its initiation in the 80s nurse prescribing has grown significantly according to
the Cumberlege report (Dowden 2016). Royal Pharmaceutical Society
competency framework now controls the nurse prescribing (RPS 2016). The framework
needs that the prescription is done safely and accurately. Moreover, the prescriber should be
patient-centred while prescribing. Critical application and demonstration of how legal, ethical
and professional factors have been applied in decision-making processes by the involvement
of the patient and enabling the patient to get better results from their treatment. The
framework is split into two sectors that entail ten competencies (RPS 2016).
The case study of a client diagnosed with type 2 diabetes in 2017 based on the RPS
framework will be discussed by the author. The primary issues were medication adherence
and a language barrier. The author will further take into consideration the legal, ethical and
professional factors in line with prescribing. To maintain confidentiality and privacy, the
identity of the client has been altered in accordance with the Nursing and Midwifery Council
codes (NMC 2018). The author performed an assessment that is holistic on the patient, taking