In October 1994 nurse prescribing was launched for the first time in Britain in eight community demonstration sites. Using nurse prescribing as an illustration, this paper aims to explore the regulation of nursing and the influence of medicine on the expansion of the nurse's role. Arguing that professional development and regulation must be understood within the context of state control, the paper questions whether nurse prescribing represents a genuine development in nursing roles or is merely an act of tacit delegation by a medical profession which is itself subject to loss of autonomy. Recognising historical renegotiation in divisions of health-care labour, sections on the introduction of nurse prescribing; changing professional boundaries; and regulation in nursing, medicine and pharmacy, are used to critique nurse prescribing as an example of growing nursing professionalisation.
Department of Health/Touche Ross.Nurse Prescribing: Final Report. A cost benefit study. London: Department of Health, 1991 .
6.
Booth, B.Over the CounterFormulary. London: Macmillan, 1994.
7.
Moran, M., Wood, B. States, Regulation and the MedicalProfession. Buckingham : Open University Press, 1993.
8.
Mahoney, D.F.Nurse practitioners as prescribers: Past research trends and future study needs. Nurse Practitioner1992; 17:1, 44-51.
9.
Safriet, B.Health care dollars and regulatory sense: The role of advanced practice nursing. The Yale Joumal on Regulation1992; 9:407, 419-488.
10.
Hadley, H.E.Nurses and prescriptive authority: A legal and economic analysis. American Journal of Law and Medicine1989; 15: 283, 245-299. 17 Department of Health.Medicinal Products: Prescription by Nurses Act. London : HMSO, 1992. 18 Department of Health.The Medicines Act. London: HMSO,1968.
Brew, M.Teaching nurses to prescribe. Nursing Times1994; 90: 21, 32-34.
13.
Appleby, J.Financing Health Care in the 1990s. Buckingham: Open University, 1992.
14.
Montgomery, M.Doctors' handmaidens. In: Wheeler, S., McVeigh, S. (eds). Law, Health, and Medical Regulation. Hampshi re : Dartmouth Publishing, 1992.
15.
Freidson, E.Profession of Medicine. New York: Harper & Rowe, 1970.
16.
Witz, A.Professions and Patriarchy. London: Routledge, 1992.
17.
Davies, C.Genderand the Professional Predicament in Nursing. Buckingham : Open University, 1995.
18.
Freidson, E.Professional Powers: A study of the institutionalisation of formal knowledge . London: University of Chicago Press, 1986. 28 Turner, B.Medical Powerand Social Knowledge. London: Sage, 1987.
19.
Hugman, R.Powerin the Caring Professions. London: Macmillan, 1991.
20.
Johnson, TJProfessions and Power. London: Macmillan, 1972.
21.
Abbott, A. TheSystem of Professions: An essay in the expert division of labour. London: University of Chicago Press, 1988.
22.
Hunt, G.New professionals? New ethics ? In: Hunt, G., Wainwright, P. (eds). Expanding the Role of the Nurse: The Scope of Professional Practice, Oxford: Blackwell, 1994.
23.
Cotter, S., Barber, N., McKee, M.Professionalisation of hospital pharmacy: The role of the clinical pharmacy . Journal of Social and Administrative Pharmacy1994, 11:2, 57-66. 34 Study finds nurses hesitate to report medication errors. The Pharmaceutical Journal1996; 257: 401.
24.
Wainwright, P.Professionalism and the concept of role extension . In: Hunt, G., Wainwright, P. (eds) Expanding the Role of the Nurse: The Scope of Professional Practice. Oxford: Blackwell, 1994.
25.
Dimond, B.Legal aspects of role expansion. In: Hunt, G., Wainwright, P. (eds) In: Expanding the Role of the Nurse: The Scope of Professional Practice. Oxford: Blackwell, 1994.
26.
Zarnow, R.A.The curriculum model for expanded roles. Nursing Outlook1977; 25:1, 43-44.
27.
Ukcc.The Scope of Professional Practice. London: UKCC1992.
28.
McGuire, J.M.The Expanded Role of the Nurse. London: King's Fund College, 1980 .
29.
Nursing Standard.Multiskilling now accepted by nurses. Nursing Standard1980 ; 8: 20, 7. 41 Pickersgill , A.A new deal for nurses too? Nursing Standard1993; 7: 35, 21-22. 42 Department of Health.The Patient's Charter. London: Department of Health, 1992 . 43 Holton, S.Feminine authority in social order: Florence Nightingale's conception of nursing and health care. Social Analysis1984; 15: 59-72. 44 Dingwall, R., Rafferty, A.M., Webster, C.An Introduction to the Social History of Nursing. London: Routledge, 1988.
30.
Abel-Smith, G.A History of the Nursing Profession. London: Heinemann, 1960. 46 Russell, S.The EC: An overview. In: Quinn, S., Russell, S. (eds). Nursing: The European dimension . Harrow: Scutari, 1993.
31.
Keyzer, D.European aspects ofthe nursing role. In: Hunt, G., Wainwright, P. (eds). Expanding the Role of the Nurse: The Scope of Professional Practice. Oxford: Blackwell, 1994.
32.
Davies, C.Professionals In bureaucracies: Conflict thesis revisited. In: Dingwall, R., Macintosh, J. (eds). Readings in the Sociology of Nursing. Edinburgh: Churchill Livingstone, 1983. 49 Alaszewski, A.Doctors and paramedical workers —The changing pattern of interprofessional relations. Quoted in: Eaton, G., Webb, B.Boundary encroachment: Pharmacists in the clinical setting. SociologyOf Health and Illness1979; 1: 69-89.
33.
Armstrong, D.The decline of medical hegemony. A review of government reports during theNHS. Social Science and Medicine1976; 10:157-163.
34.
Eaton, G., Webb, B.Boundary encroachment: Pharmacists in the clinical setting. Sociology of Health and Illness1979;1: 69-89.
35.
Bowling, A. DelegationIn General Pradice: A study of doctors andnurses. London:Tavistock Publications, 1981.
36.
Greenfields, S., Stitwell, B., Drury. M.Practice nurses: Social and occupational characteristics . Journal of the Royal College of General Practitioners1987; August: 341-345.
37.
Mahoney, D.F.A comparative analysis of nurse practitioners with and without prescriptive authority. Journal of the American Academy of Nurse Practitioners1992; 4: 2, 71-76.
38.
Rickford, F.Still held back. Nursing Times1993; 89:46,21.
Stein, L.The doctor-nurse game. Archives of General Psychiatry1967; 16: 699-703.
42.
Mackay, L ConflictsIn Care. Medicine and nursing. London: Chapman & Hall, 1993 .
43.
Stein, L.The doctor-nurse game re-visited. TheNew England Journal of Medicine1990; 322: 546-549.
44.
Hofling, C.K. , Brotzmann, E.Dalrymple, S. etal. An experimental study in nurse-physician relationships. Journal of Nervous and Mental Disease1966; 143:171-180.
45.
Miligram, S.Obedience To Authority: An experimental view. New York : Harper & Row, 1974.
46.
Andrews, S.Prescription for success. Health Direct1992; March 12.
47.
Fennell, K.Prescriptive authority for nurse-midwives. Nursing Clinics of NorthAmerica1991; 26:2, 511-516.
48.
Andrews, P.Nurse prescribing. In: Hunt, G., Wainwright, P. (eds). Expanding the Role of the Nurse: The Scope of Professional Practice. Oxford: Blackwell,1994.
49.
While, A.E. , Rees, K.L.The knowledge of health visitors and district nurses regarding products in the proposed formulary for nurse prescription . Journal of Advanced Nursing1993; 18: 1573-1577.
50.
Luker, A., Kenrick, M.An exploratory study of the sources of influence on the clinical decisions of community nurses.Journal ofAdvanced Nursing1992; 17: 457-466.
51.
Pirie, S.Nurses and Mathematics. London: Royal College of Nursing. 1987.
ThePharmaceutical Journal. Prescribing role for pharmacists within general medical practice. The Pharmaceutical Journal1994; 253: 453.
54.
The Pharmaceutical Journal. The Conference: The pharmacist as a prescriber. The Pharmaceutical Journal1996,257:412-6.
55.
Commonwealth Department of Human Services and Health in conjunction with the Australian Pharmaceutical Health and Rational Use of Medicines (PHARM) Committee.A Policy on the Quality Use of Medicines. Canberra: Commonwealth Department of Human Services and Health in conjunction with the Australian Pharmaceutical Health and Rational Use of Medicines Committee, 1994, p. 13.
56.
Hodge, M.M.Improving the Use of Medicines: Involving all stakeholders in the policy, education, research andpractice process. Seminar at Centre for Policy in Nursing Research, London School of Hygiene and Tropical Medicine, March 12,1995. (Copy details from: Anne Marie Rafferty, Centre for Policy in Nursing Research, London School of Hygiene and Tropical Medicine, Keppel St., London WC1E7HT.)
57.
Department of Human Services and Health, Australian Nurses' Federation and Royal College of Nursing, Australian Pharmaceutical Health and Rational Use of Medicines (PHARM) Committee.Nurses and the Quality Use of Medicines. Nurses and Medications: Examining roles and partnerships. (Conference report.) November 1994. Canberra: Department of Human Services and Health, 1995, pp. 10, 20, 24.
58.
Mesler, M.A.Boundary encroachment and task delegation: Clinical pharmacists on the medical team. Sociology of Health and Illness1991,13:3, 310-331.
59.
Pharmaceutical Journal. Pharmacy-the new gatekeeper to health care. The Pharmaceutical Journal1996, 257:417-8.
60.
RoyalPharmaceutical Society/Royal College of Nursing. Nurse prescribing and patient care. The Pharmaceutical Journal1995; 254:163.
61.
Hurst, K.Progress with Patient-Focused Care in the United Kingdom. Leeds: NHS Executive, 1995.
