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Effective Nurse/Non Medical Prescribing in End of Life Care: Speaker news and updates

This important national conference provides an essential update for current and aspiring nurse and non medical prescribers on prescribing at the end of life. It is widely recognized that pain and symptom control at the end of life is not always optimal, the development of non medical prescribing has a key role in improving pain and symptom control for patients at the end of life.

Marion Russell Medicines Management Advisor & Member Association for Prescribers opened the conference with a national update on developments in nurse / non medical prescribing and will cover:

  • developing confidence and competence in your ability to prescribe
  • demonstrating compliance with the NMC Code for revalidation
  • the benefits of nurse / non medical prescribing in end of life care

In her presentation Marion stated:

'The Uk has the most extended prescribing rights in nursing worldwide'

'Nurse Prescribers in the Uk steadily increase'

'NCM figures show that there are 77067 nurse prescribers in UK.'

'Royal Pharmaceutical Society competency framework for all prescribers June 2016 is the baseline for all standards.'

'Non-medical prescribers need to be Competent and to have competence. BUT the measure of competence is variable and subjective.'

Full powerpoint presentation

Pre conference abstract:

The number of professions now able to register as non-medical prescribers is expanding as the demands made on the NHS and other Health Care providers continues to increase.

This brings with it the need to ensure that medicines are not only prescribed safely but those who undertake this task are capable and competent to do so.

The new NMC Code for nurses and midwives sets out quite clearly that patient safety is the registrant's responsibility.

This presentation seeks to link all of these facets together and help to set the scene for the conference. 

Marion's Biography:

Since her retirement from the NHS in November 2013 Marion Russell has been working as an independent medicines management advisor. This includes running training days on medicines management for nurses, midwives and allied health care professionals as well as writing and reviewing medicines management related documents.

She was employed from 2003 -2013 at Guys and St Thomas NHS Foundation Trust as the Clinical Development Nurse: Medicines Management and was the Non Medical Prescribing Lead for the Trust. In this role she developed learning programmes for nurse/midwives and allied health professionals relating to medicines management, as well as  writing and monitoring the development of patient group directions and supporting nurses in non medical prescribing.

Her career in nursing spans over 50 years. She has worked in both the secondary and independent sector and held senior positions in the adult setting.

In 1980 she moved into mainstream education and qualified as a teacher. After this she worked in further education with students following social care courses.

In 1984 she entered Nurse Education and remained in this field until 2003 progressing from nurse tutor to managing education.

She was a member of the steering group working with the NMC on the development of the Standards for Medicines Management which was launched in February 2008.

She was the initiator and founder member of the Nurses Working In Pharmacy Network Group set up to support nurses who work in pharmacy.

She is a committee member of the Association for Prescribing.

This was followed by a presentation from Inge Bateman Lead Clinical Nurse Specialist In-patient Pain Service Western Sussex Hospitals NHS Foundation Trust who presented an extended session on 'Inpatient Pain Service influence on pain management at the End of Life' including:

  • So how can you develop, demonstrate and maintain continued competence in nurse prescribing?
  • Management of pain leading up to End of Life
  • Case based discussion related to the role of the Inpatient Pain Service and how this can complement the Palliative Care Team or support Hospice care

Inge commented:

'You all make prescribing decisions in very pressured environments'

'It is invaluable to have support and discussions with colleagues'

‘There’s a lot more to pain than just the physical pain’

Full powerpoint presentation

Pre conference abstract:

Non-medical prescribing needs to be used in the context of safe delivery of care and therefor part of sound governance framework within your organisation. I will share my experiences both as a Non-medical Prescriber but also as a former Non-medical Prescribing Lead for the Trust. Concerns are frequently being raised in relation to deskilling other professionals by having clinical nurse specialists and in particular if they are Non-medical Prescribers as well. It is like everything a balancing act between delivering best care here and now and long-term benefits, which I believe are best achieved by having clinical nurse specialist that are prescribers but also understand the context of prescribing within a team approach. Maintaining competency and demonstrating this can be a challenge so I will share some of the experiences from our Trust. Collaborative working is vital and I will highlight some of the changes that we have found beneficial for delivering quality care to our patients. Our organisation is using the leadership model used at Virgina Mason Institute in developing our Patients First Programme, which in a few words means that we put patients first in everything we do. Through case based discussion I will cover the role of the Inpatient Pain Service and how this can complement the Palliative Care Team or support Hospice care.

Inge's Biography

Inge qualified as a registered general nurse in Denmark and a few years later followed this up with a degree in anaesthesiology and a two year training programme to become a nurse anaesthetist. Since then she has worked in different countries mainly in the speciality of anaesthesia and acute pain as well as a lecturer at Greenwich University. Inge is currently a Lead Clinical Nurse Specialist In-patient Pain Service and for the last 16 years has been part of the inpatient pain service at Western Sussex Hospitals NHS Foundation Trust, which achieved the CQC rating of outstanding in 2016 with the In-patient Pain Service being quoted as working in a proactive manner.

Despite the fact that Western Sussex Hospitals NHS Foundation Trust is classed as a district general hospital the inpatient pain service has been able to develop innovative approaches in pain management and won the regional Acute Care Award for Enhanced Recovery 2010. Inge has been using her prescribing qualification for 14 years and was the Trust Non-medical Prescribing Lead for several years. Inge has been teaching on the Non-medical Prescribing course at Brighton University and was part of the subject lead group as a Trust Non-medical Prescribing Lead representative. She was also part of the Safe Prescribing Programme Board Health Education Kent, Surrey and Sussex and an External Reference Group Member The National Prescribing Competency Framework.

She has been an active member of the South Thames Acute Pain Conference Group committee since 2003 and became the chair in 2011.

Inge has had the opportunity to speak a National as well as local conferences both on the subjects related to pain management and Non-medical Prescribing.

Future conferences of interest:

Improving End of Life Care for People with Dementia
Monday 12 November 
De Vere West One Conference Centre

16 July 2018


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