Nurses – nurses, as these professionals refer to themselves given the predominance of women in the sector – may indicate some medications without the need for a doctor to endorse their decision, according to the royal decree prepared by the Government and whose draft has been approved THE COUNTRY. With this, the department headed by María Luisa Carcedo turns around the royal decree that was approved at the end of 2015, when Alfonso Alonso was minister. It established that nurses could "indicate, use and authorize the dispensing of medicines subject to medical prescription", but only if a doctor had "previously determined the diagnosis, the prescription and the protocol or guide of clinical practice and care to follow " This guardianship on the part of the doctors is eliminated and it is established that, for the medicines that need prescription "will be agreed […] the protocols and clinical practice and care guides "so that the nurses can indicate the medicines
The nursing profession has been claiming for more than 10 years to solve what they understand to be a legal vacuum in their work. In your day to day there are decisions (vaccinate, use antibiotic ointments, recommend an adjustment in medication for anticoagulation or diabetes, among many others) that involve the use or advice on prescription medications. In practice, they did, but they were not backed by the drug law, which states that doctors can only prescribe – that is, prescribe.
Last minute change
José Luis Cobos, member of the General Council of Nursing, recalls that two days before the Royal Decree of 2015 was published, the Ministry sent the Council of State a draft that recognized that nurses could advise and use medicines they need on their own within some protocols, but without needing in each case an instruction from the doctor. The drafted changed at the last moment without Sanidad explained why, although it is attributed to the pressure of doctors to the possible interference of professionals who have always maintained an indispensable relationship of collaboration, but with suspicion to maintain the respective competences .
Sources of the Medical Association Collegial admit that already with Dolors Montserrat (PP) as holder of Health an approach took place, and that some pitfalls have been solved. The main one, of semantic order: if the law does not allow nurses to prescribe (prescribe), they can indicate. They will not be able to write recipes either. They can write recommendation sheets. This way the responsibilities of the doctors are safeguarded without coming into conflict with the nurses.
The nursing schools demonstrated in 2015 that following the existing law to the letter could cause important problems in the consultations. As recalls Cobos, took advantage of the flu vaccination campaign (a prescription drug, so it fell within the limitations imposed by the Government) to remind its members that they could only give the corresponding injection if the primary care physician he decided it case by case and in writing, as established by the royal decree. That kind of Japanese strike even led some communities, such as the Basque Country, to issue orders exempting the toilets from complying with that part of the norm. With the new regulation, for example, in the case of flu vaccines, it will be enough to have a protocol that establishes the risk groups and nurses will be able to dispense it to those people without having to ask for any authorization.
The draft royal decree on nursing prescription introduces a change that professionals demanded. In the current text, nurses who were to dispense or indicate medicines that need a prescription had to obtain a special accreditation. In the new wording, that condition is eliminated, and it will be enough for them to register in a registry. It will be considered that the nursing degree already shows that they are prepared to do it without having to pass another control.
The text is not yet closed, but José Luis Cobos, member of the nursing schools, is confident that it will not suffer many changes, since there is a prior consensus of all affected sectors.