Nurse prescribing as an aspect of future role expansion: the views of Irish clinical nurse specialists

J Nurs Manag. 2008 Oct;16(7):813-20. doi: 10.1111/j.1365-2934.2008.00853.x.


Aim: Nurses and midwives are expanding the scope of their professional practice, assuming additional responsibilities including the management and prescribing of medications. The aim of the study was to discover the attitudes of clinical nurse specialists (CNSs) in Ireland to nurse prescribing and to examine perceived barriers to engaging in this aspect of future role expansion.

Background: The expansion of the nursing role in relation to nurse prescribing is an ongoing process and is subject to incremental iterations of legislation and professional policy. Nurse prescribing as an expanded role function has become a reality in many countries. Ireland has addressed the matter in a formal and systematic way through legislation.

Method: A questionnaire was administered to a sample of 283 CNSs practising in a variety of care settings in Ireland. Attitudes were measured using Likert-type attitudinal scales, designed specifically for the study.

Results and conclusions: Findings indicate that the majority of clinical nurse specialists were positively disposed toward nurse prescribing as a future role expansion. The fear of litigation was identified as the most significant barrier to nurse prescribing. The majority of respondents equated nurse prescribing with increased autonomy and holistic care. The findings indicate that there is a need for further examination of the educational requirements of the CNS in relation to nurse prescribing. The legislative implications for nurse prescribing and fear of legal consequences need to be considered prior to any implementation of nurse prescribing.

Implications for nursing management: While senior clinicians are willing to embrace future role expansion in the area of nurse prescribing, their Nurse Managers should recognize that facilitation of nurse prescribing needs to address the legal and educational requirements for such activity. Failure to address these requirements can represent a barrier to role expansion. This paper offers new understandings on the views of senior clinicians concerning nurse prescribing at a time of ongoing professional policy iteration and practice change in the area.

MeSH terms

  • Adult
  • Attitude of Health Personnel*
  • Drug Prescriptions / nursing*
  • Fear
  • Female
  • Forecasting
  • Health Knowledge, Attitudes, Practice
  • Holistic Health
  • Humans
  • Interprofessional Relations
  • Ireland
  • Male
  • Malpractice / legislation & jurisprudence
  • Middle Aged
  • Needs Assessment
  • Nurse Clinicians / education
  • Nurse Clinicians / organization & administration
  • Nurse Clinicians / psychology*
  • Nurse's Role / psychology*
  • Nursing Methodology Research
  • Professional Autonomy*
  • Professional Competence
  • Salaries and Fringe Benefits
  • Self Efficacy
  • Social Support
  • Surveys and Questionnaires