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Title: Mental health nurse prescribing : using a constructivist approach to investigate the nurse patient relationship
Author: Ross, Jane Daun
ISNI:       0000 0004 2739 9154
Awarding Body: University of Aberdeen
Current Institution: University of Aberdeen
Date of Award: 2013
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Background: The interpersonal relationship between nurses and clients is seen as the central element or core activity of mental health nursing. Without this relationship therapeutic alliance cannot take place. Concern has been expressed that nurse prescribing could have a negative impact on the nurse patient relationship and result in the nurse sacrificing nursing skills for the prescribing role. Aim: The aim of this study was to explore the nurse patient relationship in the mental health setting when the nurse is a prescriber. In order to do this a comprehensive literature review was undertaken and views of participants were explored and relationships described. Methodology and methods: Nurse prescribers were sent questionnaires to gather demographic data and basic qualitative data. Focus groups and interviews were undertaken within a large NHS Foundation Trust. A constructivist approach was used with 57 participants including nurse prescribers, pharmacist prescribers, nurse managers, clients and doctors. A discussion guide and an iterative approach were used to clarify findings. Data analysis was guided by a Framework approach. Findings: The majority of clients preferred to have their nurse prescribe for them. Trust was highly valued within the pre-established relationship and clients found nurses easier to talk to about their medication than doctors. Nurse prescribers placed high importance on being able to reduce and discontinue medication for the client, terming this ‘un-prescribing’. Nurse prescribers were uncomfortable with the concept of power, preferring to use the term ‘empowerment’. All groups of participants were unanimous that nurse prescribers continued to provide care and that they had not moved from a traditional ‘caring’ role to a ‘medical’ curing role and importance was placed on the therapeutic alliance between nurse prescribers and clients. Conclusion: Rather than detracting from the nurse patient relationship, results from this study suggest that nurse prescribing enables the mental health nurse prescriber to provide more holistic care than previously. The action of ‘un-prescribing’ may indicate a new culture around mental health nurse prescribing
Supervisor: Not available Sponsor: Grampian NHS Board
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available
Keywords: Mental health personnel and patient ; Nurse and patient ; Nurses