As a university lecturer on a non-medical prescribing course, I am exposed to trainee prescribers on a near daily basis. On the induction day, we ask our students about their prescribing ‘hopes’ and ‘fears’. After doing this job for more than 14 years, I can predict their answers, as the same things recur. Many students fear the increased accountability and responsibility, and the assessment at the end of the course. However, we can help allay these fears by myth-busting. I particularly love hearing the student's hopes. They fall into similar broad categories, such as completing episodes of care, improving access to medication, saving time and resources and increased job satisfaction.
One thing that straddles both hopes and fears is the ‘writing of a prescription’. I find this interesting because the mechanical task of writing a prescription is very simple; I suspect that I could teach anyone to do it. The decision about what information goes where and how much information to put is an easy skill to learn. But I think it's the accountability of putting one's signature to something and being the person responsible for the giving of a drug that hits home. I try to remind my students that, at the point in their careers where they are accessing a prescribing course, they are probably already doing the decision-making after assessing a patient or client, diagnosing and having a concordant conversation about what is needed for the patient's condition.
I also remind the students that just because they can prescribe does not mean they must prescribe, and they should continue to consider non-pharmacological options. There has been a surge in media coverage of social prescribing in recent months as we embrace a more holistic approach to care. Increasingly, social prescribing of exercise, horticulture and non-clinical community support is being reported in a positive light in the media. This is encouraging patients to ask for this and is helping to move away form a ‘pill for every ill’ culture.
A recent article in the Scottish Herald discusses a patient helped by the National Lottery-funded SPRING Social Prescribing programme (Devereux Taylor, 2019). The patient states that Healthy Options attendance and ‘fresh air’ has changed her life. Social prescribing can be just as life changing and enhancing as medication in certain circumstances, and one that we encourage our prescribing students to consider as equally as the prescription for a medication. Social prescribing is being heralded as a new initiative, but in truth the concept has been with us for decades, just now we have some research and evidence to show its benefits.
So next time you are in a prescribing situation, make sure that you have considered not only pharmacological but non-pharmacological (or even social) prescribing options.