Note of dissent
Clark, J.
Nursing Times 73(3): 80-81
1977
ISSN/ISBN: 0954-7762 PMID: 840671 Document Number: 112951
It was disappointing to read the ''official'' nursing reactions to the recommendation of the Joint Working Group on Oral Contraception that in certain circumstances suitably trained nurses should be able to prescribe the oral contraceptive. It does appear that the Working Group's proposals were reasonable and the safeguards which they proposed both for the prescribers and for the recipients were more than cautious. The reasons that have been advanced against the proposal reveal confusion and fuzzy thinking. In the case of the oral contraceptive, the risks are recognized, quantifiable, and have been subjected over the past 20 years to closer scrutiny than has ever been applied to any drug or therapeutic procedures. Its hazards are not denied, the these risks are demonstrably less than those associated with other comparable situations (notably pregnancy). The medical evidence presented to the Working Group revealed that if none of the known and specified contraindications were present, there was no way of predicting, or therefore of preventing, adverse side effects, regardless of who was responsible for the prescription of the patient's care. Accordingly, the Working Group recommended that oral contraceptives should be available only on prescription, and they specified procedures for prescriptions designed to detect and eliminate contraindications and to monitor response. The Ren appears to base its objections on 2 factors: 1) the cost of implementation, and 2) the additional nursing workload. These objections would perhaps be valid if the report had suggested that this specialist function should be performed by all nurses working in the primary care field. The break in continuity caused by a nurse's inability to sign the authorization for the treatment which she has already prescribed and whose progress she will monitor is deleterious to patient care. The Working Party's proposal should be welcomed and not rejected.