Nurses now allowed to administer medication without doctor’s authorisation

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NURSES are now permitted to prescribe medication ‘under clinical guidelines’ and in line with requirements set by their individual regional health authorities.

Until now, only doctors, podologists and odontologists have been allowed to prescribe medication, and nurses only permitted to administer drugs under the instructions of one of these.

A restricted law introduced in 2015 upset nurses, who felt they were being treated as second-class health professionals and that they were being hindered in their work, to the detriment of patients, although they admitted that the terms of the new legislation did offer them greater protection and better comfort for patients.

Back in 2015,a number of nurses explained how far the new law enabled them to act in terms of medication – they would be permitted to give a paracetamol for a headache, but not, for example, morphine.

Until then, a patient in A&E who was in pain would not be able to get any relief unless a doctor was available to authorise it, and night nurses were not allowed to provide any drugs for pain which had not already been agreed by a doctor, meaning the patient may have to suffer until the doctor’s rounds during the late morning, as on-call medics only attend to emergencies.

Giving an aspirin to a patient with a headache when there was no doctor available to prescribe it could mean a nurse being fired and struck off for ‘practising without a licence’, which is in fact a criminal offence that could even lead to a suspended custodial sentence.

Despite this, the nurses said they studied the same amount of credits in pharmacology at university as doctors do, and that many nurses are even more highly-qualified than doctors – whilst a nursing degree is much shorter than a doctor’s studies, many nurses go on to take a master’s or PhD to specialise further.

Yet some doctors do not have a PhD, meaning that although they are ‘doctors’ by profession, they are not holders of this title via academic studies.

It is not entirely clear how far the recently-passed law will allow nurses to prescribe medication and administer drugs which would have hitherto required a doctor’s prescription, although nurses explain that, in reality, the legislation reform is mostly in place to give them legal protection for actions they already perform.

“In their daily work, nurses have to make decisions and prescribe vaccinations, antibiotics and other medication without waiting for higher authorisation at every step,” one nurse clarifies.

“This created a legal loophole which put nurses at risk.

“We won’t be doing anything we weren’t already doing; it’s just that now, we’ll be protected by law in doing so.”

Another nurse, José Ramón, explains: “Do you really think that, if you’re in a hospital bed, at at 03.00 in the morning you can call a doctor to sign an authorisation for you to be given a painkiller? Well, according to legislation currently in place, that’s how it should be – doctors do not only prescribe medication but actually decide how and when to give it to you.

“However, as a general rule, when you call for pain relief at that time of the night, it will be the nursing staff who give it to you and decide whether or not to do so based upon your notes. The new law means they’re legally protected for taking that decision.

“Whilst you can go into a bar and ask the staff to give you a paracetamol or an ibuprofen and they won’t face any legal action, until now, there were actually medical professionals forbidden from doing so on pain of prison.”

Nurses across Spain had been urging the new socialist government, which came into power in early June, to approve the medication law reform in time for the ‘flu jab season, which is due to start next month.