As the study of medicines and their effects on the body, pharmacology is one of the cornerstones of medical practice. It can form a major part or even the entire course of treatment or be used to alleviate symptoms. Some medicines might be used singularly while others are used in combination with other medicines, therapies, or surgery, and with such a vast array of medicines available, pharmacology is of vital importance for all medical professionals, including nurses, at all stages of their careers.
The importance for nurses
Nursing is a multifaceted role, with nurses playing key roles in all aspects of patient care. One of their most critical roles is in administering medicines to patients. On busy wards, a nurse is likely to be caring for several different patients, each with their own medical needs. It is, therefore, vital that the nurses have a good understanding of the medicines they are administering, including being able to answer patients’ questions, knowing the dosage, how they are administered, and possible side effects.
Can nurses prescribe medicine?
In the US, the short answer to whether nurses can prescribe medicine is “yes.” However, the long answer is more complicated and depends on the level of nursing and where in the country you are practicing. Advanced practice nurses such as family nurse practitioners (FNPs) can prescribe medicine in all states, although the degree of autonomy they have in this varies. In some states, FNPs have full prescriptive authority, including the ability to prescribe controlled substances. In other states, they have reduced prescriptive authority where they can prescribe drugs that are in a written protocol authorized by a physician. Finally, there are states that give FNPs restricted prescriptive authority where physician supervision is required. As the level of autonomy is based on a state’s legislation, this can change, so wherever FNPs work, a good understanding of pharmacology is essential.
The greater degree of autonomy is something that encourages many RNs to advance their careers into a nurse practitioner role, including that of an FNP. With the demand for FNPs growing greater, it is a career path well worth considering. You will need to gain additional qualifications, with a Master of Science in Nursing (MSN) being one of the most popular entry routes. While it is possible to study this in person at a university, many nurses find that an online program is the best option for a working nurse. A good example of an effective online Nurse Practitioner Degree can be seen in the MSN-FNP program at Wilkes University. The program includes a clinical placement at a location convenient to you, while the curriculum covers essential areas of nursing, including an advanced pharmacology course.
Through nursing training and practice, you will find many areas where a knowledge of pharmacology is essential to deliver the best possible patient care.
Safe medicine administration
Safety is paramount in nursing, and as medical professionals often give medicines, nurses with a good understanding of pharmacology will help ensure that medicines are delivered in the safest possible way. When giving medicines, nurses need to make sure the right medicine is going to the right patient. They will also need to check it is being given at the right dosage and at the right interval. Dosage may vary based on age or weight, so understanding this will help ensure the nurse administers it correctly.
Drugs and medicines frequently come with side effects. As the ones carrying out the monitoring of patients, it is essential for nurses to know what they might be. Mild, short-term side effects will simply need monitoring with no cause for concern or immediate need to alert a physician. In this instance, the nurse will be able to reassure the patients and their families that the reaction is normal, giving them peace of mind. However, more serious side effects may need more intense monitoring and, in some instances, urgent treatment. Good pharmacological knowledge will allow nurses to quickly identify side effects and understand the best course of treatment.
Where advanced practice nurses are themselves prescribing the medicines, a thorough understanding of what medicines should be administered, the dosage, timing, and method of administration are even more important to maximize the benefits of the medicine and minimize the consequences. Nurses should also understand whether there are increased risks of prescribing two or more medicines together or whether a second medicine might enhance the benefits of the first. The better the understanding of pharmacology, the better the chances of prescribing and administering medicines without mistakes.
If an advanced practice nurse is prescribing a medication, they will need to first assess the patient to decide the best course of treatment. In terms of medicine, this means having a thorough knowledge of whether a condition needs medicine and which would be the most effective. Patient assessment will allow the nurse to see their current condition and use this to make the correct decisions on medication.
Patient assessment is an ongoing process. After administering medication, a patient will need to be monitored for side effects, improvement, or deterioration. These observations can be used by a nurse practitioner or physician to understand any necessary adjustments. Good pharmacology knowledge can help a nurse understand if a change in condition is a result of the medicine or is caused by some other factor that needs further investigation.
For many patients, managing their own conditions is very empowering and can cut down on the need for medical appointments or prolonged hospital stays. When being discharged from the hospital or if diagnosed with a chronic condition, patients need to be confident in any treatment they manage, including taking medication. Nurses will often be the ones who prepare patients for discharge, while FNPs who see patients at all stages of their lives are familiar with the management of chronic conditions such as epilepsy, diabetes, and asthma. Therefore, they are often the ones best placed to educate patients on how to best manage their condition, including the timing, dosage, and method of delivery of any medication.
To be able to do this effectively, a good knowledge of pharmacology is essential. If a nurse is confident in their own understanding, they will be better able to impart the necessary information to the patient. They will also be better placed to answer any questions patients might have about their medication and how to administer it. While most patients will be familiar with how to take tablets, some medicines may involve a different form of administration, such as an insulin injection or asthma inhaler. Nurses can observe patients for the first few times they are carrying out this unfamiliar action and help them to get it right.
Like nurses, patients will also need to know what happens in the event of a mistake or an adverse reaction. They need to know what they should do if they forget a dose or take too much, as well as what side effects can be considered normal and which ones require urgent treatment or monitoring. Nurses with a thorough understanding of pharmacology can ensure that patients have all the information they need and know when it might be necessary to seek expert medical help.
Monitoring and evaluation
Good pharmacological knowledge helps nurses recognize if a patient is responding as they should to their medication. Some medications work quickly, while others take a steadier process. Pain relief, for example, usually gets to work quite quickly. If the patient is still in the same pain sometime after taking the medication, this suggests it has not been effective. When carrying out observations, they can check for the expected response to the drugs. These observations are essential for the physicians who will need to know if the course of treatment is working as expected.
By understanding the effects of the medication, the nurses can also recognize if a patient is responding in an unexpected way, perhaps suggesting some other problem or a worsening prognosis. This will allow quick action to be taken.
Prevention and management of errors
Physicians are skilled medical professionals who most often make the right calls to deliver patients the best possible treatment. But they are human and, therefore, are not infallible, so mistakes can happen. They may instruct for the wrong dose of medicine to be administered or leave too short or too long a gap between doses. As they are not as familiar with the patients as the nurses who have likely given the greatest continuity of care, they may miss some aspect of the patient’s history that makes a medicine unsuitable or dangerous. It can even be something as simple as writing something in error on a care plan. Hospitals are fast-paced environments with the staff having to think on their feet and make decisions quickly, which makes room for error.
A nurse with poor pharmacological knowledge will be unlikely to pick up on an error, but those who have developed their pharmacological skills will be more likely to recognize if something is not right. They may, for example, notice that such a large dose is unsuitable for a child or question why a patient is left without medication for eight hours when it is more commonly re-administered after four. While physicians are careful and will usually be correct in their instruction, a nurse confident in their pharmacological knowledge can provide an additional degree of safety that will ensure any errors are rectified before they impact the patient.
Promoting evidence-based practice
Nursing is a skilled profession, with nurses at all levels needing to take on many different roles and display an array of both soft and clinical skills. While it is a caring profession with nurses needing to display compassion, empathy, and understanding, it is also a profession that requires a high level of clinical excellence. Patients often – and quite rightly – praise the caring abilities of the nurses who undoubtedly contribute to their comfort, but it is the science and clinical skills that will alleviate symptoms and improve conditions with the aim of a full recovery. This, of course, requires evidence-based practice so nurses can follow the best steps toward helping to treat a particular condition, illness, or injury.
A quick look at any nursing course demonstrates the amount of knowledge required to become a nurse, from understanding body systems to pathophysiology and diagnostic reasoning, as well as pharmacology. Using their knowledge in all areas, the nurse can understand the impact of different medicines on different conditions as well as on the body as a whole and use it to build a picture of how the patient is recovering. This will help provide the evidence physicians and advanced practice nurses need to decide the best treatment steps.
A good understanding of pharmacology will benefit nurses every day they work and will help them become more effective in their work. While it may be a physician who prescribes the medicine, it is often up to the nurse to administer it and to understand any potential side effects. It should also be noted that doctors are not infallible, and having a nurse skilled in pharmacology can help make sure any mistakes are rectified before the medicine is given to the patient. The skills will also be useful when answering questions from patients and their families and when educating patients on how to manage their own conditions, as it will allow the nurse to do so with more confidence and authority.
While pharmacology is important at all levels of nursing, for those who advance their careers into becoming nurse practitioners, such as an FNP, it becomes even more important. Although the exact degree of autonomy may vary, FNPs can prescribe medicines themselves, making it essential they understand the medicine classifications, the correct dosages, and safe administration. For nurses who are keen to become FNPs, this greater autonomy and expertise is part of what makes the job both challenging and rewarding.