Opinion  

It is my firm assertion that nurses are not confused about licensed and unlicensed drugs. Nurses, inherently, are careful about their prescribing habits, checking and double-checking. Lackadaisical prescribing is, historically, the domain of our medical colleagues.

Working as an advanced nurse practitioner in neonatology, I find a huge proportion of drugs are not licensed for use in children, let alone the newborn. Frequently, I come across a number of ambiguities of which my medical colleagues are not aware, mainly because they are not bound by the limitations placed upon nurse prescribers.

For example, I can prescribe erythromycin as an antibiotic but I can't prescribe the exact same preparation as a prokinetic. This is equally true of routes of administration relating to a huge range of drugs. Frequently, medical colleagues (knowing that I and my colleagues are prescribers) ask our advice when prescribing for our unique client group.

When it comes to mixing drugs, I feel the Medicines Healthcare Regulatory Authority is scaremongering. Frequently, manufacturers of licensed products allude to the fact that their product is compatible with another drug and mixing is advocated under their licence.

The nurse is not creating a new drug, merely adding two - very separate and licensed - drugs together for ease of administration. If we didn't do this in neonatology, it would have far-reaching implications for our babies' wellbeing.

If it is true that nurses could be struck off for unwittingly breaching prescribing rules, then sensible clarification clearly needs to be sought.

Robin M McMahon, advanced neonatal nurse practitioner, Wolverhampton.