Infermiere prescrittore: un rischio senza compenso adeguato

Italy, already known for the stagnation of nurses' salaries, is also paralyzed on another front: nurse prescribing. This deadlock is fueled by various "castes" that resist the evolution of other professional categories. Among these, doctors are among the most opposed, worried about losing their leadership in the healthcare field if nurses were granted the ability to prescribe medications.

Even among nurses themselves, the issue of prescribing is divisive. Most Italian nurses are against it, not so much because of the risks related to responsibility—we are already used to those—nor due to lack of preparation, because the training needed to become a nurse prescriber would be adequate, as already happens in countries like Spain, where since 2015 nurses can prescribe medications after a specific course.

The real issue holding many nurses back is another: is it really worth taking on new responsibilities when the current salary does not even remotely reflect our specialization and the value of our work? In Italy, a nurse earns as much as an unskilled worker, and this is without considering the professional risks and increasing responsibilities.

The push for the introduction of nurse prescribing comes mainly from patients and their associations. Organizations representing millions of Italian citizens, such as those of cancer patients, people with Spina Bifida, ostomates, physically disabled people such as paratetraplegics, are the first to strongly demand this reform.

The associations have even written to the Minister of Health, Roberto Speranza, and other institutional figures, urging an update of the Essential Levels of Care (LEA) to also include nurse prescribing and, in some cases, that of physiotherapists. In England, for over thirty years, nurses have been prescribing single-use medical devices without problems. It is a model that works, reduces bureaucracy, and improves the efficiency of the healthcare system, easing the burden patients have to face.

The expansion of nursing skills, including the prescription of non-ethical drugs, devices, and over-the-counter medications, would be a natural evolution of the nurse's role, improving care pathways. However, before talking about evolution, it is necessary to recognize these professionals with a decent salary. Today, the salary of Italian nurses is embarrassing, ridiculous. 

Bringing salaries up to the OECD average is the minimum to avoid the exodus of students and nurses abroad; soon there won't even be enough left to keep half the hospitals open.

The introduction of nurse prescribing would revolutionize the therapeutic and care approach, offering more direct and immediate care, especially in contexts where nurses are the main point of reference for patients, such as in the management of pressure ulcers or in long-term care. But as long as we do not receive adequate pay, Italian nurses will remain opposed. Pay us fairly before asking for further risks, duties, and responsibilities.

The requests of patients and their associations highlight how crucial it is to be able to count on well-prepared and competent nurses, willing to take on new responsibilities, provided they are supported by fair remuneration and a clear regulatory framework. Now it is up to politics to listen to these voices and take that step towards modernity that other countries have already taken.

Vincenzo Parisi - Nurse