The expanding role of nurses in surgery and prescribing in British departments of dermatology

A questionnaire to all 463 consultant members of the British Association of Dermatologists regarding nursing developments received 183 responses (40%) from over 127 departments. Sixty-nine per cent of respondents have nurse-r un clinics, anticipated to increase to 91% at base hospitals and 79% in com munity settings. Fifty-seven per cent have protocols for nurses to alter tr eatments; 20% have nurses who initiate treatments. Twenty-six per cent have nurses who prescribe with medical countersignature, and 5% have nurses who can prescribe without medical countersignature (likely to increase fourfol d). Seventy-two per cent anticipate nurses administering cryotherapy within the next few years. Few respondents supported nurses treating malignancies or lesions not seen by a dermatologist, but supervised procedures such as curettage, shave biopsy and punch biopsy were all likely to increase from a bout 15% to 30-40%, These interventional procedures, and particularly presc ribing without medical countersignature, were currently most frequent in un its without specialist registrar support. Obstacles to extending nursing ro les included opposition from administration or nursing hierarchies (about 4 0%), funding problems (about 25%) and uncertainties from departmental nurse s themselves (17%), There is clearly support from dermatologists for these developments, but the importance of adequate training, protocols and suppor t from all relevant staff is paramount.