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.