Is there a perceived risk of occupational stress among nurses and physiotherapists who are non-medical prescribers? An exploration - Abstract

Relevance: Physiotherapists have been granted the ability to prescribe independently as of August 2013 based on recommendations by the Department of Health. The author's previous research, identified that extension of scope has the potential to increase occupational stress. Conversely nurses have had the capability to independently prescribe since 1998, yet are identified as the healthcare professionals with the highest risk of occupational stress. Occupational stress is becoming an increasing problem among the United Kingdom, with healthcare professionals displaying the highest prevalence. Purpose: This study aims to gain an understanding of the perceived risk of occupational stress from physiotherapists and nurses undergoing a non-medical prescribing qualification. Methods/analysis: This study used methods of qualitative research using semi-structured interviews as data collection. Participants were recruited via a gatekeeper and seven interviews were undertaken. Methods of triangulation, peer review, participant validation and reflexivity were employed to increase rigor. Data was analysed using thematic analysis. Results: Identified themes were: organisational influence, professional relationships and internal influence, all contributing to the demand on the individual. Organisational influence explored the perceived pressure from individual trusts, time pressure and the organisational culture as a barrier. Professional relationships explored role conflict, lack of understanding of role and support. The internal influence was explored in relation to emerging roles and self-worth. Each theme was interpreted to have a cumulative effect, increasing the demand on the individual and resulting in occupational stress. Discussion and conclusions: Those intending to implement independent prescribing were identified to have an increased risk of occupational stress. Physiotherapists appeared to have a higher risk due to the recentness of this expansion of scope and differences in implementation. Impact and implications: In order to reduce the potential for occupational stress, practitioners must feel valued within their position. This can be addressed through flattening of the hierarchical structure of the NHS and increasing support for those implementing expansion of scope. Further research surrounding national levels of occupational stress within healthcare would be beneficial.