title: Nurse prescribing in general practice: a qualitative study of job satisfaction and work-related stress.
abstract: BACKGROUND
  Studies examining the impact nurse prescribing have largely focused on the efficacy of the service. It was suggested in pro-prescribing policy arguments that extending the nursing role to include prescribing would increase job satisfaction. This assertion has not been fully explored.
  
  
  OBJECTIVE
  To investigate the impact of independent prescribing for experienced nurse practitioners (NPs) working in general practice.
  
  
  METHODS
  In-depth interviews were conducted with six NPs who each had at least 3 years experience of independent prescribing in a busy inner city general practice.
  
  
  RESULTS
  Analysis of interview data yielded two main themes: as independent prescribers NPs experienced increased levels of both job satisfaction and work-related stress. Increased satisfaction was associated with having greater autonomy and being able to provide more holistic care. Increased work-related stress emerged from greater job demands, perceived insufficient support and perceived effort-reward imbalance that centred upon the enhanced role not being recognized in terms of an increase in grade and pay.
  
  
  CONCLUSIONS
  Independent prescribing increases job satisfaction for NPs in general practice, but there is also evidence of stressors associated with the role. It is important that NPs in general practice are encouraged and supported towards providing the effective patient-centred care in the community envisaged by current UK government. We acknowledge that the results presented in this paper are based on a sample limited to one city; however, it provides information that has important implications for the well being of NPs and ultimately patient care.
authors.affiliation: Department of Health Sciences, Liverpool Hope University, Liverpool, UK. cousinr@hope.ac.uk
authors.forename: Rosanna
authors.initials: R
authors.lastname: Cousins
authors.forename: Christine
authors.initials: C
authors.lastname: Donnell
mesh_terms: D000328:Adult; D011307:Drug Prescriptions / Q000451:nursing*; D005260:Female; D058006:General Practice / Q000379:methods / Q000706:statistics & numerical data; D006801:Humans; D007407:Interviews as Topic; D007588:Job Satisfaction; D008297:Male; D008875:Middle Aged; D009722:Nurse Practitioners / Q000523:psychology* / Q000706:statistics & numerical data; D024802:Nurse's Role / Q000523:psychology; D013315:Stress, Psychological / Q000209:etiology* / Q000523:psychology