Expanding Roles in Healthcare: Nurses, Midwives, Physiotherapists, Speech Therapists, Pharmacists, and Orthoptists

2023-10-15 04:05:02

At a time when six million French people do not have a treating doctor, more and more legislative provisions (Rist Law in the lead, but not only) allow an increase in the skills of certain professions.

This is the case for nurses who can now prescribe and administer all of the mandatory and recommended vaccines in the vaccination schedule, in addition to seasonal flu vaccines, to people aged 11 and over. Please note, however, that live attenuated vaccines (measles, mumps, BCG for example) in immunocompromised people cannot be prescribed or administered by a nurse.

Nurses are now also authorized to take care of the prevention and treatment of wounds as well as prescribing additional examinations and health products.

Another new feature: direct access (thus without going through the doctor’s box) to Advanced Practice Nurses (APN)halfway between nursing practice and medical practice, and the strengthening of their roles since they can now first prescribe certain products or services subject to prescription. They may be responsible for regular monitoring of patients for their pathologies and can prescribe additional examinations, request follow-up and preventive measures or even renew or adapt, if necessary, certain medical prescriptions. Also in the pipeline: the possibility for nurses to draw up death certificates. This new skill should be tested in six departments.

2 Midwives

Now, midwives can:

prescribe all vaccines in the vaccination schedule to all people for whom these vaccinations are recommended (with the exception of live attenuated vaccines in immunocompromised individuals);

– administer all vaccines in the current vaccination schedule to all people for whom these vaccinations are recommended;

– prescribe and administer seasonal flu vaccines to the entire population.

These vaccination skills are therefore added to their other missions: contraception, vaccination, preventive gynecological consultations, practice of voluntary termination of pregnancy (abortion) by medication, etc.

3 Masseurs-physiotherapists

Going to the physiotherapist without going to the general practitioner (therefore without a prescription) is now possible. If the patient has not had a prior medical diagnosis, the number of sessions that can be performed is limited to eight sessions per patient.

Physiotherapists can now also adapt, unless otherwise indicated by the doctor, as part of a renewal, initial medical prescriptions for massage-physiotherapy procedures dating back less than one year. This renewal is possible within twelve months following the date of writing of the initial prescription.

4 Speech therapists

Here too, you can go directly to a speech therapist, provided that he works in a hospital, in a clinic, in a social or medico-social establishment or, in town, in a house or health center or in town , in a coordinated care structure, including within the framework of a territorial professional health community (CTPS) if the health project provides for it.

5 Pharmacists

Since August, pharmacists have been authorized to:

prescribe all vaccines mentioned in the current vaccination schedule to people aged eleven and overwith the exception of live attenuated vaccines in immunocompromised individuals;

– administer the vaccines mentioned in the current vaccination schedule to people aged eleven and over;

– prescribe and administer seasonal flu vaccines to those aged eleven and over.

They can also now:

– renew expired chronic treatment prescriptions for three months;

– carry out (for biological pharmacists) cervicovaginal samples as part of cervical cancer screening.

Note that they might soon be authorized to prescribe antibiotics to patients with cystitis or tonsillitis, as long as a test to confirm the bacterial origin of the disease is carried out. This is in all the wish expressed by the Prime Minister, Élisabeth Borne.

6 Orthoptists

Orthoptists can now prescribe glasses and contact lenses (provided you are between 16 and 42 years old and have no contraindications) without the patient needing to go through the ophthalmology clinic.

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