The city of Shenzhen in south China’s Guangdong province will soon allow certain qualified nurses to directly issue prescriptions to patients. The initiative, the first of its kind across China, is aimed at easing the workload of doctors and meeting the needs of a rapidly aging population. 

Under new regulations, effective for five years starting Jan. 1, 2024, nurses who have obtained special certifications will be authorized to issue examinations and treatment and prescribe topical medications in specialized nursing clinics or community health service centers. 

The new regulations, jointly issued by Shenzhen’s health commission and medical insurance bureau, also stipulate that nursing specialists are required to base their prescriptions on existing diagnoses from doctors, supplemented by their own assessments.

Eligible nurses must have a bachelor’s degree in nursing and at least five years of relevant work experience, including a minimum of two years in a specialized nursing field. Acquiring a nursing specialist certificate, essential for prescribing medication, requires nurses to complete a training program of at least three months and pass a final evaluation. 

Municipal health departments are responsible for organizing this training and part of their duties includes developing a catalog detailing the types of examinations, treatments, and topical medications that nursing specialists are authorized to carry out and prescribe.

Wu Beiwen, director of the Shanghai Nursing Association, told domestic outlet the Shanghai Observer that a related policy is also expected soon in Shanghai. Wu added that the Association is collaborating with the city’s health commission to provide a specialist nurse training program. 

In China, nurses have traditionally been considered subordinate to doctors, and can only implement medical solutions prescribed by doctors. And, like most other countries, doctors and nurses undergo different training systems to develop their own areas of expertise.

Cai Jiangnan, founder and executive director of Chip Academy, a Shanghai-based health institute, told the Shanghai Observer that allowing nurses to prescribe medications would help them better meet the diverse needs of patients, particularly those with chronic illnesses in an aging society. 

“Many Western countries have already permitted nurses to prescribe medication and have established laws and regulations for this practice,” said Cai.

According to the National Health Commission, China has an average of 3.15 practicing physicians per 1,000 inhabitants, a lower ratio compared to Germany and Italy, who both have more than four physicians per 1,000 people. 

Since 2021, delegates from the National People’s Congress, China’s top legislative body, have advocated for nurses to have the right to prescribe, underscoring that it would help alleviate the shortage of medical personnel and enhance the country’s medical treatment system.

A doctor surnamed Han, from a top-tier hospital in Shanghai, told Sixth Tone that allowing nurses to prescribe would reduce the workload for doctors. “In fact, some nurse specialists have more experience with certain basic illnesses than junior doctors,” Dr. Han said.

In 2017, the eastern Anhui province announced it was considering a plan that would permit nurses to prescribe medication under a physician’s guidance for specific conditions like hypertension, diabetes, and physical wounds. 

While the proposal did not go ahead, it sparked widespread debate within the medical community. While some highlighted the benefits of more convenient services, others raised concerns about the potential for increased medical accidents and disputes between nurses and doctors.

Last year, a hospital in the southwestern Sichuan province announced that it would allow senior nurses in its digestive endoscopy center to prescribe. However, the decision was reversed within 10 days.

Editor: Apurva.  

(Header image: IC)