Wednesday, February 20, 2013

Is this discrimination against midwives? midwife prescriber Juliana Brennan

Is this discrimination against midwives?  Juliana Brennan:

About 3 weeks ago I found out that I was the first midwife in Australia to receive a PBS prescriber number.  I received this notification over the phone and in writing!

As part of becoming a Medicare eligible midwife I had to sign an undertaking to AHPRA that within 18 months of becoming Medicare eligible I would conduct a course of study in Pharmacology to become an endorsed midwife, with a medicare provider number and a PBS prescriber number. 

In 2005 I completed a pharmacology component of the Master’s Degree in Clinical Nursing (Nurse Practitioner) at Monash University, as back then, I thought the only way forward for me was to aim to become a Midwife practitioner (equivalent to Nurse Practitioner).

After I became an eligible midwife, I was invited to apply for equivalence for my pharmacology course to be recognised as a suitable course of study for my Midwifery endorsement.  This process of applying through AHPRA was very tedious (to say the least) but eventually it was decided in my favour by AHPRA that I should become the first midwife in Australia to be able to prescribe medicines based on the Prescribing Formulary put out by the Nursing and Midwifery Board of Australia.

I wrote my first prescription: for Lignocaine 1% in 20mls (a Schedule 4 medicine, listed on the AHPRA midwives formulary and the Victorian midwives formulary), and was told that it is only available at certain pharmacies, especially those attached to a Public Hospital offering Maternity Care.  However, the RWH and Eastern Health pharmacies told me they are not allowed to accept my prescription as I am not employed by the hospital!  So after all my work as outlined above, doing a course that I was required to do by AHPRA, I am not able to submit a prescription for the medicines I am legally allowed to prescribe in a public pharmacy attached to the hospitals!

Thankfully the pharmacist at Knox Private Hospital agreed to accept my prescription and had the medication needed in stock!

Even so, this does not make sense to me that a public pharmacy attached to a hospital would not accept my script, despite me having a PBS prescriber number.  Does this mean that a pharmacy like the RWH can’t accept a prescription from an outside Dr?  No it doesn’t as I have already had a script dispensed for one of my clients that was written by a Dr before I became an endorsed midwife.  The Dr is NOT an employee of the hospital.

So is this discrimination against midwives?

Many midwives have fought tirelessly to gain clinical access to several public maternity hospitals around Melbourne.  I stopped writing letters 6 months ago, as now I don’t even get a response. 

If I had clinical access to a public hospital, then my prescriptions could be accepted the pharmacist at RWH told me.

So my question is “Why does AHPRA insist on Eligible Midwives completing a suitable course of study in pharmacology in order to become endorsed midwives if we have no way of gaining access to hospitals as privately practicing Midwives, and no way of having our prescriptions for medicines dispensed from a pharmacy attached to a public maternity hospital”?

Juliana Brennan
RN, RM, M.Mid

1 comment:

Joy Johnston said...

Here are some (deidentified) comments from another social media group:
"Unbelievable :(!"
"That makes no sense! GPs have prescribing rights and no hospital access!"
"I think it's just another glitch that will get ironed out in time. We should be used to it."
"We shouldn't have to 'be used to it'"
"I don't think it's a glitch I think it's obstruction of our practice."