Work stoppages, care, examinations... These are the prescriptions that certain nurses are now authorized to issue

The government published this Wednesday, April 30, in the Official Journal the list of medications and treatments that advanced practice nurses (APNs) will be able to prescribe without the intervention of a doctor.

The right to prescribe, reserved for IPAs working in collaboration with doctors in a structure (hospital, health center, etc.) is part of the current efforts of the executive and Parliament to respond to medical desertification.

It will make it possible to concretely apply a provision of the Rist law of 2023, opening a right of direct access to advanced practice nurses , without going through doctors.

The decree is "a fundamental step forward that is fully in line with the pact to combat medical deserts that I am promoting with the Prime Minister and which reflects the ability of our health professionals to join forces to advance the health system," declared Health Minister Yannick Neuder on X.

This "decisive step forward in the recognition of nursing assistants' skills" reflects "a change in practices, renewed confidence in caregivers, but also political will," the nursing assistant union Unipa welcomed in a press release. "It now remains to urgently include these skills in the professionals' agreement" with the French health insurance system, it stated.

Advanced practice nurses complete two more years of study than nurses, for a total of five years, and have broader care-giving responsibilities. Approximately 3,000 APNs have been trained since the first class in 2019.

Under the terms of the decree published Wednesday, IPAs will be able to prescribe, among other things , sick leave of up to three days, medical transport, basic painkillers, certain antidiarrheals, amoxicillin for bacterial tonsillitis in the event of a positive test, fosfomycin for uncomplicated cystitis, and tests such as mammograms or smears.

These prescriptions "cannot be renewed without medical consultation," the order specifies. Depending on the IPA's specialty (multiple pathologies, oncology, kidney disease, psychiatry, emergencies, etc.), additional medications and treatments may be prescribed, but for the most part, this is subject to a prior medical diagnosis.

The nursing profession as a whole is undergoing profound changes. The Senate is currently considering a bill to overhaul the legislative framework governing the profession and expand direct access to nurses.

"France is finally beginning to revolutionize its healthcare system and the patient journey. It was about time; patients could no longer be left without solutions in medical deserts," Grégory Caumes, a legal expert on health issues and a longtime advocate for a greater role for nurses in care, told AFP.