The ethical and practical challenges of de facto prescribing: suggestions for mental health nurses to ensure patient and professional safety

This article explores the ethical and practical challenges of de facto prescribing in mental health nursing. De facto prescribing occurs when non-prescribing practitioners guide or instruct prescribers on medication decisions. This practice can involves risks such as misdiagnosis, adverse reactions or polypharmacy. Practical strategies for mitigating risks at individual and trust levels include consulting registered prescribers, accessing supervision, implementing and using patient group directions, engaging in continuous professional development, and reviewing audit and policy. The article emphasises the importance of adhering to professional guidelines and maintaining clear communication to ensure patient and professional safety, and effective medication management.