What Every FNP Student Should Know About Prescribing in Primary Care

As a Family Nurse Practitioner (FNP), you’ll take on one of the most important responsibilities in healthcare: prescribing medication. To do so safely and effectively, you’ll need to know what you can prescribe, when it’s appropriate, and how to make sure your patients understand and comply with their therapy plan. Here’s what you should keep in mind as you step into this part of your role.

Prescriptive Authority

States deal with prescriptive authority differently. Some give FNPs full prescribing rights, while others restrict controlled substances or require physician oversight. You should know your state’s scope of practice inside out before you graduate.

You’ll gather plenty of first-hand experience during the clinical placement phase of your MSN-FNP program. As an active practitioner, part time FNP programs even allow you to continue working while you study for the next level of your career.

Common Medications

In family practice, you’ll see a wide range of conditions that are typically treated by several main drug classes:

Antihypertensives, like lisinopril, amlodipine, and hydrochlorothiazide
Antibiotics, including amoxicillin, azithromycin, and doxycycline
Diabetes medications, most commonly metformin
Asthma and COPD treatments such as albuterol and fluticasone
Mental health medications, primarily SSRIs

By the end of your training, you’ll have a deep understanding of dosing and follow-up monitoring of these first-line drugs and more.

Safe Prescribing Practices

Before prescribing anything, you’ll conduct a patient review. This will become like second nature. Ask about allergies, look at their current medications, and check for drug interactions. Don’t forget about over-the-counter meds, supplements, and dietary implications. Recording this information, as well as why you chose the drug, what you told the patient, and when you expect to see them again, protects you and improves continuity of care.

Avoiding Common Errors

There are some mistakes you see again and again in practice. Most are preventable. The most common ones include prescribing the wrong dose or frequency, over-prescribing antibiotics, or missing red flags. In a primary care setting, you’re likely to be under pressure to see increasing numbers of patients. However, slowing down enough to be methodical and thorough is essential to avoid these kinds of mistakes. Always double-check high-risk drugs, and use electronic prescribing systems correctly; they’re there to help.

Patient Education and Adherence

Writing a prescription is only half the job. No medication in the world will work if the patient doesn’t take it. Take the time to explain exactly what the medication is for, how to administer it, and what side effects to expect or watch out for. Keep your language simple; you may be used to medical jargon, but most patients are not.

A good rule is to ask your patient to repeat the instructions back to you to show they understand. Many patients stop taking medication on their own volition when they feel better, or if side effects appear. In some cases, this can have negative health outcomes. This is one of the reasons it’s important to schedule follow-ups to adjust their healthcare plan safely and keep them on track.

Endnote

Prescribing is a science, but it’s not all about the medication. Effective patient communication is just as important. You’ll use both every day in your role as an FNP to manage chronic illnesses, treat acute problems, and improve patient outcomes. Before you do, you must understand your responsibility, learn the first-line drugs, practice safe habits, and make patient education a priority. As a fully-qualified FNP, you’ll be ready to make a difference in countless lives.