Prescribing in palliative care was an ‘early candidate’ area for the extension of nurse prescribing authority, but has failed to meet expectations. The low number of nurse prescribers working in palliative care, and the impact of the lack of this kind of professional, has received little attention. This paper gives details of an ‘in-depth service evaluation project’ relating to the prescribing activity of specialist palliative care nurse independent prescribers (SPCNIPs) in one community palliative care team to ascertain the volume of their prescribing activity as well identifications of the outcomes and influences to their prescribing activity.

Lymphoedema may be triggered by any type of injection. This is not just an issue for the cured breast cancer patient but for any patient who has undergone under-arm (axillary) lymph node removal to any degree for any type of cancer. Standard advice given to patients following axillary node removal is to avoid any injection or blood pressure measurement on the ipsilateral arm. The evidence base in this area is severely lacking. Patients have reported frustration that nurses are not informed of contraindications in carrying out such procedures on patients at risk of developing swelling. This article discusses the current evidence available on the subject of non-accidental skin puncture (NASP) relating to the patient at risk of lymphoedema and provides guidelines for any professionals conducting such procedures for patients with a history of cancer. The results from a small audit of the guidelines are cited and they reveal that out of 14 patients who underwent NASP procedures in the at risk arm, no patients reported swelling to that limb within a month of these procedures.

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