Direct access without a doctor's prescription, prescription rights, vaccination: the reform of the nursing profession, offering professionals an expanded and much more central role in the healthcare system, will come into effect, a small revolution for those concerned.
In application of the "nursing law" of June 27, 2025, a decree of December 24, published Friday in the Official Journal, specifies for the first time "the areas of activity and competence of the state-certified nurse", "defines in particular the practice of nursing as well as the modalities of the nursing consultation".
“This decree is a major step forward for the nursing profession,” said Health Minister Stéphanie Rist in an interview with the website Espaceinfirmier.fr on Friday. It “finally recognizes and secures everyday nursing practices.”
In the world of healthcare, which is centered around the figure of the doctor, this is indeed a paradigm shift. Nurses, who until now were paid based on a 20-year-old list of procedures that they could only perform with a prior prescription, will no longer be considered mere executors.
They will now be able to "initiate" care in their field of activity, nursing care "of a preventive, educational, curative, relational nature or intended for clinical monitoring".
They will therefore take "direct" care of patients within the framework of their "own role", the decree specifies.
They will be able to conduct a "nursing consultation", carry out a clinical assessment (health evaluation, history, lifestyle habits), make a "nursing diagnosis", and "develop a personalized care plan", which constitutes "an essential recognition", according to Ms. Rist.
They will take care of minor wounds or burns without prior prescription, and will monitor their progress.
The decree also gives them the long-demanded right to "prescribe health products and additional tests adapted to the clinical situation," although the list is restricted and will be specified by decree.
The text recognizes their ability to identify situations of mistreatment or psychological suffering, to provide "relational care, enabling psychological support" to patients, or to "design" and "conduct" a therapeutic education or prevention approach (falls, obesity, addictions, sexual health, vaccination).
He emphasizes their role in assessing and maintaining the autonomy of the elderly, and in the "prevention, assessment and relief" of pain and distress, particularly at the end of life.
- " Victory " -
Nurses will also be able to administer all mandatory vaccines from age 11 (except for immunocompromised individuals) without prior prescription, as well as those against influenza and Covid from age 5, and also carry out tests for certain sexually transmitted infections (HIV, hepatitis, chlamydia, etc.).
They will still be able to delegate certain tasks, the list of which will be set by decree, to nursing assistants or childcare assistants.
However, some situations remain subject to a prescription or protocol established by a doctor, such as complex postoperative care, anesthesia procedures, or the insertion of probes.
"The entire system must be operational by June 30, 2026 at the latest," Stéphanie Rist specified.
The Collective of Angry Nurses (Cilec) hailed "a victory" in a message sent to AFP.
"This is a revolution in our healthcare system," rejoiced Grégory Caumes, a lawyer specializing in health law, on X.
This is "a decisive step for the recognition of the nursing profession," according to the National Federation of Nurses (FNI), in a press release.
"This text finally enshrines, in law, the reality of nursing practice," the professional organization believes, citing in particular "the recognition of clinical nursing reasoning," "the formalization of the nursing consultation" or "the affirmation of the specific skills, professional autonomy and central role of nurses in care pathways."
But this "is not enough," warns the federation, which will be "particularly vigilant regarding the concrete conditions of practice, the resources allocated and the expected implementing texts."
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