Patients with chronic diseases such as diabetes or multiple sclerosis often need help learning how to take and manage their many medications. At the same time, pharmaceutical makers need better ways to keep patients on those medications to both ensure the drugs’ efficacy and maintain sales.

For that reason, drug companies, including Berlex, Pfizer and Serono, are recruiting RNs to serve as patient educators, pioneering a new avenue for nurses who choose to practice in patients’ homes.

This novel role for nurses does indeed hold promise for all concerned. And many nurses will find career fulfillment in this job -- if they’re able to assure themselves they can ethically reconcile the dual roles of professional caregiver and Big Pharma employee.

Medication Education

“It’s a very important service that’s much needed,” says Kathryn Bowles, an associate professor at the University of Pennsylvania’s School of Nursing. “Patients with multiple chronic conditions see a variety of doctors and end up on 12 to 14 medications with complex rules and schedules. Errors and dangerous interactions happen.”

Nurses working in doctors’ offices -- and indeed, doctors themselves -- often don’t have time to explain how to take medications, show patients how to self-inject or follow up with patients regularly. By contrast, nurses working for drug makers can dedicate themselves to providing these and related services.

Nurses can find satisfaction in this occupation, Bowles says. “It’s such a critical part of managing chronic illness,” she says. “It requires independent decision-making, and there’s variety. Every patient is unique.”

According to Victoria O’Donnell, an RN and dean of science and technology at Cañada College, “it’s an excellent career path.” All nurses, regardless of their degree, have been trained in health education, she points out.

“It’s one of the most fulfilling jobs a nurse can take,” says Carolyn Silverman, a certified diabetes educator and field manager for Innovex, a division of Quintiles Transnational that provides patient education on contract to drug makers. “These nurses help patients stay on life-saving medications in a variety of settings.” Silverman has worked as a patient educator.

And once nurses establish themselves at pharmaceutical companies, a number of related career opportunities can open up in areas such as administration and clinical research.

Ethical Dimension of Nursing for Big Pharma

Is there a potential ethical clash between the RN’s obligations as an employee of a pharmaceutical company and her fundamental professional responsibilities as a nurse? After all, the drug company is obliged to its stockholders to promote legitimate sales of its products, whereas a nurse is obliged to make sure the patient understands all his treatment options, whoever may profit from them.

“That’s something that needs to be explored, especially when there is a particular medication that’s made by a variety of pharmaceutical companies,” says O’Donnell. “It would almost be better if these nurses could do in-home care without being employed by the prescription drug maker.”

Even as Big Pharma employees, nurses are patient advocates first, which raises other practice issues. “If they are hired by a pharmaceutical company, will they be free to provide comprehensive service that looks at the whole package of medications the patient is on?” Bowles asks. “Will they look at ways to simplify the regime, perhaps even to recommend cutting a medication?”

Nurses considering employment at Big Pharma would be wise to ask specific questions about how they will practice their profession and how the company addresses potential ethical conflicts.