​​C​​ontents

Introduction

Standards​​

BCCNM li​mits and conditions for licensed practical nurse: Medical assistance in dying

Int​rod​​​u​ction​

The Licensed Practical Nurse: Medical Assistance in Dying (MAiD) standards, limits, and conditions apply to licensed practical nurses when they are aiding a physician or a nurse practitioner (NP) to provide MAiD. Licensed practical nurses do not assess clients​ for the eligibility to receive MAiD. Licensed practical nurses do not administer or prescribe MAiD or provide substances to a person at their request for their self administration of MAiD.

The role of licensed practical nurses may include:

• Providing information
• Acting as an independent witness, as described in the Criminal Code of Canada
• Acting as a proxy, for a mentally capable client who is physically unable to sign a request for medical assistance in dying
• Acting as a witness in a virtual assessment

• Aiding a medical practitioner or ​​nurse practitioner in the provision of medical assistance in dying

Licensed practical nurses cannot prescribe, compound, prepare, dispense or administer any substance intended for the purpose of medical assistance in dying. Licensed practical nurses can record information for reference use by the assessor-prescriber¹ as needed, but the assessor-prescriber is responsible for documenting the substance they administer or provide in the client's record and medication administration record.

Licensed practical nurses approached about aiding in the provision of medical assistance in dying should speak with their employer for further information about their role in MAiD. Employers may also further limit the role of nurses in MAiD.

Standards​​​​

1. Licens​​ed practical nurses ensure that a client has access to the information that the client requires to understand all of their options and to make informed decisions about medical assistance in dying and other end-of-life options such as palliative care.

2. Licensed practical nurses assess the cultural and spiritual needs and wishes of the person seeking medical assistance in dying and explore ways the person's needs could be met within the contex​t of the care delivery.

3. License​​d practical nurses work with their organizations and other members of the health care team to ensure that the person requesting or receiving medical assistance receives high quality, coordinated and uninterrupted continuity of care and, if needed, safe transfer of the client's care to another health care provider.

4. Licensed practical nurses who participate in medical assistance in dying follow legal, legislative, regulatory and organizational requirements for aiding in the provision of medical assistance in dying.​​
   

5. Licensed practical nurses may return unused substances intended for the purpose of providing medical assistance in dying to the pharmacy, when asked by the assessor-prescriber. When asked to carry out such a request, licensed practical nurses ensure the drugs are stored securely until transported and are returned to the pharmacy within 72 hours of the MAiD procedure, and they sign any forms normally signed by the assessor-prescriber to note the return of the substances.​​
   

Limits & conditions ​

Glossary​​

Additional education: structured education (e.g., workshop, course, program of study) designed for the nurse to attain the competencies required to carry out a specific activity. Additional education:

• builds on the entry-level competencies,
• identifies the competencies expected of learners on completion of the education,
• includes both theory and application to practice, and

• includes an objective evaluation of​ learners' competencies on completion of the education.

Assessor: nurse practitioner or medical practitioner who is responsible for completing an assessment of the client's eligibility for medical assistance in dying.

Assessor-prescriber: nurse practitioner or medical practitioner who is responsible for completing both an eligibility assessment and providing medical assistance in dying by prescribing and (when applicable) administering the substance to be used in MAiD. This role may be referred to by other regulatory colleges as the “prescribing nurse practitioner".

Client: individual receiving nursing care or services from a nurse.

Decision support tools (DSTs): evidence-based documents used by nurses to support clinical judgment and decision-making by guiding the assessment, diagnosis and treatment of client-specific clinical problems. DSTs come in various forms and are created by organizations or specialists in a specific area of health care.​​

Footnotes