in respect of a drug specified in Schedule I of the
Drug Schedules Regulation,
prescribe the drug,
compound the drug,
dispense the drug, or
administer the drug by any method;
for the purposes of
respiratory distress in a known asthmatic,
post-partum hemorrhage, or
conditions that are symptomatic of influenza-like illness, or
preventing disease using immunoprophylactic agents and post-exposure chemoprophylactic agents
in respect of a drug specified in Schedule II of the Drug Schedules Regulation,
prescribe the drug,
Registered nurses only prescribe medications20 when they:
Have a certified practice designation; AND
Meet the requirements for certified practice registered nurses to prescribe.
This restriction against a non-certified practice RN prescribing does not prevent them from issuing a client-specific order to be acted on by another nurse to compound, dispense or administer a medication for a specific client that is within the ordering RN's autonomous scope of practice.
The Regulation states that registered nurses may prescribe, compound, dispense or administer a limited number of Schedule I medications for specific purposes without an order. Schedule I drugs are those that normally require a prescription or an order.
Subject to the applicable limits and conditions below, the Regulation allows registered nurses to use Schedule I medications to treat the following emergencies:
Subject to the applicable limits and conditions below, the Regulation also allows registered nurses to use Schedule 1 medications:
Respiratory distress in known asthmatics
Conditions that are symptomatic of influenza-like illness
Under the Regulation, registered nurses are permitted within autonomous scope of practice to prescribe,
compound, dispense or administer medications listed in Schedule II of the provincial drug schedules. Further direction related to medications is included in the
Medication practice standard.
Schedule II medications include drugs such as:
Schedule II medications also include the following vaccines:
The Regulation permits registered nurses within autonomous scope of practice to prescribe, compound, dispense or administer immunoprophylactic and post-exposure chemoprophylactic agents to prevent disease. These agents may be in either Schedule I or Schedule II.
Registered nurses only compound, dispense or administer Schedule II medications within autonomous scope of practice to treat a condition following an assessment and nursing diagnosis. Registered nurses require a client-specific order from a listed health professional before compounding, dispensing or administering Schedule II medications to treat a disease or disorder.
For example, registered nurses would not administer insulin without knowing that a physician or nurse practitioner had diagnosed diabetes and ordered insulin therapy. Similarly, registered nurses would not inject sclerosing agents to treat varicose veins without knowing that a physician had diagnosed the underlying medical problem and ordered the treatment.
Registered nurses who carry out
insulin dose adjustment must possess the competencies and follow the
decision support tools set out by Fraser Health Authority.
The BC Centre for Disease Control (BCCDC) sets direction for clinical practice related to routine immunizations, such as childhood immunizations, and for chemoprophylaxis in contacts of clients with communicable disease.
Registered nurses compound, dispense or administer immunoprophylactic or chemoprophylactic agents only under the following circumstances:
20 In these standards, the term “prescribing” is used to describe the issuance of a prescription for a medication to be dispensed by a pharmacist or pharmacy.
Limits and Conditions on Prescribing Medications >>