Update May 2023
Clarifying BCCNM prescribing, scope
BCCNM is taking steps to change the requirements for RNs who prescribe. There has historically been some confusion around RN prescribing, as it was permitted under the Nurses (Registered) and Nurse Practitioners Regulation but the necessary supports for RNs to prescribe did not exist, e.g., training, access to prescription pads, employer supports. The term "prescribe" was also used when an RN authorized another health professional to dispense a specified medication for use by a specific client, further complicating the situation.
The decision has been made to restrict RN prescribing to certified practices nurses only. BCCNM anticipates corresponding revisions to the RN Scope of Practice, clarifying that only certified practice nurses are allowed to prescribe, will be sent to the BCCNM board in September 2023.
Public health emergency: RN and RPN prescribing
The Provincial Health Officer (PHO) in September 2020 issued an order temporarily authorizing RNs and RPNs to diagnose and treat a problem substance use condition or substance use disorder, as part of its response to the overdose crisis public health emergency. BCCNM in September 2020 introduced a new prescribing standard for RNs and RPNs. At the same time, the board also approved RN and RPN scope of practice limits and conditions for prescribing buprenorphine/naloxone to treat opioid use disorder.
A new certified practice class
In April 2023, the Ministry of Health
approved amendments to the
Nurses (Registered) and Nurse Practitioners Regulation to create a certified practice program for RNs for the treatment of Opioid Use Disorder (OUD). Certified practice RNs will be able to diagnose OUD and prescribe controlled drugs for the treatment of OUD, for which BCCNM has developed
standards, limits and conditions. Corresponding amendments to the BCCNM bylaws were
posted May 12, 2023.
Additionally, certified practice RNs will be able to issue orders to LPNs, RNs, and RPNs who have not received additional education and training, to compound, dispense and administer controlled drugs to treat OUD.
RNs and RPNs who have been prescribing under the Public Health Emergency order will be transitioned to this new certified practice class once all the required elements are in place. We will be communicating directly with these registrants over the coming months.
*Important note re: prescribing by certified practice nurses
It is imperative to note that BCCNM-approved education related to prescribing is not yet available. Organizations will need to implement processes to support RN(C) prescribing. Education specific to prescribing is required prior to existing RN(C)s acting as an RN(C) prescriber. In the meantime, RN(C)s are still authorized to administer and dispense medications using current processes established by their employer(s).
Prescribing for opioid use disorder
Until certified practice for OUD is ready, RNs prescribing under the Emergency Health Order will continue as normal.