Standards for Prescribing standards, limits, and conditions set foundational requirements for current and future scope of practice prescribing by RNs. These Standards for Prescribing apply when RNs prescribe a medication to be dispensed to or for an individual client or give a client-specific order for a medication to be administered to, or dispensed to or for, an individual client.
prescribes when they authorize another health professional to dispense a specified medication for use by a specific client.
The nurse who prescribes assumes full responsibility and accountability for issuing the prescription or giving the order; however, risk to the client is reduced by having at least two health professionals involved in the medication-related activity to ensure the appropriateness of the medication for the client and assess any risks.
In addition to the
Standards for Prescribing, and prescribing limits and conditions, RNs who prescribe medication must comply with the
Medication practice standard and the
Acting within Autonomous Scope of Practice standard, as well as any other BCCNM standards, limits or conditions.
Nurses require supports and resources to support safe prescribing. There are governmental, organizational, and regulatory pieces that need to be developed and put in place before RNs can begin prescribing. These include:
As well, there are several steps that nurses must ensure are in place before they prescribe:
Since prescribing is not an entry level competency, additional education needs to include basic prescribing competencies. BCCNM does not determine or develop the education needed for nurses to safely prescribe in their practice. Organizations/employers are in the best position to determine the specific client populations and settings for RN prescribing. Therefore, your organization/employer will provide guidance on the required additional education for prescribing, including identifying the necessary competencies for safe prescribing. Organizations/employers will also determine the condition for which the medication is prescribed as well as the medication to be prescribed.
It is difficult to say when the education will be in place to support RN prescribing. We are committed to keeping you informed about this process.
Per the regulations, RNs can prescribe Schedule II medications and a limited number of Schedule I medications.
However, organizational/employer policies may limit medications you can prescribe at their organization. Note, organizations/employers cannot expand your scope beyond that of the regulations or BCCNM standards, limits and conditions.
cannot prescribe dermal fillers.
The Provincial Health Officer (PHO) issued an order temporarily authorizing RNs to diagnose and treat a problem substance use condition or substance use disorder. This public health order follows a recent Health Canada decision granting a
temporary exemption under the
Controlled Drugs and Substances Act to allow RNs in B.C. to prescribe buprenorphine/naloxone (i.e., Suboxone or its generic form) for the treatment of opioid use disorder subject to specific conditions. BCCNM Acting Within Autonomous Scope of Practice, Medication, and Prescribing standards, limits and conditions set foundational requirements for RN prescribing of buprenorphine/naloxone.
While the public health order allows RNs to prescribe buprenorphine/naloxone for opioid use disorder, it does not allow RNs to issue a client-specific order for another nurse to administer or dispense buprenorphine/naloxone to a client if that other nurse is also not a prescriber.
You can begin prescribing once you have met
all the following criteria:
Your organization/employer recognizes you as a prescriber
You successfully complete additional education and the preceptorship requirements established by the B.C. Centre on Substance Use (BCCSU) (in development)
Your organization/employer has policies, processes and resource in place to support RN prescribing
BCCNM has provided you with a prescriber ID (Process in development)
You participate in the
B.C. Controlled Prescription Program (CPP) and obtain the duplicate prescription pads required to prescribe buprenorphine/naloxone. Email
email@example.com with any questions.
You obtain a
Medical Services Plan (MSP) number allowing you to order diagnostic tests specific to the prescribing of buprenorphine/naloxone (process in development; information is coming)
You obtain Pharmanet access
You are in good standing with BCCNM
There are several steps that that need to be completed successfully before you can begin to prescribe:
Complete the BC Centre on Substance Use (BCCSU) additional education and preceptorship
Acquire a prescriber ID from BCCNM (Process in development)
Be recognized by your organization/employer as a prescriber
Obtain Pharmanet access
Obtain a Medical Services Plan (MSP) number
Ensuring that organizational/employer policies, processes and resources are in place to support safe nurse prescribing and knowing what they are.
The BC Centre on Substance Use (BCCSU) has developed the education required for nurses to prescribe buprenorphine/naloxone. Nurses require recognition by their organization/employer as a buprenorphine/naloxone prescriber prior to enrolling in this education.
As per regulations, LPNs are not authorized to prescribe medications.
At this time, RNs are not allowed to prescribe any additional OAT medications other than buprenorphine/naloxone.
BCCNM’s Registration and QA departments are working with PharmaNet to develop the transfer of information to ensure RNs are eligible to prescribe.
When BCCNM receives confirmation from the BC Centre on Substance Use (BCCSU) that a registrant has completed the educational requirements, and the registrant signs BCCNM’s Declaration for Prescribing Buprenorphine/Naloxone form confirming they have met the regulator’s requirements, BCCNM issues a prescriber number and provides the details on how to enroll for PharmaNet. BCCNM administers the Controlled Prescription Program for all prescribing registrants. Registrants obtain the duplicate prescription pads required to prescribe buprenorphine/naloxone by logging into their BCCNM account.