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Introduction

The new 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.

Prescribing

A nurse 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.

RNs who prescribe medications must comply with the following standards:

as w​ell as any other BCCNM standards, limits or conditions applicable to the situation.

General requirements to prescribe

What do I need to do to be able to prescribe?

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:

  • Organizational/employer developing policies, processes and resources to support safe nurse prescribing. These must include:
    • Determining what the additional education will be and how to access it
    • Process to recognize RNs as prescribers
    • Outlining the accountability and responsibility of the prescribing nurse
    • Processes for consulting with and /or referring to other health professionals about the prescribing decision as needed to meet client needs
    • Processes for ensuring continuity of care for clients
  • Facilitating PharmaNet access
  • Facilitating Medical Services Plan (MSP) access for RNs if needed
  • Developing a process for RNs to obtain a prescriber ID from BCCNM

As well, there are several steps that nurses must ensure are in place before they prescribe:

  • Formal recognition as a prescriber by your organization/employer
  • Successful completion of your organization’s/employer’s required additional education
  • Acquire a prescriber ID from BCCNM (Process in development)
  • Obtain PharmaNet access
  • Obtain an MSP number if needed
What additional education do I need to complete to be able to 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.

When I am identified as a prescriber, what medications can I prescribe within my autonomous scope of practice?

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. 

RNs cannot prescribe dermal fillers.

Prescribing for opioid use disorder