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​Schedule I Drugs 

Anaphylaxis

​​Nurses (Registered Psychiatric) ​Regulation, section 6(n):

A registrant in the course of practising psychiatric nursing may, in respect of a drug specified in Schedule I of the Drug Schedules Regulation,1

i.​
P​​rescribe the drug
ii.
compound the drug
​iii.
dispense the drug
​iv.
administer the drug by any method

for the purpose of:

v.​
​​treating:

a.    ​anaphylaxis

​BCCNM limits ​​and c​onditions

1.​
​RPNs are limited to administering epinephrine to treat anaphylaxis.
2.
RPNs who administer epi​nephrine to treat anaphylaxis must follow decision support tools in the Communicable Disease Immunization Program Section V - Management of Anaphylaxis in a Non-hospital Setting2 established by British Columbia Centre for Disease Control (BCCDC)2 or equivalent approved by their employer.​
3.
​RP​​Ns who administer epinephrine must successfully complete additional education​.​

Further direction related to medication can be found in the BCCNM Medications practice standard

Further direction on prescribing medications​.

Opiate Overdose

Nurses (Registered Psychiatric) Regulation, section 6(n):​

A registrant in the course of practising psychiatric nursing may, in respect of a drug specified in Schedule I of the Drug Schedules Regulation,1

i.​
P​​rescribe the drug
ii.
compound the drug
​iii.
dispense the drug
​iv.
administer the drug by any method

for the purpose of:

v.​
​​treating:

a.    opiate overdose​.

​BCCNM limits ​​and c​onditions

1.​
​RPNs must not administer, compound or dispense a Schedule I drug to treat a suspected opiate overdose.

There are no limits or conditions on administering and dispensing unscheduled naloxone.

More information on naloxone can be found on the BCCNM website.

Further direction on prescribing medications​.

Respiratory Distress

Nurses ​​​ (Registered Psychiatric) Regulation, section 6(n):

A registrant in the course of practising psychiatric nursing may, in respect of a drug specified in Schedule I of the Drug Schedules Regulation,¹

i.​
P​​rescribe the drug
ii.
compound the drug
​iii.
dispense the drug
​iv.
administer the drug by any method

for the purpose of:

v.​
​​treating:

a.   respiratory distress in a known asthmatic​.

​BCCNM limits ​​and c​onditions

1.​
​RPNs are limited to administering salbutamol or ipratropium bromide to treat respiratory distress in known asthmatics.
2.
RPNs who administer salbutamol or ipratropium bromide to treat respiratory distress in a known asthmatic must follow a decision support tool approved by their employer.​
3.
RPNs who administer salbutamol or ipratropium bromide must successfully complete additional education​.​​

Further direction related to medication can be found in the BCCNM Medications practice standard.

Further direction on prescribing medications​.

Hypoglyce​mia​

Nurses (Registered Psychia​​tric) Regulation, section 6(n):

A registrant in the course of practising psychiatric nursing may, in respect of a drug specified in Schedule I of the Drug Schedules Regulation,¹

i.​
P​​rescribe the drug
ii.
compound the drug
​iii.
dispense the drug
​iv.
administer the drug by any method

for the purpose of:

v.​
​​treating:

a.   hypoglycemia​​.

​BCCNM limits ​​and c​onditions

1.​
RPNs are limited to administering D50W to treat hypoglycemia.
2.
RPNs who administer D50W to treat hypoglycemia must follow a decision support tool approved by their employer.​
3.
RPNs who administer D50W must successfully complete additional education​​.​​

Further direction related to medication can be found in the BCCNM Medications practice standard.

Further direction on prescribing medications​ and giving client-specific orders for Schedule I and II drugs.

​Influenza-like Illness​

Nurses (Registered ​​Psychiatric) Regulation, section 6(n):

A registrant in the course of practising psychiatric nursing may, in respect of a drug specified in Schedule I of the Drug Schedules Regulation,¹

i.​
P​​rescribe the drug
ii.
compound the drug
​iii.
dispense the drug
​iv.
administer the drug by any method

for the purpose of:

v.​
​​treating:

a.   conditions that are symptomatic of influenza-like illness​​.

BCCNM limits ​​and c​onditions

1.​
RPNs who compound, dispense or administer antiviral medication to treat symptoms of influenza-like illness must successfully complete additional education.
2.
RPNs who compound, dispense or administer antiviral medication to treat symptoms of influenza-like illness must follow the RN and RPN Decision Support Tool (Clinical Practice Guidelines) for Identification and Early Treatment of Influenza-Like Illness (ILI) Symptoms during an Influenza Pandemic in the Absence of a Medical Practitioner or Nurse Practitioner3 established by the provincial government, or equivalent approved by their employer.​
3.
RPNs must not compound, dispense or administer antiviral medication to treat symptoms of influenza-like illness for children under the age of 4.​​​

Further dire​ction related to medication can be found in two BCCNM Medications practice standard​.

Further direction on prescribing medications.​​

Immunizations and Post-exposure Chemoprophylactic Agents Schedule I and II Drugs ​

Nu​​rses (Registered Psychiatric) Regulation, section 6(n):

A registrant in the course of practising psychiatric nursing may, in respect of a drug specified in Schedule I of the Drug Schedules Regulation,¹

i.​
P​​rescribe the drug
ii.
compound the drug
​iii.
dispense the drug
​iv.
administer the drug by any method

for the purpose of:

v.​
preventing disease using immunoprophylactic agents and post-exposure chemoprophylactic agents.

BCCNM limits ​​and c​onditions

1.
RPNs who, within their autonomous scope of practice, prescribe, compound, dispense or administer immunoprophylactic or chemoprophylactic agents identified by the BC Centre for Disease Control (BCCDC) must:
  • possess the competencies established by BCCDC
  • follow decision support tools established by BCCDC​​
2.
RPNs who prescribe, compound, dispense or administer post-exposure chemoprophylactic agents for sexual assault purposes must:
  • possess the BC Women’s Sexual Assault Service Competencies for RN SANES6 (BCWSAS), and 
  • follow Decision Support Tools for Sexual Assault Nurse Examiner7 (for Registered Nurses) established by BCWSAS​  
3.
RPNs must not prescribe, compound, dispense or administer immunoprophylactic or post-exposure chemoprophylactic agents for the purpose of preventing disease in travelers (also known as travel health).
4.
RPNs must not, within their autonomous scope of practice, prescribe, compound, dispense or administer immunoprophylactic agents or post-exposure chemoprophylactic agents for children under the age of 4 years old.
5.
RPNs must not prescribe, compound or administer experimental vaccines for research purposes.​​​


See Section 7: Restricted activities that require an order​ for additional limits and conditions related to Schedule II drugs.

Further direction related to medication can be found in the BCCNM Medications practice standard.

Further direction on prescribing medications​ and giving client-specific orders for Schedule I and II drugs.

​Schedule II Drugs​

Nurses (Registered Psychiatric) Regulation, section 6(o):

A registrant in the course of practising psychiatric nursing may, in respect of drugs specified in Schedule II of the Drug Schedules Regulation¹

i.​
P​​rescribe the drug
ii.
compound the drug
​iii.
dispense the drug
​iv.
administer the drug by any method

BCCNM limits ​​and c​onditions

1.
RPNs require a client-specific order from a listed health professional to compound, dispense or administer Schedule II medications to treat a disease or disorder. For example, nurses would not administer insulin (Schedule II) without knowing that a physician had diagnosed diabetes and ordered insulin therapy.
2.
RPNs may only compound, dispense or administer Schedule II medications to treat a condition following an assessment and nursing diagnosis. Vaccines do not require the identification of a condition.​  
3.
RPNs must not carry out Insulin dose adjustment.
​​4.
RPNs who administer Schedule II drugs intravenously via a peripheral venous access device must either:

  • ​follow an employer approved decision support tool or
  • act with a client-specific order from listed health professional​. 
5.
RPNs who administer medication via central venous access devices must:

  • act with a client-specific order from an listed health professional, and
  • successfully complete additional education to administer medication via central venous access devices. ​
6.
RPNs must not administer medication via intrathecal, epidural, intraosseous or perineural routes because it is not within RPN scope of practice​.​​​

Further direction related to medication can be found in the BCCNM Medications practice standard​​.

Further direction on prescribing medications​ and giving client-specific orders for Schedule I and II drugs. Schedule II medication includes drugs such as:

  • Glucagon.
  • Activated charcoal.
  • Sublingual nitroglycerin.
  • Gentian violet.
  • Some pediculicides.
  • Some analgesics and decongestants.
  • Some vitamins.

Schedule II medications also include the following vaccines:

  • Influenza.
  • Pneumococcal.
  • Vaccines that are part of​​ a routine immunization program.

Vaccines that require special enhanced public access due to disease outbreaks. The BC Centre for Disease Control (BCCDC) sets direction for clinical practice related to routine immunizations and for chemoprophylaxis in contacts of clients with communicable disease.​

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Foot​notes

​1

​Drug Schedules Regu​lation of the Pharmacy Operations and Drug Scheduling Act of British Columbia. http://www.bclaws.ca/civix/document/id/complete/statreg/9_98

​2

Communicabl​e Disease Immunization Program. Section V - Management of Anaphylaxis in a Non-Hospital Setting. http://www.bccdc.ca/resource-gallery/Documents/Guidelines%20and%20Forms/Guidelines%20and%20Manuals/Epid/CD%20Manual/Chapter%202%20-%20Imms/SectionV_Anaphylaxis.pdf

​​3

​RN ​and RPN Decision Support Tool (Clinical Practice Guidelines) for Identification and Early Treatment of Influenza-Like Illness (ILI) Symptoms during an Influenza Pandemic in the Absence of a Medical Practitioner or Nurse Practitioner. https://www2.gov.bc.ca/gov/content/health/about-bc-s-health-care-system/office-of-the-provincial-health-officer/current-health-topics/pandemic-influenza

​4

​Imm​unization Competencies for BC Health Professionals. http://www.bccdc.ca/resource-gallery/Documents/Training%20and%20Events/Immunization/Vaccine%20Info/BCCDCImmunizationCompetencies_September2010.pdf

​5

​Communicable Disease Control Manual. http://www.bccdc.ca/health-professionals/clinical-resources/communicable-disease-control-manual

​6

​BC ​​Women’s Sexual Assault Service Competencies for RN SANES Dispensing Prophylactic Medications to Protect against STI and HIV after Sexual Assault. http://www.bcwomens.ca/Professional-Resources-site/Documents/Sexual%20Assault/DST%20for%20SANES%20Dispensing%20HIV%20PEP%20August%201,%202018.pdf

​7

​Deci​sion Support Tools for Sexual Assault Nurse Examiners http://www.bcwomens.ca/health-professionals/professional-resources/sexual-assault-service-resources  ​