The new scope of practice prescribing standard, limits, and conditions set foundational requirements for current and future prescribing by BCCNM-certified practice (CP) nurses.
What standards apply when CP nurses prescribe.
The prescribing standard applies when Opioid Use Disorder CP nurses prescribe a medication to be dispensed by a pharmacist to an individual client.
The prescribing nurse assumes full responsibility and accountability when issuing the prescription. Risk to the client is reduced when at least two health professionals are involved to ensure the appropriateness of the medication for the client and assess any risks.
CP nurses who prescribe comply with all BCCNM standards, limits, or conditions applicable to the situation, including:
Consent practice standard
Before prescribing, CP nurses:
Are familiar with their responsibilities under the
Controlled Prescription Program (for OUD certified practice area).
CP nurses prescribing for OUD must be recognized by their organization as a nurse prescriber. They also follow workplace policies, which may vary from one workplace to another.
OUD CP nurses follow the BC Centre on Substance Use's (BCCSU)
Guideline for the Clinical Management of Opioid Use Disorder when treating clients. CP nurse prescribers are permitted to prescribe buprenorphine-naloxone, methadone, and slow-release oral morphine as well as some adjunct medications for symptom management (as per BCCSU guidelines and their workplace policies).
OUD CP nurses do not prescribe for safer supply (prescribe medications as a safer alternative to the toxic illegal drug supply).
OUD CP nurses refer to BCCNM's resource
Certified practice prescribing for OUD – Consulting and referring when consulting with or referring to other health professionals when prescribing for OUD.
Prescribing and giving a client-specific order are two separate and distinct activities. They are
not the same thing.
Prescribing: A nurse
prescribes when they issue a prescription for a pharmacist to dispense a specified medication for use by a designated person. Currently only OUD certified practice nurses are authorized to prescribe. General practice nurses and CP nurses who do not have the OUD CP designation are not authorized to prescribe.
Giving a client-specific order: A nurse
gives a client-specific order when they issue an instruction or authorization, not a prescription, for another regulated health professional to carry out restricted or non-restricted activities for a client.
Giving a client-specific order may include giving instruction for a medication-related activity—compounding, dispensing, or administering, but not prescribing—to be acted on by a regulated health professional, not a pharmacist. Nurses can only give client-specific orders for Schedule II drugs.
Nurses only give client-specific orders when they meet the requirements for acting within autonomous scope of practice.
The key difference between prescribing and giving a client-specific order is that prescribing involves giving the client a prescription that must be filled by a pharmacist. Giving client-specific orders does not involve prescribing or the giving of a prescription.
RACE Rapid Access to Consultative Expertise
For further guidance on understanding and applying the standards of
practice, contact our team by completing the Standards Support intake form.