Training underway for registered nurses in Nova Scotia to write prescriptions

By the end of this year, a small batch of registered nurses will be the first in Nova Scotia to be able to write prescriptions.

A pilot training program through Dalhousie University's school of nursing began in January with three participants who are on track to complete their certification in December.

Ruth Martin-Misener, the director of Dalhousie's nursing school, said the first class includes nurses from emergency and primary care settings.

Although the program is designed to apply to a broad range of health-care settings, Martin-Misener said having nurses with prescribing authority in busy emergency departments and primary care clinics stands to deliver the most obvious benefit.

"There are gaps in access," said Martin-Misener, referring to the ongoing shortage of primary care providers.

That shortage means many Nova Scotians seek out primary care through walk-in clinics or emergency departments. The hope is that by broadening the scope of work that nurses can do in those settings, health care will become more accessible and efficient.

Nurse prescribing has been adopted in a handful of other Canadian provinces in the past few years, and it's been common practice in the U.K. for more than a decade.

"It makes sense, given the international evidence, that registered nurses could be helping to address those gaps," Martin-Misener said.

Antibiotics, contraceptives likely candidates for nurse prescribing

The medications nurses will be able to prescribe will depend on the setting in which they work and decided by their employer. Martin-Misener said in other jurisdictions, it's common for nurses to prescribe antibiotics, contraceptives and medications related to wound care.

The program has started small, but Martin-Misener said she expects demand to grow.

"I think that the gaps in care that RN prescribing has the potential to address will mean that there will be more of an uptake."

There's a possibility that another cohort of nurses could start the program this spring. The program is designed so that nurses can continue working while they study, taking one course per semester for two semesters, followed by a clinical rotation.

Any registered nurse with at least three years of clinical experience in the setting where they would be prescribing can take the course, so long as they have a letter of support from their employer.

'RNs are going to really welcome this'

Nova Scotia Nurses' Union president Janet Hazelton has been calling for prescribing authority for nurses, and said she's excited to see the program taking off.

"RNs are going to really welcome this," Hazelton said in an interview.

"When they're in an [emergency department], they feel the frustration of the patients that have to wait. They get it. We want to be efficient, we want to be doing a good job, and we want people to come in, get what they need and get out as quickly and as efficiently as possible."

Hazelton said she hopes it will eventually be integrated into the standard undergraduate program for registered nurses.

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