Transforming and Supporting Patient Care - Health Professions ...

286Chapter 12 – Profession of NursingRNs in Oregon may dispense medication for family planning andcommunicable diseases, such as STDs. In North Carolina and Missouri,public health RNs are authorized to dispense medications. Montana limitsRN dispensing authority to those who work in an emergency departmentsituated at least ten miles (16 kilometres) from an open pharmacy and whenthere is no staff pharmacist on duty at the time. The Virginia Board ofPharmacy has approved the dispensing of contraceptive medication andtetracycline by RNs when a physician, nurse practitioner or pharmacist isnot on the premises. Maryland, New York, Kansas and New Hampshire donot authorize RNs to independently dispense.In New Zealand, RNs may dispense drugs independently in a limited numberof situations, for example, dispensing the emergency contraceptive pill. InAustralia and South Africa, RNs require specific authorization to dispense,as this is considered to be outside the normal scope of practice of theprofession. In Great Britain, RNs may, in limited circumstances, labelmedication from stock and supply a clinically appropriate medicine to apatient, against a written prescription for self-administration oradministration by another professional.NPsNPs are authorized to dispense drugs in the majority of Canadian provincesand territories. In New Brunswick, NPs may administer a limited quantity ofa specific drug to the patient so that the patient may start therapyimmediately while waiting for a pharmacy to open and fill a prescription. 27In Alberta, NPs may dispense Schedule I or II drugs. 28 In Manitoba, NPs mayprescribe and distribute samples of drugs as specified in the regulations.NPs in Saskatchewan may dispense Schedule I, II and III drugs, drugsincluded in the Health Canada Non-Insured Health Benefits and medicationsnot requiring a prescription. 29 In the Northwest Territories and Nunavut, acommunity NP may select, dispense, compound and repackage medicationunder medical directives, policies and guidelines, as community healthnurses do, in addition to prescribing. 30In British Columbia, NPs may prescribe or give an order to compound,dispense or administer by any method a drug as specified in theregulations. The College of Registered Nurses of British Columbia (CRNBC)has established detailed standards, limits and conditions for the threecategories of NP practice: NP (Family); NP (Adult) and NP (Paediatrics). 31These standards each focus on the following three areas:• Diagnosis and health care management;• Prescribing and dispensing drugs; and• Physician consultation and referral.27Nurses Association of New Brunswick. Competencies and Standards of Practice for NursePractitioners in Primary Health Care. October 2002: 8.28College and Association of Registered Nurses of Alberta. Health Professions Act: Standards forRegistered Nurses in the Performance of Restricted Activities. October 2005: 7.29Saskatchewan Registered Nurses Association. Bylaw VI Categories of Practice. s.2(c).30RNANT/NU. Prescriptive Authority Guidelines for NWT Primary Health Care Nurse Practitioners(PHCNPs). 2.31College of Registered Nurses of British Columbia. Scope of Practice for Nurse Practitioners:Standards, Limits and Conditions. October 2007. Family: 24; pediatrics: 25; adult: 25.HPRAC Critical Links January 2009