Ensuring that Canadians receive the health-care services they need — when they need them — is a growing challenge in this country. Aging demographics, rising treatment costs and inadequate access to regular care are among the factors adding pressure to Canada’s health-care system.
Many experts agree that it’s critical to find new ways to deliver care and to make sure that all health professionals are contributing to their full capacity. In the view of the Canadian Nurses Association (CNA), it is time for registered nurses (RNs) across Canada to have prescribing drugs included in their scope of practice.
“The evidence is clear and compelling — RN prescribing benefits patients and improves accessibility to health-care services,” says Barbara Mildon, president of CNA.
Success of RN prescribing proven internationally
Registered nurses have prescribing authority in many countries, including Australia, Brazil, New Zealand, Sweden and the United Kingdom. Members of CNA got a first-hand look at the value of RN prescribing in 2009, when the association organized a study tour in England and Ireland. The tour included clinical site visits and meetings with nursing organizations, front-line nurses and governments.
“Registered nurses have been prescribing in those two countries for 15 years,” says Ms. Mildon. “They’ve amassed a large body of evidence that Canada can learn from. RN prescribing in the UK has reduced waiting times for patients and has increased patient satisfaction. It has also improved access to services and reduced the cost of delivery.”
Nurse practitioners a good Canadian model
Further evidence on the merits of optimizing scopes of practice is available right here in Canada. Canadian nurse practitioners (NPs) have been an important part of the health-care system for decades, and the authority for prescribing is an integral part of NP practice. Most recently, Health Canada published new regulations granting more prescribing authority for NPs under the Controlled Drugs and Substances Act.
The next goal for CNA is to see prescribing authorities extended to registered nurses. Some provinces, including British Columbia, Saskatchewan and Manitoba, are in formal or informal discussions on regulatory change, and CNA is working with these and other provincial/territorial nursing regulatory bodies and associations to help make RN prescribing a reality across the country.
Patient care benefits with optimized scopes of practice
In 2010, more than 4.4 million Canadians reported they didn’t have a regular family physician. With nurse practitioners and registered nurses taking on more primary care responsibilities, says Ms. Mildon, it is vital to ensure they are practising to their full scopes of practice.
“The most important message in terms of RN prescribing is about patient care,” Ms. Mildon says. “Typically, RNs have more regular face-to-face interaction with patients than other providers have. This makes them ideal providers to not only prescribe, but also to teach patients about medication safety and proper use.”