UR Opinion

Should Registered Nurses be able to prescribe medications and communicate diagnoses?

Katrina Smith

By Katrina Smith

Did you know that the Ontario Minister of Health, Mr. Eric Hoskins, recently announced that he will be proposing changes to the Nursing Act this spring. He plans to expand the Registered Nurse (RN) scope of practice to include prescribing medications and the communication of diagnoses to patients. As a licensed practical nurse with seven years experience, and a fourth year Bachelor of Science in Nursing student at Algonquin College in Pembroke, this thought petrifies me.
I feel that it is unsafe to expect RNs of all different levels of experience and education to be able to prescribe medications based on a one-semester pharmacology course, and differing levels of on the job experience. I quite enjoyed my pharmacology course and I even excelled at it. I excelled at my one, 3-credit (39 credit hour) course of pharmacology that I took to obtain my Bachelor of Science in Nursing, which qualifies me to write a national exam to become a RN. Does that sound like enough education to trust yours or your loved ones health concerns with? I do not believe so.
What is going to happen with employment opportunities for RNs who choose not to prescribe medications? Hospitals and other facilities in which nurses are employed, are more likely, if given the opportunity between two otherwise equal applicants, to hire the one who has accepted the responsibility to prescribe medications. This is going to force RNs who do not feel comfortable, or properly educated to prescribe, into those positions just so that they can remain employed and earning an income. I believe the prescribing authority should be left to nurse practitioners and physicians, if that is a skill that you want to do, then go back to school and get the proper education.
I am not alone in these feelings. After discussions with many health care providers including: licensed practical nurses, RNs, nurse practitioners, residents, and physicians; the theme is all the same. RNs are there to provide competent, holistic, and therapeutic care. The majority do not have the in depth knowledge required to safely and competently prescribe medications or communicate diagnoses. One individual I interviewed has just started their family practice residency. Prior to that they first worked as a RN, and then as a Nurse Practitioner over the past 25 years. They stated that they chose to go back to school and become a physician because they did not feel like they could safely provide patients with prescriptions and diagnoses based on their current education and knowledge base. Education and knowledge that they received from their time in school for nursing and advanced practice nursing, coupled with their 25 years of experience. If they didn’t feel comfortable or competent in their care, how could I?
Mr. Hoskins wants to increase the RN scope of practice, but how does he plan to ensure nurse prescribers are properly educated for these roles? Will he be there to back them up and defend them if something was to go wrong? Will he be advocating for nurse prescribers to have an increased salary? I do not know the answer to these questions, but I can make some assumptions, and they are not in favor of the nurse.

Katrina Smith
Petawawa, Ontario

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