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Medications

Section 7: Restricted activities that require an order

Schedule I Drugs

Definitions from the Regulation:

Compound in section 6(o) means to mix two or more ingredients, and in any other case to mix a drug with one or more other ingredients.

Dispense which has the same meaning as in the Pharmacy Operations and Drug Schedule Act (PODSA), includes the preparation of a drug or device referred to in a prescription and taking steps to ensure the pharmaceutical and therapeutic suitability of a drug or device for its intended use and taking steps to ensure its proper use. This includes receipt of payment on behalf of a registrant's employer for a drug dispensed or administered by the registrant, if the registrant's employer lawfully requires payment for that drug from a person in respect of the individual for or to whom it is dispensed or administered.

Prescribe, which has the same definition as prescription in the Pharmacy Operations and Drug Schedule Act (PODSA), means an authorization from a practitioner to dispense a specific drug or device for use by a designated individual. 

Nurses (Registered Psychiatric) Regul​​ation, section 7(1)(f):

A registrant in the course of practising psychiatric nursing may, in respect of drugs specified in Schedule I or IA of the Drug Schedules Regulation¹

i.​​​
​compound the drug
​ii.
​dispense the drug, or
​iii.
administer the drug by any method.

BCCNM limits and c​onditions​

1.​​​
RPNs must not administer medication via intrathecal, epidural, intraosseous or perineural routes.
​2.
​RPNs must not induce general anesthesia or maintain general anesthetic agents. However, RPNs may induce procedural sedation with a client-specific order from a listed health professional.
​3.
RPNs must successfully complete additional education to administer medication via central venous access devices.
​4.
​RPNs may administer experimental medications not yet listed in any drug schedule as part of a formal research program.
​5.
​RPNs must not compound, dispense or administer schedule I drugs for the purpose of medical assistance in dying.

In the course of practising psychiatric nursing, RPNs may, with a client-specific order from a listed health professional, compound, dispense and administer drugs that are listed in Schedule I or IA of the provincial drug schedules. Schedule I drugs are those requiring a prescription (e.g., antipsychotics). Schedule IA drugs are controlled drugs in the Controlled Prescription Program (e.g., methadone, morphine).

RPNs occasionally administer, with a client-specific order from a listed health professional, “non-marketed drugs" when needed for clients with serious or life threatening diseases. These drugs are available through Health Canada's Special Access Program and are used when conventional therapies have failed, are unsuitable or are unavailable.

Further direction related to medication can be found in two BCCNM RPN practice standards: RPN Medication Administration and RPN Dispensing Medications.

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Footnotes​

1​​​

Drug Schedule R​​egulation of the Pharmacy operations and Drug Scheduling Act of British Columbia. http://www.bclaws.ca/civix/document/id/complete/statreg/9_98