December 2019

What you need to know about over-the-counter medications

Over-the-counter (OTC) medications do not require a prescription and nurses may recommend or administer them to a patient. If you decide to recommend an OTC medication, you are accountable for the recommendation and for any outcomes of that recommendation.

Whether you should recommend or administer OTCs depends on the following three factors:

Applicable legislation

Certain pieces of legislation, such as the Public Hospitals Act, require that all treatments be ordered by a physician, Nurse Practitioner, midwife or dentist. Nurses are accountable for being familiar with and practicing under relevant legislation that applies to their practice setting. This is an accountability outlined in principle 3.9 of the Code of Conduct.

Although OTCs usually do not require a prescription, some legislation requires an order. For example, in long-term care homes, medication administered to residents must be ordered by an authorized prescriber.

In the near future, RNs who complete education approved by CNO’s Council will be authorized to prescribe certain medications, including OTCs.

For more information about the drugs that RNs will be authorized to prescribe, the requirements for RNs to become authorized to prescribe and other considerations, visit the Journey to RN prescribing webpage.

Organizational policy

Employers determine the scope and responsibilities of their employees, including determining whether nurses can recommend and administer OTCs to patients. Nurses are accountable for complying with organizational policy and, if needed, working with their employers to develop policies that align with CNO’s standards of practice and are in the interest of patient safety.

Your knowledge, skill and judgment

If legislation and employer policy permits nurses’ recommending and administering OTCs, nurses must then ensure that they have the knowledge, skill and judgment to do so safely and ethically.

When deciding to recommend, administer or prescribe any medication, including OTCs, nurses must ensure that their medication practice is informed by evidence and they follow the accountabilities in the Medication practice standard. This includes assessing whether the medication is appropriate by considering the patient, the medication and the environment. Nurses should also educate the patient about the medication.

For more information on determining whether a procedure or activity, such as recommending and administering OTCs, is within your scope of practice, see the Ask Practice FAQ: Understanding Your Scope of Practice.

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