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Registered Nurses tell CNO that RN prescribing is good for patient care

The College of Nurses of Ontario (CNO) protects the public by promoting safe nursing practice. This includes providing regulatory oversight to ensure changes in nursing scope of practice are implemented safely. 

“Nursing is a dynamic and ever-evolving profession. That’s why it is so important to gain an understanding about nurses’ perspectives on patient safety and the future of RN prescribing,” says Carol Timmings, CNO’s Chief Quality Officer and Deputy Registrar.

CNO recently conducted a survey where Registered Nurses (RNs) shared their perspectives on whether they would complete RN prescribing education when it becomes available in the future. The survey aimed to measure the interest and readiness of RNs — particularly those employed in settings where RN prescribing is permitted by law, such as public health, primary health and long-term care settings. The Public Hospitals Act does not enable RNs to prescribe medication in hospital settings.   

Out of those surveyed, 1,312 RNs, who provide direct patient care outside of a hospital, responded. Of these respondents, 56% said they plan to complete RN prescribing education; and over half said they would do so within the first six months of it being available. And 67% said their patients would benefit if they were authorized to prescribe medication.  

In sectors where laws enable RN prescribing, employers will decide if this scope change will be permitted in the practice setting and ensure safe implementation of this change. This includes ensuring RNs who prescribe have access to other health professionals, for example Nurse Practitioners or physicians, for consultation and mentorship. It also includes ensuring there is access to evidence-based decision-making supports and appropriate workplace policies. However, 78% of RNs who plan to complete RN prescribing education have not consulted their employers. 

“A key step for any RN interested in making this change to their practice is to consult and work with their employer to make sure RN prescribing will be supported in the setting,” says Timmings. “This ensures that RNs have access to necessary supports and will have the opportunity to practice and maintain competence.” 

In the survey, long-term care, home and community care support services and public health were the most common practice settings of RNs who report that they intend to complete RN prescribing education.

About 14% of respondents expressed that they did not intend to complete RN prescribing education. The reasons cited included a lack of interest, concerns about workload and uncertainty about whether their employers would permit RN prescribing. These concerns were echoed in open-ended comments, with nurses expressing apprehension about the lack of compensation for the added work.

Interestingly, 29% of respondents indicated they were unsure if they will complete education. Their reasons included the need for more information about education, including its length, cost and delivery methods, as well as uncertainties regarding whether employers will permit RN prescribing.

The survey also revealed demographic trends among respondents. Of the RNs who intend to complete RN prescribing education, the majority work in urban settings compared to rural and remote settings.

Protecting the public

RN prescribing regulations are not yet in force. These regulations still require government approval before taking effect.  

CNO’s role is to implement RN prescribing safely in Ontario. To ensure competent and safe practice, RNs will be required to complete prescribing education to become authorized to prescribe.

We are working with academic institutions interested in delivering RN prescribing education. CNO Council will approve these programs to ensure they capture the standards for safe practice.

Stay tuned on cno.org, and our social media pages for ongoing updates.

Page last reviewed August 02, 2023