More than 1,000 registered nurses (RNs) in Ontario have now gained the authority to prescribe certain approved medications, marking a major achievement in strengthening patient access to care. This has proven especially valuable in practice settings that may not have access to a traditional prescriber, such as a physician or a Nurse Practitioner.
RN prescribing became possible in Ontario following legislative changes in 2023. Since then, CNO has developed a practice standard and guidance to support safe RN prescribing practice. CNO-approved baccalaureate and continuing education nursing programs can now teach RN prescribing, and employers in eligible practice settings can provide opportunities for authorized RNs to use this authority in practice.
To learn more about what this change means in practice, we spoke to two Ontario RNs who recently gained the authority to prescribe.
Streamlining care
“RN prescribing gives me the autonomy to deliver efficient care. It strengthens my relationship with patients by providing faster access and increased trust by addressing their needs directly.” — Mario Silva, RN
Mario Silva is an RN at Halton Healthcare in Oakville and has been a nurse for about a year. He said he was drawn to the nursing profession because he wanted a career where his daily actions could ease suffering, advocate for patients and help communities lead healthier lives through hands-on, compassionate care.
Silva plans to use his prescribing authority in community clinics to prescribe medications within the RN prescribing scope, including contraceptives, travel medications, wound care treatment and smoking cessation aids He says this can help streamline care and improve patient access.
“RN prescribing gives me the autonomy to deliver efficient care,” he said. “It strengthens my relationship with patients by providing faster access and increased trust by addressing their needs directly.”
Silva describes RN prescribing as a turning point for Ontario nursing. “It addresses health care gaps,” he said, “especially for underserved populations, by ensuring patients receive timely, direct treatment exactly when and where they need it.”
Greater autonomy in practice
“RN prescribing is only a starting point to strengthening access to care for patients. RNs in primary care can offer greater continuity as they know the patients, have access to patient charts and can provide additional oversight for their care.”— Erica Atfield, RN
Erica Atfield, an RN at the Peterborough Clinic, has been a nurse for 22 years. Even as a child, she wanted to spend her life helping people. “I felt nursing was a good way to tangibly make a difference in someone’s life,” she said. “Nursing was also a skill set I could take with me anywhere I travelled or lived.”
For Atfield, prescribing authority is a small step toward greater autonomy in her practice as an RN. “It has helped me to connect at a different level with my patients and has shown me how much more I could do with more training,” she said.
She says RN prescribing can make patient visits more seamless. For example, when she sees a patient for a Pap test, she is now able to support their contraceptive needs or any other non-complex concern that falls within her prescribing authority.
“RN prescribing is only a starting point to strengthening access to care for patients,” Atfield said. “RNs in primary care can offer greater continuity as they know the patients, have access to patient charts and can provide additional oversight for their care.”
CNO continues to support safe RN prescribing through standards, guidance and practice support. Nurses and employers who have questions about RN prescribing can contact CNO’s Practice Support.