Registered Nurse Prescribing Framework
The Newfoundland and Labrador College of Nurses1 is the regulatory body for nurses in the province. The mandate of the College is to protect the public through self-regulation of the nursing profession in accordance with the Nurses Act (2024) and Nurses Regulations (2026).
The parameters for RN prescribing are set by the provincial government in the Nurses Act and Regulations which were used to guide the development of the RN Prescribing Framework. This framework is meant to be used as a guide for employer sponsors and select RNs who are interested in expanding their individual scope of practice to include prescriptive authority. The framework is linked to other relevant regulatory documents including the Code of Professional Conduct, the Scope of Practice Framework2, and the RN Prescribing Practice Guidelines.
An RN prescriber refers to an RN who has obtained the required education, authorization, and competence to add RN prescribing to their individual scope of practice as authorized by the College.
RN prescribing involves using the nursing process to:
- assess individuals within an employer sponsored area(s) of need, whom have conditions and require nursing care within the RN’s competence and authorization to prescribe
- establish a plan of care which may include:
- prescribing medications, ordering laboratory and diagnostic screening tests (including but not limited to ultrasound, x-ray, CT, etc.), and/or other non-pharmacological interventions, and making referrals within the parameters outlined by the employer sponsor.
- provide nursing care and services
With the support of a guidance document3, RN prescribing will provide improved access to prescriptive services for individuals with defined health care needs as identified by the employer sponsor.
At this time: Self-employed RNs may not prescribe as part of self-employment. RN prescribers are not permitted to prescribe any medication regulated by the Controlled Drugs and Substances Act (CDSA) and related regulations, unless receiving specific authorization from the employer sponsor and College or prescribe outside of the defined parameters as set by the College’s and employer sponsor authorization.
As RN prescribing is an expansion of the RN’s individual scope of practice, the RN Prescribing Framework is organized similarly to the Scope of Practice Framework using the same three guiding principles of education, authorization, and competence. However, to add RN prescribing to an RNs scope of practice, employer authorization is the first step, followed by education, and College authorization, where you must maintain competence, as outlined:
Step one: Obtain an employer sponsor
Step two: Complete the required continuing education courses.
Step three: Complete the College’s application process and obtain the required approval.
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- Herein referred to as the College. ↩︎
- Please refer to the most recent version of the Scope of Practice Framework for explanations/definitions of scope of practice, authorization, education, and competence, competencies, practice as a RN, and practice as an NP. ↩︎
- An evidence informed document used in the specific practice setting to guide decisions related to ordering of diagnostic and laboratory tests, and other non-pharmacological interventions, making referrals, and by prescribing medications. This document may be in the form deemed appropriate by the employer sponsor (e.g., protocol, algorithm, policy, practice procedure, guideline, etc.). ↩︎