Dispensing in the Provincial Health Authority

The Newfoundland and Labrador College of Nurses¹ is the regulatory body for all nurses in the province. The mandate of the College is to protect the public through regulation of the nursing profession in accordance with the Nurses Act.

This document describes information related to the Scope of Practice² and expectations for LPNs and RNs in Newfoundland and Labrador (NL) who practice with the approval and under the general supervision of a Provincial Health Authority (PHA) in relation to dispensing.

The authority for dispensing by RNs and LPNs is found in the Pharmacy Act which states that: “This Act shall not extend to or interfere with the dispensing of necessary drugs or medicines by registered nurses or licensed practical nurses in the course of duty when practicing with the approval and under the general supervision of a regional health authority”³.

Dispensing Defined

In NL, the Pharmacy Act identifies dispensing as a practice of pharmacy and defines dispense as “means to provide a substance or item ordered by prescription but does not include the administration of that substance or item to a person or animal”.

Dispensing a medication to an individual client occurs only once. The repackaging and/or providing of medications to an individual client once they have been originally dispensed from a pharmacy for a particular client for later administration is considered to be supplying a medication and not dispensing. For example, it is not considered dispensing to:

• administer medications to a client prepared by a pharmacy
• fill a mechanical aid or alternative container from the client’s own blister pack or prescription bottle to facilitate self-administration, or administration by a caregiver.
• repackage and label medications from the client’s own supplies.
• provide a client medications prepared specifically for the client by a pharmacy; or give a client his/ her blister pack or prescription bottle.
• obtain medication(s) from ward stock or a night cupboard that will be administered directly to a client.
• obtain medications from ward stock or a night cupboard that are labelled specifically for a particular client.

Although dispensing is mainly a practice of pharmacy, it can be a practice requirement for LPNs and RNs who, with the approval and under the general supervision of a PHA, may need to dispense prescribed medications. Examples of such specific circumstances include, but are not limited to:

• geographical areas of the province with limited or no access to a pharmacy services.
• emergency units where LPNs and RNs may dispense a portion of prescribed medications for a client when pharmacy services are not available at the time and there is an urgency to dispense a small portion of the prescribed medications (e.g., initiating a course of antibiotic therapy, and controlling the spread of a communicable disease).
• situations where LPNs and RNs on nursing units may need to dispense from a night cupboard or ward stock, enough prescribed medications to cover a client’s unexpected short leave from a health care facility (i.e., the medication has not already been dispensed for this client by pharmacy).
• specific/limited situations as approved and established by the PHA (e.g., care directives for dispensing oral contraceptives).

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