The Registered Nurses Act and Regulations is the legislation that sets out the College’s legal authority to regulate registered nurses (RN), registered nurses (extended practice) (RN(EP))*, and graduate nurses (GN). Back in 2005, when the regulation of RN(EP)s as a separate class of registrants began, prescriptive authority was granted by the government for RN(EP)s to prescribe from a very specific schedule of drugs. This legislation was recently amended to expand the prescriptive authority for RN(EP)s which will enhance public access to health services. The changes are effective August 10, 2011.
Download the
Extended Practice Regulation amendments here or download a copy of the
Extended Practice Regulation with the amendments attached to the end (a consolidated version will be available in the future). An explanation of the changes is provided in the chart below.
Effective August 11, 2011, Manitoba Health is now accepting applications for EDS part 3 drugs from nurse practitioners with the exception of controlled drugs and substances. Manitoba Health is currently updating their website to reflect these changes.
*In Manitoba the term Nurse Practitioner (NP) is synonymous with Registered Nurse Extended Practice (RN(EP)).
Amended Section of the Regulation |
Explanatory Notes |
Subsection 2(1) is amended by adding the following after item 3:
3.1 The applicant must apply to the executive director and be given approval to engage in extended practice with respect to one or more of the following patient populations described by policies approved by the board:
- (a) family (all ages);
- (b) pediatric (including neonatal);
- (c) adult
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Although section 3.1 is new, the practice of RN(EP)s declaring their client population is not new. The EP registration application process to date asks RN(EP)s to “Describe your practice in relation to client population” (e.g., specific ages of clients, individuals, families, communities). |
The following is added after section 4:
Extended practice requirements
4.1(1) A registered nurse (extended practice) may only engage In extended practice
- (a) that he or she is competent to perform or provide and in respect of a patient population for which he or she has been granted approval to perform or provide extended practice;
- (b) in respect of a patient for whom he or she is competent to perform or provide extended practice; and
- (c) in accordance with any conditions on the certificate of practice Issued to him or her.
4.1(2) In subsection (1), “competent” means having the requisite skill, knowledge and judgment to perform or provide the extended practice for the patient who is the recipient of the extended practice.
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This amendment reflects the expectations of the RN(EP) as previously identified in the Standards of Practice for Registered Nurses on the Extended Practice Register and the Competencies For The Registered Nurse (Extended Practice), RN(EP) Register. |
Subsection 6(1) is replaced with the following: |
Prescribing drugs
6(1) For the purpose of clause 2(2)(b) of the Act, a registered nurse (extended practice) may
- (a) prescribe any drug listed in Schedule 1 of the Manual for Canada’s National Drug Scheduling System published by the National Association of Pharmacy Regulatory Authorities, as amended from time to time;
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This amendment revises the formularies from which RN(EP)s may prescribe, expanding their prescriptive authority from a limited number of drugs to all drugs, with the exception of controlled drugs and substances. RN(EP)s must continue to ensure that they have the requisite knowledge of the new drugs that they can now prescribe relevant to their client population.
An overview of Schedule 1 of the Manual for Canada’s National Drug Scheduling System published by the National Association of Pharmacy Regulatory Authorities (NAPRA) can be accessed here: http://napra.ca/pages/Schedules/Overview.aspx?id=1925
To search the NAPRA National Drug Schedules access this link: http://napra.ca/pages/Schedules/Search.aspx
Although controlled drugs and substances are part of Schedule 1 of the NAPRA list, RN(EP)s cannot currently prescribe these drugs because of restrictions set out in the Controlled Drugs and Substances Act (federal legislation).
With consideration that the drug lists may be amended from to time and in accordance with The Standards of Practice For Registered Nurses on the Extended Practice Register, “RN(EP)s should establish a consultative relationship with a pharmacist.” Pharmacists are in the best position to provide up-to-date information regarding changes to the drug lists.
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- (b) prescribe any device listed in Part 1 or 2 of the Specified Drugs Regulation under The Prescription Drugs Cost Assistance Act, as amended from time to time;
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This has not changed as RN(EP)s have always been authorized to prescribe drugs and devices listed in Part 1 or 2 of the Specified Drugs Regulation under The Prescription Drugs Cost Assistance Act.
However, prescribing drugs has been removed from this section and is now covered under clause (a). As well the wording “distributing samples of them” has also been removed from this section in accordance with The Food and Drugs Act (federal legislation) which regulates the distribution of drug samples. |
- (c) prescribe drugs or devices other than those referred to in clauses (a) or (b), if the nurse is an employee of a regional health authority or health care facility who is permitted to do so by a written policy of the authority or facility;
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This legislation remains the same as the previous regulation and while this may expand RN(EP)s prescriptive authority, controlled drugs and substances remain the exception. |
- (d) prescribe any non-prescription drug in order to permit the patient to access a drug plan that covers non-prescription drugs; and
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This legislative authority remains the same as the previous regulation. |
- (e) prescribe any non-prescription device, in order to permit the patient to access a plan that covers non-prescription devices.
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This amendment will now give prescriptive authority for RN(EP)s to independently prescribe any non-prescription device, in order to permit the patient to access a plan that covers non-prescription devices. |
Subsection 6(2) and Schedule B have both been removed from the Regulation. |
The amendments described in this chart make subsection 6(2) and Schedule B redundant so they were removed from the Regulation. |
For further information about RN(EP) practice download the following:
