RN(AP) Resources

The Authorized Prescriber role enables Registered Nurses and Registered Psychiatric Nurses to bring a distinct impact on access and quality care within three practice areas in Manitoba: Sexual and reproductive health, Diabetes management and Travel Health. There is now funding available to individuals for individuals to pursue the appropriate steps to achieve the formal prescribing notation.

This FAQ is to assist managers and nurses with questions you may have regarding the AP program and the funding available. All nurses interested should discuss this opportunity with your managers.

A significant public need has been identified for the AP role for Registered Nurses (RNs) and Registered Psychiatric Nurses (RPNs). 3 central practice areas have been identified as areas of focus for the AP role:

• Sexual and reproductive health
• Diabetes management
• Travel health

This role permits RNs and RPNs, who complete a specialized education program, to prescribe medications for specific client populations. This differs from the current approach whereas RNs and RPNs administer medications with a prescriber’s order. Under the current Regulated Health Professions Act, the Authorized Prescriber Role has been added for RNs, and RPNs under General Regulation. The goal of the AP role is to:

• Target gaps in access and care for structurally disadvantaged populations and persons living with chronic illness
• Decrease health care costs through nurse-driven primary, secondary, and tertiary approaches to care
• Promote timely treatment for Manitobans in the areas of sexual and reproductive health, diabetes management, and travel health
• Expand the RN and RPN scope of practice to better meet the health needs of Manitobans

A nurse in the AP role engages in critical inquiry to determine holistic plans of care. Following thorough assessment, diagnostic reasoning and planning occurs; engaging the client and their supports as appropriate. Care involves ordering specific diagnostic tests and prescribing drugs and vaccines relevant to the AP’s areas of practice. APs maintain the responsibility of interpreting and managing the client’s test results, evaluating treatment, and working collaboratively with other health care providers to ensure the overall health needs of the client are met.

There is a deadline in place until May 31, 2024 for RNs working in the role. For RPNs this deadline is until June 1, 2024. This means that any RNs who are currently initiating prescriptions must achieve the notation before May 31, 2024 by completing a pathway through clinical competence assessment and or education. RPNs who current initiate prescriptions must achieve the notation before June 1, 2024. After these dates, RNs or RPNs without the notation can no longer prescribe or order diagnostic and screen tests related to diabetes, travel or reproductive, STBBI health.

The pathways are designed to allow the prospective RN or RPN AP to determine where they best fit.  Your employer will work with you to determine how you may meet the requirements for each of the pathways.  Once that has been determined, it is up to the RN or RPN to determine the application requirements to the CRNM or CRPNM, this information can  be found on each of their websites.

An authorized prescriber notation provides registered nurses and in the future registered psychiatric nurses with the authority to initiate prescriptions and order diagnostics and screening tests for three specific populations. These populations are travel health (RN only), diabetes health, and reproductive, sexually transmitted infections and blood borne pathogens. Each population has a specific theory course. Education requirements include three courses – prescribing course, theory course specific to the population and a clinical course

If you are a registered nurse or registered psychiatric nurse who is interested in becoming an authorized prescriber, here are 5 pathways to achieve an authorized prescriber notation.

The first step is to determine which scenario applies to you.

Scenario 1. RNs or RPNs have completed education other than the Essentials of RN Prescribing Practice at Red River College Polytech or Athabasca University – MB RN Prescribing; a theory course specific to travel health, diabetes or reproductive/STBBI at Red River College Polytech (RRCP) and a Consolidated Clinical Practicum at RRCP.

Scenario 3

RNs or RPNs have completed all of their learning about travel health, diabetes or reproductive/STBBI and initiating prescriptions on the job.

Scenario 5

RNs or RPNs with prescribing experience from other jurisdictions in Canada move to Manitoba.

If any of these scenarios apply to you, your first step is to complete an authorized prescriber notation application with your College. The College will review your application and make a referral for a clinical competence assessment. Nurses from any of these scenarios must complete a clinical competence assessment or CCA.  A CCA is an examination that assesses nursing knowledge and practice using competencies for authorized prescribers as the framework for evaluation. A CCA is completed over two days at University of Manitoba. A Clinical Competence Assessment (CCA) will be available starting in August of 2022.

Based on the outcome of the CCA, the College will inform you of the necessary next steps. There are two possible outcomes:

1. No gaps are identified in the CCA. Nurses would then be eligible for approval of an AP notation with their College for the applicable population.
2. Gaps are identified in the CCA. And must be addressed through successful completion of remedial education. Education is available through the existing RN prescriber programs at Red River College Polytech (RRCP) or the approved prescribing course at Athabasca University (AU)(MB RN Prescribing). When remedial education is successfully completed, nurses would be eligible for approval of an AP notation with their College for the applicable population.

Scenario 2.  RNs and RPNs have extensive experience and content knowledge regarding the population – travel health, diabetes or reproductive/STBBI but have not completed a prescribing course. They have obtained and maintained one of the following as an alternative to the theory course:

• International Association of Forensic Nurses Sexual Assault Nurse Examiner (SANE) Certificate
• International Society of Travel Medicine (ISTM) Certification of Travel Health
• Canadian Diabetes Educator Certification Certified Diabetes Educator (CDE)

Nurses must complete a prescribing course (either AU or RRCP) and a clinical course at RRCP and maintain their certificate or certification.

After both the prescribing and clinical courses are successfully completed, the nurses must apply and be approved for an AP notation with their College for the applicable population.

Scenario 4. Nurses are interested in the authorized prescriber role and have no experience specific to the populations of travel health, diabetes or reproductive/STBBI or initiating prescriptions. These nurses must complete all 3 components of the education; prescribing, theory and clinical courses. Education is available through the existing RN prescriber programs at Red River College Polytech or the approved prescribing course at Athabasca University (MB RN Prescribing) with the theory and clinical courses at RRCP.

When the education is successfully completed, the nurses must apply and be approved for an AP notation with their College for the applicable population.

We anticipate that a Clinical Competence Assessment (CCA) will be available starting in August of 2022.

Paths to becoming an Authorized Prescriber

Yes.  Funding is available for all required coursework, and the clinical assessments. Funding availability for the clinical practicum costs will vary by site and region. Please talk with your manager to determine which scenario applies to your individual situation and the funding that is available. Please find a breakdown below of the costs for each component:

The Clinical Competence Assessment (approx. $2448 per nurse). Wage replacement for the Clinical Competence Assessment is available which includes 2 days salary.

Red River College has prescribing courses and content courses (approx. $1500 per course) for STBBI and Diabetes health as well Athabasca offers prescribing courses (approx. $945). Please refer to the diagram above. Wage replacement is available for coursework 4 hours/week for 13 weeks approximately.

It is important that you first discuss the need for your role to become an Authorized Prescriber with your employer. If you have completed the education for AP since May 2021 please present your proof of successful completion to your employer to receive reimbursement.

It is important that you check with your employer to determine the need for your role to become an Authorized Prescriber. Should your employer determine it is appropriate for your role to become an AP you will then have access to the funding support.

If you choose to take the course on your own initiative without the support of your employer the funding will not be available to you.

Yes, you will need to pay for the educational courses upfront and will be reimbursed after you have shown proof of successful completion.

In order to be considered for the AP notation you must successfully complete the coursework. You will be reimbursed after you have shown proof of successful completion. If you do not pass the course please advise and discuss with your manager.

At this time, there is no increase in salary. 

There is no provincial funding available for salary replacement related to the practicum. In some situations, individuals may need to travel for part of the practicum. This should be arranged with your employer, and the employer will support travel costs and clinical time.

The first step is to talk with your Manager. It is important that your manager agrees that your role is a fit for prescribing in the populations of STI, Diabetes or Travel health. Your manager can work with you to determine your current experience and knowledge and the process for you to proceed, along with support you with the funding that is available for this.

There are no additional practice hours required for RNs or RPNs with a notation beyond the usual requirements. Continuing competence requirements include a self-assessment using the AP Practice expectations.

On the registration renewal application, you will be asked if you continue to practice in the role of AP as you need to maintain a role with AP competencies. If you are not practicing in an AP role for more than 3 years you are not eligible for maintaining the notation.

Yes, if you are completing a CCA, your employer will need to complete an Employer Support Form as part of your College application form. The support form is necessary to ensure you are practicing in the role and are eligible for a CCA.

Education institutions may also request an Employer Support letter as part of their admission application process.