It has been two years since Interior Health registered nurses (RNs) and registered psychiatric nurses (RPNs) began prescribing opioid agonist therapy (OAT).
In September 2020, a public health order (PHO) was issued by Dr. Bonnie Henry to enable nurse prescribing with the goal of increasing access to medication-assisted treatment and safer alternatives to the toxic illicit drug supply.
This PHO paved the way for the BC College of Nurses and Midwives and the BC Centre on Substance Use to work with the Ministry of Mental Health and Addictions and health authorities to develop the nurse prescriber scope in 2021.
Battling the effects of the toxic drug supply
Two years later, nurse prescribing in Interior Health has become a vital tool in the battle against the devastating deaths and effects of the toxic drug supply. To date, nurse prescribers have written more than 1,900 prescriptions for OAT to clients, the majority of which are self-referrals or referred from another OAT health-care provider.
“We are very proud of the progress of this nursing initiative here at Interior Health,” says Amanda Lavigne, a substance use clinical nurse specialist. “IH was the first health authority in B.C. to have a nurse prescriber write a prescription for Buprenorphine/Naloxone back in March 2021. Today we have RNs and RPNs prescribing OAT in 16 communities across IH. Planning for additional training and expansion to other areas is underway.”
Meeting clients where they are at
One of the biggest benefits of the nurse prescriber program is that nurses can meet clients where they are at. Says Amanda, “Nurse prescribers are finding creative ways to connect with people in their communities. In addition to offering expanded hours of access to OAT, nurses can reach out and follow up with clients who may have missed scheduled appointments so they can continue or restart treatment.”
In recognition of this important milestone, we spoke with a few of our nurse prescribers at IH about the differences this prescribing scope is making to their care practices.
In their words: Terry Abetkoff, RN, Virtual Nurse Prescriber, Kelowna
Why is nurse prescribing important?
"Nurse prescribing of OAT is important in providing a readily accessible option for medical treatment for at-risk clientele in the midst of an opioid crisis. Nurse prescribing is different because service is not dependent on medical coverage, and is not dependent on regular service hours (i.e., Monday to Friday, 8 a.m. – 4 p.m.). It also offers the possibility of comprehensive and supportive follow-up care. This 'supportive, in-the-moment care' model offered by nurse prescribers improves the probability of successful treatment initiation and treatment retention."
What do you enjoy about being a nurse prescriber?
As a nurse prescriber, I enjoy assisting clientele in their journey toward recovery, and the pride they express in their accomplishments. I also take pride in being a part the pioneering expansion of nursing’s scope of practice, which has added enormous value to the provision of health care in B.C.
In their words: Kristy Goosney, RN, Nurse Prescriber, Trail
Why is nurse prescribing important?
"Nurse prescribing gives us the opportunity to increase capacity of OAT clinics, as well as decrease wait times for individuals who are ready for change. It increases access points for clients to start on opioid use disorder treatment, as well as opportunities for us to follow up and meet clients where they are at."
What do you enjoy about being a nurse prescriber?
"I have enjoyed the opportunity to learn individuals’ stories: who they are, where they come from, where they want to go. I love that I’m able to provide some of the tools that can help people along their journey with health and well-being."
In their words: Crystal Head, RPN, Outreach Urban Health Centre, Kelowna
Why is nurse prescribing important?
"Nurses prescribing OAT allows increased access for clients, and offers new and innovative ways to deliver OAT health care. I was able to provide OAT treatment to clients who did not have active MSP coverage, which was a barrier to accessing user pay OAT clinics. I was able to provide individualized care and significantly more clinical support and intervention than what is available in a traditional office setting."
What do you enjoy about being a nurse prescriber?
"Becoming a nurse prescriber with Interior Health was an exciting opportunity to not only grow my professional knowledge, but to be a part of a ground-breaking team of nurses forging a new path to break down barriers for an underserved group of people.
"As the first nurse in B.C. to prescribe OAT, I was able to provide a lot of education and communication to a variety of community partners, including our local shelters, supported housing sites, RCMP, city cells, pharmacies and hospitals about the role nurse prescribers can play in promoting and supporting access to OAT treatment. I am proud to have been a part of the nurse prescriber rollout, and feel I was able to play a huge part in restructuring how clients access OAT in Vernon."
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