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Prescriptions from nurses, not docs on reserves

Article Origin

Author

Joyce Atcheson, Sweetgrass Writer, Fort McMurray

Volume

5

Issue

3

Year

1998

Page 8

In non-Aboriginal communities, drugs are prescribed by doctors with very rare exceptions. Only when doctors have given permission to use their authority can nurses prescribe antibiotics and perhaps other drugs.

In Janvier, Fort Chipewyan and Gregoire Lake, the Medical Services Branch of Health Canada hires registered nurses to prescribe drugs, said Jodi Rutley, communicable disease nurse for the Northern Lights Regional Health Centre in Fort McMurray.

In some cases, in the remote, rural communities like First Nations, not all of the nurses have taken addition education and skill development to know how to provide these services safely and competently.

Research shows many northern Alberta communities including Fox Lake, Jean D'Or Prairie, Garden River, and Assumption are getting their prescriptions made by these contract nurses. A medical doctor visits these communities periodically, but does not live there.

Prescription drugs should only be administered by a "prescribing authority". This authority has been given to medical doctors under the Medical Profession Act, based on their education.

But throughout northern Canada, nurses are the primary caregivers for geographically-isolated Native Peoples.

In Ontario and Saskatchewan, licensing bodies for doctors, nurses and druggists have signed agreements, allowing nurses to prescribe a number of drugs. In Sept. 1996, the Alberta government passed a law allowing only specially-trained registered nurses to prescribe, and only in isolated areas determined by the government.

Across Canada, the licensing bodies for nurses do not have a means to determine which nurses are qualified to prescribe, leaving the hiring to employers.

The federal government began funding programs to provide nurses with the skills and knowledge to prescribe and treat in isolated settings in the late 1960s. Nurses, whose basic two to four year education was aimed at bedside care under the orders of a doctor, spent four months learning prescription education programs.

Many nurses working in Native communities have not taken this education.

Registered nurses, along with their medical training, were also taught the specifics of prescribing drugs.

These programs operated in eight Canadian universities and were gradually stopped in the1980s on the advice of nursing leaders. Recently, the program has been revived at McMaster, Dalhousie, and Athabasca Universities.

Programs to learn this same knowledge for medical doctors are six to seven years in length.

There is a lot to know and learn when it comes to prescription drugs.

Dr. W. Eugene Sanders writes about the importance of a diagnosis based on history, physical examination, and collection of samples. Knowing when to treat is a process of education. One must know which family of germs are harmful and which family of drugs is most effective to wound harmful bacteria but leave the rest alive, notes Dr. W. Eugene Sanders How a drug is administered, side effects, the potential for addiction, and if drug-resistance is possible are all factors.

In many cases taking place in isolated communities, these decisions are up to a qualified nurse who may have gone through the four month education program.

Joyce Atcheson was a nurse in the Fort McMurray area for a number of years.