The Nurses Act was amended in July 2002 to enable the practice of nurse practitioners in New Brunswick. The nurse practitioner role is regulated in addition to that of a registered nurse because the nurse practitioner performs activities that are not considered part of the scope of practice of registered nurses.
Profile of the Nurse Practitioner
Nurse practitioners, as autonomous health professionals with advanced education, provide essential health services grounded in professional, ethical and legal standards. They integrate their in-depth knowledge of advanced nursing practice and theory, health management, health promotion and disease/injury prevention, and other relevant biomedical and psychosocial theories to provide comprehensive health services. Nurse practitioners work in collaboration with their clients and other health care providers in the provision of high quality patient-centred care. They work with diverse client populations, in a variety of contexts and practice settings.
Nurse practitioners have the competence to provide comprehensive health assessment, to diagnose health/illness conditions and to treat and manage acute and chronic illness within a holistic model of care. Nurse practitioners order and interpret screening and diagnostic tests, perform procedures and prescribe medications while integrating the principles of resource allocation and cost-effectiveness, in accordance with federal and provincial legislation and policy.
Nurse practitioners are accountable for their own practice and communicate with clients about health assessment findings and diagnoses, further required testing, referral to other health care professionals; they are also responsible for client follow-up. Nurse practitioners counsel clients on symptom management, health maintenance, pharmacotherapy, alternative therapies, rehabilitation strategies and other health programs.
Nurse practitioners have the knowledge to assess population health trends and patterns and design services to promote healthy living. They provide leadership in the development, implementation and evaluation of strategies to promote health and prevent illness and injury with interprofessional teams, other health care providers and sectors as well as community members.
Nurse practitioners collaborate in the development of policy to influence health services and healthy public policy.
Competencies and Standards
The NP role is a nursing role, and nurse practitioners must practise in accordance with all NANB standards. In addition, NPs must practice in accordance with the Standards of Practice for Nurse Practitioners.
The documents Entry-Level Competencies for Nurse Practitioners and Standards for the Practice of Primary Health Care Nurse Practitioners focus on the responsibilities in nurse practitioner practice which require additional regulation by NANB.
Nurse Practitioners (NPs) in New Brunswick who have successfully completed the required learning and clinical practice expectations, as outlined by the NANB and who have received an Exemption from Health Canada, are authorized to prescribe Methadone.
To prescribe methadone, NPs are subject to the Government of Canada’s Narcotic Control Regulations subsection 53(3), which requires practitioners to obtain a subsection 56(1) exemption under the Controlled Drugs and Substances Act (CDSA). For further information please read Fact Sheet: Nurse Practitioners (NPs) Prescribing Methadone.
The prescribing authority for NPs in New Brunswick can be found in the Schedules for Ordering for Nurse Practitioners - in Appendix 2 of the document Standards for the Practice of Primary Health Care Nurse Practitioners.
Application forms for exemption:
Verifying an exemption to prescribe methadone:
The NANB recommends that pharmacists and other stakeholders check the New Brunswick Registry for NPs, to ensure that the prescribing nurse practitioner has the authority to prescribe methadone. This registry is found at www.nanb.nb.ca under the icon REGISTRATION SERVICES –> Registration Verification.
Schedules for Ordering
The NP Schedules for Ordering outline the screening and diagnostic tests that may be ordered and interpreted, the drugs that may be prescribed and the forms of energy that may be ordered by the NP. These schedules are established through recommendations of the NP Therapeutics Committee (NPTC) and approved by the NANB Board of Directors and the Minister of Health.
The schedules are located in the NANB document Standards for the Practice of Primary Health Care Nurse Practitioners, Appendix 2
- Schedule “A” refers to Medical Imaging Tests
- Schedule “B” refers to Laboratory and Other Non-Laboratory Tests
- Schedule “C” refers to Drugs
Nurse Practitioner Practice Analysis
In February 2016, the Canadian Council of Registered Nurse Regulators (CCRNR) released the findings of the Nurse Practitioner (NP) Practice Analysis. The purpose of the NP Practice Analysis was to provide a comprehensive description of the entry-level knowledge, skills and abilities required in three streams of NP practice: adult, family/all ages and pediatric.
Representatives from 11 of the 12 nursing regulatory bodies which comprise CCRNR, coordinated the various phases of the NP Practice Analysis. Stakeholders consulted throughout the project included: nursing researchers, educators, administrators, subject matter experts and practising NPs from across Canada.
Findings from the practice analysis demonstrate that NPs across Canada use the same competencies in their practice in all Canadian jurisdictions and across the three streams of NP practice and that the differences in NP practice lie in patient population needs and the context of practice, such as age, developmental stage, complexity and health condition(s).
The NP Practice Analysis report can be found on CCRNR’s website.
New Brunswick Prescription Drug Plan Formulary
The New Brunswick Prescription Drug Program (NBPDP) Formulary is a listing of all drugs and drug products which have been determined by the Minister of Health to be entitled services. Such drugs and drug products must be listed in the Formulary in order to be considered current eligible benefits. The formulary is published semi-annually in April and October.
The prescription of drugs found on Schedule “C” of the NANB document Nurse Practitioner Schedules for Ordering may be subjected to a Special Authorization process for payment purposes. See the New Brunswick Prescription Drug Program (NBPDP) Formulary.
As of May 3rd, 2016 the government of New Brunswick no longer issues a prescriber number. Instead of a prescriber number, nurse practitioners will be identified in the system, by their NANB registration number. Therefore, NPs are to include their registration number from NANB when filling out prescriptions.
Nurse Practitioners of New Brunswick Interest Group
If you would like more information or would like to become a member of the Nurse Practitioners of New Brunswick interest group visit www.npnb.ca.