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.

Guideline for Nurse Practitioner Practice

Schedules for Ordering

The NP Schedules for Ordering, located in Appendix 1 for the Standards of Practice for Nurse Practitioners , outline the screening and diagnostic interventions and drugs that may be ordered or prescribed by the NP. These schedules are established through recommendations of the Nurse Practitioner Therapeutics Committee (NPTC) and approved by the NANB Board of Directors and the Minister of Health.

Controlled Drugs and Substances

There are key points to consider when prescribing controlled drugs and substances. NPs are encouraged to review this information in our Fact Sheet: Legal Considerations When Prescribing Controlled Drugs.

NPs in New Brunswick are authorized to prescribe methadone. Methadone prescribing is considered a post-entry level competency and as such NPs who engage in this practice are accountable to attain and maintain the necessary knowledge and skill to practice competently, safely and ethically. For further information, please refer to the Fact Sheet: Nurse Practitioners (NPs) Prescribing Methadone.

Online pharmacies

The Government of Canada offers information on how to check the legitimacy of an online pharmacy and how to report a fraudulent online pharmacy.

Shadow billing: 

• Process where non-fee-for-service providers (NPs and physicians) submit claims.

• The information is used to maintain a consistent patient history to:

• • Ensure accountability

• • Assists with future health care resource planning

• Allows the capture of all immunizations in the Medicare system

• Does not involve pharmacies or payments

For more info: GNB – Health Professionals: see Medicare section

• Nurse Practitioner Shadow Billing Manual

Insurance billing: 

• Involves a third-party payer

• • pharmacists billing insurance companies

• • dentists billing insurance companies

• • NPs or MDs billing insurance companies

• • RNs billing insurance companies (ie footcare)

• The provider of the service receives a payment.

Pharmacy billing / Prescription Monitoring Program and Drug Information System

When a pharmacy receives a script, they generally bill the insurance company, the province, or the patient. The ordering provider is entered in the pharmacy system (in NB, this is the Drug Information System known as DIS). This flows to the patient’s provincial Electronic Health Record (EHR). Authorized healthcare professionals can view a patient’s medication history in real-time in the EHR, including who the prescriber was and which pharmacy was used to purchase the medication. All community pharmacies are connected to this information system and submit prescription information. This is the way our provincial Prescription Monitoring Program (PMP) works.

NPs need to request access to the EHR to be granted a user ID and password. This will allow them to see their patients’ EHRs.

For more info: GNB – Health Professionals: see Pharmaceutical Services section

• Prescription Monitoring Program and Drug Information System

• FAQ Electronic Health Record (EHR) & NB Drug Information System (DIS)

NPs may be in interested in becoming members of the Nurse Practitioners of New Brunswick (NPNB), an advocacy group for NPs in the province. Further information can be found on the NPNB  website.