September 26, 2019
December 2019

What you need to know about over-the-counter medications

Over-the-counter (OTC) medications do not require a prescription and nurses may recommend or administer them to a patient. If you decide to recommend an OTC medication, you are accountable for the recommendation and for any outcomes of that recommendation.

Over-the-counter (OTC) medications do not require a prescription and nurses may recommend or administer them to a patient. If you decide to recommend an OTC medication, you are accountable for the recommendation and for any outcomes of that recommendation.

Whether you should recommend or administer OTCs depends on the following three factors:

Applicable legislation

Certain pieces of legislation, such as the Public Hospitals Act, require that all treatments be ordered by a physician, Nurse Practitioner, midwife or dentist. Nurses are accountable for being familiar with and practicing under relevant legislation that applies to their practice setting. This is an accountability outlined in principle 3.9 of the Code of Conduct.

Although OTCs usually do not require a prescription, some legislation requires an order. For example, in long-term care homes, medication administered to residents must be ordered by an authorized prescriber.

In the near future, RNs who complete education approved by CNO’s Council will be authorized to prescribe certain medications, including OTCs.

For more information about the drugs that RNs will be authorized to prescribe, the requirements for RNs to become authorized to prescribe and other considerations, visit the Journey to RN prescribing webpage.

Organizational policy

Employers determine the scope and responsibilities of their employees, including determining whether nurses can recommend and administer OTCs to patients. Nurses are accountable for complying with organizational policy and, if needed, working with their employers to develop policies that align with CNO’s standards of practice and are in the interest of patient safety.

Your knowledge, skill and judgment

If legislation and employer policy permits nurses’ recommending and administering OTCs, nurses must then ensure that they have the knowledge, skill and judgment to do so safely and ethically.

When deciding to recommend, administer or prescribe any medication, including OTCs, nurses must ensure that their medication practice is informed by evidence and they follow the accountabilities in the Medication practice standard. This includes assessing whether the medication is appropriate by considering the patient, the medication and the environment. Nurses should also educate the patient about the medication.

For more information on determining whether a procedure or activity, such as recommending and administering OTCs, is within your scope of practice, see the Ask Practice FAQ: Understanding Your Scope of Practice.

About CNO

The College of Nurses of Ontario (CNO) is the regulator of the nursing profession in Ontario. It is not a school or a nursing association. CNO acts in the public interest by:

  • assessing qualifications and registering individuals who want to practice nursing in Ontario.
  • setting the practice standards of the profession that nurses in Ontario are expected to meet.
  • promoting nurses' continuing competence through a quality assurance program.
  • holding nurses accountable to those standards by addressing complaints or reports about nursing care.

The College was founded in 1963. By establishing the College, the Ontario government was acknowledging that the nursing profession had the ability to govern itself and put the public's well-being ahead of professional interests.

For the latest information, please see our Nursing Statistics page.

Anyone who wants to use a nursing-related title — Registered Nurse (RN), Registered Practical Nurse (RPN) or Nurse Practitioner (NP) must become a member of CNO.

Frequently Asked Questions

Go to the public Register, Find a Nurse, to conduct a search for the nurse. Contact us if you can't find the person you are looking for.

All public information available about nurses is posted in the public Register, Find a Nurse, which contains profiles of every nurse in Ontario. Publicly available information about nurses include their registration history, business address, and information related to pending disciplinary hearings or past findings.

Unregistered practitioners are people who are seeking employment in nursing or holding themselves out as being able to practice nursing in Ontario, but who are not qualified to do so. They are not registered members of CNO. Only people registered with CNO can use nursing-related titles or perform certain procedures that could cause harm if carried out by a non-registered health professional. CNO takes the issue of unregistered practitioners seriously. See Unregistered Practitioners for more information.

To ensure procedural fairness for both the patient (or client) and the nurse, the Regulated Health Professions Act requires that information gathered during an investigation remain confidential until the matter is referred to the Discipline Committee or Fitness to Practise Committee. CNO will not disclose any information that could identify patients (or clients) or compromise an investigation. See Investigations: A Process Guide for more information.

Information obtained during an investigation will become public if the matter is referred to a disciplinary hearing. If a complaint is not referred to a hearing, no information will be available publicly.

See CNO's hearings schedule, which is updated as hearing dates are confirmed. Hearings at CNO are open to the public and the media. For details on how to attend a hearing, contact the Hearings Administration Team.

A summary of allegations and the disciplinary panel outcomes can be found on the public Register, Find a Nurse. Full decisions and reasons are also available.

Where a disciplinary panel makes a finding of professional misconduct, they have the authority to reprimand a nurse, and suspend or revoke a nurse's registration. Terms, conditions and limitations can also be imposed on a nurse's registration, which restricts their practice for a set period. Nurses can also be required to complete remedial activities, such as reviewing CNO documents and meeting with an expert, before returning to practice.

For detailed information see the Sexual Abuse Prevention section.

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