Registered Nurses (RNs) in Ontario have the option to expand their scope of practice under the Nursing Act, 1991, to prescribe specific medications and communicate diagnoses for the purpose of prescribing those medications.

Prescribing is not part of entry-level RN competencies. RNs must successfully complete prescribing education approved by CNO Council to prescribe medication, and communicate diagnoses safely, effectively and ethically.

Once an RN completes prescribing education, information will be added to their profile on CNO’s public Register, Find a Nurse. This information confirms the RN meets all the requirements and has the authority to prescribe the specified medications outlined in the Nursing Act.

RNs with the authority to prescribe can prescribe approved medications for the following purposes:

  • Immunization
  • Contraception
  • Travel health
  • Topical wound care
  • Smoking cessation
  • Anesthetics
  • Allergic reaction
  • Over-the-counter medication

For the list of medications authorized RNs can prescribe, click here.

CNO Council will review and consider approval of RN prescribing programs in December 2023.

Once education is complete, the school will verify with CNO that the RN has completed and met the requirements for prescribing. CNO will then update Find-a-Nurse to make it easy for stakeholders to identify that the RN is authorized to prescribe.

RNs with the authority to prescribe can only do so in practice settings or facilities where RN prescribing is authorized by law and permitted by the employer. The Public Hospitals Act does not enable RNs to prescribe medications in hospital settings.

Employers are responsible for determining the roles and responsibilities of their employees, including determining whether nurses can perform certain activities and procedures in the practice setting. RNs are expected to consult with their employers to confirm that prescribing is permitted in the practice setting.

CNO is developing a new practice standard to outline the legislated scope of practice and professional accountabilities for RNs who have the authority to prescribe.

The new practice standard expands on the accountabilities found in the Medication standard, Scope of Practice standard and the Code of Conduct. RNs are expected to practice in compliance with both legislation and CNO practice standards.

The new practice standard will be brought to Council for consideration and approval in Dec. 2023.

Resources will also be created or updated to support the safe implementation of RN prescribing in practice.

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