Comparing Registered Nurse Prescribing in Alberta and New Zealand

What is it about?

Our research looks at how registered nurses (RNs) can prescribe medicines in Alberta, Canada, and Aotearoa New Zealand. Both places allow RNs to prescribe, but they do it differently. Alberta’s system lets nurses prescribe certain medicines within a specific work location after completing an approved course and gaining experience. However, the nurse’s prescribing authority is tied to their workplace, so if they move, they need to reapply. New Zealand’s system requires nurses to complete postgraduate education, supervised training, and mentoring. Their prescribing role is closely linked to nurse practitioner (NP) education, meaning RN prescribing can be a step toward becoming an NP. New Zealand also expects RNs to work within teams and ask for help with complex cases. We suggest combining the best parts of both systems into a hybrid model. This model would give nurses a portable prescribing license recognized by regulators but still require local training and support from employers. It would also connect RN prescribing education with NP programs, helping nurses progress in their careers more smoothly. An example we have highlighted from Alberta to show how family medicine internships can help nurses develop prescribing skills before advancing. This is a policy and practice comparison, focusing on how education, regulation, workplace supervision, and ongoing training support safe and effective nurse prescribing.

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Photo by National Cancer Institute on Unsplash

Photo by National Cancer Institute on Unsplash

Why is it important?

Access to primary healthcare is a challenge worldwide. Registered nurse prescribing offers a way to improve timely care for patients by letting trained nurses manage common illnesses, order tests, and prescribe medicines without always waiting for a doctor. However, this only works well if nurses are properly trained, supervised, and supported. Poorly managed prescribing can put patients at risk. Understanding different ways to train and authorize nurses to prescribe helps policymakers create better systems that protect patients and make healthcare more efficient. Alberta’s approach ensures safety through local rules and site-specific authorizations, but it can limit nurses’ flexibility to move between workplaces. New Zealand’s model focuses on comprehensive postgraduate education linked to nurse practitioners, which prepares nurses for advanced practice but might require more training time. Combining these strengths has the potential to make nurse prescribing more accessible, portable, and better connected to advanced nursing roles. This can reduce the workload on doctors, improve patient access to medicines, and support nurse career growth. Our suggested hybrid model prioritizes patient safety, strong education, ongoing competence checks, and workplace support, addressing real challenges like preceptor burden and supervision gaps during nurse practitioner training. Ensuring nurses can prescribe safely is vital for health system sustainability and smooth transitions into advanced nursing roles. Key takeaways: • Registered nurse prescribing improves access to care but needs strong training and governance. • Alberta links prescribing authority to workplaces; New Zealand uses postgraduate education in teams. • A hybrid model could offer portable authorization plus local employer support and connection to advanced nurse programs. • Thoughtful design can ease nurse practitioner training and keep patient safety front and center.