Growing up in rural Nova Scotia, Gillian Varner recalls her mother Wendy was often called upon to put her nursing training to work to help friends and neighbours.
“Our house was the unofficial rural, rural emergency department,” said Varner. “I still have a memory of a neighbour who had stomped on a nail and driven it up through his foot. His wife brought him over to our house and cried ‘Wendy, where are you?’”
As always, Varner’s mom who was a registered nurse at the South Shore Regional Hospital in Bridgewater, did what she could to help. “She dealt with whatever, whenever. They had so much respect for her.”
She described her mother as her “number one mentor” when it comes to nursing. Sadly, she got to see the other side of nursing, when her mother passed away from cancer when Varner was only 10 years old. “I got an early introduction to tertiary care, hospital systems, emergency care and that kind of thing,” she said.
After training and working as a nurse in Halifax for several years, Varner jumped at the chance to return home to a job in the emergency department at South Shore Regional Hospital in 2013.
Her eagerness to learn new skills made Varner an obvious candidate for the RN prescriber training program. When a former manager mentioned the opportunity, she quickly accepted.
The Masters-level RN prescribing certificate program has been implemented in collaboration with Dalhousie University to enhance access to prescribers in multiple care settings and in rural Nova Scotia. RN prescribers are able to independently prescribe medications and devices, as well as order relevant screening or diagnostic tests within their specific area of prescribing competence and practice, and for certain patient conditions.
“That’s one of the things I love about nursing. It is always changing. It is always dynamic. There are always new things to learn. And I am always looking for new courses to take.”
After plenty of hard work, and nearly a year of courses, Varner became the first certified RN prescriber in the Western Zone this past spring. She has since brought her new training and skills to the emergency department at South Shore Regional Hospital.
“I call them my magical powers,” she said with a laugh.
In the emergency department, patients are triaged according to the Canadian Triage and Acuity Scale, or CTAS. It is a five-point scale, with level one, two or three patients being the most critically ill. Level four or five patients are less, or non-urgent.
As an RN prescriber, Varner sees opportunities to help people who must go to the emergency department because they don’t have a primary care provider.
“Under my new designation I will be able to treat and deal with CTAS-level fours and fives, and hopefully reduce the number of people who leave without being seen because of long wait-times,” said Varner. She described a situation where she can review the waiting patients with the triage nurse to see what cases might fit within her scope of practice. “I can then assess them and create a plan, and the physician can look after the ones, twos and threes.”
Varner admits the RN prescriber role is still new for the emergency department, but she is excited by the possibilities along with the physicians and other team members. She has a co-worker who is enrolled in the training, and she is looking forward to seeing how the role can grow to benefit patients.
“I am so grateful to be presented with this learning opportunity,” said Varner. “I love the aspect of being able to help people when they need help.”
More information on RN prescribing can be found on Nova Scotia Health’s RN Prescribing Library Guide and through the Nova Scotia College of Nursing.
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