Extension to the Temporary Exclusion of Eligibility for MAiD 

On February 2, 2023, the Ministers of Justice and Health of the Government of Canada introduced legislation, Bill-39, to extend the temporary exclusion of eligibility for MAiD where a person’s sole medical condition is a mental illness until March 17, 2024. The one-year extension would provide the federal government with additional time to prepare for the safe and consistent assessment and provision of MAID where the person’s sole underlying medical condition is a mental illness. 

The CRNS will continue to monitor updates from the Federal government, work with Saskatchewan Health Authority MAiD program partners and provide updates as they become available.

More information is available from the Department of Justice Canada website, MAiD Media Release.

If you have any questions, please get in touch with Practice Advice at practiceadvice@crns.ca

Antibiotic Suspension Shortage

Health Canada has declared a Tier 3 shortage for several antibiotic suspensions. Tier 3 is the most critical level and is expected to impact the health care system significantly. Many antibiotic suspensions are unavailable or sporadically available in extremely limited supply.

There may be a current supply of certain antibiotic suspensions, but we should expect these to become depleted as prescribing shifts. Tablets and capsules are currently available. This message addresses:

  • Strategies for conserving antibiotic suspensions
  • Resources for managing this shortage
  • Resources to help your patients understand the shortage

Note: All RN(AAP)s can only prescribe and dispense the medications that are identified in a CDT. Review the appropriate CDT prior to prescribing and dispensing any medication. Due to the suspension shortage, consult with a physician or NP as needed to receive orders for medications not included in the CDT.

Read the joint statement regarding the Antibiotic Suspension Shortage

UPDATE: Saskatchewan Biosimilars Initiative

The Saskatchewan Biosimilars Initiative was announced on October 20, 2022, to improve the uptake of biosimilar drugs. The Biosimilars Initiative means that patients will be covered for a biosimilar version of their biologic medication where one is available.

The Biosimilars Initiative includes ten drugs listed on the Saskatchewan Formulary: adalimumab (Humira®), enoxaparin (Lovenox®), etanercept (Enbrel®), filgrastim (Neupogen®), glatiramer (Copaxone®), infliximab (Remicade®), insulin aspart (NovoRapid®), insulin glargine (Lantus®), insulin lispro (Humalog®), and rituximab (Rituxan®). The policy will also apply to future reference biologics as new biosimilars are launched and listed on the Saskatchewan Formulary.

Established patients already receiving a reference biologic drug (or “originator” biologic) with an available biosimilar version will be required to use a biosimilar version by April 30, 2023, in order to maintain coverage under the Saskatchewan Drug Plan.

Physicians, NPs and pharmacists are asked to approach patient questions with evidence-based information to help build patient confidence in the data supporting biosimilar use and transition.

Additional resources:

November 18, 2022: Letter to Health Care Providers – Patient Communications and Patient List Request Form

October 20, 2022: Letter to Health Care Providers Regarding Saskatchewan Biosimilars Initiative

Guide for Patients

Patient List Request Form

For the most current and up-to-date news regarding this initiative, visit the Biosimilars Initiative website.

Amendment: Pharmacists Prescribing for Acetaminophen to Support Accessing Compounded Supplies During the Pediatric Analgesic Shortage

This is an update to the October 12, 2022, Nursing Practice Update. The provincial Collaborative Practice Agreement to support accessing compounded supplies during the pediatric analgesic shortage has been updated to include ibuprofen.

There is a demand surge for pediatric analgesic and antipyretic dosage forms which is creating an ongoing supply issue for patients. Pharmacists have been supporting patients by assisting with advice on alternate products, different dosage forms, repackaging bulk supplies when able, and compounding. 

To support patient access during the pediatric analgesic shortage, the College of Physicians and Surgeons of Saskatchewan, the College of Registered Nurses of Saskatchewan, and the Saskatchewan College of Pharmacy Professionals have created a short-term solution in the form of a provincial CPA which would then enable pharmacists to prescribe for pediatric acetaminophen and ibuprofen. 

Read the full statement here.

Update to Pharyngitis: Adult and Pediatric Clinical Decision Tool (CDT)

There is an updated dose of Azithromycin as a third-line oral antibiotic agent within the Pharyngitis: Adult and Pediatric CDT. This change takes effect immediately and is posted on the CRNS website along with all of the CDTs for RN(AAP) practice. 

The change in Adult and Pediatric dosing and duration of Azithromycin is consistent with the RxFiles: Drug comparison charts (13th ed.), and is as follows: 

If you have any questions, CRNS Practice Advisors are available by emailing practiceadvice@crns.ca.


RxFiles Academic Detailing Program. (2021). RxFiles: Drug comparison charts (13th ed.). Saskatoon Health Region.

CRNS Bylaws Update

The 2022 Bylaws package was presented to registrants for their approval at the annual meeting on May 5, 2022. All proposed bylaw amendments were approved which allowed CRNS to follow the established government processes for finalizing the bylaws. Administrative bylaws were filed with the Information Services Corporation (ISC) following the annual meeting and we received written approval from them on May 31, 2022. Regulatory bylaws were submitted to the Ministry of Health for Ministerial approval in June. These bylaws were approved and published in the September 9, 2022, Saskatchewan Gazette which brings them into force and effect. 

What this means for registrants is that the 2022 Bylaws are being updated and are now posted on the CRNS website for review. On November 1, 2022, all registrants will be required to comply with these bylaws. Some of the key regulatory bylaw amendments are listed below:

  • Continuing Competence Program (CCP) requirements for the revised program will be implemented for the upcoming 2023 registration year which begins on December 1, 2022. The new requirements have been outlined in Bylaw V.1 Continuing Competence. 
  • To fulfill the CRNS mandate of protection of the public, all practicing members in every category must report to the Registrar by email or phone, as soon as is reasonably practical, a charge under the Criminal Code (Canada), the Controlled Drugs and Substances Act (Canada) or any similar legislation in any province, territory, state, or country, or any charge concerning the practice of nursing or another profession in any jurisdiction. This amendment can be found in Bylaw VI Membership.
  • Bylaw VI Categories of Practice, Section 3 Nurse Practitioner Category contains a change for NP practice. It enables NPs to order or request medical imaging involving the application or detection of forms of energy for diagnostic and screening purposes and to receive and interpret reports, or to perform ultrasound imaging for the sole purpose of point of care diagnostic assistance when it is in the best interest of the client, in accordance with their practice standards and code of ethics, when they have the competence and judgment to safely do so, when it is in alignment with best practice evidence and when agency policy permits. This is an important amendment that facilitates increased access to timely care for the residents of Saskatchewan. 
  • Another bylaw that impacts NPs directly is Bylaw VI Categories of Practice, Section 4 Prescription Review Program as the language has been updated to reflect current best practices on providing prescriptions directly to a pharmacy. 
  • A new section was added to Bylaw VI Categories of Practice, Section 5 Resignation on Medical or Other Grounds. This bylaw essentially allows a CRNS registrant who identifies that their fitness to practice is significantly impacted by the effects of a physical or mental disability and choose to resign from practice to protect the safety of patients. The bylaw outlines the conditions of this process. 
  • Bylaw XV adopts the recently published RN with Additional Authorized [RN(AAP)] Practice Standards as the standards required of registered nurses practicing with Additional Authorized Practice, so this will be of special interest to RN(AAP)s and managers or interdisciplinary colleagues of RN(AAPs). The 2022 RN(AAP) Practice Standards will be posted online in the upcoming weeks.

Some of the key administrative bylaw amendments are listed below:

  • The Canadian Nurses Association (CNA) officially changed their membership structure at their 2021 annual meeting and this was implemented on January 1, 2022. Jurisdictional Membership will not exist going forward. Instead of organizations representing nurses as members, individual nurses will obtain their own memberships. Therefore, Bylaw I, Section 6 and Bylaw VII Fees, Sections 3 and 4 have all been updated to reflect this. This is important for registrants to be aware of because CRNS will no longer be collecting CNA fees during license renewal. Should registrants wish to be CNA members, they can do so independently by following this link.
  • Bylaw VII Fees also contains wording regarding fees for practicing registrants currently licensed in a jurisdiction whose nursing regulatory body has signed a multijurisdictional agreement with the council to provide virtual care in Saskatchewan. 

Should you have questions regarding the 2022 Bylaws, contact a Nursing Practice Advisor by email at practiceadvice@crns.ca or by phone at 1.800.667.9945.

NPs Authorizing RNs to Administer Bioactive Agents

Registered Nurses (RN) may be authorized by a Nurse Practitioner (NP) to administer bioactive agents such as Botox. The CRNS has collaborated with the College of Physicians and Surgeons of Saskatchewan (CPSS) over the past several months to obtain written clarification on this matter and is able to share this update. 

Prior to initiating practice, RNs administering and NPs administering and/or authorizing bioactive agents require recognition of practice through the CRNS Regulatory Services team. 

RNs and NPs must have the ongoing knowledge, skill and judgement to safely perform the injection of bioactive agents. NPs authorizing this practice must also supervise the RN to reasonably assure safety for clients. The administration of bioactive agents is beyond entry-level practice and requires an RN Clinical Protocol that includes the essential components of an RN Specialty Practice

Further guidance on including alternative and complementary therapies into RN and NP practice can be found in thisNursing Practice Update.

CRNS Nursing Advisors are available by emailing Regulatory Services at regulation@crns.ca or Nursing Practice at practiceadvice@crns.ca.

National NP Regulation Project Update, as of March 2, 2022

The Canadian Council for Registered Nurse Regulators (CCRNR) Nurse Practitioner Regulation Framework Implementation Plan Project (NPR-FIPP) continues to move forward. All project updates can be found on the CCRNR website. 

If you’d like to stay up-to-date on this project, you can subscribe to the CCRNR NPR-FIPP newsletter when you visit CCRNR website. The CRNS will be setting up meetings to inform partners of the project and involve key stakeholders in consultation. 

If you are interested in learning more about this project, email Donna Cooke, Nursing Advisor, at dcooke@crns.ca.

Alternative and Complementary Therapies

The number of RNs and NPs engaging in alternative or complementary therapies, such as aesthetics, through non-traditional employers or self-employed practice, has increased in recent times.  These practices require assessment by the College of Registered Nurses of Saskatchewan (CRNS) to determine if the activity is recognized as registered nursing practice. Being engaged in self-employed practice brings certain opportunities as well as inherent risks, therefore it is important for RNs and NPs interested in and/or practicing in these areas to:

  • Consult with a Nursing Practice Advisor to discuss your practice situation and receive guidance on next steps;
  • Consult with a Regulatory Services Nursing Advisor to discuss the Recognition of Practice process;
  • Refrain from using the RN or NP title until the activity has been recognized as nursing practice by the CRNS;
  • Ensure that the necessary resources, including but not limited to, supplies to manage untoward events, policy/procedure manual, are in place for safe patient care;
  • Ensure that you have the appropriate authority to conduct the activities; and,
  • Refrain from including hours worked in these areas in self-reported RN or NP practice hours until the activity has been recognized as nursing practice by the CRNS.

As the landscape of alternative and complementary therapies grows and changes, the CRNS applies principles of right touch regulation when working with members to reasonably assure accountable professional practice. The CRNS lives this by applying consistent and transparent processes, providing decisions that are proportionate to the risk posed and by showing agility to adapt to change while keeping the focus on public safety.

CRNS Nursing Advisors are available by emailing:

Regulatory Services at regulation@crns.ca or

Practice at practiceadvice@crns.ca.

Medical Assistance in Dying Guideline

The CRNS is pleased to announce the release of an updated nursing practice guideline, Medical Assistance in Dying Guideline, 2021. The guideline has been updated to reflect current, evidence-informed best practices, legislative changes and applies to all categories of nursing practice.

Please review this document and consider how it may relate to your practice. If you have any questions, please contact a CRNS Practice Advisor by phone at 1.800.667.9945 or 306.359.4227 or by email practiceadvice@crns.org.

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