It won't be long until questions related to marijuana begin to show up on the NCLEX.
Okay, it might be a few years. But my guess is no more than 5 years before it's included in every nursing program. At NCLEX Simplified, we take a lot of pride in staying on top of the latest news. It's our job to make sure NCLEX Simplified is the best study guide for NCLEX that it can be- and that includes making sure all information in it is thorough and up-to-date.
Within the past few months, there has been a lot of chatter at the NCSBN about marijuana and practice guidelines for nurses to follow.
The NCSBN Homepage on February 27th, 2019
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Marijuana has become legalized (at least for medical if not recreational use) in all but 17 states. That means that 33 of them are places you may encounter a patient who is mixing a form of THC with their usual medications! How do they interact with their blood pressure medications? How does THC affect their appetite or energy levels? Would you know how to administer it as a medication?
Unlike a regular medication that must go through the Food and Drug Administration (FDA), marijuana and all its forms don't have a list of approved clinical uses. There is no where to turn for recommended dosages or lists of side effects.
The NCSBN detailed its ideas in quite a long article in the Journal of Nursing Regulation, which I've summed up below.
Basically, it has decided that it's important for nursing students to possess knowledge in the following six areas:
1. Know the legality of marijuana in your state. Some states approve recreational use while others are strictly for medical purposes from licensed practitioners only. Do you know your state's rules? They might have changed or may be changing soon.
2. Know how to administer marijuana using guidelines by the Medical Marijuana Program in your state. The Medical Marijuana Program actually does the prescribing of THC compounds, not the healthcare provider. This means that they may each have their own specific rule sets, including if a caregiver is allowed to assist the patient in administration.
3. Know how marijuana works in the body and what receptors it hits. I don't know about you, but I wasn't sure myself until I looked it up! Within the next few years, nursing programs are going to be adding this information to their curriculum.
4. Know what conditions have high-quality research that support them being effectively treated for marijuana. So far, this is a limited list and does not include many conditions that you might think would qualify. Many of the certifying conditions feature intractable pain that is not well-treated by opioids or other traditional analgesics.
5. Know the safety considerations for a patient using marijuana. Is it able to be stored safely in a lock box in the home? Does the home contain minors? Does the patient know how to properly dispose of marijuana compounds that are not consumed?
6. Know that moral/social judgments should not be a part of care. Some people don't agreed that marijuana can be legalized, but the NCSBN is saying, "TOUGH!" If your patient is legally taking marijuana compounds, you must withhold any moral objections and treat the patient fairly and from a place of ethical decision-making.
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