Medical marijuana, role of the nurse, professional organization

[hotflashion, BSN, RN]

It would be nice if we could have an intelligent and professional discussion about this topic without a whole lot of judgement going on. I tried to find an appropriate topic before stating a new one but many (most? all?) of them have been closed.

Right up front I'd like to say that federal law and state law clash on the use of marijuana in a medical contex, so there's no need for anyone to state that again. Also, the action of any state's Board of Nursing is unknown, and should be researched by those who have questions. (So, call them and ask! And let us know what you've been told.) If you know of documented cases of license suspension or revocation, provide links to verifiable information, but please, no scary stories without facts.

I started by Googling the question "What is the role of the nurse in a marijuana dispensary?" My state is one of the ones that recently approved medical marijuana use and will soon be accepting applications for dispensaries. It's an occupational setting I would consider, so I am interested in hearing from nurses who work in dispensaries or clinics.

[classicdame, MSN, EdD]

there is also an American Nazi asso. but that does not make them professional. Sorry, but I have nothing but negative comments.

[Kaci82]

classicdame said:

There is also an American Nazi asso. But that does not make them professional. Sorry, but I have nothing but negative comments.

OK, I am really curious why you "have nothing but negative comments." Have you done any research at all on the benefits of medicinal marijuana?

[Esme12, ASN, BSN, RN]

I think medical marijuana has a place in medicine. I do not know that many dispensaries that employ nurses or that it is a requirement. I think think we as nurses need to be careful that although it is legal the nursing boards might not agree. They take action against legal substances all the time. I do know that I have read anecdotal stories about nurses who open and own dispensaries and in litigation with the BON over their RN license.

I went to the American Cannabis Nurses Association website and I can't get much information about them or their philosophy without paying for membership....that is off putting and makes me cautious about their charitable good works. Are you a member?

[traumaRUs, MSN, APRN]

Hot topic for me as I live in IL and we recently passed the Medical Marijuana Law which goes into effect in Jan 2014. There are only 40 specific diagnoses that will qualify for this med. However, many of my pts are already asking me to prescribe it for them.

[studentnurse9806]

Why would a dispensary need a registered nurse ? Or are u talking about np. Just curious... My state ct has also passed the mj bill but I have not heard much about the details.

[traumaRUs, MSN, APRN]

The dispensaries don't need nurses. They are called "shops" and nurses are not present.

[hotflashion, BSN, RN]

I really don't know how these dispensaries are set up and presumably that would differ from state to state. So, the way they are run (e.g., staffing requirements) and perhaps even what they are called will differ from state to state. Pharmacies don't require nurses, so perhaps marijuana dispensaries will not. But unlike a traditional pharmacy, the focus at a marijuana dispensary is on that one medication; perhaps there could be value added by providing the kind of patient education that is not normally given at a pharmacy. This might be mandated, or merely good business practice.

I joined the ACNA after I wrote the original post, but I have not yet received any membership info in response to that.

[Anna Flaxis, BSN, RN]

As far as I know, nurses are not employed in marijuana dispensaries.

I've cared for many patients who use MM. Since smoking is prohibited at my facility, they are not allowed to smoke it while at the facility.

I think, with the question of dispensaries staffing nurses aside, the role of the nurse with MM is the same as the role of the nurse with any type of CAM.

I want my patients to trust me enough to tell me what other modalities they use. This is important information for the health care team to have. For example, nutritional supplements and herbals have many interactions with pharmacalogical preparations (St. John's Wort is a biggie).

Even if their CAM doesn't have any known interactions, it's still important information to have. For example, if my patient sees a Reiki practitioner twice a month to help with their PTSD symptoms, that's good information. It tells me a lot about that person, and can open the door for further communication.

How I might feel personally about any particular CAM does not matter, and should not interfere with the patient's ability to trust me enough to disclose their use. I want my patients to trust me, and I work to make sure that trust is well deserved by being nonjudgmental about their health care choices.

[FineAgain]

Interesting. My capstone was on medical marijuana. I was interested to see if its use caused lung cancer or other URT problems. Part of the paper was about nursing implications...here is a snippet.

"The American Nurses Association has gone on record as supporting nurses' "ethical obligation to be advocates for access to healthcare for all including patients in need of marijuana/cannabisfor therapeutic use" (ANA, 2003). Further, they "actively support patients' rights to legally and safelyutilize marijuana for symptom management and health care practitioners' effortsto promote quality of life for patients needing such therapy" (ANA, 2003).Nurses are the"bedside" healthcare providers who strive to promote health, preventillness and alleviate suffering. The fundamental principles of nursing arecompassion and respect for the individual patient. A key role of the nurse isto act as a patient advocate. Nurses need to be available for patients when itcomes to the issue of medicinal cannabis."

[thenursemandy]

I saw a brief documentary that showed nurses in Israel dispense small cups of mmj to their residents that have orders for it. Some smoke it ad lib in their rooms to alleviate tremors and anxiety, or to improve appetite or promote pain relief and relaxation.

[MunoRN, RN]

I don't really see the role of an RN in a marijuana dispensary, but I do think advocating for more acceptance of the well proven medicinal uses of marijuana, specifically canabidiol, is something that would seem to be an obvious role for Nurses given our focus on patient advocacy.

Despite these seemingly natural role for Nurses as advocates of medicinal marijuana, and it's derivatives, it seems Nursing is as much, if not more, responsible for perpetuating the stigmas and misperceptions that illogically limit the use of marijuana in treating patients and keeping marijuana relegated to the "CAM" category, even though there is a wealth of evidence that says it's earned it's way out of being considered a CAM treatment.