Cannabis Nursing: Scope and Standards of Practice, 1st Edition

By American Nurses Association and American Cannabis Nurses Association

The Cannabis Nursing: Scope and Standards of Practice is an essential document for every cannabis nurse practicing in the United States. The scope of practice statement answers the who, what, when, where, how, and why questions of cannabis nursing. The standards provide authoritative statements of the actions and behaviors that all cannabis nurses are expected to competently perform, regardless of role, population, specialty, and setting.

The product of extensive thought work by many cannabis nurses, this new scope and standards document provides 18 national standards of practice and professional performance. Each standard is accompanied by detailed competencies for cannabis nurses. This premier professional resource informs and guides cannabis nurses in their vital work providing safe, quality, and competent care.

• Language: English
• Publisher: Nursesbooks
• Release date: Jun 7, 2024
• ISBN: 9781953985941

American Nurses Association

The American Nurses Association (ANA) is the premier organization representing the interests of the nation's 4 million registered nurses. ANA is at the forefront of improving the quality of health care for all. Founded in 1896, and with members in all 50 states and U.S. territories, ANA is the strongest voice for the profession

Book preview

Cover: Cannabis Nursing, Scope and Standards of Practice by American Nurses Association

Prepared by:

American Cannabis Nurses Association

Credentialing Committee / Task Group Members

Deanna M. Collins Sommers, PhD, MSN, RN, PNP-PC—Chair; BOD (2022–2024)

Connie Pascal, PhD-LIS, MCIS—Contributing Editor

Llewellyn Dawn Smith, MSN, RN-BC—ACNA Past President (2022); BOD (2016–2021)

Holly Watson-Evans, MS, APRN, FNP-BC, PMHNP-BC—Co-Chair

Graciela Hammel, BSN, RN

Sherry Kay Schreiner-Beckwith, MSN, RN, MS, MCST

Dominique Fontaine, BSN, RN, HNB-BC, HWNC-BC

Brenda McNeely, MA, BSN, RN-BC, NPD-BC

Lora Wade, LPN

Editors

Deanna M. Collins Sommers, PhD, MSN, RN, PNP-PC—Chair; BOD (2022–2024)

Carey S. Clark, PhD, RN, AHN-BC, FAAN—ACNA Past President (2017–2021)

Rachel Parmelee MSN, RN, CNE, AHN-BC—ACNA President (2022–2024)

Reviewers

Sarah Cohen, RN

Alice O’Leary, LPN

Rachel Parmelee MSN, RN, CNE, AHN-BC—ACNA President (2022–2024)

Eloise Theisen, MSN, RN, AGPCNP-BC—ACNA Past President (2019–2022)

Carey S. Clark, PhD, RN, AHN-BC, FAAN—ACNA Past President (2017–2021)

Mary Lynn Mathre, MSN, RN—ACNA Past President (2010–2014)

ANA Committee on Nursing Practice Standards

Elizabeth O. Dietz, EdD, RN, CS-NP, FAAN, Co-chair

Mona Pearl Treyball, PhD, RN, CNS, CCRN-K, FAAN, Co-chair

Nena M. Bonuel, PhD, RN, CCRN-K, APRN-BC

Patricia Bowe, DNP, MS, RN

Ahnyel Burkes, DNP, RN-BC, NEA-BC

Marlissa Esquivel, MSN, RN, AMB-BC

Tonette McAndrew, MPA, BSN, RN

Linda Inez Perkins, MSN, RN-BC

Michael Manasia, MSN, RN, OCN, Alternate

Shelly Wells, PhD, MBA, MS, APRN-CNS, BC-ACNS, ANEF, Alternate

ANA Staff

Carol J. Bickford, PhD, RN-BC, CPHIMS, FAMIA, FHIMSS, FAAN—Content editor

James Angelo, MA, Publishing director

Erin E. Walpole, PMP, Production editor

The American Nurses Association (ANA) and American Cannabis Nurses Association (ACNA) are national professional associations. This publication reflects the position of ANA and ACNA regarding the scope and standards of nursing practice and should be reviewed in conjunction with state board of nursing regulations. State law, rules, and regulations govern the practice of nursing, while Cannabis Nursing: Scope and Standards of Practice guides registered nurses in the application of their professional skills and responsibilities.

About the American Nurses Association

The American Nurses Association (ANA) is the only full-service professional organization representing the interests of the nation’s 4.2 million registered nurses through its constituent/state nurses associations and its organizational affiliates. The ANA advances the nursing profession by fostering high standards of nursing practice, promoting the rights of nurses in the workplace, projecting a positive and realistic view of nursing, and by lobbying the Congress and regulatory agencies on healthcare issues affecting nurses and the public.

About the American Cannabis Nurses Association

The American Cannabis Nurses Association (ACNA) is a non-profit 501c3 national organization dedicated to expanding the knowledge base of endocannabinoid therapeutics among nurses. ACNA’s mission is advancing excellence in cannabis nursing practice through advocacy, collaboration, education, research, and policy development. Initially envisioned by Julia (Ed) Glick and Mary Lynn Mathre in 2006, the organization was formally established in 2010. In 2011, nurse pioneers Mary Lynn Mathre, Julia (Ed) Glick, Stacie Boilard, Bryan Krumm, Ken Wolski, and Sharon Palmer became the first members of ACNA’s board of directors.

American Nurses Association

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Silver Spring, MD 20910

Cataloging-in-Publication data on file with Library of Congress

Copyright © 2024 American Nurses Association and American Cannabis Nurses Association. All rights reserved. No part of this book may be reproduced or used in any form or any means, electronic or mechanical, including photocopying and recording, or by any information storage and retrieval system, without permission in writing from the publisher.

ISBNs

Print 978-1-953985-92-7

ePDF 978-1-953985-93-4

ePUB 978-1-953985-94-1

Mobi 978-1-953985-95-8

SAN: 851-3481

Disclaimer: Nurses must be aware that cannabis and most cannabinoids are federally illegal. They must also be knowledgeable about their state’s delineated scope of nursing practice and consider the legal status of cannabis in the given state where the practice occurs. The American Cannabis Nurses Association (ACNA) is not responsible for an individual nurse’s interpretation or misuse of the document.

Our first journey is to find that special place for us.

So never lose an opportunity of urging a practical beginning, however small, for it is wonderful how often, in such matters, the mustard seed germinates and roots itself.

Nursing is a progressive art such that to stand still is to go backwards.

—Florence Nightingale

Contents

Preface

Scope of Cannabis Nursing Practice

Definitions, Guiding Principles, Core Values, and Practice Settings

Definitions of Key Terms

Cannabinoid(s)

Cannabis

Cannabinoid Therapeutics

Cannabis Care Nurse

Cannabis Nursing

Endocannabinoid Deficiency

Endocannabinoid System (ECS)

Endocannabinoid Tone

Entourage Effect

Flavonoids

Hemp

Marijuana

Medical Marijuana Program (MMP)

Recommendation of Cannabis

Terpenes/Terpenoids

Therapeutic Use of Cannabis

Guiding Philosophical Core Values and Ethical Principles of Cannabis Nursing

Core Values of Cannabis Nurses

Evidenced-Based Practice

Application of Caring and Social Justice-Based Ethics

Cannabis Health Care Consumer-Centered Care

Interprofessional Health Care Teamwork

Holistic Practice

Self-Care

Ethical Principles for Cannabis Nurses

Highly Diverse Health Care: Cannabis Nurses Thrive in Professional Practice Settings

Cannabis as a Medicine

Cannabis Prohibition

United States Public Support of Cannabis

Legalization of Cannabis in the United States

Qualifying Conditions

Regulatory Concerns

Consequences of the War on Drugs

Incarceration

Evidence for Guided Practice

Summary of Findings: NASEM 2017 Report

Inequity

Summary of Findings:Cannabis: A Handbook for Nurses: Chapter 5

Summary of Findings: NCSBN National Nursing Guidelines for Medical Marijuana

Cannabis Use Disorder

Medical Cannabis Use and Employment

Drug Screenings

Occupational-Related Policies

US Military

US Department of Transportation

Driving Under the Influence

Nursing Students

Nursing Professionals

Nurses as Cannabis Health Care Consumers

NCSBN’s Recommendations for Boards of Nursing

Educational Programs and Resources for Cannabis Nurses

University Degrees and College-Based Training Programs

The University of Maryland, Baltimore (UMB)

Pacific College of Health and Science (PCHS)

Thomas Jefferson University (TJU)

John Patrick University of Health and Human Services (JPUHHS)

Medical Cannabis Certificate Programs, Continuing Education, and Contact Hours

Education Resources and Current Textbooks for Cannabis Nurses

Summary of Research Journals Dedicated to the Therapeutic Use of Cannabis

Professional Associations for Cannabis Health Care Providers

Nurses Evolve into Advocates for Cannabis Health Care Consumers

Establishment of Formal Guidelines for Cannabis Nurses

Development of Standards of Practice and Professional Performance for Cannabis Nurses

Standards of Practice for Cannabis Nurses (2023)

Standard 1: Assessment

Standard 2: Diagnosis

Standard 3: Outcomes Identification

Standard 4: Planning

Standard 5: Implementation

Standard 5A: Coordination of Care

Standard 5B: Health Teaching and Health Promotion

Standard 6: Evaluation

Standards of Professional Performance

Standard 7: Ethics

Standard 8: Advocacy

Standard 9: Respectful and Equitable Practice

Standard 10: Communication

Standard 11: Collaboration

Standard 12: Leadership

Standard 13: Education

Standard 14: Scholarly Inquiry

Standard 15: Quality of Practice

Standard 16: Professional Practice Evaluation

Standard 17: Resource Stewardship

Standard 18: Environmental Health

Conclusion

References

Glossary

Appendix A—NASEM Findings

Index

Preface

The American Cannabis Nurses Association (ACNA) used the American Nurses Association (ANA) (2021b) Recognition of A Nursing Specialty, Approval of a Specialty Nursing Scope of Practice Statement, Acknowledgment of Specialty Nursing Standards of Practice, and Affirmation of Focused Practice Competencies to inform decision-making about the quality and validity of competencies relevant to cannabis nursing. ACNA formed a task group from their membership to research the competencies of other nursing specialties and standards set forth by ANA. Multiple iterations and revisions of this research now serve as the foundation for the competencies outlined in this document. The Nursing: Scope and Standards of Practice (Fourth Edition) (2021a) serves as a template for all nursing specialty organizations when describing the details and complexity of that specialty practice and as a resource. ACNA’s Scope and Standards of Practice (2019) were also used as a framework and template for the updated and revised Cannabis Nursing: Scope and Standards Practice (2023) document.

Scope of Cannabis Nursing Practice

Cannabis nurses are confronted with political and legal challenges and barriers in their nursing practice. The federal ban of cannabis as a Schedule I drug creates conflict between state and federal laws and limits access, research, and education about cannabis as a medicine. The lack of consistent regulations, guidelines, and policies for cannabis nursing across different states creates confusion, inconsistency, and liability issues for cannabis nurses. Stigma and misinformation surrounding cannabis use affect the public perception, professional recognition, and ethical dilemmas for cannabis nurses. Additionally, nursing curricula lack learning opportunities about medicinal cannabis outside the frame of substance abuse. The discovery of the endocannabinoid system (ECS) and growing acceptance of medical cannabis requires cannabis nurses to be knowledgeable, adaptable, and resilient to provide optimal care and advocate for cannabis health care consumers. Cannabis nurses also need to advocate, educate, and collaborate to integrate cannabis nursing knowledge and competencies into mainstream health care, which provides the foundation for the cannabis nurse’s scope of practice.

The ECS, discovered in 1992, has expanded the field of scientific research on the plant Cannabis sativa L. Nurses at all levels of practice have witnessed a surge in health care consumers’ desire for education that exceeds nurses’ knowledge and acceptance of cannabis as a medicine. Cannabis health care consumers often rely on untrained, nonmedical individuals or online searches for information and guidance on how to use medical cannabis along with or instead of other treatment modalities. Retail workers in dispensaries commonly offer advice