Cannabis nursing as a specialty has been an involved and complicated work-in-progress for more than a decade with the American Cannabis Nurses Association as well as the Cannabis Nurses Network and many others. In this exclusive interview, healthcare professionals Laura Barrett-Nutting, MBA, BSN, RN, co-founder and Executive Director of the National Clinical Directors Consortium and owner of Ask Nurse Laura, Heather Manus, RN, founding member of Cannabis Nurses Network, Mary Lynn Mathre, President and co-founder of Patients Out of Time and Founding Member of the American Cannabis Nurses Association (ACNA), and Dawn-Marie Steenstra, LPN, SDC, QA, SCC, a Clinical Director of Dispensaries in Maryland, and a co-founder for the National Clinical Director Consortium discuss the transformative effects of the American Nurses Association's (ANA) official recognition of cannabis nursing as a specialty practice (1,2).
Discover how this historic decision is poised to revolutionize the nursing landscape, empower patients, and open new doors for healthcare practitioners across the board. Learn how the Cannabis Nurses Network has been working in a parallel manner training and preparing nurses in education, public speaking, professional development, and writing to prepare for this day and to be the front line in educating peers and professionals. Explore the potential benefits for both nurses and patients as this groundbreaking development reshapes the future of healthcare.
How do you see the ANA acceptance of cannabis nursing as a specialty nursing practice change the landscape of nursing moving forward?
Laura Barrett-Nutting: Thank you for this question. I cannot start without sharing my gratitude for the American Cannabis Nurses Association and its members who dedicated their time over the years to develop these criteria and continue to pursue a Cannabis Nurse specialty within the American Nurses Association. I have been a member over the years, but cannot take credit for their amazing work getting it done. The first and most important way I see ANA's acceptance of cannabis nursing as a specialty is that it legitimizes the nurses that have been working in this space for years. We have read the research; we have done the clinical practice, and we know or know how cannabis and another plant medicines are helping our patients. Secondly, and I speak to my own experience, this news gives nurses who have been working in a more traditional field an opportunity to serve their purpose and feel like they are improving patients’ lives every day. With so much burnout in many areas of traditional nursing, we need an opportunity to make a lasting difference in the health and wellbeing of the patients we serve.
Heather Manus: Oh, it's absolutely thrilling! The acceptance of cannabis nursing as a specialty practice by the ANA is a game-changer that validates the work we have been engaged in for over a decade! We're looking at a current nursing landscape that's undergoing a dynamic transformation. Cannabis nursing will bring a fresh perspective and innovative care options to nurses & patients everywhere, offering a holistic approach to health and wellness.
Mary Lynn Mathre: This is a huge step forward for the ANA to recognize cannabis nursing as a specialty. With the discovery of the endocannabinoid system (ECS), a small corps of nurses recognized this as a specialty and formed the American Cannabis Nurses Association in 2010 with the ultimate goal of being accepted among our peers as a specialty. Thanks to the hard work of a team of nurses at the ACNA in developing the scope and standards of practice, the ANA was able to confirm this specialty area of practice.
Dawn-Marie Steenstra: In many specialties of practice, we have Nurse Navigators as a title for nurses who specifically work as patient advocates in different disciplines. Nurse Navigators work with patients in various specialties, especially within the past few years. Nurse Nique Pichette DNP, MSN, RN developed the possibility of Cannabis Nurse Navigators because of the complexities involved in different health disciplines that the cannabis plant affects. I suspect cannabis nursing will be utilized in hospitals and inpatient settings to help patients in their treatment plans, guidance in dispensaries or assisting in education with doctors and recommending physicians moving forward. There will be specialized training curriculum developed over time and certification by independent nursing groups and approved by the American Nursing Association. The ACNA created and updated Standards of Practice, ethical guidelines, and legal protections for nurses in this field which follow the National Council of State Boards of Nursing (NCSBN) guidelines (3).There will be a National Certification Test for Competency, much like any other specialty nursing practice. Laws will need to be made surrounding the practice ethical guidelines, and legal protections for nurses in this field will need to be created. From what I understand the final certification and testing could still be a few years off to catch up with nursing school education and training.
What new doors have opened because of the acceptance of cannabis nursing as a specialty practice by the ANA?
Barrett-Nutting: The work to create the guidelines and get approval for this nursing specialty was years in the making. It will take time to establish criteria and testing options for credentialling nurses in this field. With this, nursing schools at any and all colleges and universities can add a tract for cannabis nursing to their coursework. To my knowledge there are no colleges or universities actively teaching a credit hour course for cannabis nursing. If anyone reading this learns otherwise, please share it with me. Some nursing programs have been forward thinking enough to bring in myself or some of my peers in cannabis nursing to speak to their nursing students about cannabis as a treatment option and nursing considerations.
Manus: With cannabis nursing gaining recognition, countless new doors have and will continue to swing wide open! We're talking about opportunities for personalized endocannabinoid system care, research opportunities, education advancements, and collaboration that were previously restricted by stigma and wide gaps in knowledge. This acceptance by the ANA paves the way for groundbreaking advancements in the field of nursing, including the self-care of nurses.
Mathre: Too soon to tell, but given the special issue of the Journal of Nursing Regulation on cannabis nursing in 2018 and now the recognition by the ANA, we will hopefully begin to see hospitals and clinics seeking cannabis nurse consultants to provide guidance in the safe and appropriate use of this healing herb for their patients as well as ways to keep the ECS functioning optimally.
Steenstra: Nurse consulting, doctor's assistants, pain clinics, addiction programs, hospitalists and Nurse Navigators for inpatient facilities, dispensary oversight, and most importantly research opportunities, contributing to better understanding of cannabis’ therapeutic value potential and safety considerations that must be in place and taught.
How do you see this helping patients? How will it help nurses?
Barrett-Nutting: After working in and dealing with stigma in the cannabis healthcare space for almost 10 years, I see this new nursing specialty helping patients similarly to how a state approving adult use helps patients. We generally see more people with medical conditions approaching or trying cannabis when the legislation in their state approves adult use. My patients and now some adult use consumers have shared that it feels more acceptable once it is adult use or recreational. As cannabis nurses, and my provider and pharmacist peers, we see an increase in the need to educate and support safe and responsible cannabis consumption.
I hope the approval of cannabis nursing as a specialty by ANA will help nurses, particularly those who like me, were afraid to learn about cannabis, to consider taking some classes, doing some research, and learning ways to encourage open communication about cannabis with our patients and peers.
Manus: This is a win-win for patients and nurses alike! Patients will benefit from personalized, cannabis-informed care that addresses a wide range of health issues. Nurses, on the other hand, will have access to exciting new tools and techniques to improve patient outcomes while expanding their own skill sets, including self-care. It's all about empowering the nurse, who in turn will empower the patient.
Mathre: Patients are often seeking the therapeutic use of cannabis from friends or family members and many remain hesitant to discuss it with their primary care provider due to its federal status as a Schedule I “drug” and the stigma related to marijuana. In states that allow medical use of cannabis, patients generally get their information from “bud tenders” rather than a healthcare professional. In states with legal access for adults, the market swings towards high THC content products, which are often too strong for many patients. Cannabis nurses can help guide the patient to the best route of administration, the best variety, and the appropriate dose and schedule of administration. This is especially important for patients naive to cannabis.
Cannabis nurses can consult with home healthcare, clinic, hospital, and nursing home staff to ensure safe and appropriate use of cannabis with patients who could benefit from its use. They can help develop standards of care in hospital facilities so that cannabis patients can continue to receive their medicine if inpatient. Patients who use cannabis are often able to reduce or eliminate other prescription medications - this makes life easier for the patient and the nurse.
Steenstra: Nurses freely educating patients will mitigate patient risks associated with use, such as medication interactions or adverse side effects. Collaboration across disciplines in harm reduction. Reduction of poly pharmacy are huge concerns in healthcare, as well as assisting those with chronic pain issues. Addiction intervention and a safe pathway away from narcotics and more dangerous drugs currently in use will be an interesting pathway forward as well as alcohol cessation programs.
What changes are you most excited to see now?
Barrett-Nutting: Honestly, I am excited to see how we are going to credential the “OG cannabis nurses” with grandfathering or testing processes since we are paving the way for this challenging and emerging field of healthcare.
Manus: The changes ahead are incredibly exciting! We can't wait to see nurses confidently integrating cannabis knowledge into their practice, leading to improved patient satisfaction and better health outcomes. We're also likely to see more innovation, research, and evidence-based approaches, which will further legitimize the specialty of cannabis nursing.
Mathre: Clearly the federal placement of cannabis as a Schedule I drug is unfounded and the plant should be completely de-scheduled so that anyone can grow this safe and healing plant. Cannabis products available for sale must meet good manufacturing standards to assure quality products that are clearly labeled. I am looking forward to nursing jobs being posted for a cannabis nurse consultant at various patient care facilities.
Steenstra:I am just so thrilled that Schedule I, in theory, has been destroyed regarding cannabinoid therapeutics at this point! The government and the medical community are both admitting at the same time it has medical value. That alone destroys its place in the Controlled Substance Act as a Schedule I!
As nurses we have lived under the prohibitionist mentality and stigma associated with it for years. The scheduling will change, and with that the public at large will realize that this plant is possibly the most exciting discovery once again and capable of changing the entire healthcare paradigm. (Imagine cancer centers and hospices allowing cannabis to be utilized in treatment hand in hand!)
Our Cannabis Nurses Network (CNN) initiated and implemented Ryan's Law in California in 2021; the CNN Ryan’s Law team is actively pursuing this work in other states as well. Nurse Laura and I are working with CNN and the Connor Sheffield Foundation to implement a similar law or hospital policy in Maryland.
How does ANA’s decision affect the National Clinical Directors Consortium/Cannabis Nurses Network?
Barrett-Nutting: Our National Clinical Director Consortium is an umbrella bringing together nurses, pharmacists, and providers working in cannabis healthcare to establish standards for education, practice, laboratory testing and our role. With the ANA’s approval of cannabis nursing as a specialty for nurses, I hope with see the National Association of Boards of Pharmacy (NABP) and the American Medical Association (AMA) follow suit for pharmacists and providers.
Manus: ANA's decision provides a real boost for the Cannabis Nurses Network and other related work in the field. It means more recognition, resources, and support for our mission to educate and advocate for cannabis-informed nursing care. It's not just a win for us; it's a win for healthcare as a whole, making it more inclusive and forward-thinking. The future is looking bright, and we are thrilled to be shaping the future of nursing!
Steenstra: I also hope to go to facilities, especially long-term care, assisted livings and hospice to teach nurses about the plant and how it can change the lives of seniors most importantly quality of life in all ways.
I have been around the movement for the entire duration, and this is a huge relief finally for nurses to be able to “step out of the cannabis closet” and educate their peers without fear of reprisal.