Cannabis Nursing is a sector of the healthcare landscape with growing interest and vast potential. How does this particular profession address the booming need for education and worldwide support for cannabis medicine? The Society of Cannabis Clinicians interviewed three Cannabis Nurses to gain insight on their line of work and how they navigate cannabis therapeutics in patient care.

What got you started in cannabis nursing?

“As a home health psychiatric nurse, I became keenly aware of cannabis usage among the home-bound patient population. This began with a 32-year-old diagnosed with Multiple Sclerosis who was wheelchair-bound and received 24-hour assistance. Upon receiving his chart and nursing assignment, I noticed the word “CANNABIS” listed as the first medication on his record. I would later learn he insisted on listing cannabis in his chart due to the significant positive benefits he was receiving. This led me to conduct a detailed assessment of his cannabis usage. He firmly rejected any type of stigma or judgment from healthcare providers regarding his medical cannabis use. From that point forward, I began assessing patients for medical cannabis use and inquiring in regards to legal patient status.” ~Heather Manus, RN- CEO of Cannabis Nurses Network

“It’s been a long journey. While conducting my master’s thesis, Marijuana Disclosure to Health Care Professionals in 1984-85, I learned some folks were using it as medicine in ways I never heard of (MS, spinal cord injuries, morning sickness). In a follow-up, I met the first five patients who were receiving cannabis cigarettes from the federal government through the now closed Compassionate Investigational New Drug (IND) program. The potential value of this herbal remedy and the hypocrisy of the federal government ignited my responsibility as a patient advocate to do something to correct the problem.” ~Mary Lynn Mathre, President and Co-founder of Patients out of Time

“I became interested in cannabis back in 2012 after my own personal health concerns led me to explore traditional remedies. As I studied the plant, I was instantly fascinated by the broad range of conditions it could treat. Over time, I found that it was more effective than other standard treatments but yet was never offered to patients. It wasn’t until 2014 when I was finishing up my Nurse Practitioner certification that I learned many patients were curious about cannabis as a treatment option but had no idea where to start. It was then I realized there was an opportunity to help patients navigate cannabis as a medicine.” ~Eloise Theisen, President of the American Cannabis Nurses Association (ACNA)

What advice do you have for someone wanting to become a cannabis nurse?

“Educate yourself about the history of cannabis prohibition, the endocannabinoid system, and cannabis therapeutics. You need a solid understanding of these topics to address the stigma surrounding the plant. This is also crucial to navigating the roadblocks to patient access due to federal prohibition and state laws. Speak the truth to your colleagues, hospital administrators, legislators, and others to help end cannabis prohibition. A cannabis nurse recognizes the value of this plant as a food source, a healing herbal medicine, and its use in environmentally friendly products. Think of cannabis therapeutics rather than medical cannabis – this puts it in the nurses’ domain as a therapeutic agent, rather than the medical domain, limited to requiring ‘permission’ from a health care provider.” ~Mary Lynn Mathre

“The role of a cannabis nurse is still in its infancy. At the federal level, cannabis remains a Schedule I drug. Yet we have 33 states plus the District of Columbia who allow for medical cannabis. Unfortunately, there is no consensus on qualifying conditions and a person may be allowed to use medical cannabis in one state but not in another. This makes it difficult for nurses to know how to navigate cannabis as medicine. It is important to understand both federal and state laws. I recommend contacting the state’s board of nursing and seeking clarification on the scope of practice for nurses. Be curious. Patients are using it. The more we know about the science, the better we can guide them safely and effectively.” ~Eloise Theisen

“My advice to nurses who are new to cannabis is: never stop learning. Question everything and use your critical thinking skills to continue growing through knowledge. Remember that knowledge is power. Remain in a state of wonder. Taking steps toward facilitating a revolution in healthcare will serve a cannabis nurse throughout their life and career. Be brave. Patients trust you. They are counting on you to be a holder of knowledge and sharer of wisdom.” ~Heather Manus

What are some of the unique challenges that cannabis nurses face when navigating patient situations?

“There are many unique challenges when it comes to cannabis nursing. The lack of clinical trials makes it difficult to recommend specific cannabinoid profiles for various conditions. There are no protocols based on thousands of studies. When a patient wants to use cannabis, it can take some exploration to find the right profile, amount, and route of administration. I have found that this approach can improve the chances of success for most patients. The treatment can be individualized. Yet most people struggle with this approach as they are accustomed to the method of ‘Take this pill 3x a day and I’ll see you in three months.’ Working closely with them to dispel myths and misconceptions can help them achieve success faster and decrease potential adverse effects.” ~Eloise Theisen

“As long as cannabis remains in Schedule I, everything relating to the therapeutic use of cannabis puts the patient, the nurse, and the nursing license in jeopardy. Access to quality cannabis products can be a challenge due to high costs, no insurance coverage, a lack of local delivery, and the illegalities of crossing state lines. Some patients only have access to the illicit market. There is no federal oversight on quality control. Hospitals and nursing homes may not allow nurses to talk to patients about the plant. Some state boards of nursing will discipline nurses who work in the cannabis industry. Nurses may not be able to personally use it therapeutically and still maintain their licenses.” ~Mary Lynn Mathre

“The greatest challenge I have experienced has come from the nursing and healthcare community. This includes stigma, lack of information, ego, fear, censorship, funding considerations, and influences from pharmaceutical companies which have hindered continued education efforts. The cannabis industry is growing. As a result, the healthcare sphere must be armed with the knowledge to adequately assist patients. Integrating endocannabinoid system assessments and cannabinoid therapeutic options are essential for the healthcare industry to implement now.” ~Heather Manus

Bios of Featured Cannabis Nurses

Mary Lynn Mathre, RN, MSN, CARN

Mary Lynn has more than 40 years of experience as a nurse and has specialized in addiction since 1987 and cannabis since 1990. She is the co-founder and President of Patients Out of Time, 
a non-profit organization devoted to educating health care professionals and the public about the therapeutic uses of cannabis. She is the editor of Cannabis in Medical Practice: A Legal, Historical and Pharmacological Overview of the Therapeutic Use of Marijuana (1997) and co-editor of Women and Cannabis: Medicine, Science and Sociology (2002).

Eloise Theisen, RN, MSN, AGPCNP-BC

Eloise is an adult geriatric nurse practitioner living in Northern California. Eloise continues to advocate for patients at the local and national levels and has successfully increased access in local cities. Eloise continues to develop continuing cannabis education for healthcare professionals, and worked with over 25 nurse practitioner students who have shown a special interest in cannabis medicine. She is currently the President of the American Cannabis Nurses Association.

 

Heather Manus, RN

Heather is a Registered Nurse specializing in all aspects of medical cannabis care. “Nurse Heather” began her career as a Registered Nurse providing psychiatric home health care to patients in New Mexico. She is the CEO of the Cannabis Nurses Network, a global professional development organization with the mission of connecting, elevating, and empowering nurses through Education, Opportunity, Recognition, and Advocacy.

Further Reading

• A Day in the Life of a Cannabis Nurse
• Cannabis Nurses Answer Common Patient Inquiries
• Calling the Cannabis Nurses Hotline
• Patient Education is a Phone Call Away: An Inside Look at a Cannabis Nurses Hotline
• Cannabis use in palliative care – an examination of the evidence and the implications for nurses