What Nursing Could Contribute to the Medical Cannabis Program
Since joining the medical cannabis program, I have observed the same problem time and again. A patient receives their certification, walks into a dispensary, and finds themselves facing dozens of products, almost always without clear guidance on what to do with all of them. The medical consultation that authorizes treatment is a starting point, but what happens next?
Patients have to learn how to manage their treatment, recognize its effects, and determine whether it is actually helping them. Often, they do this on their own, without knowing what to watch for, what questions to ask, or when to seek guidance.
That gap has a name, and nursing can help fill it.
Nurses understand how the human body works, as well as diseases, pharmacology, and potential interactions between medications. They are also trained to identify changes in a patient’s condition, document relevant findings, and recognize when a situation requires attention. I am not talking about replacing the physician, whose role is essential. I am talking about contributing through education, observation, assessment, and follow-up—tools that are part of nursing practice and can help provide more comprehensive care. What could a nurse do? They could start by helping patients understand what they are using, its possible effects, and what to consider when choosing a product or method of administration.
The goal is not to tell patients what to use, but to teach them to understand their options and make more informed decisions.
Safety matters, too. Reviewing the medications a patient uses, identifying potential interactions, and recognizing risk situations that warrant further evaluation are important aspects of care. In medical cannabis, this requires specific knowledge, because potential interactions do not always have the same clinical significance, and each patient may respond differently.
Another essential aspect is setting realistic expectations. Cannabis is not a universal cure, and it does not produce the same effects in everyone. Understanding this helps patients observe their response more objectively and recognize when the treatment is not providing the expected benefit. But I believe one of the greatest contributions would be in follow-up.
What is the patient feeling? Has the symptom they want to manage improved? Have they noticed any adverse effects? How are they sleeping? Have they experienced changes in their concentration, mood, or day-to-day functioning?
The answers provide important information about the patient’s experience.
A nurse can help organize and document these observations, identify changes that merit attention, and communicate findings to the appropriate professional. This allows treatment decisions to be based on clearer information while respecting each professional’s role and responsibilities.
Nurses can also help patients understand product quality. Learning to read a label, understand information about a product’s composition, and know what to ask about laboratory testing are useful tools for making informed decisions.
However, taking on this role responsibly requires training. In Puerto Rico, there are continuing education initiatives on medical cannabis for nursing professionals. Their limited duration, however, may make it difficult to address the full complexity of cannabis. Learning about the plant is a start, but supporting someone throughout their treatment requires combining that knowledge with clinical assessment, pharmacology, and the safety standards of professional practice.
I speak from my own experience. After recognizing this need, I have devoted myself to developing an educational model that teaches patients to better understand the plant and observe their response in a responsible and mindful way. This work has developed over time, drawing on years of self-directed study, my nursing education, and my experience as a patient.
The goal is for patients to learn to look beyond the name of a strain or its THC percentage.
They should be able to observe how their body responds, recognize the changes they experience, and keep a record of those experiences so they can better understand their treatment and know when to consult the professionals involved in their care.
However, patients enrolled in the medical cannabis program do not always have access to this kind of support.
I believe personalized patient education should be part of treatment, and that the system should recognize and integrate efforts of this kind. A medical cannabis program should not simply certify a patient and leave it at that.
Education and follow-up deserve a place in that process.
Nursing has the knowledge and tools to help meet this need. We need to start a conversation about how to prepare these professionals and integrate their work responsibly, with clearly defined roles and the patient’s best interests in mind. Education does not end when a patient receives their certification. That is where an important part of the work begins.
The system simply needs to recognize this role and open the door to it.
Eileen Cestary
RN, BSN | Divulgadora de cannabis medicinal
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