NJSNA: APNs Worthy Without Physician Pacts

 In News

New Research Makes The Case To Eliminate Joint Protocol

TRENTON, N.J.—Sept. 28, 2021—Referencing recent research, the New Jersey State Nurses Association announced today that it reaffirms its support for Advanced Practice Nurses to have full prescriptive privileges without financial agreements with physicians.

The Advanced Practice Nurses of New Jersey (APN-NJ) recently released its report, “Maximizing Access to Health Care in New Jersey – The Case for Full Practice Authority”, which underscores the fact that APNs with temporary privileges to write prescriptions without a contractual agreement with a licensed physician have played a vital role in strengthening the state’s health care during the ongoing pandemic. New Jersey Executive Order #112 removed the contractual restrictions between APNs and physicians during the COVID-19 outbreak. The suspension of the joint protocol requirement has now been legislatively extended through January 1, 2022.

“APNs have proven their worth during a health care crisis,” said Mary Ellen Levine, DNP, MSN, RN, CHPN, NJSNA president. “Evidence-based research reinforces the fact that APNs are fit to practice to the full extent of their education and licensure. It’s time for New Jersey to join 25 other states and the District of Columbia and free APNs from this barrier.”

According to the recent report from APN-NJ, there are several findings that make the case:

  • During the 16 months that the joint protocol has been suspended, there have been no reports to the NJ Board of Nursing that this action has undermined patient safety.
  • APNs in state with full practice authority are no more likely to be reported to the National Practitioner Data Bank than those working in more legally restricted states.
  • The care provided by APNs more often prevents costly emergency room visits and rehospitalizations.
  • APNs are more likely to care for patients who are vulnerable, disabled and underserved. In fact, states that allow APNs to have full practice authority experience 17% lower outpatient costs and 10.9% lower prescription drug costs per Medicaid beneficiary than those states with restricted practice.

Carolyn Torre RN, MA, APN, FAANP and Suzanne Drake, RN, PhD, APN are co-authors of the APNNJ report.

“With the exception of the joint protocol requirement for prescribing, APNs have been practicing autonomously in New Jersey for nearly 30 years,” Torre said. “Patients deserve the right to unrestricted access to their care!”

In addition to the pandemic, New Jersey continues to face a shortage of primary and mental health providers. New Jersey will need more than an additional 1,000 primary doctors, or about 17 percent of the current workforce, to meet demands by 2030, according to the Robert Graham Center’s New Jersey: Protecting Primary Care Physician Workforce report.

NJSNA continues to advocate for increased consumer access to health care by eliminating the collaborating agreement between an advanced practice nurse and a physician. This agreement restricts APN’s ability to practice to the full extent of their education and licensure, known as full practice authority.

By statutory law in New Jersey, the collaborating agreement requires the APN and the physician to review one patient case per year.  There is no supervisory requirement by the physician. In fact, the physician does not even need to be in the same town or county as the APN or be in the same specialty.

APNs are trained at the graduate level to evaluate patients, diagnose illness, and prescribe medication to patients, focusing on the well-being of the whole person, not just a disease. APNs include NPs, clinical nurse specialists (CNS) and APNs-anesthesia. They are licensed and regulated by the New Jersey Board of Nursing. Approximately two-thirds of Garden State APNs are NPs; the largest number of CNSs provide mental health services and practice psychiatry. Nurse midwives are licensed and regulated by the New Jersey Board of Medical Examiners.

APNs were legally recognized as healthcare professionals by the New Jersey Legislature in 1991 and, two years later, certification of APNs and standards for joint protocols were enacted.

To learn more about the New Jersey State Nurses Association, please visit njsna.org.


NJSNA, established in 1901, is a constituent member of the American Nurses Association.  The New Jersey State Nurses Association (NJSNA) represents the interests of more than 140,000 registered nurses and advanced practice nurses as an advocate for the nursing profession. NJSNA’s lobbying arm continues to protect the nursing profession through legislative victories. Its nonprofit foundation, the Institute For Nursing, helps nurses further their careers by providing continuing education, scholarships and research grants, in addition to invaluable networking opportunities. For more information, visit www.njsna.org, or call (609) 883-5335.

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