NJSNA Asks Governor to Extend Order Until APNs Freed From Physician Pacts

Five Nursing Groups Want Financial Considerations To End 

TRENTON, N.J.—June 1, 2021—The New Jersey State Nurses Association today asked Governor Phil Murphy to extend Executive Order #112 until Advanced Practice Nurses (APNs) have full prescriptive privileges without a collaborating agreement with a physician.

Last week, a coalition of nursing groups that included NJSNA issued a joint statement that highlighted the Governor’s executive order last year that temporarily freed APNs from the need for a collaborating agreement as the state fought the COVID-19 pandemic. For the last 14 months, the statement reads, New Jersey’s APNs have safely practiced with full authority “without this burdensome tether.”

“New Jersey APNs have proven that they are up to the challenge during the state’s darkest days,” said Mary Ellen Levine, DNP, MSN, RN, CHPN, NJSNA president. “We must not squander an opportunity to deliver significant savings in health care by providing greater access to affordable, high-quality health care to more state residents.”

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.

Full practice authority allows APNs to evaluate patients, diagnose, order and interpret diagnostic tests, initiate and manage treatments and prescribe medications under the exclusive licensure authority of the state board of nursing without a collaborating agreement, or joint protocol, with a physician. The bill, A-1760, would remove the requirement of a collaborating agreement.

There are more than 10,000 active APNs in New Jersey, with most of them being nurse practitioners (NPs). NPs provide primary care and refer patients to specialists for more advanced treatment. 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.  APN’s are ready now to be able to fill in that void.

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.

5 Nursing Groups Issue Joint Statement

A coalition of nursing groups, including NJSNA, Forum of Nurses in Advanced Practice of NJSNA, Society of Psychiatric Advanced Practice Nurses, NJ Association of Nurse Anesthetists and Advanced Practice Nurses of New Jersey issued yesterday the following statement:

“On April 1, 2020, Governor Phil Murphy signed Executive Order (EO) #112, “An Order Directing The Removal Of Barriers To Health Care Professionals” in response to the public health emergency caused by the COVID-19 pandemic. This EO removed a long- outdated barrier to practice facing NJ APNs and allowed them Full Practice Authority (FPA) without the necessity for a joint protocol with a physician in order to prescribe or order medications.

Over the last 14 months, NJ APNs have safely practiced without this burdensome tether, safely prescribing medications, caring for those with psychiatric & substance use disorders that have markedly increased during the pandemic, administering anesthesia, and caring for those with general and complex health care needs in all health care settings, including primary and acute care. For New Jersey APNs, this pandemic has brought opportunity both to modernize our workforce and provide significant savings in healthcare costs by providing greater access to affordable comprehensive healthcare to a greater number of New Jersey citizens. APNs together are working to make full practice authority a permanent reality in New Jersey.”