Nurse Practitioner Scope of Practice: New Jersey

The last time I was in New Jersey, I was en route to India to meet with the MidlevelU tech team. Due to seemingly unnecessary flight delays, I got stuck in the state and wound up spending the night in Newark rather than Mumbai, halfway across the world, as planned. Needless to say, the experience was frustrating. Nurse practitioners practicing in New Jersey seem to have some frustrations with the state of their own. 

New Jersey doesn't rank among the worst states for nurse practitioner practice, but it certainly doesn't fall among the best. Let's look at the specific rules and regulations governing nurse practitioners practicing in New Jersey. 

New Jersey's Nurse Practitioner Supervision Laws

Nurse practitioners practicing in New Jersey are technically independent providers. In fact, legal documentation refers to NPs as "licensed independent practitioners". They may diagnose and treat patients free of physician oversight. Medical documentation created by NPs in the state does not need to be signed by a physician. In New Jersey, nurse practitioners are regulated and licensed by the board of nursing. State law holds nurse practitioners independently responsible ethically and legally for all care provided. Responsibility does not rest with a supervising or collaborating MD. 

New Jersey offers a perk to newly graduated NPs. Nurse practitioners may practice following completion of their nurse practitioner program but before passing the national NP certification exam. To practice prior to taking the exam, new grads must apply for a work permit allowing for practice prior to certification. If the NP fails the certification exam twice, this temporary practice permit is revoked. 

New Jersey's Nurse Practitioner Prescribing Laws

In order to prescribe medications, nurse practitioners practicing in New Jersey must collaborate with a physician. The collaborating physician does not need to practice on site with the NP but can maintain communication through phone or e-mail. A "joint protocol" outlining this collaborative relationship must be maintained and signed each year by the NP and MD. Within this collaborative agreement, nurse practitioners may prescribe Schedule II to V controlled substances. They may also request, receive, and dispense pharmaceutical samples. Unless employed by a federal institution such as the VA, the collaborating physician must also be licensed in the state of New Jersey. 

Prescriptions written by nurse practitioners in New Jersey must contain information for both the NP and the collaborating physician. Nurse practitioners must also complete a one-time, six hour course in controlled substance prescribing. 

Other Scope of Practice Laws in New Jersey

Nurse practitioners practicing in New Jersey are allowed to pronounce death. The cause of death, however must be determined by a physician. NPs are also permitted to complete temporary work disability forms as well as perform DOT physicals. 

Lawmakers in New Jersey have considered legislation allowing nurse practitioners to prescribe independently. But, until such legislation passes, NPs practicing in the state remain tied to MD's as the ability to prescribe is necessary in most practice settings. 

New Jersey NPs weigh in! How do state scope of practice laws affect your practice?

 

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