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Advanced practice nurses (APNs) represent a significant group of professionals who possess specific responsibilities, have rigid regulations for their activities, and need to comply with various rules regarding the certification and prescriptive authority. APNs need to acquire a minimum of a Master’s level of education and support their skills through continuous learning in the area of their expertise. The regulatory organizations that command the area of APNs in the state of New Jersey are the Division of Consumer Affairs and the Board of Nursing. One of the crucial aspects of advanced nurses’ practice is a controlled substance prescription, which also requires specific criteria fulfillment. In such a way, APNs need to conduct six hours of continuing education related to CDS. It is also crucial to comply with the regulation of signing a joint protocol with a collaborating physician to obtain prescriptive authority.
The nursing field occupies an essential place in the healthcare industry and has its regulations and guidelines to perform high-quality services. Advanced Practice Nurses (APNs) represent a group of professionals who carry substantial duties and have a critical responsibility for the treatment of and effective care of patients. New Jersey State Nurses Association (2006) defines APNs as “registered nurses with master’s level nursing education (at minimum) who provide expert clinical care in a variety of settings (para. 1). Thus, APNs have a vital role and are obligated to perform at the highest level. This paper aims to investigate the requirements for Advanced Practice Nurses in New Jersey and their implications.
First, it is significant to review the necessary aspects that APNs in New Jersey have to follow for prescriptive practice. According to the New Jersey Division of Consumer Affairs (2015), APNs possess a prescriptive authority and are requested to have a joint protocol with a licensed physician before advocating any medical devices or medication. Consequently, expert nurse practitioners in NJ have the power for prescriptive activities but have to comply with additional regulations. Moreover, when the nurses apply for prescriptive authority, they are required to have a continuing professional education certificate obtained five years before the application date (New Jersey Division of Consumer Affairs, 2015). In such a way, APNs need to fulfill rigid guidelines to acquire a possibility for prescriptive practice.
The next crucial point is the regulatory organizations that have authority over APNs in New Jersey. All APNs exist under the banner of the Division of Consumer Affairs and have to be certified by the Board of Nursing (BON) (Nursing Licensure, n. d.). Hence, those are the official bodies that control the practice of advanced nurses. Moreover, APNs and healthcare institutions need to comply with the required certifications. In NJ, APNs receive their certificates from the BON that can accept authorizations issued by agencies accredited through the American Board of Nursing Specialists or the National Commission for Certifying Agencies (Nursing Licensure, n. d). Therefore, APNs are required to hold a registered nurse license and the certification issued or accepted by the BON within the state.
Besides specific regulations APNs need to comply with to possess a prescribing authority, there are numerous guidelines and requirements for other aspects of their practice. First, it is crucial to understand the point of education and continuous learning for advanced nurses. All APNs are required to complete a graduate education program with a minimum of 39 hours in pharmacology and six contact hours of controlled dangerous substance (CDS) related pharmacology (Drake & Torre, n. d.). In such a way, there are particular essential fields, in which nurses, applying for advanced practice, need to have expertise. Additionally, APNs need to acquire at least 30 contact hours of continuing education related to their specialty, and the BON does not identify that those hours need to be pharmacology-related (Drake & Torre, n. d.). Consequently, there is a significant emphasis on continuing knowledge among APNs to ensure their professionalism and the ability to follow new developments within their area.
The paragraphs above mention the necessity of obtaining a joint protocol with a collaborating physician before moving to the prescription stage. This agreement represents “an ongoing process consistent with agreed-upon parameters of their respective practice” in the form of a written contract between APN and a physician (Drake & Torre, n. d., p. 2). Thus, advanced nurses need to have collaboration arrangements with doctors and have to comply with it carefully, remembering about physician’s involvement in prescribing medications. The joint protocol needs to include particular elements to be valid. Hence it should incorporate the information about the nature of the practice, record-keeping methodology, patient population, medication categories, specific points for recording, and rules for consultations (Drake & Torre, n. d.). APNs are obligated to ensure the legitimacy and rationality of this agreement. Moreover, a discussed protocol needs to be reviewed and signed again at least annually by both parties involved (Drake & Torre, n. d.). It is vital to update it to reflect possible modifications in functions or skills.
Another critical point regarding APNs’ performance and operations concerns the guidelines of the Center for Disease Control and Prevention (CDC). Advanced practice nurses need to apply for prescribing CDS, and after they possess an authority to do this according to the protocol (Drake & Torre, n. d.). As mentioned earlier, each APN is required to obtain six hours of continuing education related to CDS. Moreover, before starting the registration to acquire the Federal Drug enforcement agency number, APNs have to have CDS prescription ability in the state of New Jersey (Drake & Torre, n. d.). Revisioning of the joint protocol is essential for this point as well to decide the necessity of collaboration. The BON can check compliance with all regulations through “random audits upon license renewal” (Drake & Torre, n. d., p. 3). Consequently, the area of prescribing controlled dangerous substances is a sensitive field within the nurses’ practice and needs careful attention.
There are also other significant aspects related to the prescription of CDS. First, APNs need to make sure whether a patient already had treatment with a specified drug or pharmaceutical substitute (New Jersey Division of Consumer Affairs, n. d.). A particular system in which the professionals can access medication history exists. The New Jersey Prescription Monitoring Program (NJPMP) can help APNs to observe the medical record (New Jersey Division of Consumer Affairs, n. d.). Therefore, APNs need to carefully turn to the issue of prescribing CDS and take each case separately. The CDC suggests that practitioners should be cautious with the dosage of CDS and avoid increasing the dose or have a precise justification for this move (New Jersey Division of Consumer Affairs, n. d.). The professionals need to follow those guidelines to achieve the best treatment results and avoid potential dangers.
The point of prescribing the medication or medical devices and following existing requirements is an essential topic for APNs. The paragraphs above mention the necessity of collaboration with a physician through signing a joint-protocol. It is also crucial to remember that APNs can have the prescriptive authority within the state of New Jersey, where they got their certification required by the BON. One can say that the presence of those regulations might limit the power possessed by APNs, although they aim to eliminate the risks and ensure the safety of patients. The curious point is that all individual APNs have their prescription blank pads printed on special paper, as required by the NJ statute (The Society of Psychiatric Advanced Practice Nurses, n. d.). It is a significant request because it helps to avoid alterations in the medications or doses.
Thus, possessing a prescriptive authority with specific limitations is a serious responsibility for practitioners. Additionally, every APN must remember that in the case of prescribing controlled dangerous substances, only one medication of this type can be in one prescription (The Society of Psychiatric Advanced Practice Nurses, n. d.). There are numerous details concerning collaborative practice with physicians, as well. For instance, besides carefully designing joint protocols, the parties involved should develop specific guidelines defining roles and responsibilities (The Society of Psychiatric Advanced Practice Nurses, n. d.). As a result, clear standards and instructions shape the abilities of APNs within the area of expertise. All the established regulations and legislation related to the medication prescription and APNs’ power within this field are vital for the professionals, and any violation might have adverse consequences. In conclusion, APNs in New Jersey have to comply with strict regulations, possess a particular level of education, obtain specialized certifications, and be engaged in continuous learning.
References
- Drake, S., & Torre, C. (n. d.). New Jersey advanced practice nurses. Web.
- New Jersey Division of Consumer Affairs. (n. d.). Frequently asked questions: For advanced practice nurses licensed by the Board of Nursing. Web.
- New Jersey Division of Consumer Affairs. (2015). New Jersey Board of Nursing. Advanced practice nurse certification.
- New Jersey State Nurses Association. (2006). New Jersey State Nurses Association: Fact sheet on APNs.
- Nursing Licensure. (n. d.). Advanced practice nurse license requirements in New Jersey: Nurse practitioner, clinical nurse specialist, nurse anesthetist. Web.
- The Society of Psychiatric Advanced Practice Nurses. (n. d.). Guidelines for collaborative practice for the NJ advanced practice nurse. Web.
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