APRN REGULATIONS: A COMPARISON OF NY AND NJ

Ernie Lindain Jr.

William Paterson University: Department of Nursing

NUR5081: The Role of the Advanced Practice Nurse

Dr. Elisa Green

July 6, 2024

INTRODUCTION: STATE DEMOGRAPHICS

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New Jersey

• APN role established in 1991 (New Jersey Consumer affairs, 2021)
• Diverse practice settings, with high concentration in urban areas
• Higher proportion in specialized areas (pediatrics, geriatrics, etc.)

New York

• APN role established in 1988 (NYS Nursing: Licensing Requirements, n.d.)
• More distributed practice settings, including rural areas
• Higher proportion in primary care

EDUCATIONAL REQUIREMENTS AND CLINICAL HOURS

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New Jersey

• Minimum in master’s degree
• Must be an accredited/approved graduate program, according to state regulations
• 500 clinical practice hours required

New York

• Minimum in master’s degree
• Must be accredited/approved graduate program, according to state regulations
• 1000 clinical practice hours required

BOARD CERTIFICATION/�RENEWAL OF LICENSES

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New Jersey

• Must pass national certification exams (ANCC, AANP)
• License renewal every 2 years
• Continuing education: 30 contact hours every 2 years

New York

• Must pass national certification exams (ANCC, AANP)
• License renewal every 3 years
• Continuing education: 45 contact hours every 3 years

RENEWAL OF CERTIFICATIONS

American Academy of Nurse Practitioners (AANP) requires renewal of certifications must be met within a 5 year period. There are two options for renewal.

• Recertify by examination (AGNP, ENP or FNP)
• By practice hours and continuing education
• Minimum 1000 practice hours as an NP
• Minimum 100 contact hours of advanced CE
• Pharmacology is mandatory with at least 25 contact hours

(Continuing Education – AANPCB, 2019)

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RENEWAL OF CERTIFICATIONS (CONT.)

American Nurses Credentialing Center (ANCC) also offers national certification exams for nurse practitioners. AANP only offers NP certifications. ANCC is a part of ANA and offers certifications for APNs at various levels, including NPs. ANCC also accredits health care organizations and offers continuing education courses.

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(American Nurses Credentialing Center, 2022)

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COLLABORATIVE AGREEMENT

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New Jersey

• APNs are required to have a collaborative agreement with a physician to obtain prescriptive authority. This agreement outlines the scope of practice and the extent of collaboration between the APN and the physician.

New York

• NY requires a formal collaborative agreement for APNs to practice.
• While collaborative relationships with physicians are mandatory, they are only recommended after certain conditions are met.
• New York State Law (N.Y.C.R.R. § 64.5 (c)) requires a nurse practitioner to have a minimum of 3,600 hours of experience of written practice agreement and written practice protocols, prior to practicing independently (NYS Nursing: Licensing Requirements, n.d.).
• This allows for greater autonomy and flexibility in practice for APNs.

ADMITTING/HOSPITAL PRIVILEGES

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New Jersey

• Admitting/Hospital privileges more difficult obtain, requiring extensive documentation and approval process with a collaborating physician
• In hospital setting may need physician co-signatures for certain orders and treatments

New York

• APNs enjoy greater autonomy and can practice independently within the hospital setting.
• Can make clinical decisions, admit patients, and provide comprehensive care without requiring physician oversight.
• Easier to obtain admitting privileges with collaborative agreement
• Involves meeting hospital-specific credentialing requirements, which generally recognize the full practice authority granted to APNs by state law.

(New Jersey Board of Nursing, 2022; NYSED: New York State Education Department, n.d.)

PRESCRIPTIVE AUTHORITY (CDS, DEA)

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New Jersey

• Requires joint protocol with collaborating physician
• Application of prescriptive forms from the state
• Application of CDS number and DEA Registration with Department of Justice

New York

• Can independently prescribe and administer schedule II drugs
• Application of prescriptive forms from the state
• Requires NPI from US Center of Medicaid and Medicare Services
• DEA Registration with Department of Justice
• Full prescriptive authority, after conditions are met with at least 3,600 clinical practice hours with collaborating physician

APRN COMPACT LICENSES

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• Both states are not part of a APRN nursing compact. The APRN Compact gives allowance through multistate licensing to practice beyond home state lines in participating compact states.
• The National Council State Boards of Nursing oversees and regulates this compact. The states that are involved in this compact include Utah, North Dakota, South Dakota, and Delaware.
• Because New York and New Jersey aren’t participants of the compact, a nurse practitioner must abide by the licensure requirements in their respective states.

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(APRN Compact, n.d.)

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CONCLUSION

The comparison between NJ and NY APRN practices emphasizes the similarities and differences in educational requirements, certification processes, practice restrictions, and regulatory environments.

NJ imposes more collaborative requirements and practice restrictions, while NY offers greater practicing autonomy and flexibility for APNs.

These differences impact the health care delivery and the roles that APNs can play in their respective states.

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REFERENCES

• American Nurses Credentialing Center. (2022). American Nurses Credentialing Center | ANCC. ANA. https://www.nursingworld.org/ancc/
• APRN Compact. (n.d.). APRNCOMPACT. https://www.aprncompact.com/
• Continuing Education - AANPCB. (2019). Aanpcert.org. https://www.aanpcert.org/recert/ce
• Mandatory Prescriber Education. (n.d.). Www.health.ny.gov. https://www.health.ny.gov/professionals/narcotic/mandatory_prescriber_education/
• New Jersey Consumer Affairs (2021). Njconsumeraffairs.gov. https://www.njconsumeraffairs.gov/renewals/Pages/Nurse.aspx#E
• New Jersey Board of Nursing. (2022). NEW JERSEY BOARD OF NURSING LAW AND PUBLIC SAFETY. https://www.njconsumeraffairs.gov/regulations/Chapter-37-New-Jersey-Board-of-Nursing.pdf
• NYS Nursing: License Requirements. (n.d.). Www.op.nysed.gov. https://www.op.nysed.gov/professions/nurse-practitioners/certification-requirements
• NYSED: New York State Education Department. (n.d.). NYS Nursing: Practice Information: Prescription Privileges. Www.op.nysed.gov. https://www.op.nysed.gov/professions/nurse-practitioners/practice-issues/prescription-privileges

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