Advanced practice nurses (APNs) are instrumental in increasing access to quality care throughout the United States. State regulations surrounding their scope of practice differ which directly impacts the level of independence granted to nurses. This paper will discuss the differences in the scope of practice between New Jersey and Floridas current regulatory structure. Regulations surrounding licensure and practice impact autonomy, patient access, and overall healthcare quality within a state.
New Jersey Scope of Practice
New Jersey allows APNs to evaluate and manage patients as they see fit when it comes to diagnoses and treatment. According to N.J. Stat. 45: 11-49, advanced practice nurses may evaluate and manage patients healthcare needs, which includes starting treatment plans for patients within the population they focus on. Prescriptive authority in New Jersey requires collaboration with a physician. There needs to be a jointly written protocol between an APN and a collaborating physician in order for the nurse to prescribe medication, controlled dangerous substances, and devices. N.J. Admin. Code 13:37-7.9. This measure hinders complete autonomy for advanced practice nurses and complicates the profession.
Florida Scope of Practice
Florida employs a dual practice structure for advanced practice registered nurses (APRNs). Florida law states that APRNs can either practice under the standard regulations of the state or apply for approval to practice without supervision. Florida Statute 464.0123 states that upon meeting the requirements of experience and education, APRNs can diagnose, treat, and prescribe for patients within the area of primary care. APRNs who qualify for autonomous practice still need to adhere to certain guidelines, but the pathway allows for more freedom than the current standard regulations. Requirements for autonomous practice are stated by the Florida Board of Nursing and include things such as disclosure of practice and continued education.
Comparison of New Jersey and Florida Regulations
APRNs in both New Jersey and Florida can practice to the full extent of their license. When looking specifically at prescriptive abilities and supervision, the states stand out against each other. New Jersey requires physicians to be a part of the process when issuing a protocol for medications. In Florida, there is an option for APRNs to practice without physician supervision. These legislative decisions play into a larger movement to increase the capabilities of NPs to meet the primary care needs of communities. According to (McMenamin et al., 2023), primary care by NPs results in quality of care that is comparable and, in some measures, improved to care by physicians. Research also shows that states with full practice authority experience improvements in patient access and quality measures. (Dunbar-Jacob et al., 2025)
Implications for Access and Distribution of the Workforce
The policy surrounding a nurses scope of practice can limit or improve access to healthcare. Floridas policy allowing for independent practice by qualified APRNs allows them to open practices and provide services to patients. New Jersey requiring collaboration for advanced practice nurses can limit their ability to meet the needs of underserved areas. Studies have shown that limiting the practice ability of NPs can worsen provider shortages.
Conclusion
In conclusion, New Jersey and Florida have opposing regulations when it comes to APRN autonomy. New Jersey requires physician collaboration to prescribe medications, while Florida allows for independent practice. Multiple studies show that allowing NPs to practice to the full extent of their license can improve patient access and care. Legislation regarding the scope of practice should continue to be assessed as the demand for primary care increases.
References
Dunbar-Jacob, J., et al. (2025). State health and the level of practice authority for nurse practitioners. Nursing Outlook.
Florida Board of Nursing. (n.d.). Advanced practice registered nurse (APRN).
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