At least two dozen states, including Connecticut, Maryland and New York, have eliminated many anti-AFN practices; Pennsylvania lawmakers are also considering similar laws. But doctors continue to protest the changes, and in New Jersey, the measure had not been passed until Monday. Currently, 21 states allow NPs to practice independently and prescribe drugs on their own. The Senate Public Health Committee approved a bill to abolish the so-called Common Protocol – the written agreement with a doctor that now allows advance practice nurses to be prescribed in the Garden State, with near-unanimous support monday, after several hours of passionate testimony for and against the controversial legislation. The measure does not yet have a hearing in the Assembly and still has to overcome other obstacles before it can become law. In New Jersey, a common protocol is a written document prescribed by the state, which outlines guidelines for prescribing drugs and devices for an AFN in a specific practical environment; this common protocol must be agreed and signed cooperatively by the AAP and its medical member-designate cooperating. It must be reviewed, updated and co-signed at least once a year. Although the language may vary from practice to practice in the common protocol, each common protocol must follow the project defined by the new Jersey State Board of Nursing rules at 13:37-6.3www.state.nj.us/lps/ca/nursing/nurjon.htm. An example of how to write the common protocol is the NJSNA website www.njsna.org/suggested_template.htm There has been a great step forward in transforming health care by allowing RDAs to practice as an independent practitioner, including the right to prescribe drugs. For example, the American Association of Life Practitioners (AANP) has stated that five decades of research support, that NPPs “should have full normative authority, including the issuance of privileges, as part of their practices.” Other nurses have found that AFNs naturally work with a large number of other providers – which they promised would not change if the law were passed.
Some apns choose not to be prescribers and therefore do not need common protocols. These include many nurses who depend on other clinical staff. And APN nurses nurses are subject to slightly different rules that require them to sign a common protocol with a licensed anesthesiologist, who must be in the building when the AFN patient is in surgery.