| Course | NUR-8100 Health, Healthcare Policy, and Politics |
|---|---|
| Module | Module 5 |
| Paper type | Policy brief: nursing workforce and scope of practice |
| Length | About 830 words, 6 pages |
| Format | APA 7 student paper |
| School | Thomas Edison State University |
| Program | Doctor of Nursing Practice |
| Updated | October 2026 |
Free sample paper for NUR 8100 Module 5
Removing the Joint Protocol: A Policy Brief on Full Practice Authority for Advanced Practice Nurses in New Jersey
Student Name
Doctor of Nursing Practice, Thomas Edison State University
NUR-8100: Health, Healthcare Policy, and Politics
Mentor Name
Month Day, Year
Removing the Joint Protocol: A Policy Brief on Full Practice Authority for Advanced Practice Nurses in New Jersey
Purpose
This brief asks the Senate Health, Human Services and Senior Citizens Committee to consider legislation granting full practice authority to advanced practice nurses in New Jersey, removing the requirement that they hold a joint protocol with a collaborating physician in order to prescribe medications and devices. It summarizes the problem, the evidence, the stakeholders and the options, and recommends a path forward.
The Problem
New Jersey, like much of the country, faces shortages of primary care clinicians, with the gaps deepest in rural counties in the south and northwest and in low-income urban neighborhoods. Advanced practice nurses are educated and nationally certified to assess, diagnose and treat patients, and in New Jersey they may do so independently in many respects. Prescribing, however, requires a written joint protocol with a physician. In practice, the protocol often functions as a paperwork arrangement rather than active clinical collaboration, but it carries real costs: nurses must find a willing physician, sometimes pay for the arrangement and lose the ability to prescribe if the physician retires, moves or ends the agreement. Clinics in shortage areas are the most likely to struggle to find collaborating physicians.
The Evidence
The research falls into three groups. The first concerns quality. Kurtzman and Barnow (2017) compared nurse practitioners, physician assistants and physicians using five years of national survey records from federally funded health centers. On most of the measures the three kinds of clinicians looked alike, and where they differed, nurse practitioner visits came out ahead on smoking advice and health teaching.
The second concerns what happens when states grant independence. Traczynski and Udalova (2018) used differences in when states passed laws allowing nurse practitioners to practice and prescribe without physician oversight. Where states let nurse practitioners work on their own, people got more routine checkups, some quality measures improved and fewer emergency visits were made for problems a clinic should have handled.
The third concerns access and the workforce. Xue et al. (2016) pulled together the research on state practice laws and found that broader authority went with more nurse practitioners, quicker growth in their ranks and more care used, most of all by rural and disadvantaged residents.
| Evidence | Finding | Relevance to New Jersey |
|---|---|---|
| Health center visits | Quality largely comparable; more counseling by nurse practitioners | Safety concerns not supported |
| State law changes | More checkups, less preventable emergency use | Benefits seen after independence |
| Systematic review | More nurse practitioners and more care in rural and vulnerable groups | Shortage areas likely to gain most |
Stakeholders
Supporters include the state's nurse practitioner and nursing associations, AARP and many consumer groups, community health centers and rural health advocates. Opponents include physician organizations, which argue that physician collaboration protects patients and that nurse practitioners' training is shorter. Insurers and hospital systems have mixed positions, depending on their staffing models. Legislators will weigh these arguments alongside the evidence and the experience of states that have already changed their laws, which now number more than half of states and the District of Columbia.
Options
Option one is to keep the current law. It preserves physician collaboration but continues the barriers described above, particularly in shortage areas.
Option two is a transition-to-practice model. Advanced practice nurses would practice under a joint protocol for a set period after certification, such as two years or a defined number of hours, and then gain full practice authority. Several states have adopted this approach, which addresses concerns about new graduates while removing the requirement for experienced nurses.
Option three is immediate full practice authority for all certified advanced practice nurses, removing the joint protocol entirely.
Fiscal Note
The state would spend very little to make this change. The Board of Nursing would update its rules and forms, and the reporting requirement recommended below would need a small amount of staff time. Indirect effects on spending are more likely to be savings than costs, since the study of state law changes found fewer emergency visits for conditions that good outpatient care should prevent, and Medicaid pays for many of those visits.
Recommendation
The committee should advance legislation adopting option two: full practice authority after a transition period of 24 months under a joint protocol. This option is supported by the evidence on quality and access, addresses the main concern raised by opponents and follows a path that other states have taken without evidence of harm. The legislation should require reporting on the number and location of advanced practice nurses and on access in shortage areas, so that the committee can evaluate the change after five years.
Conclusion
The joint protocol requirement limits primary care where it is most needed while the evidence does not show that it improves quality. A transition-to-practice model would preserve support for new clinicians and expand access in shortage areas. Advanced practice nurses in New Jersey are ready to provide that care, and the committee can make it possible.
References
Kurtzman, E. T., & Barnow, B. S. (2017). A comparison of nurse practitioners, physician assistants, and primary care physicians' patterns of practice and quality of care in health centers. Medical Care, 55(6), 615-622. https://doi.org/10.1097/MLR.0000000000000689
Traczynski, J., & Udalova, V. (2018). Nurse practitioner independence, health care utilization, and health outcomes. Journal of Health Economics, 58, 90-109. https://doi.org/10.1016/j.jhealeco.2018.01.001
Xue, Y., Ye, Z., Brewer, C., & Spetz, J. (2016). Impact of state nurse practitioner scope-of-practice regulation on health care delivery: Systematic review. Nursing Outlook, 64(1), 71-85. https://doi.org/10.1016/j.outlook.2015.08.005
NUR 8100 Module 5 instructions, in plain terms
The NUR-8100 catalog description asks students to examine policy from the nursing workforce perspective and to advocate for sound health policies, and with no public syllabus to confirm the assignment, this fifth module is set on a policy brief. Expect a short, structured document addressed to a named decision maker: purpose, problem, evidence, stakeholders, options and a recommendation. Briefs are judged on clarity and usefulness to a busy reader, so headings, a summary table and plain language matter. Some classrooms set a word or page limit; check it. Address the brief to a real office in your state, and make sure every claim about the law is current. Expect to be asked for a fiscal note or a sentence on cost, since legislators always ask.
How this NUR 8100 Module 5 example is built
The brief states its purpose and the committee it addresses in two sentences. The problem section explains primary care shortages in named regions and how the joint protocol works in practice. Three bodies of evidence follow: health center visit quality, state law changes and a systematic review on access and the workforce, summarized in a three-row table. Supporters and opponents are named with their arguments. Three options are set out, from keeping the law to immediate independence. The recommendation chooses a 24-month transition model with reporting requirements, and a short conclusion restates the case for the committee. A brief fiscal note answers the cost question a legislator will ask first.
Where the marks sit in the NUR 8100 Module 5 rubric
Policy briefs are graded on clarity, accuracy and usefulness to the named decision maker. Mentors look for a clear request in the opening, a problem described in local terms, evidence from peer-reviewed studies summarized accurately, stakeholders on all sides and options that a legislator could choose among. The recommendation should be specific and feasible, with a plan for evaluation. Plain language and short sections matter more in a brief than in a paper. A summary table is often credited, as is a short fiscal note that answers the cost question before it is asked. APA citations are still expected, though the reference list may be brief. Briefs that acknowledge and answer the opposing argument tend to earn the top marks.
NUR 8100 Module 5 help from the desk
Students often write a policy brief as a long essay, with paragraphs of background before the request. Put the request first. Another common weakness is presenting only one option, which leaves the decision maker nothing to weigh. Give two or three. Avoid jargon such as scope of practice without explanation. Describe your state's current law accurately, since legislators know it well. Name opponents and their strongest argument. Make the recommendation specific, with timelines and measures. Keep it short, and add a sentence on cost. A legislator reads the first paragraph and the recommendation first, so make both stand alone. The desk can draft your NUR-8100 policy brief to the office and length your directions name, with the first one free.
Write yours, or have the desk draft it
This paper is an original model document written by our desk, not a submitted student paper and not an official Thomas Edison State University document. Read it for the moves, then write your own to the instructions in your classroom. If you want one built to your exact prompt and rubric, the first custom sample is free and arrives in 24 to 48 hours.
More NUR 8100 and Doctor of Nursing Practice sample papers
- NUR 8100 Module 1: Policy Process Paper: New Jersey's Safe Staffing Bill and Multiple Streams
- NUR 8100 Module 2: Access Policy Paper: What Medicaid Expansion Changed
- NUR 8100 Module 3: Quality and Payment Paper: The Hospital Readmissions Reduction Program
- NUR 8100 Module 4: Social Justice Policy Paper: Twelve Months of Postpartum Medicaid
- NUR 8100 Module 6: Advocacy Paper: Written Testimony on Hospital Nurse Staffing Ratios
- NUR 8250 Module 5: Budget and Staffing Economics Paper: Nurse Staffing, Turnover Costs and a Unit Budget Case
- NUR 7630 Module 4: Diagnostic Accuracy Paper: Pretest Probability, D-Dimer and Predictive Values
- NUR 8000 Module 3: Clinical Inquiry Paper: Building Evidence-Based Practice on a Unit
- NUR 8320 Module 1: Leadership Styles Paper: Relational Leadership, Burnout and a Nurse Executive's Development Plan
NUR 8100 Module 5 questions, answered
Where can I find a free NUR 8100 Module 5 sample paper?
The complete brief is on this page. It asks a New Jersey Senate committee to grant full practice authority to advanced practice nurses after a transition period.
What is a joint protocol in New Jersey?
A written agreement between an advanced practice nurse and a collaborating physician that New Jersey requires for the nurse to prescribe medications and devices.
Is nurse practitioner care as good as physician care?
In health centers, a visit with a nurse practitioner matched a physician visit on most measures and more often included quit-smoking advice and teaching.
What happens when states grant nurse practitioners independence?
Studies of state law changes found more routine checkups, improvements in some quality measures and fewer preventable emergency visits.
What is a transition-to-practice model?
A policy that requires new nurse practitioners to practice with physician collaboration for a set period, often two years, before gaining full practice authority.