By Angela Starkweather, Persephone Vargas, Donna Nickitas, Joseph Cipriano, and Jamille Nagtalon-Ramos

In classrooms and clinical sites across New Jersey, we are preparing a world-class generation of clinicians. As nurse educators, we provide the master’s- and doctoral-level education required for advanced practice nurses to earn licensure and certification to evaluate, diagnose and treat patients in this state.

Yet after years of investment, we are watching our students — including those training to become nurse practitioners and nurse anesthesiologists — graduate and immediately cross state lines to practice.

They’re not leaving the profession. They’re leaving New Jersey.

Why? New Jersey’s outdated regulatory framework makes it far less attractive for advanced practice nurses to work here than in most of the nation.

In March 2020, Gov. Phil Murphy declared a state of emergency and public health emergency through executive order. On April 1, 2020, a subsequent executive order temporarily suspended statutory provisions governing the scope of practice for health care professionals, including the requirement that advanced practice nurses maintain joint protocols with collaborating physicians.

During that period, advanced practice nurses delivered high-quality primary, specialty and acute care throughout the state without any disruption to patient safety. The experience demonstrated that modernized practice models can work effectively in New Jersey.

But those emergency orders are set to expire April 2, forcing advanced practice nurses back under a law that makes it illegal for them to practice without a regulated contract with a physician.

While communication and care coordination among clinicians are essential, mandatory contractual agreements have not been shown to improve clinical outcomes or patient safety. Instead, New Jersey’s restrictive laws make it harder for patients to access care, artificially limit choices and contribute to higher health care costs.

They are also undermining our ability to retain and grow the nursing workforce. Twenty-seven percent of New Jersey–licensed advanced practice nurses hold active licenses in other states.

Compared with neighboring states that grant full practice authority — allowing nurses to work to the top of their education and training — New Jersey is at a competitive disadvantage.

As deans at Rutgers School of Nursing and Rutgers School of Nursing–Camden, we see the consequences firsthand. Our graduates take positions in states with modern laws that allow them to fully use their education and bring all of their skills to the patients they serve.

New Jersey is falling behind. Twenty-seven states, the District of Columbia and two U.S. territories have already removed unnecessary barriers, modernized their nursing laws and are seeing the benefits.

Our graduates could help meet New Jersey’s growing demand for high-quality patient care — if we don’t lose them first.

The good news is that there is a no-cost, no-delay solution. Modernizing New Jersey’s nursing licensure laws would help address workforce shortages, expand patient access and strengthen our health care system.

It’s time to make a permanent change. New Jersey can continue exporting highly trained clinicians to neighboring states, or it can lead with policy that reflects the rigor of modern nursing education — and the needs of its residents.

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Angela Starkweather is dean of the Rutgers School of Nursing.

Persephone Vargas is associate dean of the Advanced Practice Division at the Rutgers School of Nursing.

Joseph Cipriano is associate dean of graduate programs and advanced practice nursing at Rutgers School of Nursing–Camden.

Jamille Nagtalon-Ramos is an assistant professor at Rutgers School of Nursing–Camden.

Image caption: Nurse practitioner students hone their health assessment skills

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This Opinion article was published on 3-22-26 on NJ.com