Legislature looks to limit lay use of the title ‘nurse’

An Assembly panel unanimously approved legislation that would fine individuals who call themselves nurses without holding the proper licenses.

Nurses told the Assembly Regulated Professions Committee, which unanimously approved the bill, the change is needed to help maintain trust in nurses, though some witnesses urged steeper fines and other changes that would bar chatbots from identifying themselves as nurses.

Margaret Farrell Daingerfield, president of the New Jersey State Nurses Association, told lawmakers that nurses are held to strict regulatory requirements that ensure that they can competently assess the health of the patients, administer treatments, and make critical decisions in high-stakes environments.

“When individuals without this training use this title, it blurs the line between qualified professionals and unlicensed personnel,” she said.

Those blurred lines could create confusion that risks patient safety, Daingerfield said, adding it also risks eroding trust in the profession broadly by allowing unlicensed individuals to represent themselves as healthcare providers.

Though existing law already bars lay people from representing themselves as registered nurses, advanced practice nurses, and licensed practical nurses — including through their abbreviations — it does not place the same restriction on the title “nurse.”

The difference between a licensed provider and someone representing themselves as a nurse isn’t always readily apparent, Daingerfield said.

A niece who had hired a “baby nurse” did not realize the individual was not a licensed nurse until her mother, who is a nurse, came to visit, Daingerfield said.

Daria Waszak, executive director of the New Jersey Collaborative Center for Nursing, asked the committee to consider raising existing fines for misrepresenting oneself as a registered, advanced practice, or licensed practical nurse. Those are set at $200 for a first offense and $500 for subsequent missteps.

And she said lawmakers should bar artificial intelligence chatbots from calling themselves nurses to prevent consumers understand when they are speaking to an actual nurse.

“Regardless of where it is, any setting where health interactions take place, it is very important that it remains clear to a consumer when they are interacting with a licensed human nurse and they are not,” Waszak said.

The bill has no Senate companion.

Midwives

The panel also unanimously approved legislation that would create a new board to license midwives who are presently overseen by the State Board of Medical Examiners. The board also licenses doctors, physician assistants, and other healthcare professionals.

Midwives provide reproductive healthcare, including labor assistance, within or outside of a hospital. Some are licensed as nurses in addition to the midwifery licenses they need from the Board of Medical Examiners.

A more specific licensing board would be better able to assess the work of midwives, said Mia Leong, a midwife at the Haledon-based Rowan Birth Services.

“The people responsible for setting standards for midwives should understand the work that midwives actually do and the specific needs of the communities that we serve,” she said.

Multiple midwives urged the panel to add language saying midwifery is distinct to healthcare and to remove language that would require midwives to carry professional liability insurance, arguing that requirement could be financially ruinous.

Insurance requirements would be better left for regulators or a separate bill, said Vicki Hedley of the New Jersey Certified Professional Midwives Association.

“The bill creates an insurance mandate without creating a corresponding mechanism to ensure that appropriate and affordable professional liability coverage is actually available to the midwives who would be licensed under the act,” she said.

Only one New Jersey insurer offers liability policies to midwives, Hedley said.

The Senate advanced a companion bill through the Senate Commerce Committee in June, but the two versions are not identical, and it’s unclear how their differences will be reconciled.