This bill has been filed in both the House and Senate, and focuses on four types of Advanced Practice Registered Nurses (APRNs) including the following: Nurse Practitioners, Certified Nurse-Midwives, Certified Registered Nurse Anesthetists and Clinical Nurse Specialists. If passed, the bill would allow all APRNS to expand their scope of practice by excluding the requirement of a supervising physician in order to practice. This means that every APRNS would be allowed to practice independently and would only be regulated by the Board of Nursing.
Proponents of the bill highlight access to care in rural areas as their reasoning to pass such sweeping change, we have not seen a measurable increase of rural providers in the other 21 states where this type of bill has been passed. Furthermore, APRNs are not limited by geographic boundaries under current NC law, yet they tend to concentrate their work in the same areas as physicians and other medical providers.
NCMS opposes this bill. We believe that the current statutory structure requiring physician supervision of APRNs allows nurses from a variety of backgrounds and training to practice at the top of their individual training. By eliminating physician supervision and reducing their scope of practice to the words in statute, NC nurses will be left with a shared definition that is the lowest common denominator skill set. As the entire healthcare system values a team approach to care delivery, this proposal seems to go in exactly the opposite direction.