By | May 24, 2021

At least 102 state legislators are backing a North Carolina bill that would allow Advanced Practice Registered Nurses (APRNs) to practice independently, without physician oversight. (Adobe Stock)

At least 102 state legislators are backing a North Carolina bill that would allow Advanced Practice Registered Nurses (APRNs) to practice independently, without physician oversight. (Adobe Stock)
By Nadia Ramlagan – Producer, Contact
May 24, 2021
RALEIGH, N.C. – As many Advanced Practice Registered Nurses inch closer to retirement, they’re unsure who will fill their shoes. They point to North Carolina’s physician supervision requirements for APRNs as creating barriers that make it harder to ensure rural patients have access to care.

Psychiatric nurse practitioner Dona Caine-Francis has provided mental-health services in Brunswick County for more than 40 years. She wants to retire, but has faced challenges finding a replacement.

She said one APRN who has expressed interest in taking over her practice will likely pay hefty fees for a doctor’s supervision.

“And she will probably be paying $1,000 a month to have a physician collaborate with her, and have a collaborating contract,” said Caine-Francis.

Amazon, the Alliance for Connected Care, and the Convenient Care Association are on a growing list of organizations expressing public support for the SAVE Act, legislation that would lift the North Carolina rules that require doctor supervision for APRNs.

The American Medical Association and other physician groups argue collaborations are needed for patient safety.

Caine-Francis pointed out that each year, the state’s rural counties need more APRNs, especially to provide Medicaid and Medicare services.

“However, the whole ‘collaborating physician’ piece is a barrier to our ability to offer services,” said Caine-Francis.

Caine-Francis said she is convinced that the mental health needs of people in her community, and across the state, depend on lawmakers passing the SAVE Act.

“And there’s no psychiatrist in all of Brunswick County,” said Caine-Francis. “So a lot of the primary care physicians [who] do not feel comfortable in prescribing the psychotropic medications, will often refer their patients to me.”

A report this month by the National Academy of Medicine cited North Carolina as one of the eleven most restrictive states in the country for APRNs.

References:
NC SB 249, 2021/2022 session
NC HB 277, 2021/2022 session
Amazon Endorses the SAVE Act 5/13/21
The Alliance for Connected Care Announces Support for the SAVE Act 5/14/21
The National Academy of Medicine: The Future of Nursing 2020-2030 5/11/21