In the April 2019 AARP Bulletin there is an article discussing the restrictive laws in North Carolina that control Advanced Practice Registered Nurses.*
North Carolina is where I now live. While I no longer practice as a nurse practitioner, I’m always on the lookout for the latest restrictions or advances in APRN practice. And I am saddened with this particular write-up. Why? Because the story shows that the years of research proving that APRN’s give the same level of safe, quality care as physicians in similar settings is totally disregarded. Therefore, limiting the use of APRN’s has caused the following:
Many rural North Carolina counties face severe provider shortages. Three have no primary care doctors, 26 counties have no OB-GYN, and 32 are without a psychiatrist, . . . .
North Carolina:
- Ranked 35th for overall health care
- Ranked 41st for infant mortality
- 56% of low-income children don’t have a doctor
(Michelle Crouch, Bridging the Health Care Gap, AARP Bulletin/Real Possibilities, April 2019. p 44.
In 2017, a bill to expand APRNs practice was defeated. Both the NC Medical Society and the NC Academy of Family Physicians opposed this bill, in spite of the fact that “moving restrictions on APRNs could save the state $400 million to $4.3 billion in health care costs annually” and, could increase the number of APRNs to correct the health care shortage.
I have almost 40 years’ experience in watching the struggle to limit APRNs practice. I know many physicians who work alongside nurse practitioners, nurse midwives, and mental health nurses who promote their role in keeping our communities healthy. From my viewpoint, it’s the efforts of organized medicine that disregards putting patients first and values only its own economic growth.
A new bill to remove barriers to APRN practices is expected to be introduced this year. I will be following this closely. It is my dream that in the near future, all states will give APRN’s full practice authority.
See how APRN practice varies from state to state.
*Advanced Practice Registered Nurse
- Certified Nurse Practitioners
- Certified Nurse Midwives
- Certified Nurse Anesthetists
- Clinical Nurse Specialists
Nursing Stories & Other Tales 
I think we’ve been around too long. It’s disheartening to see such slow progress. Especially with robust stats to show NPs effectiveness and the dire need.
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Had to laugh at your comment that “we’ve been around too long.” Funny but true. However, who will be the keeper of historical facts if not us old timers?
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I know! I just had a similar discussion about the little progress made over my long career in reducing the stigma of mental illness. Seems like we should have had that solved years ago. Distressing!
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I recently read an article on Medscape that argued against the increased use of NPs and PAs. I argued that some doctors were more afraid of losing money to other professionals than enabling their patients to receive the best care possible no matter what the circumstances are. I am not an NP, but I’ve been an RN since ’86 and I think that the whole concept of NP’s is awesome, plus the care that I’ve personally received from NP’s is impeccable (in my unbiased opinion, of course!)
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Of course, I totally agree with you. We need to support our APRNs. Wonderful that you argued your case in favor of NPs.
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