I haven't read anything recently about North Carolina BON talking about expanding the NP role or granting NPs more autonomy like other states. To date I think NC is one of 28 states that require a supervising physician. Is there any indication that this is still on the table?
Jan 27, '12
not sure if you know but supervising MD in NC can be "collaborating". When I was in college, (a small school) student health was run by an FNP, she worked without an MD, but had an MD available by phone. They can work alone but need to have a signed contract stating what conditions they will refer to an MD.
To try and answer your question, I don't think anything is in the works for changing anything right now.
Nov 16, '12
I am considering relocating to Charlotte, NC. I'm going to look at the NPA and share my interpretations. I was recently accepted into a psych NP program and am curious to know what my options would be upon completion of the program. Do you currently live in NC?
Nov 17, '12
I live in NC and it's true that we must have a "collaborating" physician but that doc does not need to be on premises or even involved in the practice to qualify as your "collaborating." He or she must be available (and designate another physician when he/she is not available) for consult which may be telephone, face-to-face, carrier pigeon, etc., for questions that may come up during patient care. NPs in NC may own their own practices, but must employ an MD/DO to be the collaborating physician of record. There is information about how frequently the NP and doc must meet to discuss a specific clinical issue (and a form for keeping track of these meetings) available on the NCBON website. A new collaborating relationship requires monthly meetings x 6 months, and then the meetings decrease to once every 6 months thereafter.
NPs in NC are governed by BOTH the BON and the Medical Board...and I believe that has a lot to do with money and control versus actual evidence based information concerning outcomes of patient care by NPs. And we have to pay annually for renewal of our collaborating relationship. And we have to pay for renewal of both the RN and the NP licensure (excuse me, but isn't the RN implied in the NP license?) so I believe lots of this is $$$ driven. In addition, the physicians so far refuse to allow JUST the BON to govern us. Not that the Medical Board actually does anything for us, but they seem to want to keep their hands in the the mix.
Nov 17, '12
Thank you for the feedback. Who knows, maybe I'll be a legislative rebel and come down there and overthrow the current system. I just wish there was consistency throughout the states. Sure would have been nice for ObamaCare to address the issue of NP autonomy, that would be a great step towards healthcare reform!
Nov 19, '12
Since ObamaCare is rife with rules yet to be defined/written, perhaps you could still get in there for us!
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