The State of Practice for Nurse Practitioners in North Carolina
The State of Practice for Nurse Practitioners in North Carolina: Restricted Practice Requiring Collaborative Agreements with a Supervising Physician
North Carolina is one of the states that has restricted practice for nurse practitioners (NP). This means that the NP can only practice under the direction and constant supervision of a physician in a collaborative agreement. The NP is restricted in at least one aspect of practice and full practice authority is non-existent (NCBON, 2020; NCNA, 2020; Harkey et al., 2017). This state of affairs however goes against available evidence that shows that NPs are as efficient and able as physicians in providing treatment to patients suffering from various ailments. As such, there is no reason why North Carolina NPs should not be granted full practice authority (FPA) or practice autonomy (Harkey et al., 2017) The State of Practice for Nurse Practitioners in North Carolina.
The Nurse Practice Act in North Carolina also requires that a NP have a collaborative practice agreement governing prescription by the NP. This agreement specifies all the drugs that the NP is allowed to prescribe. She can therefore only prescribe according to the agreement with the supervising physician. If she has to prescribe a drug not in the agreement, the physician must authorise it (NCBON, 2020). For the same reasons given above, there is no evidence to suggest that NPs cannot safely prescribe medications autonomously. As a matter of fact, almost half of the states have now granted FPA to NPs and they are autonomously prescribing without any physician supervision.
North Carolina legislation allows NPs to prescribe drugs that are approved by the Food and Drug Administration as well as schedule II-V of the controlled substances. However, this can only happen under the supervision of the collaborating physician and in accordance with their collaborative practice agreement (NCBON, 2020) The State of Practice for Nurse Practitioners in North Carolina. This should not be the case, however, because NPs are highly educated to postgraduate levels in including in advanced pharmacology. They are therefore qualified, fit, and safe to prescribe independently.
The collaborative approach to treating rashes, for instance, requires that the NP only prescribes a limited range of medications specified in the collaborative practice agreement between them and the physician. As has been argued above, however, the NP should not practice with a collaborator because there is no evidence that supports the need for this. NPs are highly educated, trained, and adequately tested for safe practice (Harkey et al., 2017) The State of Practice for Nurse Practitioners in North Carolina.
Harkey, K., Little, S., & Lazear, J. (2017). The struggle for full practice in North Carolina. The Journal for Nurse Practitioners, 13(2), 131–137. Doi:10.1016/j.nurpra.2016.08.025
North Carolina Board of Nursing [NCBON] (2020). Nursing practice act. Retrieved 16 March 2020 from https://www.ncbon.com/laws-rules-nursing-practice-act-nursing-practice-act
North Carolina Nurses Association [NCNA] (2020). NP practice information. Retrieved 16 March 2020 from https://ncnurses.org/networking/councils-and-commissions/nurse-practitioner-council/np-practice-information/ The State of Practice for Nurse Practitioners in North Carolina