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Bills Suggest Bigger Role for NC Nurses in Health-Care Access


Friday, March 15, 2019   

SPRUCE PINE, N.C. - Nurses and nurse practitioners would play a bigger role in North Carolina's health-care system under some new legislation.

A bipartisan bill that has the support of more than 60 state lawmakers would make access to basic health-care services easier by cutting red tape for advanced-practice nurses and nurse practitioners. Sen. Ralph Hise, R-Spruce Pine, said he introduced Senate Bill 143 so that nurses can provide more primary-care services in areas that need it most.

"Representing a rural area in western North Carolina, one of the challenges we find is that it's very difficult to recruit primary-care doctors to our region to practice," he said. "We really have a gap in people being able to access services, and this really allows us to use nurses to fill some of that gap."

Companion legislation, House Bill 185, is being carried by Rep. Josh Dobson, R-Marion.

Critics have pointed out that nurse practitioners receive less training than doctors and may not be fully prepared to work without a doctor's supervision. However, Hise said the need is great. Rural North Carolina has higher rates of drug and alcohol use, suicide and teen births, plus more uninsured patients and preventable hospitalizations. These areas also face a shortage of almost every type of provider.

"This is work that nurses already do," he said. "The requirements right now - they have to constantly be under a doctor's supervision in order to do that. This bill would allow them to operate in hours that they may not currently be able to, because there's not a doctor there, and would move them more into working to a team approach with their doctors."

Twenty counties in the state don't have a pediatrician and 26 don't have an OB-GYN, according to the North Carolina Health Professions Data System. Hise said the bills don't change what nurses are allowed to do, but lets them work within their current scope without unnecessary restrictions.

AARP North Carolina is one group lending its support to the bills. State president Cathy Sevier said it's a matter of the rising demand for health-care services, due in part to an aging population that's growing, even as the number of primary-care doctors is shrinking.

"Nurse practitioners, advanced-practice nurses in all of the fields - midwifery, anesthesia, clinical nurse specialists - all provide the level of care in a much more affordable way, and very safely," she said.

The Senate bill is working its way through the Rules Committee before being considered by the Health Care Subcommittee in coming weeks.

Texts of SB 143 and HB 185 are online.

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