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Rural NC Farmworker Clinics Rely on APRNs


Tuesday, January 18, 2022   

Volunteer Advanced Practice Registered Nurses serve North Carolina's most vulnerable communities, yet many say the state's supervising physician requirements are an additional obstacle to providing patients with timely, high-quality health care.

Assistant Professor with the School of Nursing in the College of Health and Human Services at the University of North Carolina at Wilmington, Amanda Culp-Roche, said she's been volunteering with a rural farmworkers clinic in the Sampson-Duplin County area for the past year.

Her collaborating physician retired last month, so she's had to search around for a new one. She said she believes it's an unnecessary burden.

"And during this whole pandemic," said Culp-Roche, "we have really shown that, yes, we can provide a great service to patients and to those vulnerable populations that really need us - without having that oversight or that restriction of a collaborating physician."

Legislation proposed last year sought to remove supervising physician requirements.

According to the National Academy of Medicine, North Carolina is one of the most restrictive states in the country for APRNs.

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

Culp-Roche added that many of her clients suffer from chronic health conditions, lack insurance, and have nowhere else to turn for medical care. She said she's been luckily enough to find a doctor willing to be her supervising physician so she can resume volunteering.

"Well, thankfully for me," said Culp-Roche, "this particular farmworkers clinic has a really good relationship with a community clinic. The wonderful director there has said that he would be my collaborating physician."

Research from UNC Chapel Hill shows that by 2033, North Carolina will face an estimated shortage of more than 12,000 registered nurses. However, experts note the novel coronavirus pandemic could shift the course of supply and demand.

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