North Carolina is experiencing a nursing shortage while demand for nurses is growing at the same time. This makes it an interesting place to work as a nurse, as you are almost guaranteed to find employment. Additionally, the U.S. Bureau of Labor Statistics has reported that the average annual salary for a registered nurse (RN) in the state was $59,290 and rising. Although this is not the highest in the country, the cost of living in the state is much lower too.
ENTRY LEVEL PRACTICE NURSES
Entry level nursing is a three stage process:
STAGE 1. DECIDE WHETHER YOU WANT TO BECOME AN LPN (LICENSED PRACTICAL NURSE) OR AN RN.
LPNs complete a one year diploma program. However, it is more popular to become an RN through a two year associate’s degree (ADN) or four year bachelor’s degree (BSN), as these two options offer better job prospects, career growth and salary.
STAGE 2. MEET THE PREREQUISITES TO BE ACCEPTED INTO SCHOOL.
In addition to your high school diploma or GED, most ADN and BSN programs will also require you to complete a number of undergraduate courses. It is important to do well on these to increase your chances of being accepted in the program.
STAGE 3. TAKE AND PASS THE RELEVANT NCLEX EXAM.
ADVANCED PRACTICE NURSES
STAGE 1. EARN A GRADUATE EDUCATION RELEVANT TO YOUR CHOSEN SPECIALTY.
- A CRNA (Certified Registered Nurse Anesthetist) must complete a program at master’s level that has been accredited by the Council on Accreditation of Nurse Anesthesia Educational Programs.
- A CNS (Clinical Nurse Specialist) must be educated to MSN level. The degree should have included 500 hours of clinical training in an area of specialization.
- An NP (Nurse Practitioner) must complete an MSN level program that includes at least 400 contact hours and a preceptorship of 400 hours, particularly if you graduated before December 31, 1999. Additionally, various standards have been set in terms which classes should be included in the curriculum.
- A CNM (Certified Nurse Midwife) must have completed relevant education that meets the needs of the American College of Nurse-Midwives at MSN level.
STAGE 2. BECOME NATIONALLY CERTIFIED IN YOUR CHOSEN SPECIALIZATION (CRNA, CNS, NP AND CNM).
The following bodies are recognized by the Board:
- The National Board of Certification and Recertification of Nurse Anesthetists (NBCRNA), which recognizes the Certified Registered Nurse Anesthetist (CRNA).
- The ANCC (American Nurses Credentialing Center), which recognizes the Adult Nurse Practitioner, Acute Care Nurse Practitioner (ACNP), Gerontological Nurse Practitioner (GNP), Family Nurse Practitioner, Adult Psychiatric Mental Health Nurse Practitioner (PMHNP), Pediatric Nurse Practitioner (PNP) and the Family Psychiatric Mental Health Nurse Practitioner (PMHNP).
- The PNCB (Pediatric Nursing Certification Board, which recognizes the Pediatric Nurse Practitioner in Acute Care and Primary Care.
- The AANP (American Academy of Nurse Practitioners), which recognizes the Adult Nurse Practitioner and the Adult-Gerontology Primary Care NP.
- The NCC (National Certification Corporation for the Obstetric, Gynecologic and Neonatal Nursing Specialties), which recognizes the Women’s Health Care Nurse Practitioner (WHNP) and the Neonatal Nurse Practitioner (NNP).
- The AMCB (American Midwifery Certification Board), which recognizes the Certified Nurse Midwife (CNM).
Please note that CNS recognition is voluntary, but it does increase your job prospects.
STAGE 3. BECOME LICENSED BY THE BOARD TO PRACTICE IN YOUR AREA.
- For NPs, the Nurse Practitioner Registration & Initial Approval Application must be completed with supportive documentation and relevant fees. You can check the status of your application online and you must verify the license once you have received it.
- For CNRAs, the Initial NC CRNA Recognition form must be completed. Again, you must include all relevant documentation and fees. You will be certified for either one or two years initially depending on the renewal date of your national certification.
- A CNS must complete the relevant application form with supportive documentation and fees.
- A CNM must complete a number of different forms. Again, relevant documentation and fees have to be included.
NPs and CNMs are granted prescriptive privileges for legend and controlled substances, so long as they meet the regulations of federal and state laws. They must enter into a collaborative agreement with a physician that outlines the prescriptive privileges they expect to have. Additionally, they must apply for a DEA number.
CRNAs must also enter into a prescriptive agreement but are not able to prescribe medication or make a diagnosis, unless they are directly supervised at the time.
The collaborative agreement should set out how the nurse and the physician can contact each other at all times. It should be signed by both parties and should be available in any area where you practice. It must also be reviewed regularly. The regulations on the collaborative agreement for a CNM are even more stringent.
STAGE 4. RENEW YOUR LICENSE BY DEMONSTRATING CONTINUING COMPETENCE.
You do this by:
- Completing a self-assessment
- Meeting all State requirements for continuous education (CE)
- Meeting all CE requirements from your national certification agency
NPs must first renew their RN licenses each year before the end of the month of their birth. This can be completed online. You must also notify the board of any changes in your practice arrangements.
As a CRNA, you must maintain your national certification renewal cycle. This should be every other year in July. You will receive a reminder of this and you must inform the Board of your renewal.
As a CNM, you must renew your license yearly, by your month of birth. You can print can your renewal certificate printed from the Nurse Gateway. You must complete the Approval to Practice Annual Renewal as well.
North Carolina Board of Nursing
4516 Lake Boone Trail
Raleigh, NC 27607
Phone: (919) 782-3211
Fax: (919) 781-9461