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North Carolina Nursing Timeline 1947-2002
To address the critical, post-WWII nursing shortage, the NC Nursing Practice Act is amended to include regulations for licensed practical nurses, or LPNs, who work under the supervision of physicians or registered nurses to provide hands-on care for patients.
A national study called "Nursing for the Future" reinforces the growing feeling that professional nurses should be educated in nursing schools in colleges or universities rather than in hospitals.
Due to the efforts of Elizabeth Scott Carrington, the UNC-CH School of Nursing opens as the first in the state and one of only three in the South to offer a four-year, baccalaureate degree. By 1955, there were baccalaureate nursing programs at Duke University, Winston-Salem State Teachers College, and NC A&T University in Greensboro.
NC Memorial Hospital is completed. In 1953, it opens the nation's first intensive care unit, requiring advanced preparation for nurses.
Duke's School of Nursing revolutionizes graduate nursing education by introducing the first clinical masters program in nursing in the country.
Dean Helen Miller of the NC Central School of Nursing establishes a program enabling African-American nurses to return to school to get their baccalaureate degree. (photo courtesy of NC Central University Archives)
Margaret DolanMargaret Dolan becomes the first North Carolinian to serve as president of the ANA. She also served as president of the American Public Health Association, the National Health Council, and the American Journal of Nursing Company. (photo courtesy of NCNA)
A survey finds that NC still suffers a severe shortage of nurses with baccalaureate degrees. In 1966, Eloise "Patti" Lewis becomes founding dean of the UNC-Greensboro School of Nursing and establishes its four-year baccalaureate program. (photo courtesy of UNC Greensboro University Archives)
Predicting severe shortages of nurses, the 1964 same survey recommends that schools of nursing be established in the state's new system of community colleges, which was funded by the General Assembly in 1957. Today, 57 of NC's 58 community colleges offer three-semester programs to prepare licensed practical nurses and/or five-semester associate degree programs to prepare registered nurses.
With the establishment of Medicare and Medicaid, access to health care is greatly expanded. Yet NC ranks 43rd in the number of physicians per citizen, and recruitment of primary care doctors to underserved areas is especially difficult. Some mountainous and eastern areas have only one sixth the number of such doctors as urban areas in the central Piedmont.
Dr. Lucy Conant, dean of the UNC School of Nursing, works with Med School Dean Isaac Taylor and Department of Public Health Nursing chair Margaret Dolan to develop one of the first nurse practitioner programs in the nation.
Audrey Booth, an assistant professor at the UNC-CH School of Nursing, becomes a leader in the NC Regional Medical Program, a statewide educational project that helps legitimize the nurse practitioner role statewide and provides funding for several training programs. Booth would later become chair of the NC Board of Nursing and associate dean of the UNC-CH School of nursing. (photo courtesy of UNC-CH School of Nursing; Booth is third from right)
NC begins a network of Area Health Education Centers (AHECs), one of the nation's first such programs. Today, AHEC offers nurses throughout NC access to RN to BSN and Masters in Nursing outreach programs, as well as a wide variety of continuing education opportunities through the state's nursing schools.
Cynthia Freund works with AHEC to establish in Tarboro the state's first nurse practitioner training program outside of Chapel Hill. Upon successful demonstration of the regional training program concept, Freund joins the UNC-CH faculty to set up a statewide consortium of nurse practitioner training programs.
NC passes hallmark legislation by licensing nurses to perform medical acts and prescribe medications. By 1976, there are 90 nurse practitioners in NC. Today, approximately 2,000 nurse practitioners practice in the state.
A major milestone in the self-regulation of nursing is achieved when NC becomes the only state in the nation to allow nurses to elect nurse members to the Board of Nursing rather than having them appointed by the Governor. Nine members are RNS, four are LPNs, and the Governor continues to appoint two members representing the public.
Certified Nurse Midwives receive recognition to practice in NC. Throughout the '80s, the number of those practicing hovers around 40. In 1991, East Carolina University opens the first nurse midwifery educational program in the state, and nearly 200 certified nurse midwives are practicing within a decade.
Clara Adams-Ender, a 1961 graduate of the NC A&T School of Nursing, becomes a brigadier general and chief of the Army Nurse Corps, the second African-American and the second Tar Heel to be named chief. While managing 22,000 professional nurses worldwide, Adams-Ender implements a program enabling enlisted personnel to get a baccalaureate in nursing, which is necessary for a commission as a nurse officer in the Army Nurse Corps.
The UNC School of Nursing establishes a PhD program in Nursing as a badly needed resource in the state for faculty preparation and research. The state's second doctoral program in nursing opens in 2002 at the East Carolina University School of Nursing.
This year inaugurates the Nursing Scholars Program which provides monies for students to attend community colleges, universities and hospital schools of nursing. Graduates can "pay back" their scholarships by working in NC hospitals. It is the most comprehensive scholarship program in the country.
In response to a severe nursing shortage, the NCNA spearheads the creation of the NC Center for Nursing, the first state-funded agency in the nation dedicated to assuring adequate nursing resources for its citizens.
Legislation is passed to allow nurse practitioners, nurse midwives and psychiatric clinical nurse specialists to receive direct reimbursement from insurance companies. As a follow-up, in 1995, a Collaborative Practice Act is passed which allows advanced practice registered nurses to form corporations and become partners with physicians, psychologists and other health care workers.
Beverly Malone, former dean of the NC A & T University School of Nursing, becomes the second North Carolinian to be elected President of the American Nurses Association. In 2000, she resigned this position and becomes the Deputy Assistant Secretary for Health in the US Department of Health and Human Services.
A Robert Wood Johnson Foundation report documents that advanced practice nurses face a number of barriers in the South, including poor public awareness about their training and scope of practice; exclusion from lists of health providers maintained by managed care companies; and lower Medicaid reimbursement than that offered to physicians providing the same services. In addition, nurse practitioners and certified nurse-midwives face organized opposition from physicians to their practice. The report singles out NC and Florida as Southern states making effective use of advanced practice nurses.
The General Assembly passes legislation which requires that all health care providers have their credentials prominently displayed on their name badges. It also protects the title of "nurse" for the first time.
NC becomes the sixth state to join in the multi-state compact which allows registered nurses and licensed practical nurses to practice in compact states. By 2002, eighteen states have signed on to the multi-state compact.
NC Baptist Hospital in Winston-Salem is named the first NC Magnet Hospital by the American Nurses Credentialing Center. High Point Regional Hospital and Catawba Valley Medical Center in Hickory join NC Baptist the following year. In 2002, North East Medical Center in Concord becomes the fourth North Carolina hospital to be recognized by the Magnet Recognition Program for Excellence in Nursing Service.
Legislation is passed which allows advanced practice registered nurses to be listed on HMO provider panels.
The North Carolina Nurses Association celebrates its 100th anniversary jointly with the North Carolina Board of Nursing which comes of age on March 3, 1903. Mary Lewis Wyche, founder of the North Carolina Nurses Association, is named to the ANA Hall of Fame.