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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
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.
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