Regulation and North Carolina Statutes

1. Regulation and North Carolina Statutes Unit 3

2. Regulation of Nursing Practice • Protection of Public • Licensure • Certification

3. Licensure • Permission to practice • Establishes minimum competence • Enforced by Board of Nursing • Board established through Practice Act • Elected Board in North Carolina

4. Certification • Competence established above minimum criteria

5. Functions of Board of Nursing • Govern own operation • Approve/deny Schools of Nursing • Examine/license applicants • Review licenses • Regulate specialty practice • Disciplinary procedures and actions

6. Authority of Board of Nursing • Legislative - rules and regulations • Quasijudicial - hearings • Administrative - license control

7. Types of Licensure • Mandatory Licensure: regulates practice • Permissive Licensure: protects title only • Institutional Licensure: government regulates institution who in turn regulates staff practice

8. Nurse Practice Acts • 1903: North Carolina had first permissive Nurse Practice Act • 1938: New York had first mandatory Nurse Practice Act

9. Elements of Nurse Practice Acts • Definition of Nursing • Requirements for licensure • Exemptions - Grandfather clause • Licensing across jurisdictions:reciprocity, endorsement, examination, waiver

10. Disciplinary Hearings • Filing of complaint • Review of complaint • Disciplinary action • Appeal to court for reversion

11. Expanded Practice Scope • Nurse Practice Act • NP Rules and Regulations • Medical Practice Act • Joint Statements • Standing Orders

12. Updating Practice Acts • Legislative action: amendments • Rules and Regulations • Sunset Laws

13. Advanced Roles • Nurse Anesthesia, 1878 • Nurse Midwifery, late 1800’s • Nurse Practitioners, 1965

14. Issues for NPs • Prescriptive authority • Admitting privileges • Reimbursement • Direct access to provider

15. Issues for CRNAs • Physician supervision • Medicare reimbursement • AAs

16. Common Areas of Liability • Medication errors • Falls/restraints • Failure to assess • Failure to communicate • Technology • Suicide prevention • Discharges – patient advocate

17. Right to Work • Definition: protects employees from being required to join a Union as a condition of receiving or retaining a job. • Right to work protected under Taft-Hartley Act (1947) • Prohibits agreements between trade unions and employers making membership or payment of union dues or “fees” a condition of employment. • Enforced in states mostly in the South and West (includes NC)

18. Benefits of Right to Work • Workers free to join or refrain from joining unions • Employers free to manage company without outside interference • States may experience higher economic growth and job creation • i.e. new auto factories located in right to work states (2008) • States may have lower unemployment rates

19. Benefits of non Right to Work States • Free collective bargaining • Higher employee wages • Greater on-site worker safety and health consideration • Job protection from firing