COVID-19 Guidance and Temporary Waivers

• Nurse Practitioner Order to Relax Scope Requirements
• Nurse Practitioner Temporary Flexibility for Quality Improvement Plans 
  • 2021 Updated Expiration Date 

• NEW GRADUATES (REGISTERED NURSE AND LICENSED PRACTICAL NURSE PROGRAMS)

  • Length of time a temporary permit is valid

    • HOW LONG IS A TEMPORARY PERMIT VALID?
    • The temporary permit will be valid for 6 months with no renewal option.
    • The graduate takes and passes the NCLEX examination and all requirements for Criminal background Check have been fulfilled. Once all requirements for licensure are met, the temporary permit will be deactivated, and a North Carolina permanent license will be issued.
    • The graduate takes and fails the NCLEX examination. Upon electronic notification from Pearson Vue of a “Fail” score, the NCBON will automatically deactivate the temporary permit. At that time the graduate must be removed from the role by the employer and may not perform any nursing function. The graduate may work in an unlicensed assistive personal (UAP) role but must meet all requirements of that role. For example, if hired as a Nurse Aide II, the graduate must be listed on the Nurse Aide II Registry.

  • Supervision requirements for new graduates working on temporary permit

    • WHAT DOES “RN SUPERVISION” MEAN?
    • “RN Supervision” means that there is always a Registered Nurse available to the graduate nurse. How this supervision is implemented will depend on the agency/area of practice in which the new graduate is working.

  • Job limitations for new graduates working on temporary permit

    • WHAT IS THE NEW GRADUATE RN OR LPN ALLOWED TO DO?
    • The new Graduate RN or LPN should do only those activities he/she is competent to perform. The process for determining competency and the policies related to what activities the graduate nurse can perform need to be developed by the employing agency.

  • Title for new graduates working on temporary permit

    • WHAT TITLE IS TO BE USED FOR THE GRADUATE RN OR LPN?
    • The title to be used is Graduate RN or Graduate LPN.

  • Employer verification of Temporary Permits

    • HOW CAN A TEMPORARY PERMIT BE VERIFIED?
    • A temporary permit for the Graduate RN or LPN can be verified using the same system currently used for license verification on the NCBON website. The verification will clearly identify the expiration date and the type of permit issued.

• OUT-OF-STATES REGISTERED NURSES AND LICENSED PRACTICAL NURSES REQUESTING TO WORK IN NORTH CAROLINA

  • Employer requirements for hiring or granting permission for volunteer RN/LPN to work during a State of Emergency

    • WHAT ARE THE REQUIREMENTS FOR ALLOWING OUT OF STATE RN/LPNS TO WORK, VOLUNTEER, OR PROVIDE TELEHEALTH SERVICES IN MY SYSTEM/FACILITY DURING THE STATE OF EMERGENCY?
    • Nurses who hold an active, unrestricted multi-state license in any Nurse Licensure Compact state or a single state license in North Carolina can practice in North Carolina at any time.
    • Licensed nurses holding an active, unrestricted single state license in a compact or non-compact state can practice in North Carolina during periods of declarations of emergency or state of disaster designation under the following guidelines:
    1. An employing system/facility, prior to employing any nurse must verify active, unrestricted licensure of all nurses (RN and LPN), from all states (compact or non-compact). Licensure information can be verified easily through NURSYS. 
    2. An employing system/facility must maintain a record of the names and verified license number for a period of 1 year and provide this information to the Board if requested.

  • Licensing requirements for out of State RN/LPNs requesting to work in North Carolina during a State of Emergency

    • WHAT ARE THE REQUIREMENTS FOR LICENSED RNS/LPNS FROM OUT OF STATE THAT WANT TO WORK OR PROVIDE TELEHEALTH SERVICES IN NORTH CAROLINA DURING THE STATE OF EMERGENCY?
    • Nurses who hold an active, unrestricted multi-state license in any Nurse Licensure Compact state or a single state license in North Carolina can practice in North Carolina at any time. Licensed nurses holding an active, unrestricted single state license in a compact or non-compact state can practice in North Carolina during periods of declarations of emergency or state of disaster designation under the following guidelines:
    • *An employing system/facility, prior to employing any nurse must verify active, unrestricted licensure of all nurses (RN and LPN), from all states (compact or non-compact). Licensure information can be verified easily through NURSYS.
    • *An employing system/facility must maintain a record of the names and verified license number for a period of 1 year and provide this information to the Board if requested.

• ADVANCED PRACTICE REGISTERED NURSES WORKING IN STATE OF EMERGENCY

  • Requirements for Out-of-State Advanced Practice Registered Nurses requesting approval to practice in North Carolina during a State of Emergency

    • WHAT ARE THE REQUIREMENTS FOR OUT-OF-STATE NURSE PRACTITIONERS WHO WANT TO WORK IN NORTH CAROLINA DURING THE STATE OF EMERGENCY?
    • An NP approved to practice in North Carolina, or another state may perform medical acts, as an NP under the supervision of a physician licensed to practice medicine in North Carolina during a state emergency-COVID-19;
    • the NP shall notify the NCBON in writing of the names, practice location and telephone number for the NP and each primary supervising physician within 15 days of the first performance of medical acts, as an NP during the state emergency, and the NCBON shall notify the North Carolina Medical Board; and
    • teams of MDs and NPs practicing shall not be required to maintain on-site documentation describing supervisory arrangements and plans for prescriptive authority as otherwise required.

  • Requirements for Nurse Practitioners practicing outside their certification during a State of Emergency

    • I’M A NURSE PRACTITIONER APPROVED TO PRACTICE IN NORTH CAROLINA. MY FACILITY WOULD LIKE TO MOVE ME TO PRACTICE IN ANOTHER AREA OF THE FACILITY IN A POPULATION FOCUS I’M NOT CERTIFIED IN. CAN I DO THIS?
    • Nurse Practitioners may be reassigned to a new practice area within the same facility (i.e., hospital, multi-specialty group practice) without regard to their academic preparation and national certification and without updating his or her supervisory arrangements, so long as:
    • the nurse practitioner is reassigned to perform only those medical duties which the nurse practitioner is competent and qualified to do; and
    • the nurse practitioner has reasonable and immediate access to a physician, either in person or electronically, should medical issues arise.
    • The NCBON understands many Nurse Practitioners are being asked to practice in a new area or with a new patient population during the state of emergency. During the state of emergency period, health care organizations or supervising physicians may ask Nurse Practitioners to work outside the patient population for which the Nurse Practitioner holds national certification. This may be necessary to meet critical needs in North Carolina. In these situations, the Nurse Practitioner may collaborate with or be supervised by different physicians for whom he/she has not worked with before. Facility administration should ensure that the Nurse Practitioner is reassigned only those activities which the practitioner is safe and competent to perform.
    Nurse Practitioner Order to Relax Scope Requirements

  • Nurse Practitioner supervision requirements during a State of Emergency

    • I’M A NURSE PRACTITIONER, AM I REQUIRED TO HAVE AN ONSITE SUPERVISION IN ORDER TO PRACTICE? WHAT DOES THAT MEAN?
    • On-site supervision shall mean having immediate access, either in-person or electronically, to a physician who is physically present on the premises should medical issues arise.

  • Telehealth practice during a State of Emergency

    • CAN AN APRN PRACTICE TELEHEALTH DURING THE STATE OF EMERGENCY?
    • NCBON will follow Federal guidelines, which states APRNs licensed anywhere in the US, may practice to their full scope.
    • APRNs must have an active, unrestricted approval to practice with their home Board of Nursing and practicing in an organized system or emergency agency.
    • Supervision and scope will be at the discretion of the agency with whom the person is practicing.

• Information on North Carolina Coronavirus Response

  Get the latest on on the state's response to COVID-19. Text COVIDNC to 898211 to receive regular alerts on the rapidly evolving situation and North Carolina’s response.

  • NC Government COVID-19 Information
  • NC COVID-19 Executive Orders and Directives
  • NC Department of Health and Human Services Guidance
  • CDC COVID-19 Information for Healthcare Workers

• NCBON Update to Nurse Practitioners

  • 2021 Regulatory Waiver Extension Notification

  • 2020 Regulatory Waiver Notification

• Nursing Surge Capacity Resource

  This resource has been compiled through the collaboration between the North Carolina Board of Nursing (NCBON), the North Carolina Healthcare Foundation (NCHF), the North Carolina Organization of Nurse Leaders (NCONL), and the North Carolina Directors of Nursing Administration in Long Term Care (NC DONA/LTC).

  Nursing Surge Capacity Resource

• Volunteer as a Health Care Worker

  On behalf of Department of Health and Human Services (DHHS) Secretary Mandy Cohen, the Board of Nursing is providing the following information regarding volunteering as a Health Care Worker.

  Volunteer as a Health Care Worker

  • NC Response Management System (NC TERMS)
  • American Red Cross – check your local areas