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How North Carolina is Adapting to a Shortage of Nurses During the COVID-19 Pandemic
Friday, August 27, 2021

As the number of COVID-19 cases in the U.S. accelerates once again, this time in the form of the "delta variant," the nation faces a shortage of nurses just when it needs them most.

North Carolina has unfortunately not escaped the shortage—in fact, it is among the states hardest hit. 

The nursing shortage isn't new. As early as January 2012, the American Journal of Medical Quality indicated the country was facing a nursing shortage, which it predicted would last through 2030. And not just small towns have been impacted. As of July 26, 2021, two of North Carolina's largest healthcare providers in the triangle—Duke Health and UNC Health—were each seeking to recruit more than seven hundred nurses.

The shortage is the result of a variety of factors—among them, an aging (and retiring) nurse population, increased demand caused by the aging of the "baby boomer" generation, attrition due to the stress of COVID-19, and a lack of university faculty to teach nursing students. The North Carolina Board of Nursing (the "NCBON"), which oversees licensing of all of the state's nurses, recently took note of this last factor and reversed course on certain regulations slated to go into effect in 2021

In January 2019, the NCBON revised 12 NCAC 36.0318 such that, effective January 1, 2021, 80% of full-time nursing faculty at any given nursing program, and 50% of part-time faculty, would be required to hold a master's degree in nursing. Previously, only 50% of the total faculty were required to hold a master's degree.

With the pandemic in full swing at the start of 2021, NCBON, and the public at large, feared the amendments to 12 NCAC 36.0318 could result in the shuttering of nursing programs throughout the state. This fear especially resounded with those in rural parts of the state, where populations are smaller and there is less accessibility to universities and other well-funded nursing programs. 

Just ten days into the new year, NCBON issued a waiver of the amendments through January 1, 2022, citing the COVID-19 pandemic as its reason. But the roll-back didn't stop p there. Ostensibly in connection with the rise of the "delta variant," NCBON took action on August 1, 2021, to entirely repeal its revisions to 12 NCAC 36.0318.

Even if abating the shortage of nurses is not an attainable goal in the short term, NCBON's rule-making agility has allowed it to confront the state's needs as they change in real-time. While beneficial for the state as a whole, however, frequent regulatory changes can be difficult to track, and cumbersome to implement. 

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