North Carolina Advanced Practice Registered Nurses: A Report on the Advanced Practice Registered Nurse Workforce in North Carolina

By Erin Fraher, Connor Sullivan, Catherine Moore, Tony Kane, Andy Knapton, Lorinda Coombs, Evan Galloway

Sep 25, 2024

Introduction

The lack of robust, state-level data on the Advanced Practice Registered Nurse (APRN) workforce makes understanding gaps in supply and demand challenging. To address this gap, an interprofessional team of researchers investigated trends in the demographic, education, practice and geographic characteristics of the four APRN roles in NC – Nurse Practitioners (NPs), Certified Nurse Midwives (CNMs), Certified Registered Nurse Anesthetists (CRNAs) and Clinical Nurse Specialists (CNSs). The report, detailing findings from the study, is the culmination of work undertaken by the Cecil G. Sheps Center’s Program on Health Workforce Research and Policy with funding from the North Carolina Board of Nursing (NCBON).

The study is timely as the state considers ways to address the growing demand for health care services and better understand the roles that APRNs play in meeting this demand. The report will also be useful to provide policy makers with empirical data on APRNs as discussions of APRN-related legislation continue.

What makes the North Carolina APRN Report Unique?

Most APRN studies are at the national level, and while some state-level APRN studies exist, they often rely on surveys and suffer from low response rates that may produce results that are not representative of the true population of APRNs. This study used licensure data from the NCBON, which represent a full census of the APRN workforce in NC.

Key Findings

Figure 1. Cumulative Percentage Growth of North Carolina Nurse Practitioners, Physicians, Physician Assistants, 2000-2022

This line chart shows the percentage growth of three healthcare professions over time - Nurse Practitioner, Physician Assistant, and Physician. The Nurse Practitioner line experiences the most rapid growth increasing over 400% from 2000 to 2022. Physician Assistant growth is also substantial at around 200% over the same period, while Physician growth is more modest at around 30%.

Note. Data from 2020 and 2021 are unavailable because of issues with the data which make longitudinal comparisons misleading.

Figure 2. North Carolina Nurse Practitioners as a Percentage of Nonmetropolitan Clinicians in the State, 2000-2022

This stacked bar chart chart shows the proportion of non-metro clinicians from 2000 to 2022 belonging to the following three professions: Nurse Practitioners, Physician Assistants, and Physicians. Generally, the proportion of nurse practitioners has increased substantially, while the proportion of physicians has decreased.

Note. Clinicians are defined as nurse practitioners (NPs), physicians, and physician assistants (PAs). Physician data from 2020 and 2021 were unavailable because of data collection issues during the pandemic. Nonmetropolitan county status was defined using US Office of Management and Budget Core Based Statistical Areas (CBSAs). Nonmetropolitan counties include micropolitan counties and non-CBSAs. The definition of nonmetropolitan corresponds with the delineations in place for each year of data.

 

Suggested Citation: Fraher E, Sullivan C, Moore C, Kane T, Knapton A, Coombs, L, Galloway E. A Report on the Advanced Practice Registered Nurse Workforce in North Carolina. Program on Health Workforce Research and Policy. Cecil G. Sheps Center for Health Services Research. The University of North Carolina at Chapel Hill. September 24, 2024.

Funding & Acknowledgements
The HPDS is maintained by the Program on Health Workforce Research and Policy at the Cecil G. Sheps Center for Health Services Research at the University of North Carolina at Chapel Hill, in collaboration with the North Carolina Area Health Education Centers Program (AHEC), and the state’s independent health professional licensing boards. Ongoing financial support is provided by the NC AHEC Program Office. Although the NC HPDS maintains the data system, the data remain the property of their respective licensing board. This information or content and conclusions are those of the authors and should not be construed as the official position or policy of, nor should any endorsements be inferred by NC AHEC. To learn more about NC AHEC please visit: https://www.ncahec.net.

Recent Posts