FAQ | Disaster Relief in North Carolina

During periods of official disaster designation, nurses from states outside of North Carolina (NC) are authorized to practice in NC in an organized system/facility, with the American Red Cross, or with other official Disaster Relief Organizations under the following guidelines:

• Nurses holding an active, unrestricted single-state license in any jurisdiction can practice in North Carolina by applying for a temporary emergency license at no cost through the NCBON. Information on current waivers can be found here.
• Nurses holding an active, unrestricted single-state license in any jurisdiction can practice in North Carolina by applying for a temporary emergency license at no cost through the NCBON. Information on current waivers can be found here. To apply for an emergency temporary waiver, go to the Nurse Portal at www.ncbon.com.
• Prior to allowing practice, the employing system/facility, the American Red Cross, or other official Disaster Relief Organizations, must verify active, unrestricted licensure of all nurses (Registered Nurse and Licensed Practical Nurse), from all states (compact and non-compact). Licensure information can be verified easily through "NURSYS QuickConfirm License Verification."
• The employing system/facility must maintain a record of the names and verified license numbers for a period of one year and provide this information to the Board if requested.

You can volunteer through a volunteer organization such as the American Red Cross, an employing North Carolina healthcare system/facility, or other official Disaster Relief Organization. The eligibility requirements for volunteers is available at the official American Red Cross website.

A Nurse Practitioner working in North Carolina from out-of-state must be supervised by a physician licensed with the North Carolina Medical Board.

Additional information can be found at: https://www.ncbon.com/news-publications-statistics-frequently-asked-questions-nurse-practitioner 

In a disaster situation, available caregivers and managers/administrators need to work together to provide care for essential client needs while assuring rest periods for one another.

It is essential that Registered Nurse managers/administrators and nursing staff work together to provide safe care to all clients in a manner consistent with nursing law and rules. Clear communication is essential to arrive at solutions that best focus on essential client care needs without compromising either patient safety or a nurse’s license. Short staffing and extended work hours pose considerable challenges for licensed nurses and managers/administrators in emergency situations.

For more specific information regarding Extended Work Hours, Short Staffing, and Abandonment, please review the North Carolina Board of Nursing position statement titled, Staffing and Patient/ Client Safety.

*The North Carolina Board of Nursing and the Division of Health Service Regulation have issued a Joint Position Statement on Nursing Work Environments that may provide additional guidance.

The NC Board of Pharmacy has waivers that make refills more accessible to affected NC patients as follows: HurricaneAftermath (ncbop.org)

If you have an active Approval to Practice as an NP in NC or another state, you can practice (without a CPA or QI meetings) in any of the declared counties or surrounding county as long as you have a collaborating physician. You are required to notify the NCBON within 15 days of this practice. Email aprnpractice@ncbon.com with the required information. 21 NCAC 36.0814 Practicing During a Disaster

The statute that answers this question is G.S. 90-21.14 (ncleg.net)

Please understand that Board staff will work with individuals to ensure that nurses under investigation will be given an opportunity to participate in any investigation. We are aware that damage in the western part of the state could impact on a nurse’s response time, and we will work to accommodate an extension request. We are also cognizant that patient care and staffing needs take priority, particularly during a natural disaster.

Please reach out to your point of contact at the Board via phone or email and Board staff will certainly grant an extension given the circumstances.

The NCBON has licensure staff to assist with questions related to your license. You can email general@ncbon.com, email a specific department using the Email Us form, or call 919-782-3211.

Nursing law provides the nurse the right to accept or refuse lawful assignments. The individual nurse is responsible for ensuring they are safe and competent to accept an assignment. The Nursing Practice Act and Administrative Rules 21 NCAC 36.0224 (a) for the RN and 21 NCAC 36.0225 (a) for the LPN require the nurse to accept only assignments for which they can safely and competently perform. Practicing during a disaster or a declared state of emergency does not waiver the nurse’s responsibility to practice within the legally defined scope of practice and provide a standard of nursing care. Nurses and nurse managers/administrators must carefully consider the implications for safe nursing practice before making and accepting an assignment. The Board of Nursing always encourages the nurses to negotiate with their manager/administrator for an assignment that would provide safe competent patient care. Some strategies for negotiating a safe assignment include requesting education and training specific to the patient population and nursing care activities, orientating to the unfamiliar unit/area, requesting a mentor or preceptor, and agreeing to perform those activities in which the nurse is competent to perform. 

Additional information is located in The Bulletin article Accepting An Assignment and Position Statement Staffing and Patient/Client Safety

If your students can safely engage in community activities, to do so would be of great help to the community and enhance their individual learning of community needs during a disaster. Engaging with community partners during the recovery efforts provides students with unique opportunities to learn about disaster preparedness, disaster recovery, and to utilize their nursing skills (which have been validated as competent) in non-traditional healthcare settings to the benefit of their local community. Learning comes in various forms and through various experiences and we support efforts to safely engage your students in this way. This is with the understanding that appropriate faculty or preceptor oversight is provided to the student consistent with 21 NCAC 36. 0321(c) and (d). For additional questions, please email eduaction@ncbon.com.