GUIDE
January 3, 2022
River with fall leaves on trees in North Carolina

For those who are looking to make their mark in the field of nursing, North Carolina provides an ideal destination for building a career.

This diverse state is home to some of the top nursing schools in the country, that also happen to provide generous scholarship packages, and consistently ranks in the top ten when it comes to the best states to be a nurse.

Raleigh and Durham are two of the most educated cities in the U.S. and serve as healthcare and technology hubs that attract talent from all over the world. As a result, the population is growing rapidly, which means an increased demand for skilled healthcare providers.

Whether you love the mountains, the beach or a vibrant nightlife, North Carolina offers it all. Residents enjoy easy access to the Blue Ridge Parkway, the Appalachian Mountains, as well as, the famed Outer Banks with miles of pristine beaches. Raleigh, Durham, Charlotte and surrounding cities also host the state’s symphony, ballet company and art museums and hundreds of festivals, music venues and other free community events.

North Carolina is also home to several James Beard award-winning chefs and is one of the country’s premier cities for foodies. Perhaps best of all, a temperate climate with short winters means that you can enjoy all the state has to offer, year-round.

Part One Nursing in North Carolina

Between 2010 and 2020, North Carolina’s population grew by 903,905 individuals, an increase of 9.5%, faster than the national growth rate of 7.3%. Currently, there are more than 10.4 million people living in North Carolina as of the 2020 census, making it the ninth-largest state in the country. A robust job market, state policies that are designed to attract companies like Amazon and Google, and an affordable cost of living continue to attract over 100,000 new residents per year.

This translates into an increased demand for healthcare services and with dozens of nationally recognized hospitals in the Raleigh-Durham area alone, there are plenty of opportunities for employment.

A recent study from the Health Resources and Services Administration (HRSA) ranks North Carolina as #45 when it comes to projected demand for nurses, yet these numbers may not accurately reflect what is happening in the state.

The study projects that there will be a surplus of 16,500 nurses in NC by 2030. However, these numbers may be skewed because many of the people who come to the state to earn their nursing degree will return to their home state after completing their degree and training.

So while the state is certainly responsible for training a large number of nurses, not all of them will remain for work.

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Part Two North Carolina Board Of Nursing

The mission of the NC Board of Nursing is to protect the public by regulating the practice of nursing. This includes education, licensure, and practice. There are almost 184,000 licensed nursing professionals in the state. Here’s a breakdown by practice level:

Practice Level Licenses
Registered Nurses 148,069
Licensed Practical Nurses 22,554
Nurse Aide II 11,188
Nurse Practitioners 8,562
Nurse Anesthetists 2,656
Certified Nurse Midwife 508
Clinical Nurse Specialist 1,046

Contact Information

For the latest information on licensure in North Carolina, you can contact the State Board of Nursing directly through the following methods:

OFFICE HOURS

8 am - 5 pm Monday through Friday

**Appointments are required and can be made via the website. 

PHYSICAL ADDRESS

4516 Lake Boone Trail

Raleigh, NC 27607

MAILING ADDRESS

P.O. Box 2129

Raleigh, NC 27602-2129

PHONE AND EMAIL

Phone: (919) 782-3211

Fax: (919) 781-9461

Email: general@ncbon.com

Part Three Getting Licensed In North Carolina

Since July 2000, North Carolina has been part of the Nurse Licensure Compact which grants a multi-state license to any nurse licensed in one of the following states:

  • Alabama
  • Arizona
  • Arkansas
  • Colorado
  • Delaware
  • Florida
  • Georgia
  • Guam
  • Idaho
  • Indiana
  • Iowa
  • Kansas
  • Kentucky
  • Louisiana
  • Maine
  • Maryland
  • Mississippi
  • Missouri
  • Montana
  • Nebraska
  • New Hampshire
  • New Jersey
  • New Mexico
  • North Carolina
  • North Dakota
  • Oklahoma
  • South Carolina
  • South Dakota
  • Tennessee
  • Texas
  • Utah
  • Virginia
  • West Virginia
  • Wisconsin
  • Wyoming

Ohio and Pennsylvania have passed laws and are awaiting implementation from the state. Additionally, Vermont is set to implement the compact license on 2/1/2022. 

North Carolina is one of the many states that require all applications be submitted online. The state utilizes a Nurse Gateway portal. You must first register on the portal in order to receive an access login.

LICENSURE BY EXAM

If this is your first nursing license, you must apply for licensure by exam. The process for taking the NCLEX requires the following:

  • Your Examination application 
  • Your submittal of the North Carolina Board of Nursing Identification Document. You can reprint your prefilled Identification Document by completing the steps below upon submission of your Examination application.
    • Log in to the Nurse Gateway portal
    •  
    • Create a Username and Password to access your information and applications. If you have already created a Username and Password, you will only need to log in to your profile.
    • Select 'Exam Application' in the Licenses/Certificates dropdown
    • Complete the application and pay the $75 application fee
  • Your Electronic School Verification or Official Transcript Copies 
    • North Carolina graduates program verification will be provided to the North Carolina Board of Nursing by your Program Director within 30 days of program completion.
    • Out-of-State graduates are required to provide a “FINAL” official transcript, the transcript must include your legal name (first & last), degree awarded and date of completion or conferral.
      • Mail to: NCBON, Exam Department, P.O. Box 2506, Raleigh, NC 27602-2506
      • Transcripts must be delivered directly from the university or an approved transcript vendor. No other forms or documents are required from the school.
      • Active-in-program transcripts will not be accepted.
  • Graduates of International nursing education programs must complete a Credentials Evaluation Service (CES Professional Report) or provide a CGFNS Certificate or VisaScreen. English proficiency testing is required for many Internationally educated nurse applicants.
  • Your registration and payment of fees to Pearson Vue

For more information on licensure by exam, see the NCBON’s website.

LICENSURE BY ENDORSEMENT

Nurses with an active license outside of compact states will have to submit an application in order to receive a state endorsement. This process requires the following:

  • A completed online application
  • A criminal background check. This is a fingerprint-based system that is verified by both the State and Federal Bureaus of Investigation and comes with a $38.00 fee.
  • Proof of successfully completing a licensed nursing program
  • Proof of passing the NCLEX
  • Documentation of having met the continuing education requirements
  • A license endorsement fee of $150.00

INACTIVE LICENSES

Inactive licenses are licenses that have either not been renewed accidentally or individuals purposely let lapse. In order to be eligible for reinstatement, one of the following requirements must be met: 

  • 15 Contact Hours of continued education and 640 hours of active practice within previous 2 years
  • National Certification or Recertification by a National Credentialing Body recognized by the Board
  • 30 Contact Hours of continued education
  • Completion of a Board-Approved Refresher Course
  • Completion of a minimum of two (2) semester hours of post-licensure academic education related to nursing practice
  • 15 Contact Hours of continued education and completion of a nursing project as Principal Investigator or Co-Investigator to include statement of problem, project objectives, methods, date of completion and summary of findings
  • 15 Contact Hours of continued education and Authoring or Co-Authoring a nursing-related article, paper, book or book chapter
  • 15 Contact Hours of continued education and developing and conducting a nursing continuing education presentation or presentations totaling a minimum of five contact hours, including program brochure or course syllabi, objectives, date and location of presentation, and approximate number of attendees

LICENSE VERIFICATION

Verifying your license with NC is free and easy. All you have to do is enter your license number or social security number into the state’s online verification system. The verification process also provides you with the opportunity to enroll in automatic updates so that you can receive email notifications of any changes in your licensing and reminders of when it is time to apply for renewal.

RENEWALS

In North Carolina, RN and LPN licenses are valid for two years. Nurses are required to renew their license by the last day of their birth month. In order to renew a license, applicants must pay a $100.00 renewal fee and provide proof that they have met all continuing competence requirements. Fortunately, there are a variety of ways to meet these requirements. North Carolina currently requires 30 continuing education hours for renewal. 

It is also important to keep in mind that the state does not offer any extensions or exceptions. If you do not renew your license in time, it will automatically be registered as expired. To begin the online application and endorsement process, visit the NC Nurse Gateway.

Part Four North Carolina Nurse Salaries 

According to ZipRecruiter.com, the average annual pay for an RN Nurse in North Carolina is $58,597 a year. Salaries can be as high as $93,719 and as low as $9,653, the majority of RN Nurse salaries currently range between $45,853 (25th percentile) to $71,193 (75th percentile) with top earners (90th percentile) making $83,662 annually in North Carolina.

For nurses, compensation packages tend to be a little more complex than the average job. There are plenty of opportunities to earn additional money based on working different shifts, taking on overtime, earning additional certifications and leading new hire training.

In North Carolina, employers are required to pay overtime, which is calculated as 1.5 times the normal hourly pay, for any hours that exceed a typical 40-hour work week. This law covers nurses although it does not apply to shifts lasting longer than 8 hours as long as the weekly total amounts to 40 hours or less. Even though nurses typically work 36 hours per week, overtime doesn’t kick in until the 40 hour mark is reached.

In addition, the state does not mandate the workers receive a certain number of breaks and meal time during their shifts. However, you would be hard-pressed to find an employer who doesn’t have their own policy for providing rest time.

Depending on the hospital or healthcare facility, nurses in NC can enjoy a nationally competitive salary along with benefits that include:

  • Paid holidays and/or extra holiday pay for working holidays
  • Excellent vision, dental and health coverage
  • Discounts on cell phones and fitness memberships
  • Tuition reimbursement

Nurses who are willing to take on extra responsibilities, earn additional certifications and work less popular shifts, can make almost double the median salary of other nurses in the state.

Highest Paying Cities in North Carolina

Metro Area Hourly mean wage Annual mean wage
Durham $35.24 $73,302
Raleigh $31.57 $65,659
Burlington $30.00 $62,392
Greensboro $31.34 $65,196
Charlotte $30.66 $63,774
Winston-Salem $32.95 $68,537
Jacksonville $29.99 $64,630
Greenville $31.94 $66,430
Gastonia $30.52 $63,485
Wilmington $31.15 $64,799

(ZipRecruiter.com)

Part Five Magnet Hospitals in North Carolina

The American Nurses’ Credentialing Center (ANCC) awards hospitals who demonstrate a high degree of quality nursing, according to set standards, with the Magnet status.

Nurses who work at Magnet hospitals report higher job satisfaction, fewer injuries and more opportunities for advancement. These hospitals represent some of the most renowned facilities in the country, which also means that they have a highly competitive hiring process that only selects the best of the best. 

North Carolina Magnet Hospitals

Organization Name City
MH Mission Hospital, LLP Mission Hospital Asheville
University of North Carolina Hospitals Chapel Hill
Carolinas Medical Center Charlotte
Presbyterian Medical Center (Novant Health) Charlotte
Duke Regional Hospital Durham
Duke University Health System Durham
Duke University Hospital Durham
Cone Health Greensboro
Vidant Medical Center Greenville
Catawba Valley Medical Center Hickory
UNC Rex Healthcare Raleigh
WakeMed Health and Hospitals Raleigh
Forsyth Medical Center (Novant Health) Winston Salem

Part Six Best Nursing Programs in North Carolina

North Carolina is home to one of the best state university systems in the country, as well as, dozens of private colleges and universities that attract the best students and faculty from around the world. For nursing students, that means plenty of opportunities to enroll in competitive programs and continue education that will set you up for future success and help you stand out when it comes time to apply for jobs.

Whether you want to work towards your BSN or are looking to earn an advanced nursing degree, here are the top schools and programs worth applying to:

1. Duke University

Duke University is located in the heart of Durham and consistently ranks among the top 10 schools in the country. The nursing program offers truly innovative curriculum and access to state-of-the-art facilities and technology. The extensive Duke University Health System, which location across the state, provides plenty of opportunity for clinical experiences. The nursing program has an 11% acceptance rate and a graduation rate of 95%.

Continuing education, certification and graduate programs and surprisingly flexible and allow students and faculty to work together to create a curriculum that fits the goals and interests of the student. 

2. University of North Carolina – Chapel Hill

UNC boasts another nationally and internationally recognized nursing school. It is also only one of three schools in the country to offer the Hillman Scholars Program in Nursing Innovation, which allows participants to earn a BSN-PhD in seven years. This program is part of the school’s commitment to foster the next generation of scientists who will drive healthcare innovation. Students should expect a rigorous course of study while also enjoying access to award-winning faculty and advanced facilities.

3.  University of North Carolina - Wilmington

Programs at UNCW are designed to help RNs earn their BSN and other advanced degrees and prepare students for the RN licensure exam. Students can also earn a BA and or MA in Clinical Research in addition to other advanced degrees and certifications. While the Wilmington campus is smaller than other locations, students still enjoy access to the best training and technology that the UNC health system has to offer.

4. Queens University of Charlotte

Queens University is conveniently located close to premier health care centers and offers an intimate learning environment with a small student-to-faculty ratio. Students can choose between a regular or accelerated BSN program and enter the graduate school to pursue a variety of advanced educational and career options. A variety of online courses also make this program great for those with a busy schedule. 

5. Gardner-Webb University

At the Hunt School of Nursing, students can choose to earn a AND, BSN, RN to BSN or MSN. You can pursue practically any nursing path and even earn a Doctor of Nursing Practice. The school offers an extensive selection of coursework and specializations with instruction from highly acclaimed and respected instructors. Students are well prepared for passing the NCLEX and enjoying a successful career in nursing.

Part Seven North Carolina Nursing Unions and Organizations

North Carolina has a long history as a right to work state. In 1947, the government decided to ban mandatory union dues. Since then, employers are not allowed to require that their employees join unions. However, employers can recognize unions and employees have the right to weigh the pros and cons of joining an available union and make the best choice for themselves.

Read about the Pros and Cons of Nursing Unions.

That being said, North Carolina does not have an existing nursing union and there is no sign that one will form anytime soon. The North Carolina Nurses Association (NCNA) is the main organization in the state that works to promote better educational opportunities, working environments, and compensation packages for nurses throughout the state. The NCNA is actively involved in lobbying and advocating for the rights of nurses and patients and works to pass relevant legislation and support political candidates who they believe will be good for the profession.

Without the support and backing of a union, it is often up to individual nurses to become more active participants in the field and work with organizations to change regulatory and licensing practices. For instance, there is current regulation in place that limits Nurse Practitioners (NPs) to practice as an RN when they are outside their designated facility. For example, an NP who has been registered by the National Board and is employed by UNC could not write a prescription outside of a UNC facility. The NCNA is fighting to change these regulatory restrictions.

Part Eight Latest Nursing News in North Carolina

It was only a few years ago that projections for a nationwide nursing shortage were commonly accepted as fact. However, more recent studies have shown that some states, including North Carolina, are actually on track to have a nursing surplus by 2030. All these mixed messages should be taken with a grain of salt.

The projected number of registered nurses in NC may be higher than normal due to the number of reputable nursing programs in the state. Top programs attract ambitious students from around the globe, but that doesn’t necessarily mean that once the students are licensed that they will stay in NC to work.

In addition, some researchers point out that nurses aren’t evenly distributed throughout the state. Large cities, that also tend to offer higher salaries, aren’t experiencing problems with nursing shortages, However, rural areas are having trouble filling positions.

Part of the problem is that while there are LPNs available, even rural hospitals are now looking to hire BSN-RNs. Those who were promised a career in nursing from the local community college may have additional years of school ahead of them before they are able to compete even in areas with shortages.

BSN-RNs who are willing to work outside of urban areas in North Carolina will have more immediate job prospects. For those looking to work in the area’s biggest and most prestigious hospitals, the competition may be tough, especially as the area continues to draw in a new crop of professionals each year.

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