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Steps to Becoming an APRN in Texas

texas nursing

Get your Graduate Degree in Texas
Earn your National Certification in Texas
Apply for your APRN License in Texas
Renewing your License in Texas

 

The Texas Board of Nursing (phone: 512-305-6843, apn@bon.texas.gov) is a decision-making board that operates under the guidance of the Governor of the State of Texas and in compliance with the Texas Occupations Code to regulate the practice of nursing and nursing educating programs in Texas. The Texas Board of Nursing grants approval for qualified registered nurses to work as advanced practice registered nurses (APRN) in four categories:


  • Certified Registered Nurse Anesthetist (CRNA)
  • Certified Nurse Practitioner (CNP)
  • Certified Nurse-Midwife (CNM)
  • Clinical Nurse Specialist (CNS)

To be approved to work as an APRN in Texas, you must hold a valid, unencumbered Texas RN license.

Texas Job Statistics

  • 2011 base salary for NPs in Texas: $94,868
  • February 2001, Texas Board of Nursing adds providing controlled substances during intrapartum/immediate postpartum to CNM scope of practice
  • January of 2001, Texas Board of Nursing allows RNs to execute orders given by APRNs
  • Texas Board of Nursing declares epidural/intrathecal administration of analgesic/anesthetic pain control agents is within the RN scope of practice

*Nurse Licensure Compact

Texas is part of the Nurse Licensure Compact inclusive of these participating states: Arizona, Arkansas, Colorado, Delaware, Idaho, Iowa, Kentucky, Maine, Maryland, Mississippi, Missouri, Nebraska, New Hampshire, New Mexico, North Carolina, North Dakota, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, and Wisconsin. The Compact offers practice privileges for registered nurses in all compact states. An RN license issued by any compact state is valid for practice in all other compact states.

The APRN Compact, which was proposed by the National Council of State Boards of Nursing in 2000, has not been implemented to date and no date has been set for implementation. However, three states – Utah, Iowa, and Texas – have passed laws that will allow for easy assimilation of the APRN Compact when it is implemented. Once implemented, the APRN Nurse Compact will operate in a similar fashion to the Nurse Licensure Compact.

With an active RN license, you may take the steps necessary to become licensed as an adanced practice registered nurse.


 

Step 1. Get Your Graduate Degree

To qualify for APRN licensure in Texas, you must complete an advanced practice nursing educational program within a college or university authorized to award graduate degrees. All advanced educational programs in Texas must be approved by the Board or accredited by a national accrediting body recognized by the Board and the U.S. Department of Education. All advanced educational programs outside of Texas must be accredited by a national accrediting body that is either recognized by the Board or by the appropriate licensing body in the state where the program is located.

Review accreditation agencies listed on the United States Department of Education database of national and regional accreditation agencies (check institutional and specialized and programmatic accrediting agencies).

You are exempt from the master’s degree requirement if you graduated before January 1, 1996. Nurse-midwives and healthcare nurse practitioners that completed bachelor’s programs on or after January 1, 2003 through December 31, 2006 may be eligible to receive wavers from the master’s degree requirement. Contact the Board for more information.

Core Requirements

The Texas Board of Nursing follows the APRN Regulatory Model and requires the following core courses for APRNs:

  • Pathophysiology (all general principles applicable across the human lifespan)
  • Advanced pharmacology (includes pharmacokinetics, pharmacodynamics, and pharmacotherapeutics of broad categories of agents)
  • Physical evaluation/assessment (includes assessment of all systems of the body, advanced assessment methods, techniques and concepts)

Additional CNS and NP Coursework Requirements

If you completed your nurse practitioner or clinical nurse specialist program on or after January 1, 1998, your graduate program curriculum content must include:

  • Didactic and clinical learning experiences
  • Concept and principles critical to advanced practice nursing
  • Professional and legal implications of the nurse in the advanced role
  • Knowledge and skills relevant to practice in the area of specialty
  • Evidence of inclusion of: pharmacotherapeutics, advanced assessment and pathophysiology, and/or psychopathology (for APRNs in the psychiatric/mental health specialty only)
  • Evidence of theoretical and clinical role preparation
  • Evidence of clinical major courses in the specialty area
  • Evidence of a practicum/preceptorship/internship to integrate clinical experiences in essential content and clinical major courses

If you are a clinical nurse specialist professional seeking approval for prescriptive authority, your graduate program must also include, at a minimum, a separate course in diagnosis and management of diseases and conditions within the clinical specialty area recognized by the Board.

Dual or Blended Role Specialty Programs Coursework

If you are preparing for a dual or blended APRN role, you must complete separate advanced practice nursing educational programs for each role and/or specialty area. The program must also include a minimum of 500 separate, non-duplicated clinical hours for each role and specialty within the APRN program.

Prescriptive Authority

In order to be approved for prescriptive authority, you must hold an active, unencumbered RN license and have full approval to practice as an APRN in Texas (RNs with interim approval for advanced practice nursing are not eligible for prescriptive authority).

Your application for prescriptive authority must include evidence of completed graduate-level courses in advanced pharmacotherapeutics, advanced pathophysiology, advanced health assessment, and diagnosis and management of diseases and conditions within your specialty role and population focus area.

Note: CNPs, CNMs, and CRNAs will have completed these educational requirements in their advanced practice nursing educational program. Clinical nurse specialists must submit documentation showing the completion of separate, dedicated graduate courses in the above areas (see above).

The Board of Nursing does not require CRNAs to hold prescriptive authority to write orders for drugs and devices for the purpose of administering anesthesia or anesthesia-related devices. However, if you are a nurse anesthetist and you intend to administer general anesthesia, regional anesthesia or monitored anesthesia in some outpatient settings, you may need to be registered for prescriptive authority with the Board. Contact the Board for more information.


 

Step 2. Earn Your National Certification

After you complete your graduate-level education, you are then eligible to take an exam to become nationally certified in your general area of specialty:

  • Certified Nurse Anesthetist (CNA)
  • Certified Registered Nurse Practitioner (CRNP)
  • Certified Nurse-Midwife (CNM)
  • Clinical Nurse Specialist (CNS)

Specialty Area and Population Focus Certification

An advanced practice nurse in Texas is authorized to hold a title in the following population foci:

  • Nurse Anesthetist
  • Nurse-Midwife
  • Nurse Practitioner
    • Acute care adult
    • Acute care pediatric
    • Adult
    • Family
    • Gerontological
    • Neonatal
    • Pediatric
    • Psychiatric/mental health
    • Women’s health
  • Clinical Nurse Specialist
    • Adult health/medical-surgical nursing
    • Community health nursing
    • Critical care nursing
    • Gerontological nursing
    • Pediatric nursing
    • Psychiatric/mental health nursing

If you are not qualified to use one of the above titles, the Board may also grant approval of the use of the following specialty titles:

  • Acute Care Clinical Nurse Specialist
  • Critical Care Nurse Practitioner
  • Cardiovascular Clinical Nurse Specialist
  • Emergency Nurse Practitioner or Clinical Nurse Specialist
  • Family Clinical Nurse Specialist
  • Home Health Clinical Nurse Specialist
  • Maternal (Parent)-Child Health Clinical Nurse Specialist (with or without sub-specialization)
  • Neonatal Clinical Nurse Specialist
  • Oncology Nurse Practitioner or Clinical Nurse Specialist
  • Pediatric Critical Care Nurse Practitioner
  • Perinatal Nurse Practitioner or Clinical Nurse Specialist
  • School Nurse Practitioner
  • Women’s Health Clinical Nurse Specialist

Board Recognized National Certification Agencies

To receive your APRN license in Texas, you must first become certified in your specialty through one of the following national certifying bodies recognized by the Texas Board of Nursing:


 

Step 3. Apply for your APRN License

To apply for your APRN license in Texas (with or without prescriptive authority) you must either complete a paper application or an online application. You must also include the following documentation with your completed application:


  • An official transcript showing your APRN graduate degree. The transcript must show the date your degree was awarded. If you received your graduate education from more than one institution, you must include an official transcript from all institutions.
  • Evidence of your current national certification in the advanced role and population focus area for which you are applying.
  • A copy of your Compact RN license if you obtained your RN license from another Compact state (If your RN license is from Texas, you are not required to send a copy of the license).
  • A completed “Consent to Release Information” form (found in Part II of the application). You must send the consent form to the Program Director for completion. The Program Director must then send the consent form directly to the Texas Board of Nursing, ATTN: APRN Application Office, 333 Guadalupe Street, Suite 3-460, Austin, TX 78701.
  • A check or money order of $100 for Advanced Practice Licensure only, or $150 for Advanced Practice Licensure with Prescriptive Authority, made payable to the Texas Board of Nursing.

Send the check or money order, along with the completed application (Part I) and required documentation to the Texas Board of Nursing, ATTN: APRN Application Office, 333 Guadalupe Street, Suite 3-460, Austin, TX 78701.

Note:

If you are requesting licensure in more than one role and/or population focus area, you must submit a separate application and fee for each license.

If you are applying for prescriptive authority alone, do not fill out the APRN application. Instead, fill out the Application for Prescriptive Authority.

Checking Status of Initial Licensure Application

You can check the status of your APRN application here by entering your name, date of birth and application type into the Texas Board of Nursing’s license application query system.

Interim Approval for APRN

If you want to receive a 120-day Interim Approval for APRN practice while your application is under review and you are awaiting full licensure, answer “yes” to question 9 on the application. Anyone expecting to become employed within 60 days is strongly encouraged to apply for Interim Approval.

Interim Approval cannot be extended or renewed, and the Board may not grant approval for an Interim Approval if they suspect you may not meet the requirements for the full APRN licensure.

You may apply for prescriptive authority at the same time you apply for your Interim Approval, but the Board will not grant your prescriptive authority until full APRN licensure has been granted.

Prescriptive Authority

A separate Application for Prescriptive Authority can be filled out by professionals who have already obtained their advanced practice license. If you are applying for both advanced practice licensure and prescriptive authority, a separate prescriptive authority application should not be completed, as it is included in the APRN application.

In addition, if you already hold prescriptive authority in one role or population focus area, and you are applying for prescriptive authority in another role or population focus area, you must apply for prescriptive authority again in the new role or population focus area if you wish to authorize or issues prescription drug when working in that particular role or population focus area.

In addition to completing an Application for Prescriptive Authority, you must also submit:

  • A check or money order for $50 made payable to the Texas Board of Nursing
  • If you are a clinical nurse specialist, you must answer question number 8 and enclose official transcripts and course descriptions describing courses in advanced assessment, pathophysiology, pharmacotherapeutics, and medical diagnosis and management of diseases and conditions within your specialty area.
  • A photocopy of your current national certification document (which shows the expiration date) in your advanced role and specialty.
  • If you hold a license in one of the Compact states, you must enclose a photocopy of your compact RN license (you do not need to enclose a copy of your RN Texas license).

Mail all documents, along with your completed application and related processing fee to the Texas Board of Nursing, ATTN: APN Office, 333 Guadalupe Street, Suite 3-460, Austin, TX 78701.

Controlled Substances

If you intend to prescribe any controlled substances, you must comply with the following requirements:

  • You must provide verification that you and the delegating physician have met all requirements for delegation of prescriptive authority to an advanced practice nurse set forth by the Texas Medical Board (512-305-7030).
  • After you and the delegated physician have met all requirements, you must then submit an application for controlled substances permit through the Texas. Department of Public Safety (DPS). You must have a prescriptive authority number from the Texas Board of Nursing before you can apply for a controlled substances registration. Applications are available by contacting the Texas Department of Public Safety (512-424-2188, tppcsr@txdps.state.tx.us).
  • After the DPS controlled substances permit has been issued, you can then apply for a DEA registration number. You can obtain applications here on the DEA website.

Remember: You cannot legally prescribe controlled substances in Texas until you have both a current DPS controlled substances permit and a DEA registration number.


 

Step 4. Renewing Your License

RN and APRN licenses are renewed on a biennial basis. You can renew your RN and APRN license at the same time online using the Nurse License Renewal form, or you can print out a paper version of the License Renewal form. Paper processing time takes two weeks. To avoid any late fees, the Board recommends that you postmark your renewal no later than the last day of the month in which your license expires. You can also place your advanced practice license on inactive status using this form (no fee is required).

You can renew your APRN license online, unless:

  • You have defaulted on a Texas Guaranteed Student Loan
  • You have not met the mandatory continuing education requirements
  • You have been selected for a continuing education audit
  • You have been selected for a criminal background check and the process has not been completed
  • Your primary state of residence is a Compact state other than Texas
  • Your license number and/or the last four digits of your social security number do not match the information on the Board files

In addition to a completed application, you must submit a check or money order in the amount of $133 (for both RN and APRN renewal) made payable to the Texas Board of Nursing (there is no fee to renew your prescriptive authority). If the application is 1 to 90 days past the expiration date, the fee for renewal is $193. You must also include a copy of your current national certification document with your application.

Mail your national certification document, along with your completed application and related processing fee to the Texas Board of Nursing, ATTN: APN Office, 333 Guadalupe Street, Suite 3-460, Austin, TX 78701.

If you apply online, you can receive your license within two business days. When renewing your license online, you must include your license number and the last four digits of your social security number. You can make payment with either a credit card or web check.

Delinquent APRN Renewals

If your APRN license renewal is 90 days or more past the expiration date, you must complete the License Renewal Form (Delinquent over 90 Days) form.

In addition to the renewal form, you must also provide evidence of 20 hours of continuing education certificates, as well as a copy of your national certification documents for each advanced practice title you hold. Mail all documents, along with your completed application and processing fee of $253, made payable to Texas Board of Nursing, to the Texas Board of Nursing, 333 Guadalupe Street, Suite 3-460, Austin, TX 78701.

Inactive/Retired APRN Renewals

If you are seeking to reactivate your APRN license that is either inactive or retired, you must complete the Reactivation Application for Recognition as an Advanced Practice Nurse and submit a fee of $60 made payable to Texas Board of Nursing, along with copies of your continuing education certificates, a copy of your current RN license from a Compact state, and a copy of your current national certification. Mail all documents, your completed application and processing fee to the Texas Board of Nursing, 333 Guadalupe Street, Suite 3-460, Austin, TX 78701.

Keeping your APRN License Active/Reactivating your APRN License

You must complete 20 contact hours of continuing education and 5 additional contact hours of continuing education in pharmacotherapeutics (if you hold prescriptive authority) within each two-year renewal cycle, and attain, maintain or renew you national certification in your specialty area and/or population focus.

You must also complete a minimum of 400 practice hours in your advanced practice role and population focus during each two-year renewal cycle.

Continuing education hours must be obtained through programs approved by a credentialing agency recognized by the Board.  You can view a list of these agencies here.

If less than four years, but more than two years, have passed since the completion of your advanced practice nursing program and you do not have 400 practice hours in your advanced practice role and population focus in the preceding 24 months, you must demonstrate proof of the completion of 400 hours of general practice under the direct supervision of a physician or an APRN licensed by the Board.

If more than four years have passed since the completion of your advanced practice nursing program and you have not practiced in your specialty area and population focus area in those four years, you must complete a refresher course or extensive orientation in your advanced practice role and population focus, which includes:

  • Advanced assessment
  • Diagnosis and management of problems within the specialty
  • Pharmacotherapeutics
  • Ordering and interpreting of diagnostic test and laboratory values appropriate to the specialty
  • Safe and competent practice in the performance of procedures appropriate for the role and specialty (e.g., suturing, intubation)
  • A minimum of 400 hours of clinical practice

Advanced Practice Registered Nurse Associations in Texas

There are a number of professional organizations that support APRNs in Texas:

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