The Nurse Practice Act in Texas is a crucial legislation that outlines the scope of practice, licensing requirements, and standards of care for nurses in the state. It is designed to protect patients and ensure accountability for safe and competent care. The act includes specific guidelines for professional conduct, ethical considerations, and disciplinary actions for nurses. It is vital for nurses practicing in Texas to familiarize themselves with the provisions of the Nurse Practice Act to ensure they are providing safe and effective care while adhering to the legal and ethical standards set forth by the state.
The act is essential for maintaining high-quality healthcare and protecting the well-being of patients, and it is designed to safeguard public health and safety by establishing the framework for nursing practice, education, licensure, and disciplinary actions.
Nurse Practice Act in Texas
The practice of Advanced Nurse Practitioners (ANPs) in Texas is regulated by the state and defined by the Board of Nursing, allowing APRNs to practice healthcare within their scope with physicians’ close supervision and delegation. For instance, in Section 157.0512 of the Texas Occupations Code, it is stipulated that “A physician may delegate to an advanced practice registered nurse or physician assistant, acting under adequate physician supervision, the act of prescribing or ordering a drug or device as authorized through a prescriptive authority agreement between the physician and the advanced practice registered nurse or physician assistant, as applicable.” As a result, APRNs cannot practice independently within the state.
Additionally, the Texas Nurses Association (TNA) has stated that despite decades of experience and a near-impeccable track record related to patient outcomes, APRNs do not have full practice authority. APRNs can only practice to the full extent of their education and training when they contract with a physician to “supervise” their practice. APRNs in Texas face limitations in their practice and have significant barriers, such as the lack of prescriptive authority. Under Section 157.052 of the Nurse Practice Act, an APRN must have a “Prescriptive Authority Agreement” with a physician, which indicates that no matter how extensive an APRN’s knowledge, education, and skills may be, their practice will still be limited. Another barrier is the limitations in insurance reimbursement. Coverage is limited to the services an NP is trained and educated to perform, and reimbursement for services beyond these parameters is often not available.
Furthermore, according to TMA, “services may be covered under part B if all of the following are met: They are the type that is considered physician’s services if furnished by an MD or DO; They are performed by a person who meets the definition of an NP/PA or qualifies as a CNS; They are performed under the supervision of an MD/DO (for PA’s only) or are performed in “collaboration” with an MD/DO (for NPs and CNS’s only); the practitioner is legally authorized to perform the services in the state in which they are performed; and, They are not otherwise non-covered.” These barriers impact the patients mainly by limiting their access to affordable yet quality healthcare that APRNs can provide, especially in suburban areas.
In the end, APRNs do not mean to replace physicians but to help people in our community access affordable healthcare and avoid delays in the care needed, especially in suburban areas, as I’ve previously mentioned, where APRNs are willing and available to render their services.
- Texas Statutes. Texas Occupation Code. Retrieved January 19, 2021, from, https://texas.public.law/statutes/tex._occ._code_section_157.0512
- Nursing Practice Act, Nursing Peer Review, Nurse Licensure Compact, & Advanced Practice Registered Nurse Compact. 2009.https://www.bon.texas.gov/pdfs/practice_dept_pdfs/npa/npa2009.pdf
- Texas Nurses Association. Policy Position |Policy Council. (2020-2021). Full Practice Authority for APRNs.