Texas is a great state to get to work as a nurse. Demand is high and salaries average at $67,860 and rising, according to the U.S. Bureau of Labor Statistics. But how do you become a nurse in Texas? If you are interested in becoming a nurse in Texas, you will need to apply through their state board of registered nursing. The Board is the state governmental agency that is responsible for implementing and enforcing all of the laws pertaining to nurse education, licensure, practice and discipline.
ENTRY LEVEL PRACTICE NURSES
To first enter the nursing workforce is a three stage process.
STAGE 1. CHOOSE WHETHER TO BECOME AN LVN (LICENSED VOCATIONAL NURSE) OR AN RN.
To be an LVN, complete a one year diploma or certificate program. To be an RN (Registered Nurse), complete a two year associate’s degree (ADN) or a four year bachelor’s degree (BSN). The longer you study, the better your job prospects, growth opportunities and salary.
STAGE 2. COMPLETE ALL PREREQUISITES FOR ENTRY INTO THE NURSING PROGRAM.
Exact requirements vary from one school to another, but most ADN and BSN programs will require you to complete an undergraduate statistics course. You must also have completed your high school or GED. It is important to have good grades, as admission to nursing programs is highly competitive.
STAGE 3. PASS THE RELEVANT NCLEX EXAM.
The NCLEX examination for LVNs is the NCLEX-PN. For RNs, it is the NCLEX-RN.
ADVANCED PRACTICE NURSES
The Texas Board of Nursing describes the process of becoming an APRN (Advanced Practice Registered Nurse) in four stages.
STAGE 1. COMPLETE AN ADVANCED PRACTICE NURSING DEGREE PROGRAM AT MASTER’S LEVEL.
The Board must have approved the program and it must be nationally accredited by an agency recognized by the U.S. Department of Education. The Board has also set a number of core requirements for the courses to be accepted, as they follow the APRN Regulatory Model. As such, the curriculum must include:
• Advanced pharmacology
• Physical evaluation/assessment
There are also additional requirements for the specializations of APNs. The Board recognizes the following specializations:
1. CRNA – Certified Registered Nurse Anesthetist
2. CNP – Certified Nurse Practitioner
3. CNM – Certified Nurse Midwife
4. CNS – Clinical Nurse Specialist
If you wish to become a CNS or CNP, your coursework must also include:
• A mixture of didactic and clinical experiences.
• Principles and concepts relating to APN.
• Legal and professional implications of being an APRN.
• The necessary core courses as described above, as well as psychopathology for those who specialized in psychiatric/mental health.
• Clinical and theoretical role preparation.
• Majoring courses in an area of specialization.
• Preceptorship, practicum or internship.
You can also apply for a dual or blended role as an APRN. If you choose to do this, you must complete an educational program that meets the standards for each of the roles. Additionally, each specialization must include 500 clinical hours.
If you want to obtain prescriptive authority, you should also have taken part in a course focusing on diagnosis and management of conditions and diseases in your specialty area. Furthermore, you can only apply for prescriptive authority if you hold an RN license in Texas. You must demonstrate that you have completed courses in:
• Advanced pathophysiology
• dvanced pharmacotherapeutics
• Diagnosis and management of conditions and diseases in your population focus and specialty role
• Advanced health assessment
As a CNP, CNM or CRNA, your educational program will have included these requirements. As a CNS, however, you must complete this separately and evidence this to the Board. As a CRNA, you do not need prescriptive authority so long as you use devices and drugs specifically to administer anesthesia. However, if you also want to administer general, regional or monitored anesthesia, you must apply for prescriptive privileges and meet the necessary requirements.
STAGE 2. BECOME NATIONALLY CERTIFIED IN ONE OF THE FOUR AREAS OF SPECIALIZATION.
Additionally, you can choose a specific population focus to specialize in. The Board recognizes the following nation certification agencies:
• The ANCC (American Nurses Credentialing Center), which recognizes the Adult Nurse Practitioner, Acute Care Nurse Practitioner (ACNP), Gerontological Nurse Practitioner (GNP), Family Nurse Practitioner, Adult Psychiatric Mental Health Nurse Practitioner (PMHNP), Pediatric Nurse Practitioner (PNP) and the Family Psychiatric Mental Health Nurse Practitioner (PMHNP).
• The AANP (American Academy of Nurse Practitioners), which recognizes the Adult Nurse Practitioner and the Adult-Gerontology Primary Care NP.
• The AACN (American Association of Critical-Care Nurses), which recognizes the Acute Care Nurse Practitioner.
• The NCC (National Certification Corporation for the Obstetric, Gynecologic and Neonatal Nursing Specialties), which recognizes the Women’s Health Care Nurse Practitioner (WHNP) and the Neonatal Nurse Practitioner (NNP).
• The PNCB (Pediatric Nursing Certification Board, which recognizes the Pediatric Nurse Practitioner in Acute Care and Primary Care.
• The National Board of Certification and Recertification for Nurse Anesthetists (NBCRNA), which recognizes the Certified Registered Nurse Anesthetist (CRNA).
• The AMCB (American Midwifery Certification Board), which recognizes the certified nurse midwife (CNM).
STAGE 3. APPLY TO RECEIVE YOUR APRN LICENSE WITH OR WITHOUT PRESCRIPTIVE AUTHORITY.
You can complete a paper application. However, it is much easier and quicker to complete your application online. You must include various pieces of documentation with your application, pertaining to your education, experience, certification and identity. You must also include the necessary fees ($100 for APRN or $150 for APRN with prescriptive authority). You must submit and application and fee for each role or population you want to be licensed in. You can check your application status online.
You can also apply for Interim Approval, which is valid for 120 days. If you believe you will be employed within the next 60 days, it is recommended that you apply for this (answer “yes” to question 9 on your application), as it will often take longer for your application to be processed. You cannot extend or renew your Interim Approval. You cannot have prescriptive authority on an interim license.
You can apply for prescriptive authority separately, if you are already licensed as an APRN. You must include relevant documentation and fees. If you wish to prescribe controlled substances, you must apply through the DEA.
STAGE 4. RENEW YOUR LICENSE EVERY TWO YEARS.
Both your APRN and RN licenses can be renewed online. You must include a fee of $133. There is a $60 penalty if you renew late. It should take just two business days to receive your renewed license if you apply online.
Texas Board of Nursing
P: (512) 305-7400
F: (512) 305-7401