The nurse in this category has completed extensive post-baccalaureate education and clinical experience to qualify as a Nurse Practitioner. The scope of practice defines the tasks that an APN can carry out. The state where the license is valid and in use is responsible for determining whether or not the holder has the necessary skills, knowledge, and competence. Each calls for in-depth knowledge of research about academic requirements, the field of practice, and the profession as a whole. If APNs could get specialty accreditation, the number of people who choose to become APNs would rise. The NONPF key competencies guide the master’s and doctorate programs of member institutions, which aim to prepare advanced nurses to provide safe, effective treatment. This article will explore Advanced Practice Nursing (APN), including its definition, scope of practice, and the steps necessary to get an Advanced Nursing Degree. We will go through the specifics of getting your license in Texas, the state’s educational and regulatory requirements, and your ability to prescribe medicine. In addition to discussing the basic skills of a Nurse Practitioner, my strengths and areas for improvement as an Advanced Practice Registered Nurse in Texas, as well as the academic activities I have engaged in to assist me in attaining these nursing abilities, will be reviewed. We will wrap up by talking about the qualities of a leader and the methods I want to use to develop those qualities to attain a leadership position inside complex systems.
Advanced Practice Nurse Scope of Practice
The Advanced Practice Registered Nurse Consensus Work Group and the National Council of State Boards of Nursing Advanced Practice Registered Nurse Advisory Committee developed a Consensus Model for APRNs in July 2008. This resulted in a more unified framework for APRN laws throughout Texas (Mack, 2023). This Consensus Model describes in detail the requisites for becoming an APRN in Texas, including a license, education, and a criminal background check, as well as the standards of nursing practice, certification programs you may wish to investigate, the ability to prescribe medication, and the extent to which APRNs are allowed to practice in the state.
Educational Requirements
According to the Texas State Board of Nursing (ASBN), a Certified Nurse Practitioner (CNP), Clinical Nurse Specialist (CNS), Certified Registered Nurse Anesthetist (CRNA), or Certified Nurse Midwife (CNM) are all examples of APRNs in the Lone Star State (“Texas Board of Nursing – Advanced practice information,” n.d.). This calls for finishing a Master’s program in nursing at a recognized university and meeting all the necessary coursework and clinical experience criteria. The master’s program is designed so that students may focus their studies on an area of interest, allowing them to acquire the specialized knowledge they will need to succeed. Finally, you must prove to the State Board of Nursing that you are qualified to practice your chosen specialty by holding certification from a national, accredited organization.
License Requirements
Obtaining your APRN license in Texas requires passing a few exams. The first step is to set up an account on the Texas Nurse Portal using an email other than your work email. Finally, to get things forward quickly, you should visit nursys.com and recover your whole license history by inputting the required information. After that, you must provide a notarized statement on official business letterhead stating that you worked as a Registered Nurse for at least 2,000 total hours. You should also provide the month and year you received each degree in your educational background. Finally, one must provide documentation of any national certificates earned, their related issue, and expiry dates. After gathering these things, you must send in your application with a payment of $125 for your first licensing, $160 for your prescriptive authorization, and $30 for temporary permission (Texas APRN Requirements, 2021). There may be several hoops to go through to get your license, but it will be well worth it in the long run.
Regulatory Requirements
The RN and APRN licenses must be current and in good standing at all times to be eligible for renewal. Suppose you want to renew your Texas nursing license every two years. In that case, you must complete 15 contact hours in your specialty area every time, plus an extra five contact hours in pharmacy-related areas linked to your specialty if you also have prescriptive power. The cost to renew an APRN license is $65, and that of an RN license is $100 every two years (Texas APRN Requirements, 2021). Many certifications have different criteria, so it is important to research your possibilities. For this study, I will focus on the Psychiatric Mental Health Nurse Practitioner – Board Certified specialty (PMHNP-BC). This certification costs about $300 each time it is renewed and expires after five years if it is not renewed.
Practice Authority
After working 6,240 hours under a collaborative practice agreement, having no holds on any nursing licenses in any jurisdiction, and holding a current prescriptive authority certificate, Advanced Practice Nurses in Texas are granted full practice. One must renew your certificate every three years for complete independent practice authorization. This implies that APRNs are qualified to assess and diagnose patients, order and interpret a wide range of diagnostic tests, and treat and manage any conditions or diseases they identify, including the administration of medicines.
Prescriptive Authority
APRNs have the authority to prescribe a wide range of drugs. Schedules II–V drugs and hydrocodone combination products, which were reclassified from schedule III to schedule II in 2014, are inside the APRN’s scope of practice for prescribing purposes. The following are examples of restrictions placed on the ability of APRNs to prescribe medicines. Prescriptions prepared by an APRN must include their DEA registration number. Suppose the patient does not already have a prescription for an opioid antagonist. In that case, the daily dosage is equal to or greater than 50 morphine milligram equivalents (MME), a benzodiazepine has been prescribed in the past or is prescribed in conjunction with the opioid, or the patient has a history of a substance use disorder, the APRN must prescribe an opioid antagonist and provide education on how to use the antagonist. This does not apply to hospice or end-of-life care. You should include in the patient’s medical record any concerns about whether or not providing this antagonist is in their best interest. The APRN should not prescribe Schedule II opioids for more than five days; if the patient still requires them beyond that time, a physician referral should be made. It is permissible for APRNs to write prescriptions for Schedule II stimulants if the following conditions are met: the patient’s original prescription was written by a physician; the patient’s physician must have evaluated the patient within six months of the APRN writing the prescription; the prescription is not for a new diagnosis; and the patient’s condition has not changed. APRNs are not allowed to write prescriptions for Schedule II drugs for themselves or their families. You must inform the Board of Nursing within seven days if you lose your prescriptive power. Two RNs working under an APRN’s supervision at any one practice site may be granted access to the PDMP (Justia US law, n.d.).
Nurse Practitioner Core Competencies
I went through the National Organization of Nurse Practitioner Faculties’ (NONPF) Core Competencies one by one, thinking about which ones I already excelled at and which still needed to work on. Knowledge of Practice, Patient-Centered Care, Population Health, Practice Scholarship and Translational Science, Quality and Safety, Interprofessional Collaboration in Practice, Health Systems, Technology and Information Literacy, Professional Acumen, and Personal and Professional Leadership are the ten pillars of the core competencies (AACN Essentials NONPF Nurse practitioner advanced-level nursing education, 2022). I will also discuss the research and reading I want to do to prepare me for my new role as a nurse practitioner.
Competency Areas that are Personally Strong
I used some self-reflection as I read through the Core Competencies to determine which ones I already felt confident in. I have a solid foundation in both client-centered care and business savvy. I have confidence in my abilities in these areas because I tailor my care to each patient’s specific needs rather than applying blanket policies, and I always do my research before acting on my findings. Good communication with patients and families is crucial, as is putting the patient first and listening to their concerns. I need to be well-versed in the rules and regulations pertaining to the nursing license I now possess and the advanced nursing license I want to get in the future.
Competency Areas Where There is Room for Growth
I recognize that I excel in certain areas, but I also know that there is always room for improvement and new insights to be gained. My weak spots lie in technology, information literacy, practice scholarship, and translational science. Since I have yet to start working as a nurse practitioner (NP), I still need to gain a firm grasp on the best available evidence in the field, and I am not entirely comfortable with technology in most facets of my life. I have the opportunity to develop in these areas. Thus, I want to devote extra time and effort to these topics throughout my education.
Scholarly Activities to Help Achieve NP Competencies
The American Association of Nurse Practitioners (AANP) and the American Psychiatric Nurses Association (APNA) are just two of the nursing organizations that I have examined and am contemplating joining in order to further my academic interests (APNA). I also want to start attending the nursing conferences often held in my region. Nevertheless, given that I reside in a more remote part of Texas, many of these events will take some time to get there.
Leadership Skills
Different leadership skills may be needed for an NP to lead in complex systems, and I plan to improve my Nurse Practitioner leadership skills in several ways. With a good leader, nurses can do their jobs better everywhere. To be the best mentor, you need to put in the time to learn how each of the nurses you are in charge of learns. This is important because you are in a unique position and must be careful to bring about the right changes on your team.
Three Leadership Skills Required to Lead in Complex Systems
Emotional intelligence, the ability to communicate effectively, and the ability to exert influence will be the three pillars of this discussion of leadership qualities. We would benefit greatly from developing and refining our Emotional Intelligence. Empathy, respect, self-awareness, and self-regulation are traits we can see in a person with high emotional intelligence (Scully, 2015). Next to confidence, communication skills are essential for every leader. Maintaining eye contact and speaking clearly and accurately are two of the most fundamental social skills. As a nurse leader, you need sophisticated verbal and nonverbal communication skills to improve patient outcomes. Prominence and influence are further hallmarks of advanced nursing practice. There are several ways in which nurses utilize their influence and authority to better their patients’ health and well-being, such as through creating supportive workplaces and setting an example of effective leadership.
Two Strategies to Help Develop NP Leadership Skills
I want to develop my potential as a nurse practitioner leader by participating in a wide range of experiences and courses. As a method, I want to learn from the examples of the leaders around me. Leaders include my superiors, my fellow NPs, and several coworkers and friends who stand out to me because of their eloquence in verbal and nonverbal exchanges (both verbal and nonverbal). One other option is to participate in conferences, both online and in person. As I learn best by seeing and then doing, these methods will prove invaluable as I work to become a more effective NP leader. If I want to succeed as a leader in my chosen field, I must first figure out how I learn best.
Conclusion
We have reviewed the definition of advanced practice nursing, its scope of practice, and the requirements for earning an advanced nursing degree. We covered how Advanced Practice Nurses in Texas may exercise full practice power, including prescriptive authority, provided they meet specific qualifications. As I prepare to become an Advanced Practice Registered Nurse in Texas, I reflected on my progress toward achieving the Nurse Practitioner Core Competencies and the strengths and opportunities for improvement I have encountered along the way. I also discussed the academic pursuits that will help me get there. We concluded our conversation by addressing the qualities of a leader and the methods I would use to develop those qualities to attain a leadership position within complex organizations.
References
Justia US law. (n.d.). 2011 Texas statutes: Occupations code: Title 3 – Health professions: Subtitle E – Regulation of Nursing: Chapter 305 – Ncsbn advanced practice registered nurse compact. Justia Law. https://law.justia.com/codes/texas/2011/occupations-code/title-3/subtitle-e/chapter-305/
Mack, F. P. (2023). Advanced practice registered nurse consensus model. Textbook for the Adult-Gerontology Acute Care Nurse Practitioner. https://doi.org/10.1891/9780826160799.0001b
Scully, N. J. (2015). Leadership in nursing: Recognising inherent values and attributes to secure a positive future for the profession. Collegian, 22(4), 439-444. https://doi.org/10.1016/j.colegn.2014.09.004
Texas APRN Requirements. (2021, September 21). APRN license requirements in Texas | How to become a nurse practitioner in TX. NursingLicensure.org – A more efficient way to find nursing license requirements in your state. https://www.nursinglicensure.org/np-state/texas-nurse-practitioner/
Texas Board of Nursing – Advanced practice information. (n.d.). Welcome to the Texas Board of Nursing Website. https://www.bon.texas.gov/practice_nursing_practice_aprninfo.asp.html
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