In Texas, nurse practitioners (NPs) operate under a restricted practice model, meaning they must work under a supervisory or collaborative agreement with a physician to provide patient care. The Texas Board of Nursing regulates NPs and mandates specific licensure and certification requirements. To be licensed in Texas, NPs must complete a graduate-level NP program accredited by a national nursing accrediting body and obtain national certification in their specialty area. Additionally, Texas NPs are required to complete continuing education to maintain their certification and licensure. Prescribing privileges in Texas are also restricted, requiring NPs to have a written agreement with a supervising physician to prescribe medications, including controlled substances, which are limited by the Texas Medical Board and the Texas Board of Nursing (AANP, 2024a).
In contrast, Oregon offers a full practice environment for NPs, allowing them to evaluate patients, diagnose, interpret diagnostic tests, and initiate treatments, including prescribing medications and controlled substances, independently of physician supervision. The Oregon State Board of Nursing governs NP licensure and certification, requiring NPs to complete an accredited graduate or doctoral NP program and obtain national certification. The educational prerequisites ensure that NPs in Oregon are well-prepared to practice independently. Oregon’s full practice authority significantly enhances NPs’ ability to deliver comprehensive care, as they can exercise their full clinical training and expertise without mandatory physician oversight (AANP, 2024b).
The differing regulatory environments between Texas and Oregon highlight the impact of state laws on NP practice. In Texas, the restricted model imposes limitations on practice autonomy and prescriptive authority, potentially affecting the efficiency and breadth of care NPs can provide. On the other hand, Oregon’s full practice model empowers NPs to utilize their full skill set, which can improve access to healthcare, particularly in underserved areas. Understanding these regulatory landscapes is crucial for NPs to navigate their professional responsibilities and maximize their contribution to patient care (AANP, 2024c).
Question: What are the potential benefits and challenges of implementing full practice authority for nurse practitioners across all states in the U.S.?
References
American Association of Nurse Practitioners. (2024a). State practice environment.
https://www.aanp.org/advocacy/state/state-practice-environment
American Association of Nurse Practitioners. (2024b). State advocacy.
https://www.aanp.org/advocacy/state
American Association of Nurse Practitioners. (2024c). Practice information by state.
https://www.aanp.org/practice/practice-information-by-state
