Nurse Practitioner Scope of Practice: Texas
Ahh, the Lone Star State, famous for it’s spirit of pride and freedom, the Alamo and the invention of Dr Pepper. Among the lesser known facts about Texas is that it is home to nearly 10,000 nurse practitioners. Does Texas’ independent attitude extend to state laws governing NP’s?
Nurse practitioners in Texas do not enjoy as many freedoms as NP’s in many other states. In fact, Texas falls at the lower end of the spectrum regarding the freedoms it offers nurse practitioners. Let’s take a look at the laws governing nurse practitioners in the Lone Star State.
Texas’ Nurse Practitioner Supervision Laws
Despite attempts from nursing organizations to advocate for independent practice laws, nurse practitioners in Texas must work under physician supervision. In 2009 and 2011, nursing organizations lobbied to change these laws but were unsuccessful largely as a result of physician protest. Nursing organizations plan to again request changes to nurse practitioner supervision statutes sometime in 2013.
For the time being, nurse practitioners must practice under physician supervision. The nurse practitioner must practice within 75 miles of the supervising physician. Physicians may not supervise more than four nurse practitioners at one time. The supervising physician must also ramdomly review at least 10 percent of the nurse practitioner’s patient charts each month.
Texas’ Nurse Practitioner Prescribing Laws
Consistent with strict supervision guidelines, nurse practitioners in Texas are allowed to prescribe only under physician supervision. Furthermore, they may only prescribe a 30 day supply of medications and are not allowed to prescribe schedule 2 drugs such as Lortab or Adderall. All prescriptions written by the nurse practitioner must include the supervising physician’s name, address, DEA number and phone number.
Other NP Scope of Practice Laws
Nurse practitioners in the Lone Star State are not allowed to signs death certificates or handicap parking permits. They are, however able to sign worker’s comp claims and be officially named primary care providers.
The scope of practice for nurse practitioners in Texas is limited. In keeping with the state’s attitude of independence these rules and regulations will hopefully change in the future. For now, NP’s practicing in Texas are subject to laws requiring strict physician supervision in prescribing and practice.