Barriers to Practice as an Advance Practice Nurse in Texas
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Barriers to Practice as an Advance Practice Nurse in Texas
APRNs cannot practice the full scope of their knowledge and training in most parts of the United States because of the restrictions imposed on them. Schirle et al. (2020) define APRNs are registered nurses (RNs) with advanced education and training, typically a master’s or doctoral degree, who can assess, diagnose, and treat patients and whose scope of practice is defined by variable state-based practice regulations. Major barriers to their practice include federal policies, state laws, institutional practices and culture, and outdated insurance reimbursement models (Altman, Butler, & Shern, 2016). Other barriers include poor administrator relations, poor physician relations, and others’ lack of understanding of the APRN role (Schirle et al., 2020).
The restrictions imposed on nurses are also experienced in Texas. In Texas, APRNs are not allowed to use the full extent of their education, experience, and credentials. For instance, they cannot practice independently but under physician supervision, prescribe schedule two drugs, or sign death certificates or handicap permits (Wofford, 2019). Health advocators have been fighting for APRNs to be allowed full practice authority (FPA) in Texas and the US at large but to no avail. For instance, House Bill 1792 has been proposed to allow nurse practitioners with at least 2,080 hours under the delegation of a physician to practice independently. TNP’s 2021 Legislative Agenda pushed to protect, promote, and advance the nurse practitioner profession in Texas for better healthcare provision (Wofford, 2019). Representative Donna Howard has been active in advocating for better nursing practice at both states (Texas) level and the federal level. Advocacy still forms a potent approach toward granting APRNs full practice rights.
References
Altman, S. H., Butler, A. S., & Shern, L. (Eds.). (2016). Assessing progress on the Institute of Medicine report The Future of Nursing.
Schirle, L., Norful, A. A., Rudner, N., & Poghosyan, L. (2020). Organizational facilitators and barriers to optimal APRN practice: An integrative review. Health care management review, 45(4), 311.
Wofford, P. (2019). Texas Nurse Practitioners Fight for Full Practice Authority. nurse.org. https://nurse.org/articles/texas-nurse-practitioners-fight-for-practice/