Nur 635-APRN Prescribing Practice in Texas Essay

Nur 635-APRN Prescribing Practice in Texas Essay

Nur 635-APRN Prescribing Practice in Texas Essay

Nurse Practitioners (NP) provide services in rural and underserved settings as compared to physicians. However, different state regulations limit their ability to fully serve the patient. For instance, APRNs have limited prescriptive authority, depending on the regulations set by the board of nursing of the given state (Phillips, 2019). In Texas, there are two main limitations for APRNs concerning their prescriptiveprivileges. The first limitation is that a physician must delegate the prescriptive authority to APRNs through a written document required by the law, “the Prescriptive Authority Agreement (PAA)”. The second limitation is related to the restriction of prescribing a controlled substance.

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As outlined in the Texas Medical Board (TMB) Rule 193.7 and the Texas Board of Nursing (BON) Rule 222.5, several requirements must be met by APRNs to qualify for prescriptive authority. First, the practitioner must have a full and active APRN license that was issued by the BON (Klein, 2021). The APRN must also acquire a valid prescriptive authority number from the BON. The nurse must also be in good standing, and disclose any past or present disciplinary actions against the practice license. Once approved to enter PAA, the APRN is required to immediately notify the TMB for physician investigative purposes. The prescriptive privilege is however restricted to the state of practice.

When in a different state, and a family member decides to ask you to refill her levothyroxine, as an APRN, it is necessary to acknowledge that prescribing across state lines entails three main laws, federal law, state law, and scope of nursing practice law (Phillips, 2019). All these laws have different regulations which restrict prescriptive practice across state lines. As a new prescriber, guidelines for prescribing out of state prohibit the filling of prescriptions written by APRNs licensed out of state.


Klein, T. (2021). Regulation of Prescriptive Authority. The Advanced Practice Registered Nurse as a Prescriber, 45.ISBN: 978-0-813-80524-5

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Phillips, S. J. (2019). 31st Annual APRN legislative update: improving state practice authority and access to care. The Nurse Practitioner44(1), 27-55.

Depending on the board of nursing in your state, there may be additional requirements to become a prescriber after you complete your APRN program. For example, those who are being licensed/practicing in California are required to take an additional 3-hour pharmacology course for prescribing privileges. Describe the necessary steps required, for your state (TEXAS), in order to become a prescriber? Hypothetically, after you have completed these steps, you decide to celebrate on a family vacation in a different state. Your sister asks you to refill her levothyroxine because she forgot to pack her medication. What are the legal and ethical implications in your state as a new prescriber?

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