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Specific Information for Completing the Application for Authorization to Practice as an Advanced Practice Nurse

General Information:

There are two parts to the application labeled Part I and Part II, respectively. You must complete Part I in its entirety. Part II and an official transcript are used to verify your advanced practice nursing educational preparation. Part II should be completed by the Program Director. It is your responsibility to send Part II to the school and to request an official transcript be sent to the board office. The Program Director should send Part II directly to the board once it is completed. The program completion date listed on Part I must match the date listed on Part II of the application. If you are uncertain of your completion date, contact your Program Director prior to completing Part I of the application to confirm the date. The completion date is the date when the program/program director determines you have met all requirements and finished/exited the advanced practice nursing education program. If your advanced practice nursing education program is permanently closed, an appropriate designated official (such as the registrar) must complete Part II.

You are reminded that Parts I and II of the application are legal documents. The application, therefore, must be complete (all questions answered) and legible. Correction fluid (such as white-out) is not acceptable. If you make a mistake, place a single line through the error, make the correction, and place your initials by the correction. Applications that are incomplete, illegible, or appear to be altered by the use of correction fluid must be re-done before they can be approved.

Please Note: You must sign and date the bottom of Page 1 of the application. You must also legibly print your name and social security number on the top of page two of the application.

Instructions Relating to Specific Questions on the Application Form:

Questions 1 through 4:

Please print legibly or type your legal name, address, telephone contact information, social security number, date of birth, and RN license number. You must hold at least a current, valid temporary Texas RN license or a current, valid compact RN license. If you hold a current, valid Texas RN license (temporary or permanent), please list this number on the application. If you hold a current, valid compact RN license from a party state, please list the compact state and RN license number on the application and attach a photocopy of your compact RN license from the party state.

If you do not hold a current, valid RN license in Texas or a compact state, visit our web site at www.bon.texas.gov (available 24 hours/ 7 days) to apply. Questions regarding the RN endorsement process may be submitted via the webmaster (webmaster@bon.texas.gov) or you may telephone our office at (512) 305-6809 during regular business hours. If you are uncertain whether your RN license is from a compact state, you may find this information by visiting our website or telephone our office during regular business hours for assistance. (Please Note: Texas is not currently part of the compact for advanced practice registered nurses.)

If you hold a temporary Texas RN license, the application may be processed and you may be granted Interim Approval to practice in your advanced role and specialty for up to 120 days. However, the board will NOT grant provisional or full authorization to practice as an Advanced Practice Nurse until you are issued a permanent Texas RN license. If you have questions relating to the processing of your permanent Texas RN license, contact the Licensing Department at (512) 305-6809 during regular business hours.

Question 5:

Mark only one title per application. Your title must reflect the advanced practice role and specialty for which you were prepared by your advanced practice nursing education program. For example, if your program prepared you as a pediatric nurse practitioner, you must list this as your title. If you wish to be authorized for more than one title, you must submit a separate application, fee and supporting documentation for each title you request. Your title is determined by the role preparation and clinical focus of the advanced practice nursing education program of study. ( Please note: You must be prepared in a specific advanced practice role, i.e., nurse anesthetist, nurse practitioner, nurse-midwife or clinical nurse specialist). If you are a nurse practitioner or clinical nurse specialist, you must also list a specialty area based on your educational preparation (not your practice setting or patient population). Authorization to practice as an advanced practice nurse and titles cannot be granted based on your practice setting alone or based on national certification alone [refer to Rule 221.4(c) included in the application packet]. If none of the titles describe your educational preparation, please check "Other" and indicate the appropriate title (e.g., Emergency Nurse Practitioner)*. You must provide documentation that the advanced educational program included both didactic content and clinical experiences that focused in the clinical specialty area and that you have met ALL curricular requirements outlined in Rule 221.3. Course titles and course descriptions must reflect the appropriate role and specialty preparation, and the program must verify the specialty preparation through its written program information materials.

*Effective January 1, 2006, the board recognizes only certain titles for legal entry into advanced practice. The titles recognized by the Board are listed on the application form. If you checked "Other" and completed your program prior to January 1, 2010, you may be eligible for an exemption. Please refer to Rule 221.7(e)(1) for the titles that may be granted by exemption. If you are requesting a title that is an exempt title, please submit a written request for an exemption. The request must bear your original signature and indicate the title you are requesting. You must demonstrate that all other requirements for authorization to practice as outlined in current rules are met in order to be granted authorization to utilize an exempt title.

Question 6:

Specify the name and location (city and state) of the institution/school where you completed your advanced practice nursing education program for this role and specialty. If your institution/school has multiple campuses, please list the city and state for the campus where you attended classes.

The date of completion must specify at least the month and year that you completed your program. If you are completing the application in the same month that you completed your program, you must specify the month, day and year. (Please note: This date must match the date specified by your program director on Part II of the application).

Specify the length of your advanced practice nursing education program (in credit hours) and indicate whether it was a Certificate, Master's, or Post-Master's level program. (Please note: Rule 221.3(a) requires that the program be a post-basic advanced practice nursing education program). Rule 221.3 (c)(3) requires that the program be at least one academic year in length (approximately nine calendar months) and include a formal preceptorship. For applicants who completed their advanced practice nursing education programs on or after January 1, 2003, the advanced practice nursing education program must be at the master's degree level. Women's health nurse practitioners and nurse-midwives may be eligible for a waiver from the master's requirement [see Rule 221.7(d)]. If you are a women's health nurse practitioner or nurse-midwife requesting a waiver from the master's requirement, please submit a written request for the waiver. The request must bear your original signature. You must demonstrate that all other requirements for authorization to practice as outlined in current rules are met in order to be granted authorization to practice at any level.

Question 7:

Specify the name of the organization that accredited your program at the time you completed the program. If the program was not accredited by an organization recognized by the Texas Board of Nursing, please specify "none." Pursuant to Rules 221.3, relating to Education and 221.4, relating to Requirements for Full Authorization to Practice, the advanced practice nursing education program must be accredited by an organization recognized by the Board for all applicants who completed their programs after December 31, 1995.

The Board recognizes accreditation of advanced practice nursing education programs by the following accrediting organizations:

(Please note: If you have a question regarding whether the Board recognizes the organization that accredited your program, please e-mail us at apn@bon.texas.gov or call our office at (512) 305-6843 during regular business hours).

Question 8:

The Texas Board of Nursing recognizes specific certification examinations/certification maintenance processes offered by national certifying organizations as meeting the certification requirement for authorization to practice in each advanced practice role and specialty. Please review the list included in the application packet that provides information regarding the certification examination that is recognized as meeting the certification requirement for the title you requested.

If you completed your program prior to January 1, 1996 and you hold current national certification in your advanced role and specialty, please enclose verification of current certification (must show expiration date). If you do not hold current national certification, you may still be eligible for authorization to practice if you have met the requirements for program accreditation and educational preparation. Staff will determine if the requirements have been met when they review Part II of the application and your official transcript. If you do not hold current national certification in the advanced role and specialty, answer "No" to question number eight (8).

If you completed your program on or after January 1, 1996, you must provide documentation that you have met both the program accreditation requirement (refer to question number seven) and the requirement that you obtain national certification.

If you hold current national certification in your advanced role and specialty (as listed in question five), please enclose verification of current national certification (must show expiration date).

If there is no certification examination in your advanced role and/or specialty and the Board has not assigned an alternate examination, then you must submit a separate written statement requesting a waiver of the certification requirement. In order to waive the certification requirement, you must complete 1000 hours of documented supervised practice with an appropriate board-approved preceptor. The supervised preceptorship must be completed during a 12 month (consecutive) period following completion of your advanced practice nursing education program. Clinical hours completed in your program cannot be counted toward meeting this requirement. (Please note: Your preceptor must be approved by the board prior to beginning the supervised preceptorship). Forms for obtaining preceptor approval will be sent to you if you have been deemed eligible for the waiver.

Question 9:

If you anticipate employment within the next 30 to 60 days, we strongly suggest you request 120-Day Interim Approval by answering "Yes" to question number nine (9). Interim Approval will allow you to have temporary authorization to practice as an advanced practice nurse for up to 90 days. During this time period, you may practice in your advanced role and specialty while your application is being processed. Interim Approval is usually granted to eligible applicants within thirty (30) business days of receipt of Part I of the application and supporting documentation (documentation of current national certification and photocopy of compact RN license if applicable). (PLEASE NOTE: If board staff have reason to believe that you may not meet the requirements for full or provisional authorization, 120-Day Interim Approval will not be granted until evidence that you have met the requirement(s) in question is received and reviewed by staff). For example, if board staff have reviewed applications from previous graduates of your program and determined the curricular requirements were not met, 120-Day Interim Approval will not be granted until further clarification is received and reviewed by staff. You will be notified in writing if additional information is required before you may be granted 120-Day Interim Approval.

Question 10:

Prescriptive authority is not granted to advanced practice nurses automatically. If you wish to have your application evaluated for prescriptive authority at the same time it is evaluated for authorization to practice as an advanced practice nurse in the role and specialty indicated in question five, you should answer yes to this question and include the additional $50 processing fee for prescriptive authority. If you do not wish to have the application evaluated for prescriptive authority at this time, you may say no and skip to question number thirteen (13). Separate applications are available should you decide you need prescriptive authority in this role and specialty at a later time.

(Please Note: Prescriptive authority is specific to each advanced practice role and specialty. If you have not been granted prescriptive authority in the role and specialty for which you are applying, you will not be eligible to authorize or issue prescription drug orders while practicing in this role and specialty, even if you already hold prescriptive authority in another role and specialty).

Question 11:

Please list the clinical specialty area of practice in which you will utilize your prescriptive authority. Examples of clinical specialty areas include, but are not limited to, areas such as women's health, pediatrics, geriatrics, and family practice. (Please note: physical locations such as rural health clinic, hospital, or private physician's office are not acceptable). Please do not list your title when answering this question.

Question 12:

Clinical nurse specialists must provide documentation that they have completed separate, dedicated courses in advanced assessment, pathophysiology, pharmacotherapeutics, and medical diagnosis and management of diseases and conditions within the clinical specialty area in order to be approved for prescriptive authority. Each of these courses must be at least 45 clock hours (equivalent to three semester credit hours) in length and must be a graduate level academic course from an accredited institution. In the blank provided, please indicate the course number and title for the course that you completed in medical diagnosis and management. Official transcripts and course descriptions from the program(s) that provided these courses are required (refer to Rule 222.2). (Please note: These courses are required for clinical nurse specialists seeking prescriptive authority regardless of when they completed their programs).

Current Board policy states that clinical nurse specialists in psychiatric/mental health nursing who hold national certification in this role and specialty from the American Nurses Credentialing Center will be considered to have met course requirements for pathophysiology and medical diagnosis and management of diseases and conditions within the clinical specialty area. Clinical nurse specialists in psychiatric/mental health nursing must still provide official transcripts and course descriptions verifying that they have completed courses in advanced assessment and pharmacotherapeutics that meet the above specified criteria.

Question 13:

You must declare one state as your primary state of residence. Rule 220.1(3) defines primary state of residence as "The state of a person's declared fixed permanent and principal home for legal purposes; domicile." This is generally the state where you have your driver's license, vote, and pay taxes. You may have only one primary state of residence. (Please note: If Texas is your primary state of residence, you must possess a Texas RN license to be eligible to apply for advanced practice authorization).

Question 14:

Please indicate the state(s) in which you intend to practice upon authorization to practice in the State of Texas.

Questions 15 through 19:

Please review these questions very carefully. If you answer "YES" to one or more of the questions 15 - 19, you must attach a letter of explanation indicating the circumstance(s) you are reporting to the Texas Board of Nursing. The letter of explanation must be signed and dated. If it is determined that the issue being reported to the BON meets the criteria for opening a case according to our current rules, you may be required to pay additional review fees (up to $189). Once we have a complete application, required documents and the fee, if applicable, your file will be transferred to our Enforcement Department for review. This review may take a minimum of three months. The BON will not approve an applicant for licensure at any level or issue Interim Approval to practice as an advanced practice nurse until a decision has been rendered by the Enforcement Department.

For those applicants with a compact RN license: Please note that eligibility requirements may vary slightly from one state to another. Each board of nursing makes eligibility determinations based on its Nursing Practice Act and other laws and regulations governing professional licensure in the specific jurisdiction. Because laws and regulations can and do vary from one state to another, it is possible that boards of nursing will have different determinations regarding the same issue. Therefore, you should not presume that determinations regarding eligibility issues previously rendered by other boards of nursing will be the same determination rendered by the Texas Board of Nurse Examiners.

Question 20:

In order to receive authorization, Rule 221.4a(3) requires that you have completed 400 hours of current practice in the advanced role and specialty area within the preceding biennium (two years). Current practice is defined as "Maintaining competence as an advanced practice nurse by practicing in the advanced role and specialty in the clinical setting, practicing as an educator in the clinical and/or didactic portion of an advanced educational program of study, or practicing as a consultant or an administrator within the advanced specialty and role [Rule 221.1(7)]". Practice hours must be in the advanced practice role. Practicing at the RN level does not meet this requirement. Teaching in a basic nursing program (ADN, diploma, or BSN) does not meet the advanced practice requirement. You do not need to send verification of your practice hours unless you are asked to do so. The board reserves the right to audit any applicant for compliance with this requirement, and we will ask for this information if you are audited. (Please note: If you are applying for authorization to practice within 24 calendar months of your program completion date, you are deemed to have met this requirement and may answer "yes" to this question).

If you cannot answer "yes" to this question, you are not eligible to apply for authorization to practice at this time. Please contact our office at (512) 305-6843 during normal business hours and staff will assist you in determining what requirements must be met prior to completing the application.

Question 21:

In order to receive authorization, Rule 221.4a(4) requires that you have completed 20 contact hours of continuing education in the advanced role and specialty area within the preceding biennium. [For questions related to CE activities, please refer to Rule 216. 3(3), available on the board's web site at www.bon.texas.gov]. The board reserves the right to audit any applicant for compliance with this requirement, and you will be required to submit documentation verifying that you have met the CE requirement if you are selected for an audit. Do not send this documentation unless requested to do so. (Please note: If you are applying for authorization to practice within 24 calendar months of your program completion date, you are deemed to have met this requirement and may answer "yes" to this question).

If you cannot answer "yes" to this question, you are not eligible to apply for authorization to practice at this time.