Practice Must Include Medical Utrgv Np Legal Scop

Practice Must Include Medical Utrgv Np Legal Scop

Practice Must Include Medical Utrgv Np Legal Scop






1) Discuss the NP’s legal scope of practice in relation to other care providers.

2) Identify and discuss the form of physician involvement practiced in your state.


ANPs Legal Scope of Practice in Relation to Other Providers

Nurse practitioners are one of four APRN professionals prepared through a graduate level program and licensed through their individual state. “The American Association of Nurse Practitioners (AANP) defines full practice authority (FPA) as those who evaluate patients; diagnose, order and interpret diagnostic tests; and initiate and manage treatments, including prescribing medications and controlled substances, under the exclusive licensure authority of the state board of nursing” (Vacek & Vukovic, 2019, p. 131). Like NPs, physician assistants (PA) have prescriptive authority based on state laws. In some states, PAs need physician supervision to prescribe controlled substances, while in others, they do not. One major difference for NPs, however; is that some states allow practice autonomy, granting full authority to prescribe controlled substances without physician supervision (Timmons, 2017).

Form of Physician Involvement in Texas

NPs were granted the ability to prescribe medications over thirty years ago, however; the level of authority varies across all fifty states. The highest level of prescriptive authority is the ability to prescribe without physician supervision (Vacek & Vukovic, 2019). In Texas, nurse practitioners are unable to prescribe without delegation of authority or physician supervision. Some of the requirements include a collaborative agreement between providers, monthly quality assurance meetings to discuss and consult on cases, and all physician information on the prescriptions. There is no longer a minimum requirement of distance, however; the physician needs to also be licensed in the state of Texas and available as needed to the NP. Also, the physician may not have more than seven fulltime APRNs under their license unless they are in a hospital facility or in medically underserved communities (Texas Board of Nursing, n.d.).


Timmons, E. (2017). The effects of expanded nurse practitioner and physician assistant scope of practice on the cost of Medicaid patient care. Health Policy, 121(2), 189-196. doi:

Texas Board of Nursing. (n.d.). Frequently Asked Questions – Advanced Practice Registered Nurse. Retrieved January 18, 2021, from

Vacek, L., & Vuckovic, K. (2019). Pharmacotherapeutic Preparation for Nurse Practitioner Full Practice Authority. The Journal for Nurse Practitioners, 15(7), 131-134. doi:


1. Discuss the NP’s Legal Scope of Practice in Relation to Other Care Providers.

As license nurse practitioners (NPs), we coordinate with other healthcare professionals and other individuals. The NP scope of practice, on the other hand, includes a wide range of health care services not limited to, assessment; ordering, interpreting diagnostic and laboratory tests and supervising, but includes medical diagnosis and treatment, prescription medication, management of acute, chronic, and complex health problems, health promotion, disease prevention, health education, and counseling to individuals, families, groups, and communities. We may also serve as health care researchers, interdisciplinary consultants, and patient advocates.

The NP role is consistent with the APRN consensus model practicing in the population of family, pediatrics, women’s health, adult-geriatrics, neonatal, and psychiatric mental health. The scope of practice is not setting specific but rather based on the needs of the patient (Buppert, 2018). According to the Texas Board of Nursing, advanced practice’s scope evolves through experience, knowledge acquisition, evidence-based practice, technology development, and changes in the health care delivery system (Texas board of nursing, 2021).

The scope of practice varies only slightly between a nurse practitioner (NP) and a physician. In full practice regions, NPs can practice independently without mandated oversight or supervision of the physician; but in relation to a restricted state like Texas, NPs have a limited scope of practice and must collaborate with the physician. Often the most significant difference between the NP and a physician is that a physician is permitted to diagnose and prescribe treatment. In contrast, nurse practitioners must remain within their medical specialty. An advanced practice nurse (APN) can make limited diagnoses, but only under a physician’s delegation of prescriptive authority and pursuant to a physician’s supervision. On the other, the physician assistant scope of practice must include medical services delegated by a supervising physician within the education, training, and experience of the physician assistant. (Texas Medical Associate, 2021).

2. Identify and Discuss the Form of Physician Involvement Practiced in Your State.

Texas is under a restricted practice state, which means the state practice and licensure law restricts a nurse practitioner’s ability to be fully operational without a physician’s collaborative effort. The Texas board of nursing requires supervision, delegation, or team-management by a physician for the NP to provide patient care. Hence, there must be a collaborative agreement between the physician and advance nurse practitioner in delivering health care services. These may include but are not limited to protocols or written authorization in order to exercise professional judgment by the APN appropriate with his/her experience and education.


Buppert, C. (2018). Nurse Practitioners Business Practice and Legal Guide (6th ed.). Burlington, MA: Jones & Bartlett Learning.

Texas Medical Association (TMA). (2021). Delegation of Physician to a Non physicians. Retrieved from

Texas Board of Nursing. (2021). APRN Scope of Practice. Retrieved from