Texas grants first nurse practitioner full practice authority

By | 2020-04-15T16:42:44-04:00 July 26th, 2017|11 Comments

According to an Amarillo Globe-News article published June 7, a nurse practitioner has been granted full practice authority in the state of Texas.

Charlene Seale is a certified nurse practitioner at the Thomas E. Creek VA Medical Center in Amarillo.

“I felt very fortunate,” Seale was quoted as saying, about being chosen as the state’s first NP to have full practice authority. “So now we are working with the other 31 nurse practitioners to put them through that same application process and hope to have them through the process by the end of the summer.”

The article went on to say that “though the private sector in Texas is not eligible to grant full practice authority to NPs, the U.S. Department of Veterans Affairs gave its healthcare systems the ability to do so in December 2016. The Amarillo VA Healthcare System was the first to take this step.”

A June 4 Forbes article looked at the demand for nurse practitioners and at states that are lifting hurdles.

“With the rise of full practice authority in 22 states and the District of Columbia, more patients than ever have direct access to high-quality nurse practitioner care in every setting – including the veterans’ health system,” said American Association of Nurse Practitioners then-president Cindy Cooke, DNP, FNP-C, FAANP, in an AANP press release.

“There are several states also considering full-practice authority, such as North Carolina and Pennsylvania, the AANP said,” according to the Forbes article “The state activity follows last year’s decision by the Department of Veterans Affairs to grant direct access to advanced practice registered nurses,” the article stated.

According to the Department of Veterans Affairs document, published in the Federal Register on December. 14, 2016, “the Veterans Health Administration payroll data revealed that, as of August 31, 2016, VHA employs 940 physician anesthesiologists (physicians), 5,444 nurse practitioners, 937 CRNAs and 386 nurse specialists. Nurse practitioner is currently No. 3 in the top 5 difficult to recruit and retain nurse specialties.”

Meanwhile, the AANP announced in early June that there are more than 234,000 licensed nurse practitioners in the country.

“The NP role continues to attract attention and gain recognition with its fourth consecutive appearance on the U.S. News and World Report list of The 100 Best Jobs, this year ranking second,” said Cooke in the press release. “We are proud of the high-quality, patient-centered care that nurse practitioners provide their patients. The demand for these exceptional healthcare providers has never been greater,” she added.

In March, a Nurse.org article looked at states such as Oklahoma, which recently granted nurse practitioners authority to write prescriptions, and South Dakota, which just granted full autonomy to them.

“The nationwide legislative grapevine is sending signals that Massachusetts, Pennsylvania, North Carolina, and several other states are also considering loosening up restrictions on nurse practitioners,” the article stated. “It can now be easily predicted that we will eventually see the majority of states in the U.S. granting complete autonomy to nurse practitioners.”

A related article from Nurse.org cited a U.S. News and World Report “Best Jobs Rankings for 2017” as gauging nurse practitioner as the No. 2 best job in the U.S.

“All in all, healthcare is a consistent growth industry that dominates the good news in terms of jobs in the United States, with pharmacists sailing above the rest at No. 1, and advanced practice registered nurses (APRNs) demonstrating a consistently strong showing in general,” the article stated.

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About the Author:

Sallie Jimenez
Sallie Jimenez is content manager for healthcare for Nurse.com from Relias. She develops and edits content for the Nurse.com blog, which covers industry news and trends in the nursing profession and healthcare. She also develops content for the Nurse.com Digital Editions. She has more than 25 years of healthcare journalism, content marketing and editing experience.


  1. Avatar
    SILAS ORIEDO July 31, 2017 at 6:36 am - Reply

    Great.am a registered nurse in Kenya.happy to note that Nursing is gaining the respect it deserves.

  2. Avatar
    Charlene Seale August 4, 2017 at 1:51 pm - Reply

    Great to know the news is reaching far and wide. Nursing is a wonderful profession. So fortunate to be a nurse, I have received much more from the profession that I have given. It is truly a joy.

    • Avatar
      Angelina May 22, 2019 at 9:52 pm - Reply

      Ms. Seale,

      A Great Big Congrats! That is a big step for APRNs.

      If you don’t mind me asking Since you got “full practice authority”. Are there any restrictions to this APRN approval?

      Has anything changed since you got this distinction?

      Can you only work for VA hospitals?


  3. Avatar
    Konstance Cook-Withers October 11, 2017 at 12:18 am - Reply

    I’m a Californian,
    However, we all need to rally as one voice to lift the legislative restrictions imposed upon us in our individual states that would begin allowing us to practice without restrictions to the full extent of our education and training. This can begin with educating the community and legislative powers about the role of the NP and the benefits that can be afforded to the community as NP’s begin to work under the full extent of their licensure, accreditation, certification, and education. Let’s all unite in this effort.

  4. Avatar
    Leslie August 23, 2018 at 11:57 pm - Reply

    Interesting that the further you go below the Mason Dixon line, the less authority NP’s have to practice the medicine we were educated and trained to practice. I’m surprised we (women) are even allowed to vote. in Texas. Seriously. We need to stand up, push back, and fight for the right to do our job to it’s fullest. Our abilities, education, skill, and success as providers have been proven repeatedly. This is about the AMA bullying nurses out of fear. Physicians are being held accountable now, NP’s are doing an excellent job in medicine, and patients often prefer (we have the studies) NP’s.

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    Huru October 1, 2018 at 7:59 pm - Reply

    this distinct honor should not be allowed to the new grad I would add… I am in a FNP program with over 20 years bedside nursing experience by the way… the new NP does not have the competency to practice and needs to develop their expertise. this is because we do not have a “residency” program… we are taught to primarily research articles and write papers…

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    Nurse Rechett April 5, 2019 at 12:02 pm - Reply

    Somehow equating getting the vote to being expected to have the full rights and benefits of an MD is nonsense. NPs fill a very valuable role as a secondary provider, period. NPs practicing with zero MD oversight is negligent at best. To even try to equate the level of training (and clinical hours) that an MD receives vs an NP is well, plain negligent as well….don’t even get started on the DNPs who are clearly and never will be “doctors” and marketing yourself as one is pure false advertising. While NPs supplementing physicians and having physician oversight is a well balanced relationship, an NP with pure autonomy is dangerous and of course the government would do it first, further showing how poorly veterans are treated. I myself can identify 2 occasions where NPs have provided me poor care (I’m just 40) as well as two anecdotal stories from my parent where in one case had they listened to the NP it likely would have killed them, and this was an NP specializing in just one field. The NP refused to do another stress test as my parent had just had one six months prior. Had he not known his own body (having had 3 heart attacks and over 10 stents already) and insisted, the 95 percent blockage would have killed him. There is a place for NPs in care for patients, but lets please put them in their proper place and NPs PLEASE stop thinking you’re a doctor…you’re not, you’re a nurse with advanced credentials and far, far, far, far less clinical hours then any MD.

    • Avatar
      Angel May 22, 2019 at 10:04 pm - Reply

      Nurse Rechett,

      I’m so sorry that you had a bad experience, we don’t know the full details of your story. But I have been to many, many, many Advance Nurse Practitioners and I have yet to meet one that has not been able to provide excellent medical care to my family, my parents and myself.

      As of this date, we see the primary physician maybe once a year. Which is fine, because we absolutely love the excellent medical care that our doctor’s office nurse practitioners provide and we trust them with our medical needs 110%.

  7. Avatar
    Robert Hernandez September 25, 2019 at 11:37 am - Reply

    Texan NP to Nurse Rechett: I’m sorry but i disagree with you in the use of the term “Doctor” I sacrificed and put in the time to receive my doctorate. That being said…. I’m sorry Medical Doctors or the American Medical Association have not trademarked or cornered the market on the title of Doctor. Just as MD write their credentials Dr. John Do, M.D. to identify they are a medical doctor the same is true of an NP. So yes my cards say Dr. with my name followed by my degree DNP, as well as both my NP credentials. So it’s not that we are trying to be medical doctors, we are a specialty practice, so if you want to wait for only an MD to see you good luck. AS far as receiving subpar care from the NPs in your area not all NPs are the same and would gladly thank you for not lumping all NP together based on your experience.

  8. Avatar
    LAZARUS April 2, 2020 at 2:15 pm - Reply

    WE NEED TO FIGHT AND FIGHT …………..WE Texas Nurse Practitioners NEED TO Fight for Full Practice Authority…………

  9. Avatar
    Marlowe A Driscoll August 21, 2020 at 8:18 pm - Reply

    Robert Hernandez;
    I am very thankful for your comments, the training I am receiving is intense, my M.D. friends tell me my classes are covering the same exact classes they had to take. Please realize Nurse Rechett, Nurses have years of bedside care before they become Advanced Practice Nurses. Physicians see a patient for just a few minutes and then develop the plan of care. Both professions are competent in the quality of patient care. I am proud to say I am opening a clinic for the patient with addiction issues, frankly, how many M.D.’s do see taking on this specialty. This population falls in the category of health disparity, this is one of the reasons why we trust in Advanced Practice Nurses, as we are willing to take care of patient populations that are underserved. I believe everyone deserves a chance of good health.

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