How to Become an FNP in Texas
July 27, 2021Family nurse practitioners (FNPs) are needed nationwide, and if you're wondering how to become an FNP in Texas, you're in good company. The supply of Texas nurse practitioners is lagging and projected to leave 25% of the demand unmet by 2030.
By becoming an FNP in Texas, you'll have a rewarding career while improving access to primary care.
Use this blog to find out how. Plus, explore why so many FNPs choose to build their careers in the Lone Star State.
What is an FNP?
Before covering how to become an FNP in Texas, let's explore the FNP role.
An FNP is a licensed advanced practice registered nurse (APRN) who delivers various primary care services to patients of all ages. To become an FNP, you must hold a Registered Nurse (RN) license and a Bachelor of Science in Nursing (BSN).
The FNP role emphasizes health promotion and disease prevention. However, FNPs are also prepared to manage acute and chronic illnesses throughout the lifespan. During a typical workday, an FNP might:
- Conduct history and physical exams
- Order, perform and interpret diagnostic tests
- Develop treatment plans for illnesses, conditions and injuries including prescribing medications
FNPs practice in health care settings that deliver primary care. Many work in hospital outpatient clinics, private practices, public health departments, school-based clinics and federally qualified health centers.
More NPs are certified in family health than any other specialty. Approximately 7 in 10 hold an FNP certification.
Why Become an FNP in Texas?
Texas is a fantastic place to become an FNP. It offers a promising career outlook with high employment demand and salary potential.
Employment Outlook
Texas has the 10th highest job growth rate for NPs in the country. The U.S. Bureau of Labor Statistics (BLS) projects that Texas NP employment will grow by roughly 32% between 2018 and 2028.
Why is the demand for NPs so high? The Texas Hospital Association credits several factors, including:
- Chronic Illness: More Americans than ever are experiencing chronic diseases.
- Population Growth: The population of Texas is growing twice as fast as the national average.
- Primary Care Shortage: The state's shortage of primary care physicians means 40% of Texas counties have unmet primary health care needs.
Together, these circumstances have created an enormous need for primary health care providers in Texas. Fortunately, FNPs are qualified to fill the gap.
FNPs are educated to deliver primary care to patients across the lifespan. That means they can expand primary health care access to millions of Texans.
Salary Outlook
Earning potential is another benefit of becoming an FNP in Texas.
Texas is the 15th highest-paying state for NPs. The average NP salary is $116,700, and the top quarter takes home an average of $131,210. Both of these figures exceed the national mean NP income of $114,510.
FNPs can earn more in certain regions of Texas. Here are the 13 areas where the average NP salary is higher than the national average.
- Coastal Plains Region: $140,540
- Abilene: $127,760
- Laredo: $126,370
- Houston-The Woodlands-Sugar Land: $125,810
- Midland: $123,470
- West Texas Region: $122,610
- Brownsville-Harlingen: $121,050
- Border Region: $120,230
- Waco: $119,710
- Texarkana: $118,660
- Dallas-Fort Worth-Arlington: $116,740
- North Texas Region: $116,530
- San Angelo: $115,260
- Learn more about nurse practitioner salary.
What is the FNP Scope of Practice in Texas?
The scope of FNP practice varies by state, depending on the practice and licensure laws.
According to the American Association of Nurse Practitioners (AANP), state practice environments for NPs fall into three categories:
- Full Practice: State practice and licensure laws permit NPs to practice to the full extent of their education and training.
- Reduced Practice: State practice and licensure laws require NPs to deliver patient care under a collaborative agreement with another health care provider or "limit the setting of one or more elements" of NP practice.
- Restricted Practice: State practice and licensure laws require NPs to deliver patient care under the supervision of another health care provider.
Texas is one of 11 states that permit NPs restricted practice authority.
FNPs in Texas practice under the supervision of a physician. They must follow protocols jointly developed with the supervising doctor and may apply for prescriptive authority through the Texas Board of Nursing (BON).
However, Texas NPs are actively working to expand their scope of practice.
According to Texas Nurse Practitioners (TNP), the professional association for Texas NPs, the state legislature is considering several bills that would loosen restrictions on prescriptive authority and death certificate signature authority.
If you want to become an FNP in Texas, follow TNP for updates on legislation that will affect your future practice.
How to Become an FNP in Texas in Six Steps
Now that you understand the FNP role and career outlook, let's review how to become an FNP in Texas.
The six steps
- Earn a bachelor's degree in nursing.
- Obtain RN licensure in Texas.
- Complete an accredited FNP education program.
- Obtain FNP national certification through examination.
- Get licensed as a Texas FNP.
- Find employment.
This process is rigorous but will lead to a satisfying career treating patients across the lifespan as a family nurse practitioner.
Step #1: Earn a Bachelor's Degree in Nursing
Completing an accredited Bachelor of Science in Nursing (BSN) program is the first step in how to become an FNP in Texas.
Why earn a BSN? The American Association of Colleges of Nursing (AACN) advocates for all RNs to be prepared with a minimum of a bachelor's degree in nursing.
It points to research that links nursing education at the baccalaureate level and above to:
- Lower mortality rates
- Fewer medication errors
- Better patient outcomes
Another reason to earn a BSN is that most FNP programs require it for admission. Earning your BSN will help you become an FNP in Texas faster than starting the process with an Associate Degree in Nursing (ADN).
Step #2: Obtain RN Licensure in Texas
Once you've completed your BSN, your next step toward becoming an FNP in Texas is to obtain RN licensure. All APRNs must hold and maintain RN licensure.
The Texas BON requires FNPs to be licensed as RNs in Texas or another state in the Nurse Licensure Compact.
Here's how the RN licensure process works in Texas if you apply as a new nurse through examination:
- Apply for RN Licensure with the Texas BON
First, complete an online application to become an RN in Texas. The application includes a criminal background check and a processing fee. - Register for the NCLEX-RN
The NCLEX-RN is the national RN licensure exam. Register for the exam online through Pearson Vue. - Take the Texas Nursing Jurisprudence Examination
In Texas, RN licensure candidates must pass an exam covering the Texas Nurse Practice Act and the BON Rules and Regulations. You can register for and take the exam online. - Receive NCLEX-RN Eligibility Decision
The Texas BON will determine whether you're eligible to take the NCLEX-RN after receiving your:- RN licensure application and fee
- Criminal background check results
- Passing score for the Texas Nursing Jurisprudence Examination
- Proof of graduation from an RN education program
- Take the NCLEX-RN
Follow the instructions you receive from Pearson Vue to schedule and take the NCLEX-RN. You must sit the exam within a year of registering with Pearson Vue. - Receive Your NCLEX-RN Results
You'll receive your NCLEX-RN results from the Texas BON within six weeks of the exam date. In 2020, 9 in 10 baccalaureate-prepared candidates passed the exam.
Do you already hold RN licensure in another state? If so, you'll apply for Texas RN licensure through endorsement.
The endorsement process includes an application, a criminal background check, processing fee and the Texas Nursing Jurisprudence Examination. Applicants for Texas RN licensure by endorsement do not have to take the NCLEX-RN again.
Step #3: Complete an Accredited FNP Education Program
Texas-licensed RNs are ready for the next step toward becoming an FNP in Texas, which is to complete an accredited FNP education program.
Colleges and universities offer FNP programs at the master's degree, doctorate and post-graduate certificate levels. Doctoral programs are ideal for aspiring FNPs seeking terminal nursing education. Post-graduate certificate programs are geared toward candidates who already have a master's in nursing.
If you have a BSN only, then the fastest way to become an FNP in Texas is to pursue a master's-level FNP program. Most can be completed in 18 to 24 months of full-time study.
Whichever program you choose, be sure the curriculum has the following components required by the Texas BON:
- Preparation in the core competencies for the FNP role.
- Three separate courses in advanced health assessment, advanced pharmacology and advanced physiology and pathophysiology.
- Content about the legal, ethical and professional responsibilities of APRNs.
- A minimum of 500 hours of supervised clinical experience directly related to the FNP role and population, including the pharmacotherapeutic management of patients.
What is the Importance of Accreditation?
The accreditation status of your FNP program is essential.
Accreditation demonstrates that the program meets the minimum standards of preparation for FNP practice. That's why graduating from an accredited FNP program is an eligibility requirement for FNP certification exams and state APRN licenses.
Two agencies accredit FNP programs: the Commission on Collegiate Nursing Education (CCNE) and the Accreditation Commission for Education in Nursing (ACEN). Graduates of both types of accredited programs are eligible to become FNPs.
Step #4: Obtain FNP National Certification through Examination
After graduating from an accredited FNP education program, you'll be prepared to obtain FNP national certification.
Texas FNPs must be credentialed by one of two approved certifying bodies: the American Association of Nurse Practitioners Certification Board (AANPCB) or the American Nurses Credentialing Center (ANCC).
Both require FNP certification candidates to complete an online application, pay an application fee and pass an exam.
The AANPCB and ANCC FNP certification exams are multiple-choice and evaluate clinical knowledge and skills in advanced nursing practice across the lifespan.
You're eligible to take the exams if you provide proof you meet the following requirements on the exam application:
- A current, unencumbered RN license
- Completion of an accredited FNP education program
- Completion of at least 500 supervised clinical hours related to FNP practice
The exams are scored on a pass/fail basis and have similar success rates. In 2020, the AANPCB and ANCC FNP certification exams were passed by approximately 85% and 89% of candidates, respectively.
Your FNP national certification is valid for five years. To renew yours, you'll need to fulfill the requirements outlined by the certifying body that granted it.
Step #5: Get Licensed as a Texas FNP
The next step in becoming an FNP in Texas is to apply for state APRN licensure.
The application process takes place online through the Texas BON. You'll submit the following:
- A nonrefundable $100 application fee (or $150 if applying for prescriptive authority)
- Proof of a current, unencumbered RN license
- Proof of FNP national certification
- Proof of completion of an accredited FNP education program and supervised clinical practice hours
The Texas BON typically approves APRN license applications within 30 days of receipt.
In some cases, the BON grants interim licensure approval for no more than 120 days. This status is for applicants who appear to meet the licensure requirements but must submit additional information to verify eligibility.
Licensure Renewal
Licensed FNPs in Texas must renew their state APRN and RN licenses simultaneously, once every two years.
All applicants should complete at least 400 practice hours within the two years preceding renewal. They must also complete 20 contact hours of continuing education in the FNP role or maintain national FNP certification.
Depending on their practice setting and time in practice, Texas FNPs seeking licensure renewal may also need to complete continuing education in the following areas:
- Forensic evidence collection
- Older adult or geriatric care
- Nursing jurisprudence and nursing ethics
- Pharmacotherapeutics
- Pain Management
- Prescription of Opioids
- Human trafficking prevention
- Tick-borne disease
Obtaining Prescriptive Authority
Texas FNPs cannot prescribe controlled substances without obtaining prescriptive authority from the BON. Obtaining prescriptive authority is an optional step in how to become an FNP in Texas.
You can apply for prescriptive authority on the application for Texas APRN licensure.
The Texas BON issues successful applicants with a prescriptive authority number. Use this number to register with the Drug Enforcement Administration (DEA).
According to the U.S. Department of Justice, all NPs authorized to prescribe controlled substances must register with the DEA. Registration enables the DEA to prevent controlled substance abuse by monitoring prescriptions.
Step #6: Find Employment
The last step towards becoming an FNP in Texas is to find employment.
Licensed Texas FNPs can search for jobs using the online job boards of nursing organizations. The AANP, TNP and American Nurses Association all offer this resource.
You can join the TNP as an FNP student. In addition to employment resources, the TNP gives members access to networking, continuing education and professional advocacy.
How to Become an FNP in Texas Online
Are you ready to become an FNP in Texas? Take the first step with help from Texas Woman's University.
We offer a highly ranked online Master of Science in Nursing – Family Nurse Practitioner program for BSN-prepared working nurses. The program is authorized to enroll students in Texas and more than 20 other states.
(If you want to become an FNP but already have your MSN, consider our online post-master's FNP certificate.)
The online MSN – FNP is uniquely designed to help nurses like you develop as holistic primary care providers. It consists of engaging online learning, clinical rotations in your local community and one residency experience at our campus in Denton, Texas.
As a student, you will:
- Understand the range of factors that can impact health and wellbeing.
- Deepen your knowledge of advanced topics to develop essential competencies.
- Discover a range of resources for assessment, analysis and diagnosis.
- Understand advanced practice nursing from multiple perspectives.
- Build the professional, interpersonal and leadership skills needed for success.
The MSN-FNP program is CCNE-accredited and recognized for its high quality nationwide. U.S. News & World Report ranked it as the best online FNP master's program in Texas and the ninth-best in the nation.
