Nursing in Texas

Texas has about 31.7 million residents, second only to California, and its registered nurse workforce is the second largest in the country. Nurses in the state average $95,380 a year, 20th among the fifty states and the District of Columbia.

Licensure

The Texas Board of Nursing licenses registered nurses, licensed vocational nurses and advanced practice registered nurses. Its office is on Congress Avenue in Austin, telephone (512) 305-7400. Rules, applications and license verification are at bon.texas.gov.

Texas was among the first states to implement the Nurse Licensure Compact, in 2000. A nurse living in Texas holds one multistate license good in every other compact state, including all four states Texas borders: New Mexico, Oklahoma, Arkansas and Louisiana.

Texas calls its second tier licensed vocational nurses rather than licensed practical nurses. Only California uses the same term. The license is the same thing.

Staffing law

Texas sets no nurse to patient ratios. It does require every hospital to run a nurse staffing committee with at least sixty percent of its members frontline nurses, and to adopt a written staffing plan the committee has reviewed.

State law also protects a nurse's right to refuse an assignment the nurse is not competent to perform, and to report unsafe conditions without retaliation. That protection has a history behind it: two nurses in Winkler County were criminally prosecuted in 2009 after reporting a physician to the state medical board, and the case, in which both were acquitted, drove changes to whistleblower protection for nurses. See nurse staffing and patient outcomes and nursing ethics.

Nurse practitioner practice

Texas is in the restricted group. Advanced practice registered nurses prescribe under delegated authority from a physician through a prescriptive authority agreement, and the state limits how many nurse practitioners one physician may delegate to. Given how much of Texas is rural, the requirement comes back to the legislature again and again. See nurse practitioner practice authority and collaborative practice agreements.

Nursing education

Texas Woman's University's College of Nursing, teaching in Denton, Dallas and Houston, is among the largest nursing programs in the country. The Cizik School of Nursing at UTHealth Houston, the University of Texas at Austin School of Nursing, UT Medical Branch at Galveston and the Anita Thigpen Perry School of Nursing at Texas Tech carry further large programs. Prairie View A and M University runs one of the oldest historically Black nursing programs in the south, based in the Texas Medical Center. The community college system supplies a very large share of the state's associate degree graduates.

Pay and workforce

The Texas Medical Center in Houston is the largest medical complex in the world by employment and floor area, and it holds MD Anderson Cancer Center, Texas Children's Hospital, Houston Methodist and Memorial Hermann. Dallas and Fort Worth carry Baylor Scott and White, Texas Health Resources, Parkland Health and Children's Health. San Antonio, Austin and El Paso hold further large markets.

The Rio Grande Valley and West Texas are rural, with hospitals a long way apart and a heavy reliance on critical access hospitals. The border region and an uninsured rate among the highest in the country put heavy load on emergency departments and county hospital districts. See rural and frontier nursing.

Travel and flexible work

Texas is the second largest travel market in the country by volume and an average one by intensity. It carries more travel postings in NurseRecruiter's full archive, 2009 to 2026, than every state except California, and ranks twenty-fourth of fifty-one once its 261,050 employed registered nurses are counted. The absolute numbers make it a reliable place to find work; the ratio explains why rates here are rarely the highest going. See where the assignments are.

Texas is also the third most requested destination among nurses naming states they would work in, and more nurses hold a profile here than anywhere except Florida. Of the Texas registered nurses on this site, 40 percent say they will consider travel assignments and 45 percent per diem shifts, both close to the national figures. Compact membership since 2000 means a Texas licence already covers the four neighbouring states and most of the south. See travel nursing and per diem nursing.

Notable nurses

Anita Perry worked seventeen years as a nurse in Haskell and later as a nursing instructor, and became first lady of Texas in 2000. Texas Tech University renamed its nursing school the Anita Thigpen Perry School of Nursing in 2008.

Sources

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