APRNs are registered nurses with advanced education in one of four APRN roles. They include clinical nurse specialists, nurse anesthetists, nurse-midwives, and nurse practitioners. APRNs are licensed by each state’s board of nursing. The Texas Board of Nursing licenses over 20,000 APRNs.
APRNs are educated at the graduate level (master or doctoral degree), and are always nurses first, centering their practices around the patients and families they serve. While APRNs provide health care services that overlap with physicians, their practices focus on health care for specific populations.
Types of APRNs
Clinical Nurse Specialists (CNSs)
There are about 1350 CNSs in Texas. They earn master or doctoral degrees to become expert clinicians in specialty areas such as geriatric, critical care, oncology, or psychiatric-mental health care. CNSs develop improved methods of nursing care delivery to individuals and populations, teach nurses and other health care professionals, and act as clinical consultants. Some CNSs also assess and manage individuals’ health problems and prescribe medications. Therefore, in some settings, CNS and NP roles are similar. Research on CNS practice demonstrates positive outcomes including reduced hospital costs, reduced frequency of emergency room visits, and reduced medical complications in critical care patients.
Download the CNS brochure from the National Association of Clinical Nurse Specialists (NACNS):
Texas Clinical Nurse Specialists
Certified Registered Nurse Anesthetists (CRNAs)
Certified Registered Nurse Anesthetists (CRNAs) are Advanced Practice Registered Nurses (APRNs) registered by the Texas Board of Nursing (BON). Certification as a nurse anesthetist is granted through the American Association of Nurse Anesthetists Council on Certification. CRNAs hold a current Texas state license as a registered nurse, graduate from an approved nurse anesthesia educational program, successfully complete the certification examination and comply with continuing education requirements for recertification.
Nurse anesthetists were the first professional group to specialize in and provide anesthesia services in the United States, beginning in the 1880s. Today there are over 45,000 CRNAs practicing throughout the United States, of which, over 4,200 are licensed in Texas. CRNAs administer more than half of the anesthetics in the state and are the sole anesthesia providers for over three million of Texas’ rural population in 66 counties. Their services are essential to maintain surgical, obstetrical, and trauma stabilization for rural Texans where 48% of hospitals in Texas rely on independent CRNAs.
American Association of Nurse Anesthetists
Texas Association of Nurse Anesthetists
Certified Nurse Midwives (CNMs)
About 400 CNMs practice in Texas. Their practice is defined as the independent management of women’s health care. It focuses on pregnancy, childbirth, postpartum care, newborn care, and the family planning and gynecological needs of women. CNM practices are structured to allow for consultation, collaboration, and referral to other health care providers for care outside the nurse-midwives’ expertise.
Ninty-six percent of births attended by nurse-midwives in Texas occur in hospitals. In 1999, CNMs in Texas attended 13,202 hospital births, 594 births in free-standing birth centers, and 129 home births. They continue to demonstrate a model of prevention, patient education, and family-centered care that has been very successful in lowering health care costs and improving outcomes.
American College of Nurse-Midwives
Consortium of Texas Certified Nurse-Midwives
Nurse Practitioners (NPs)
Almost 15,500 nurse practitioners are licensed by the Texas Board of Nursing. NPs specialize in the areas of neonatal, pediatrics, adult/gerontology, family, psychiatric-mental health, or women’s health. They treat patients who have acute and chronic illnesses and also perform wellness physical exams. NPs combine diagnosing and treating patients with educating patients and their families about health promotion and disease prevention.
Nurse practitioners provide health care within their scope of practice and collaborate with or refer patients to physicians or other specialists when needed. About half of the patients to whom NPs provide health care are underserved Texans. Some of these Texans have no other source of health care, but most prefer to see a NP because of the comprehensive care and value they receive. Not only do NPs treat patients compassionately and competently, but they enjoy the extra time NPs spend teaching them about their diagnosis and how to make their health concerns manageable.
American Association of Nurse Practitioners
Texas Board of Nursing. (2015, December 22). Currently licenses Texas RNs recognized as advanced practice registered nurses by county or employment and recognition group. Retrieved from http://www.bon.texas.gov/pdfs/statistics_pdfs/2015TexasStatistics/Dec2015/APRN.pdf