1. Rounds, Linda R. PhD, FNP

Article Content

In "Testing the Fate of APRN Practice?" (Issues Update, April), Susan Trossman states that the Texas Board of Nurse Examiners (BNE) proposed to cease recognition of nurse midwives, adult nurse practitioners, and clinical nurse specialists in gerontologic nursing. This is false. These three categories of advanced practice registered nurses (APRNs) are among those the board proposed to continue to recognize. Also, the article implies that the board proposes to continue recognizing advanced practice nursing titles in oncology, emergency, and palliative care, which is not the case.


Additionally, the article presents comments only from those opposed to the proposed rule. Apparently there was no attempt made to obtain comment from any of the board members, BNE staff, or anyone who supported the proposal.


Before this rule was proposed, the board requested that a committee of APRNs examine the issue. Before approving the proposed rule for the board's consideration, the committee discussed this issue for more than a year in open meetings. Trossman didn't interview any committee member or anyone who participated in the meetings. As a result, AJN 's readers have been given a biased update with no insight into the extensive discussion and research that formed the committee's recommendation.


The article also implies that the Texas BNE is the only board of nursing that would limit the APRN titles that are legally recognized by the state. However, several boards already limit recognition of APRNs to certain titles. Furthermore, there are many nurses (in Texas and nationally) who support the Texas BNE's proposed rule. Their opinions are not reflected in the article.


Finally, this rule wouldn't limit any APRNs from obtaining additional education and training or board certification after initial recognition or licensure. APRNs may then elect to enhance their education afterward without the burden of seeking additional legal recognition from the BNE. The proposed rule doesn't prevent educational institutions from developing advanced practice educational programs. In fact, the board sees this as a limitless opportunity for nursing programs to create elective courses and postmaster's options for subspecialization in any number of areas.


Editor's note: By agreement with the ANA, AJN edits the ANA's columns minimally. During the editing of this article, AJN asked the ANA to clarify whether the Texas BNE was proposing to continue or to cease recognition of nurse midwives, adult nurse practitioners, and clinical nurse specialists in gerontologic nursing, since it was not clear from the original submission. We published the ANA's response-that the titles were proposed for elimination-which was incorrect. The letter above is an edited version of the original sent to the ANA, which may be found online at


Linda R. Rounds, PhD, FNP


President, Texas Board of Nurse Examiners, Austin, TX