PMHNP Practice Agreements in Texas

Healthcare institutions experience high admittance rates due to increased demand for healthcare services. Based on this facet, hospitals strive to maintain excellent medical care delivery by hiring qualified personnel. In fact, nurse practitioners enroll for courses to better their skills. Notably, Psychiatrist Mental Health Nurse Practitioners (PMHNPs) prove their competencies through evaluation examinations offered by the American Nurses Credentialing Center (ANCC). After completion and licensure, PMHNPs in Texas are allowed to operate, although with close collaboration with qualified physicians. Notably, the fight for self-autonomy in operations poses a challenge in the process of disseminating medical services between PMHNPs and physicians in the state. It is important to identify the challenges and barriers for practice, to warrant effective application of measures leading to cohesion in the health sector. PMHNP Practice Agreements in Texas

PMHNP Practice Agreement in Texas

The healthcare system is governed by diverse ministries of health all over the globe. In the United States, the Affordable Care Act provides frameworks through which practitioners operate. However, it is important to note that independent states have a distinct provision for practitioner practice. For instance, the Texas practice laws allow PMHNPs to own licenses for operation (Graves, Mishra, Dittus, Parikh, Perloff, & Buerhaus, 2016). However, they are restricted various nursing aspects. PMHNPs may execute medical decisions pursuant to protocol and written agreement by qualified physicians. Additionally, physicians have the authority to delegate PMHNPs in matters pertaining to drug prescription. Additionally, PMHNPs are only allowed to prescribe Schedule Two to Five drugs under specific restrictions. PMHNP Practice Agreements in Texas

Physician Collaboration Issues in Texas

Texas is mostly a rural state, with many of its healthcare institutions positioned in the conurbations. Notably, the shortage of qualified physicians poses a detrimental challenge in the process of care delivery (Ura, 2014). The few available physicians serve a large population and are not sufficiently placed to satisfy the health demands of the population. Based on this aspect, PMHNPs fail to disseminate treatment interventions, since the few physicians available are unable to approve their requests. Additionally, PMHNPs are not approved by state-contracted insurance companies. The aspect demoralizes the practitioners since they attend to patients without pay.

Barriers to Independent PMHNP Practice in Texas

The inability of PMHNPs to operate in full capacity is one of the contagious issues facing the healthcare system in Texas. It is evident that PMHNPs in Texas are trained and qualified enough to handle patients. However, the Texas practice authority bars them from full operation, unless advised by physicians (Blore n.d). Basically, this inadequacy is detrimental to the future of American healthcare delivery. Additionally, the physicians’ body in Texas is not willing to relent on its roles in medical care delivery in Texas. In fact, they are opposed to granting PMHNPS full autonomy, for fear of losing lucrative contracts. According to Ura (2014), physicians in Texas claim that allowing PMHNPs to operate independently would jeopardize patient safety.

Addressing PMHNP Practice Issues in Texas

The numerous barriers to PMHNP practice pose a significant challenge and eventual degradation of the health status of people in Texas. It is important to ensure a cohesive healthcare system to warrant sustainability. Stakeholders in the state ought to grant full autonomy to PMHNPs, to fasten the process of service delivery. Additionally, the American Nurses Credentialing Center (ANCC) ought to provide bridging courses to the PMHNPs to ensure they acquaint themselves with necessary skills, similar to those of physicians (Blore n.d). Additionally, there is a need for the Texas administration to ensure incorporation of PMHNPs in state-contracted insurance programs to ensure they receive timely payment. Through this aspect, PMHNPs would experience job satisfaction, leading to high productivity. Besides, the state would minimize cases of brain drain from other well-paying states. PMHNP Practice Agreements in Texas


The high demand for medical services requires healthcare institutions to hire qualified personnel, to warrant self-efficacy. Notably, PMHNPs play an integral role in maintaining mental stability amongst victims. However, Texas does not allow full practice for PMHNPs, as they require approvals from physicians. The aspect delays dissemination of urgently needed medical care. It is important to address such situation, by allowing PMHNPs practice on a full-time basis, to minimize delays.


Blore, J. (n.d). Texas Nurse Practitioners: The Fight for Full Practice Authority. Nursing Practice Schools. Retrieved from

Graves, J. A., Mishra, P., Dittus, R. S., Parikh, R., Perloff, J., & Buerhaus, P. I. (2016). Role of geography and nurse practitioner scope-of-practice in efforts to expand primary care system capacity. Medical care, 54(1), 81-89. doi :

Ura, A. (2014). Nurse practitioners say that greater autonomy would cure challenge. The Texas Tribune. Retrieved from PMHNP Practice Agreements in Texas

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