According to Milstead & Short (2019), the federal government has


According to Milstead & Short (2019), the federal government has a general legislation that applies to all sates for public protection. The legislators are also central to the development of policies and allocation of resources to improve healthcare infrastructure to enhance the reliability and effectiveness of service delivery. However, there is state-specific differences. I will be comparing Texas, where I practice with Alaska.


In Texas, each advanced practice registered nurse must practice within his/her individual scope. What determines individual’s scope of practice are: clinical experience in various settings, continuing nursing education, formal course work and developments in healthcare all impact individual scope of practice.

Legal Title. Title reflects education, and certification must be consistent with education. APRN cannot change their legally recognized titles or designations through experience or continuing nursing education but with additional formal educational. Rule 221:2  

To practice as APRN in Texas, the national certification is one of the requirements for licensure as an APRN in Texas. However, one is expected to meet all of the requirements that are outlined in Rules 221.3 and 221.4 in order to be licensed, practice, or hold yourself out as an APRN in Texas. In addition, Texas law does not allow APRN to practice independently. Without the closely-regulated physician supervision Rule 221:3.

Since Senate Bill 406 became effective in 2013, Texas law states that the supervising physician should enter into a written, signed, and dated “prescriptive authority agreement” with the APRN.


Alaska advanced practice nurses hold RN licensing and advanced practice authorization.

To practice as an Advanced Practice Registered Nurse (APRN), you must first be licensed as a RN in Alaska, 12 AAC 44.400(a)(2). Unlike in Texas, in Alaska, an APRN have full practice autonomy. The individual must be licensed to practice in the role for which the individual has received specialized education, in accordance with 12 AAC 44.380.

Differences Between Texas and Alaska

The major difference between Texas and Alaska APRN is that in Alaska, all APRNs have full practice autonomy (FPA).  In Alaska, the Advanced Practice Registered Nurse is a registered nurse authorized to practice in the state who, because of specialized education and experience, is certified to perform acts of medical diagnosis and the prescription and dispensing of medical, therapeutic, or corrective measures under regulations adopted by the board” in accordance with AS 08.68.850(1) and practice with full autonomy.


The APRN has additional in-depth and advanced clinical training and skills suitable for use to provide specialized services. Therefore, Adherence with the regulations is crucial to the understanding of individual scope and the boundary of their operations. Before enrolling as an APRN in both states, certain general criteria must be met to to ensure certification.


Advanced Nursing Practitioner Requirements.

Alaska Board of Nursing.

APRN Scope of Practice

Milstead, J. A., & Short, N. M. (2019). Health policy and politics: A nurse’s guide (6th ed.). Burlington, MA: Jones & Bartlett Learning.The Nurse Practitioner Association New York State. (n.d).  About Us. Retrieved from

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