Use of titles in the APRN's signature and identification-- from CNAP

Dear CNAP Supporters,

Please find below a reminder from the Texas Board of Nursing (BON) regarding the Use of Ttiles in the APRNs Signature and Identification.  We hope you will fnd this useful in your practice.

The BON started issuing license numbers to advanced practice registered nurses in 2014. This prompts the question: Is APRN the correct licensing credential to use when signing documentation?

The BON is very clear regarding professional identification:

BON Rule 221.11 - Identification
When providing advanced practice nursing care to patients, the advanced practice registered nurse shall wear clear identification that indicates the individual is a registered nurse with the appropriate advanced practice designation authorized by the BON.

Furthermore, Board Rule 221.2(b) states that advanced practice nurse cannot be used as a title.  Since advanced practice nurse and advanced practice registered nurse are synonymous terms in the Nursing Practice Act, this rule also prohibits APRNs in Texas from using APRN as a title

Therefore, until new rules are adopted (probably in late 2016), APRNs must use RN as their licensing credential (S. Cropley, personal communication, June 30, 2015).[1] In addition to identifying their RN license, the BON requires APRNs to identify their advanced practice role and population focus area. For instance, an adult-gerontology nurse practitioner must sign using the credentials, RN, AGNP.

As an example, Texas law requires that nurse "Jane Doe" who is licensed to practice in Texas as a family nurse practitioner must use, at minimum, "Jane Doe, RN, FNP".  An individual may choose to use other credentials in accordance with personal preference or facility policy.  Therefore, it may be appropriate for this individual to sign "Jane Doe, RN, FNP-BC" or "Jane Doe, MSN, RN, FNP".  However, it is not in accordance with Texas law for this individual to sign "Jane Doe, APRN" or "Jane Doe, FNP".  Please note that the Board of Nursing does not specify the order in which the credentials must be signed.

The APRN may include other credentials indicating educational preparation, certifications and honors, if the APRN desires to do so. The BON offers the option of embedding RN in other credentials. This gives nurse anesthetists a break because their certification credential is CRNA. Since RN is included in this credential, the BON allows nurse anesthetists to simply write CRNA after their names.

In summary, the BON allows some variation in the way APRNs list titles after their names. At a minimum, the title must include RN and the APRN role and population focus recognized by the BON. All other credentials, and the order of those credentials, are at the APRN's discretion.

A special thank you ot Lynda Woolbert for the infortamtion in this article!

Thank you!

[1] Dr. Stacey L. Cropley, DNP, RN, CPN, is the BON's Nursing Consultant for Advanced Practice.