How to become a nurse in Texas
Behind California, Texas employs the second-most nurses in the United States. There’s an array of nursing opportunities in this vast state, including the largest medical complex in the world, which includes the world’s largest children’s hospital and largest cancer hospital. If you want to become a nurse in Texas, you should first familiarize yourself with the Texas Board of Nursing (BON), which regulates nurse licensure in the state.
“The [nursing] landscape definitely offers rich opportunities,” said Dr. Melissa Ethington, Assistant Dean of Admissions & Student Affairs and Assistant Professor at the University of Texas Health Science Center at Houston (UT Health) Cizik School of Nursing. “Opportunity is as versatile as Texas’s population is and as its culture is.”
Continue reading to ensure you understand the steps to begin a rigorous and rewarding career in nursing in the state of Texas.
Start your nursing career in Texas in 8 steps
Get a degree from an approved nursing program.
The entry-level degrees needed to be an RN in Texas is either an associate degree of nursing (ADN) or a bachelor’s of science in nursing (BSN). You may choose to pursue a master’s degree if you plan to become an advanced practice registered nurse (APRN). Nursing programs must be approved by the Texas Board of Nursing (BON).
Complete an application for the Texas nursing jurisprudence exam.
As you near graduation, you need to submit an online application through the Board to take the Texas nursing jurisprudence examination. This can be done through the Board’s online nursing portal. You must pass this examination before you can take the NCLEX.
Complete a criminal background check.
Before you can take the NCLEX, you also need to complete a criminal background check. If you are a student applicant, you must contact your nursing program directly to do this. More information on the background check process for non-students and out-of-state applicants can be found on the Board’s website.
Register for the NCLEX.
According to the Board, you should register with Pearson Vue (third party vendor who administers the NCLEX) to take the National Council Licensure Examination (NCLEX®) 30 days prior to graduating from your nursing program.
Pass the Texas nursing jurisprudence exam.
This online exam consists of 50 items which must be completed in two hours. You must answer at least 75% of the questions correctly to pass. Your passing result will be added to your online file with the Board.
Pass the NCLEX.
Once the Board has received your application, fees, evidence of a criminal background check, passing result on the nursing jurisprudence exam and an affidavit of graduation from your nursing program (which is sent to the Board by your school directly upon graduation), the Board will deem you eligible to take the NCLEX. You will receive an authorization to test (ATT) from Pearson Vue which is good for 75 days, within which you must take and pass the exam.
Start your nursing career.
You will receive your nursing license from the Board of Nursing after successfully passing the NCLEX. At this point you are ready to get to work—nurses can find jobs in a variety of healthcare settings, including hospitals, clinics, schools, long-term and assisted living facilities and so much more.
Keep up your continuing education requirements.
LVNs and RNs in Texas must complete 20 contact hours of continuing nursing education (CNE) in the nurse’s area of practice or demonstrate the achievement, maintenance or renewal of a Board-approved national nursing certification in the nurse’s area of practice every two years.
How long does it take to become a nurse in Texas?
The biggest factor affecting how long it takes to become a nurse in Texas is the kind of degree you earn. An ADN typically takes two to three years to complete, and a BSN typically takes four. Shorter still would be an accelerated BSN, which can take as little as 18 months to complete (assuming you already have a college degree, which takes more time).
As you near graduation for your nursing program, there are a few things you should do to prepare to obtain your RN license:
“The nursing jurisprudence exam is required for any of the professional nurse licensure candidates in Texas. It goes over the rules and regulations, pretty much making sure that you know what you’re getting into,” said Ethington.
You can take the nursing jurisprudence examination 15 business days after registering. The online exam consists of 50 questions which must be answered in two hours or less. You need to answer at least 75% of the questions to pass.
Once the Board receives and verifies the following, you will receive an authorization to test (ATT) from Pearson Vue to take the NCLEX:
The ATT is valid for 75 days. Once you pass the NCLEX within this timeframe, the Board will issue you your nursing license which can be accessed online.
If you completed as many steps as you could before graduating so that you could take the NCLEX as soon as possible, you could have a nursing license in Texas within a few months or less of graduating.
Continuing education requirements
RNs in Texas must submit evidence to the Board of Nursing that they have completed their continuing education requirements every two years. Keep in mind that continuing education requirements vary for other levels of nursing, such as APRNs.
RNs must complete 20 contact hours of continuing nursing education in the nurse’s area of practice. As an alternative in lieu of the 20 contact hours, RNs can also demonstrate the achievement, maintenance or renewal of a Board-approved national nursing certification in the nurse’s area of practice (and any continuing education requirements needed to maintain said certification). The Board of Nursing has a list of approved certifications on their website.
“My continuing education is not just in a formal sense, but in the everyday. Even when I talk to a student, and they have been exposed to a different teacher who has a different way of teaching something, I learned through my students and I realized education comes in all aspects from different forms,” said Ethington.
Ethington said that continuing education is not just about completing requirements to renew your license. Committing yourself to being a lifelong learner is an essential part of growing as a nurse professional. Part of that is being able to admit when you don’t know something and devoting yourself to fill in those knowledge gaps. Ethington said she would tell her students, “Question me. Ask me things. Don’t be ashamed to say ‘I don’t know it.’”
Nurse job outlook in Texas
According to the U.S. Bureau of Labor Statistics (BLS), the employment of RNs across the nation is expected to grow 5.6% through 2032, as fast as average across all occupations. That being said, numerous nursing organizations including the Texas Nurses Association are advocating for the expansion and support of nursing education in order to address staffing shortages made worse by the COVID-19 pandemic. In time, this could lead to more job openings as nursing education and healthcare systems grow.
The COVID-19 pandemic worsened burnout in the nursing profession, which was common even before the pandemic began. Ethington said that it’s imperative that nurses take care of themselves to avoid burnout.
“If I had to go back to my younger self, I would give myself permission to take time off, take vacation and be there in the present moment on your vacation.”
Median annual salaries for nurses in Texas
The mean annual wage for Texas nurses statewide is slightly higher than the national median wage for registered nurses, which is $81,220. The Houston metropolitan area—and the location of Texas Medical Center, the world’s largest medical complex—ranks as the highest paying metro area in the state. The metropolitan areas of Dallas, Austin, San Antonio and Killeen also get honorable mentions as the next highest paying cities for nurses in Texas behind Houston.
Median Hourly Wage$38
|Metro area||Median Salary||Bottom 10%||Top 10%|
|Houston-The Woodlands-Sugar Land, TX||$82,340||$63,100||$106,780|
|Dallas-Fort Worth-Arlington, TX||$82,200||$62,990||$106,880|
|Austin-Round Rock, TX||$81,400||$62,570||$103,900|
|Wichita Falls, TX||$79,800||$60,010||$81,130|
|San Antonio-New Braunfels, TX||$79,020||$59,710||$104,110|
|Beaumont-Port Arthur, TX||$78,630||$60,660||$98,400|
Source: U.S. Bureau of Labor Statistics (BLS) 2022 median salary; projected job growth through 2032. Actual salaries vary depending on location, level of education, years of experience, work environment, and other factors. Salaries may differ even more for those who are self-employed or work part time.
Besides location and the type of facility you work for, Ethington said that a combination of education and experience are going to be the two biggest factors in determining your earning potential. She said that although some people may think that a higher degree means you’ll automatically get a higher salary, you need to have the experience to match, too.
Requirements for foreign-educated nurses
Nurses that were educated overseas and wish to practice in Texas must complete a few extra steps to earn a nursing license. The Board of Nursing has a flowchart which summarizes the steps for foreign-educated nurses at a broad level, but should be consulted directly for all requirements needed to earn your Texas nursing license.
In order to be eligible to take the NLCEX in Texas, international candidates submit and/or satisfy the following:
- Application for licensure by NCLEX examination
- Completed criminal history report
- If their nursing program was not conducted in English, passing scores on an English proficiency exam, such as the Test of English as a Foreign Language (TOEFL)
- A completed Credential Evaluation Service (CES) Professional Report. The Board accepts CES reports from several different providers
- Verification of Licensure (VOL) form from all countries, states, provinces and/or territories where they hold or have held a license, if applicable
- Criminal background check
- Applicants must have worked within the four years prior to the filing of the NCLEX application and be within four years of their date of eligibility in order to sit for the NCLEX
Useful organizations to know
The Texas Board of Nursing regulates licensing for all types of nurses. They should be consulted for all questions pertaining to earning or renewing a nursing license in the state. All nursing education programs meant to prepare students for nurse licensure must also be approved by the Board.
The Texas Nurses Association (TNA) is the largest state nursing association in the country which aims to empower Texas nurses to advance the nursing profession. By joining this association, members get access to exclusive benefits including networking opportunities, continuing education, discounts and an automatic membership with the American Nurses Association.
The Texas Organization for Nursing Leadership (TONL) focuses more on empowering nurse leaders in the state. TONL acts as a forum for nursing leadership to discuss relevant issues in nursing, propose solutions, develop nursing standards, impact legislative change and more. Members also receive special benefits.
The Texas Nursing Students’ Association (TNSA) is dedicated to promoting professionalism and leadership among student nurses. TNSA helps students preparing for initial licensure and provides members with many different benefits. To join, your nursing program must be a constituent of the National Student Nurses Association (NSNA).