Texas Attorney General Opinion: JC-117 Page: 3 of 10
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Ms. Katherine A. Thomas, M.N., R.N. - Page 3
professional nursing. The term does not include acts of medical
diagnosis or prescription of therapeutic or corrective measures.
Professional nursing involves:
(G) the performance of an act delegated by a physician under
Section 157.052, 157.053, 157.054, 157.058, or 157.059.
Id. 301.002(2)(G). The Board of Nurse Examiners is also required to adopt rules to "approve a
registered nurse as an advanced practice nurse." Id. 301.152(b)(2). The terms "advanced nurse
practitioner" and "advanced practice nurse," which have the same meaning, may include a CRNA.
The Medical Practice Act creates the Texas State Board of Medical Examiners to regulate
the practice of medicine in this state. See id. 152.001-.059, 153.001-.055. Under that act, a
person practices medicine when the person diagnoses, treats, or offers to treat "a mental or physical
disease or disorder or a physical deformity or injury by any system or method, or... attempt[s] to
effect cures of those conditions" either (1) while professing to be a physician or a surgeon or (2) for
direct or indirect compensation. Id. 151.002(13) (defining "[p]racticing medicine"). Nevertheless,
the Medical Practice Act does not apply to a properly licensed registered or vocational nurse
"engaged strictly in the practice of nursing in accordance with the applicable licensing acts and other
laws of this state." Id. 151.052(a)(4).
Chapter 157 of the Occupations Code describes circumscribed situations in which a physician
may delegate particular tasks. Section 157.058 explicitly allows a physician to delegate anesthesia-
related services to a CRNA in certain settings:
(a) In a licensed hospital or ambulatory surgical center, a
physician may delegate to a certified registered nurse anesthetist the
ordering of drugs and devices necessary for the nurse anesthetist to
administer an anesthetic or an anesthesia-related service ordered by
(b) The physician's order for anesthesia or anesthesia-related
services is not required to specify a drug, dose, or administration
(c) Pursuant to the physician's order and in accordance with
facility policies or medical staff bylaws, the nurse anesthetist may
select, obtain, and administer those drugs and apply the medical
devices appropriate to accomplish the order and maintain the patient
within a sound physiological status.
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Texas. Attorney-General's Office. Texas Attorney General Opinion: JC-117, text, 1999; (texashistory.unt.edu/ark:/67531/metapth274426/m1/3/: accessed December 13, 2018), University of North Texas Libraries, The Portal to Texas History, texashistory.unt.edu; crediting UNT Libraries Government Documents Department.