Registered Nurses


A registered nurse (RN) without a Clinical Nurse Specialist (CNS), Nurse Practitioner (NP) or Certified Nurse Midwife (CNM) certification may provide Texas Health Steps (THSteps) medical checkups only under direct physician supervision. This means that the physician must be either on site during the checkup or immediately available to furnish assistance and direction to the RN during the checkup.

Before a physician can delegate a THSteps checkup to an RN, the physician must establish the RN's competency to perform the service as required by the physician's scope of practice. The delegating physician is responsible for supervising the RN who performs the service and remains responsible for any service provided to a client.

To establish competency, the RN must complete required online education courses prior to providing checkup services. The RN or their employer must maintain documentation that the required modules were completed.

Online Provider Education Enrollment

THSteps Online Provider Education training modules are available online. To find the RN courses, click on “Required Courses for Texas Health Steps Nurses,” then choose among the courses. You will be prompted to sign in to your account or register for a new account before going to the course module.

Course Updates

THSteps courses are reviewed regularly for content and re-accreditation. Courses may become unavailable while being updated. RNs in the process of completing required training while these modules are unavailable are encouraged to complete them once they become available again.

Online modules are updated regularly to include new content. RNs who have already completed the required modules are encouraged, but not required, to retake the updated versions. All THSteps modules are approved for continuing education units for RNs as well as other medical disciplines.

Documenting Your Training

THSteps developed the optional Verification of RN Competency to Perform THSteps Checkups form (PDF) for documentation of required training. RNs using the optional form should indicate any modules that were unavailable at the time of their training.

A record of completed and in progress courses can also be found on the THSteps Online Provider Education website under My Courses.

Helpful Information