The Texas Board of Nursing (formerly the Board of Nurse Examiners for the State of Texas) regulates nursing practice in the State of Texas pursuant to the Nursing Practice Act, the Texas Administrative Code and other guiding statutory such as the Health & Safety Code and Chapter 53 of the Texas Occupations Code. The Board is charged with regulating RN (Registered Nurse), LVN (Licensed Vocational Nurse) and Advanced Practice Nursing designations such as clinical nurse specialist. They also regulate and grant prescriptive authority to nurses who are credentialed to apply for DEA / DPS prescriptive authority.
The Board is charged with protecting the public and accordingly it grants, denies and disciplines nursing
licenses / nurse registrations based on what they perceive to be actual or potential violations of the Nursing Practice Act. The Board is comprised of thirteen (13) members, nine (9) of whom are nurses and four (4) who are public members. The Board appoints an Executive Director who is responsible for the day to day affairs of running the agency which are voluminous and include such areas as processing license applications, handling open records requests, promulgating internal rules and procedures, developing policies and procedures on the handling of a variety of matters and running a staff which consists of over one-hundred employees.
Contrary to popular belief a nurse under going an investigation of their license due to alleged practice errors or behavioral transgressions encounters Board Staff and not the Board. The investigators, enforcement team, and Texas Board of Nursing attorneys / lawyers who advise the Board and generate all of the offers of Agreed Orders and policies regarding the same are Board Staff. In fact, a nurse undergoing a disciplinary action / investigation will rarely encounter an actual Board member. Even the Informal Conferences are run and determined by Staff of the Board. Board members will only be encountered if a nursing license applicant is invited to attend a meeting of the Eligibility & Disciplinary Committee or if the nurse has gone through the contested case hearing process at the State Office of Administrative Hearings and the matter goes to the Full Board for consideration. Even in these cases the Nurse is rarely afforded an opportunity to appear even though it is well within their rights.
Within the Board’s Staff the disciplinary guidelines and determinations with respect to nursing license discipline are set forward and policed by the Executive Director, the Enforcement Division, the division on Nursing Practice and the attorneys and lawyers who are employed as Board Staff, but represent the Texas Board of Nursing. Matters of legal representation that go beyond mere discipline and that involve appeals, rule making, declaratory judgments and administrative writs and law suits in District Court are sent to the Office of the Attorney General. These cases are not tried by the attorneys who are employed by the Texas Board of Nursing as staff lawyers as they generally involve more complex legal issues that go beyond the expertise and competency level of the Texas Board of Nursing’s Office of the General Counsel. Moreover, due to internal work demands and inherent conflicts of interest these cases are outsourced to the Attorney General.
In generic terms there are two (2) types of cases investigated by Staff of the Board:
2. Behavioral Cases
c. Allegations of Mental Health Issues / Psychiatric Disorders
d. Pain Management / Required Narcotic Consumption
For a detailed description of each type of case please click on the specific issue involved and visit the firm’s
blog on the Texas Board of Nursing which is updated by our attorney’s weekly. The blog addresses current legal issues within the Texas Nursing Board, Texas professional licensing law and administrative law in general.
The Texas Board of Nursing and Board Staff pride themselves on being a tough and vigorous agency taking the public’s protection charge to heart. Unfortunately, in order to accomplish this goal they have developed streamlined policies, ideals and procedures which are often questionable or illegal and do not take into account the individualized situation of the Nurse before them. This results in the unwarranted discipline and misconduct of hundreds of nurses who appear before Board Staff or go through the disciplinary process without competent legal counsel each year in Texas. Oftentimes the licensure sanctions are severe including license probations, suspensions, surrenders and revocations. What makes it worse is that oftentimes the investiagtors lure the nurse into a false sense of security telling them throughout the process that if they just cooperate it will be ok.
Grounds for Discipline
The Most commonly pursued grounds for discipline include the following:
- Standard of Care Violations
- Sexual & Personal Boundary Violations
- Fraud, Theft & Deception
- Chemical Dependency & The Intemperate Use of Drugs & Alcohol
- Lying & Falsification
- Failure to Comply with CE Requirements
- Failure to Timely pay Licensure Fees
- The Commission of a Criminal Offense
- Malpractice Suits & Judgments
- Other Conduct Likely to Deceive or Defraud the Public
Types of Penalties
- Monitoring
- Administrative Penalty (Fine)
- Directive to Fulfill Neglected Obligation (Specific Performance)
- Public Reprimand
- License Restriction or Impositions on Practice
- TPAPN Directive
- Probation of a License Suspension
- Active Suspension as a Requirement of Probation
- Revocation
Furthermore, as a requirement of the probationary sanctions or terms the Board can order a nurse to undergo counseling, additional training and education or restrict his ability to practice as deemed appropriate. For a detailed description of Disciplinary Guidelines click the appropriate heading below:
Monitoring
Criteria Regarding Intemperate Use
Consequences of a Criminal Conviction
Schedule of Administrative Fines.
Factors Considered for Imposition of Penalty/Sanction and/or Fines.
Disciplinary Sanctions for Sexual Misconduct
Disciplinary Sanctions for Fraud, Theft and Deception
Disciplinary Sanctions for Nurses with Chemical Dependency
Disciplinary Sanctions for Lying and Falsification
