Texas Board of Nursing
The Texas Board of Nursing (BON) regulates the practice of nursing through power granted to it by the state legislature pursuant to the Texas Nursing Practice Act. The act authorizes the Board to issue licenses and subsequently discipline nurses for violations of the Nursing Practice Act and the administrative rules and regulations the Board has adopted for interpreting and applying its statutes. The BON is authorized to establish criteria for licensure of all registered nurses (RN’s), licensed vocational nurses (LVN’s) and advanced practice nurses (APN’s) in the state of Texas and subsequently discipline these nurses via their authority over the licenses.
There are over 300,000 licensed nurses in Texas and the Board of Nursing is known as one of the most active and punitive of the state licensing boards. This number is significantly larger than the combined total of licensees overseen by the Texas Medical Board, Texas State Board of Pharmacy, Texas State Board of Dental Examiners, and Texas State Board of Veterinary Examiners. As the general trend in health care appears to be a drift towards more treatment by skilled nurses in all settings and an increased reliance on Nurse Practitioners and other Advanced Practice Nurses in primary care, the Nursing Board’s mandate can only be expected to continue to grow along with the state’s burgeoning population.
The nursing license defense attorneys at the Leichter Law Firm have substantial experience with the Texas Board of Nursing and have represented well over a thousand nurses over the past decade. These have included the entire gamut of potential issues from cases involving patient death and serious felony offenses to minor practice violations and documentation errors. The firm regularly litigates and wins cases which proceed to full contested case hearings with an administrative law judge at the State Office of Administrative Hearings. The Board and its staff recognize our name and are used to dealing with the attorneys of the Leichter Law Firm on a near-daily basis. Equipped to litigate a case and prevail all the way through District Court and beyond, the attorneys at the Leichter Law Firm are well versed in navigating the Board’s investigation and complaint process and ensuring an effective result for our nurse clients.
Disciplinary cases involving the Texas Board of Nursing involve two distinct aspects: substantive and procedural. The substantive aspect involves the allegation or matter type (for example a complaint that a nurse’s committed a practice error leading to patient harm) while the procedural part pertains to where in the disciplinary process the case is situated (for example whether or not the BON has filed formal charges).
Procedural milestones or stages in the development of an investigation or BON disciplinary case can be segmented as follows:
- Receipt of an Initial Complaint Letter
- Investigation Phase
- Informal Settlement Conference
- Agreed Order Negotiations
- Formal Charges
- State Office of Administrative Hearings (SOAH) Contested Case Proceedings
- Appeals and Motions for Rehearing
- Temporary Suspension Hearings
- Probation or Agreed Order Violations
- Appeals of Board Actions to District Court
Texas Board of Nursing cases handled by the lawyers of the Leichter Law firm routinely involve the following substantive matters:
- Practice Violations
- Criminal Arrests and Convictions
- Intemperate Use of Drugs or Alcohol
- Chemical Dependency/Substance Abuse
- TPAPN Violations
- Unprofessional Conduct
- Negative Nurse Peer Review
- Discipline by Another State Licensing Board
- Complaints Originating from DADS or APS
- Documentations Errors
- Inability to Practice due to a Physical or Mental Health Condition
- Allegations of Patient Abuse
- Scope of Practice Violations
- Non-Therapeutic Prescribing by an APN
- Board Order Violations and Compliance Issues
- Failure to Disclose Criminal History
- Falsifying Documentation
Complaints with the Texas Board of Nursing can originate from a multitude of different sources. Some of the most common include other nurses, former employers, patients and their families, law enforcement and criminal prosecutors, and the Texas Department of Aging and Disability Services. The Board also has the ability to open complaints on their own initiative when they come across potential violations during their investigation of another nurse.
At the outset, investigations conducted by the Texas Board of Nursing are confidential and not subject to public disclosure. If an investigation progresses far enough without being dismissed, however, the case becomes public after the Board files formal charges against a nurse’s license. Eventually a case could proceed to a full-contested case hearing before an Administrative Law Judge and result in the drafting of a Proposal for Decision presented to the Board for their consideration. That being said, most cases with the BON are resolved through either a dismissal or an Agreed Order negotiated between the nurse and the Staff of the Board. Oftentimes this involves attending an informal conference in Austin with Board Staff.
The attorneys at the Leichter Law Firm are well versed in the Board’s procedures and the likely outcomes for a given type of case and fact scenario. Through experience we are aware of little used procedural mechanisms and case resolutions which can result in the dismissal of a case or a non-public order. This knowledge and experiences helps keep the costs down for our clients as unnecessary attorney hours and other billing is not required to understand the basic statutes, regulations, and precedent applicable to a given case.
If you have received a letter of investigation from the Texas Board of Nursing or are at any stage of the legal process with the Board you should consider retaining experienced legal counsel to protect your nursing license. Far too often simple mistakes or missteps by an unrepresented nurse result in a snowballing investigation or the imposition of a disciplinary order which could have been avoided. Furthermore, the disciplinary process involves a mire of statutes and regulations almost always weighted in the Board’s favor. Constitutional due process issues may also be implicated. An effective, successful defense of your license requires both familiarity with the medicine and nursing standards involved as well as a working knowledge of the applicable laws and their interaction with each other. If you have a case with Texas Board of Nursing, feel free to contact the nursing license defense attorneys of the Leichter Law Firm today at 512-495-9995.