Nursing Practice Act - 2009

1 INursing Practice Act, Nursing Peer Review,Nurse Licensure Compact, &Advanced PracticeRegistered Nurse CompactTexas Occupations Code and Rules Regulating thePractice of NursingEffective September 2009 Agency MissionThe mission of the Texas Board of Nursing (BON or Board) isto protect and promote the welfare of the people of Texas byensuring that each person holding a license as a nurse in thisstate is competent to Practice safely. The Board fulfills itsmission through the regulation of the Practice of Nursing and theapproval of Nursing educational programs. This mission,derived from the Nursing Practice Act, supersedes the interestof any individual, the Nursing profession, or any special 81st Regular Session of the Texas Legislature passed fourbills which amend the Nursing Practice Act (NPA).

2 House Bill (HB) 3961 enacts new requirements for physical andpsychological evaluations related to fitness to Practice andrequires confidentiality of information collected for emergencyrelief work and certain health information provided forlicensure. HB 3961 also authorizes a study by the NursingResource Center, at the Texas Department of State HealthServices, evaluating competencies of clinical judgements andbehaviors that professional nurses should possess at graduationof professional Nursing Bill 4353 allows the Board to issue a special license to aperson already licensed to Practice Nursing in Mexico.

3 Thelicense will allow the person to Practice Nursing in a Texashospital located in a county that borders Mexico. The personmust have received a score of at least 475 on a Test of Englishas a Foreign Language (TOEFL) examination and a passingscore on the English language version of the National CouncilLicensure Examination (NCLEX). The nurse must achieve apassing score of 560 on the TOEFL exam within a year ofreceiving the special license to continue practicing Nursing inTexas. The provisions of HB 4353 expire September 1, Bill (SB) 476 amends the Nursing Practice Act byadding new Section relating to Refusal of MandatoryOvertime.

4 Following passage of SB 476, nurses working in ahospital may refuse to work mandatory overtime and refusingto work overtime does not constitute patient abandonment. SB 476 also amends the Texas Health and Safety Code by add-ing Chapters 257 and 258, which requires the governing bodyof a hospital to adopt, implement, and enforce a written officialnurse services staffing policy that ensures that an adequate num-ber and skill mix of nurses are available to meet the level ofpatient care needed. SB 476 also requires hospitals to estab-lish nurse staffing committees as standing committees of thehospital.

5 These committees must meet at least on a quarterlybasis. The nurse staffing committee is required to develop andrecommend a nurse staffing plan to the hospital s governingbody. The requirements for committee membership are spe-cific and require the various types of Nursing services providedby the hospital to be adequately represented on the Chief Nursing Officer (CNO) is a voting member of thecommittee and 60% of the committee must be RNs who spendat least 50% of their work time in direct patient care. RNsserving on the committee must be elected by their peers whoprovide direct patient care at least 50% of their work are to meet during working hours and nurses areto be relieved of other duties in order to attend the staffing plans should be used as a component of the nursestaffing budget and nurses are encouraged to provide input tothe nurse staffing committee without fearing retaliation fromtheir Bill 1415, which amends the Nursing Practice Act.

6 Re-quires the Board to study the feasibility of implementing a pi-lot program regarding the deferral of final disciplinary actionno later than February 1, 2010. The pilot program would onlyapply to sanctions other than reprimand, denial, suspension orrevocation of licensure for violations of the Nursing to the Practice of Nursing in the State of Texas. As youcontinue to Practice as a nurse in Texas, it is your responsibilityto be aware of changes to the law and the Board s rules andregulations. Changes are reported in the Board s quarterlynewsletter mailed to all nurses licensed in Texas as well asposted on the BON web site.

7 To assist you in being aware ofthese changes, the Board offers the following information anddetailed table of 301 of the Texas Occupations Code (TOC) containsthe Nursing Practice Act (NPA) which creates the BON anddefines its responsibility for regulating Nursing education,licensure and Practice . Chapter 303 relates to Nursing PeerReview and Chapter 304 relates to the Nurse LicensureCompact. Chapter 305 introduces the Advanced PracticeRegistered Nurse Compact which will be implemented at a laterdate. These chapters of the TOC define Nursing Practice andgive the Board the authority to make rules which implement andinterpret the NPA.

8 Licensees are required to comply with theNPA and the Board s rules. The NPA and the Rules areamended from time to time. Only the Legislature can change theNPA, so statutory changes only occur every two years. TheBoard makes rule changes as needed to assist in the applicationof the NPA to evolving Practice conditions and settings. It isnecessary, therefore, that you keep up with the changes. Youmay obtain copies of this pamphlet at a nominal cost by writingto the Board s office at 333 Guadalupe, Ste. 3-460, Austin,Texas 78701; calling 512/305-7400; or accessing our web pageat person practicing or offering to Practice Nursing in thisstate is required to have a license.

9 Your license must be renewedevery two years in order to continue practicing in Texas. Oncelicensed, you are authorized to use the title RN or LVN andare required to wear a name tag identifying yourself as a RN or LVN while providing patient must keep the Board informed of your current address at alltimes. To inform the Board of your address change or a namechange, send written notice, clearly marked change of address or name change to the Board s office within ten (10) days ofthe occurrence. Failure to do so can result in a lapse of yourlicense and potential disciplinary practicing in this state are expected to know and practicein compliance with chapters 301, 303, 304 and 305 of the TOCand with the Board s Rules.

10 Please refer to the following QuickReference section, as well as the rules and excerpts printed inthe back of this booklet. A complete set of the Board s Rulesand Regulations Relating to Nurse Education, Licensure andPractice can be found at our web site or purchased from theBoard ReferenceSections of the Act:Chapter 301 - NursesSec. (2) & (5)..Definitions of Exceptions to the NursingPractice : BON authority toestablish criminal investigationsunit to investigate suspectedcriminal Criminal History RecordInformation for LicenseApplicants: Requirement toprovide criminal history record asprerequisite for Special License: Lower TOEFL scores accepted for Mexican nursesworking in border Renewal: Procedure to renewyour license every two Competency:Describes the required types andnumber of hours of CE to keepyour license Forensic Evidence CollectionComponent in ContinuingEducation.