Sunday, June 8, 2014

This is from my firm's website,

Nurses always ask what can they do to improve  the regulation of their practice by the Texas Board of Nursing.  There are questions of how to make the process more fair, especially for those nurses who have never had a violation before and have a wonderful history of nursing practice.  Now, nurses can make a difference and ensure that two proposed rules pass; two proposed rules which will benefit nurses in Texas.

All nurses should read the recently proposed changes for the BON's  rules sections §213.32, Corrective Action Proceedings and Schedule of Administrative Fines and §213.35, Knowledge, Skills, Training, Assessment and Research (KSTAR) Pilot Program(22 Texas Administrative Code §213)  These rules will help nurses with minor practice violations resulting in disciplinary actions at the level of Remedial Education (§213.32) and at the level of Warning with Stipulations and Remedial Education (§213.35).  The levels include with and without a fine.

The Corrective Action Proceeding is non-reportable to the databanks and is not considered a disciplinary action.  Previously this option was restricted previously to administrative documentation type cases such as failing to inform the Board of a minor past criminal conviction or a failure to monitor the renewals of nurses under your supervision.  Expanding this option to practice issues will help the type of cases in the past where a nurse has a stellar nursing practice history but has made an error of some type; having these nurses put under disciplinary orders was one of the biggest problems facing the Board in my opinion.

Allowing deficiencies in nursing practice to be corrected by the KSTAR program is a great step in the regulation of nurses.  The  typical Board Order may not have addressed specific issues a nurse had and instead lumped all violations of a certain level into the same remedial courses.  The program will not be cheap for the nurse, but if the success is anything like that of other professions who have utilized a KSTAR like program, the program will be successful in preventing recurring Board Orders for additional violations.  This program will be reportable and will be a disciplinary action.

Each program has specific requirements and restrictions, but these two proposed rules are something nurses should support.  In order to help ensure passage of these rules, read the rules and if you are in support, send a letter to James W. Johnston, General Counsel, Texas Board of Nursing, 333 Guadalupe, Suite 3-460, Austin, Texas 78701, or by e-mail to, or faxed to (512) 305-8101.  An additional copy of the comments on the proposal or any request for a public hearing must be simultaneously submitted to Melinda Hester, RN, Lead Nursing Consultant for Practice, Texas Board of Nursing, 333 Guadalupe, Suite 3-460, Austin, Texas 78701, or by e-mail to, or faxed to (512) 305-8101. If a hearing is held, written and oral comments presented at the hearing will be considered.

A public hearing is where the public is allowed to voice their opinions regarding the rule in person before the Board; a hearing is not required for comments to be considered if submitted in writing, to the two staff members above as directed and submitted no later than 5:00 p.m. on June 23, 2014  for §213.32, the Corrective Action Proceeding proposed rule and no later than 5:00 p.m. on July 7, 2014 for  §213.35, the KSTAR proposed rule.

Wednesday, April 23, 2014

New design for Texas BON website

The Texas BON has a new website and I really like it.  They have made it more comprehensive and have information and documents present that were not easily available are now there for easy use.  A lot of work went in to the re-design of the site and it shows.  Good Job!

Tuesday, September 24, 2013

Texas Board of Nursing Agreed Orders-a Recent Problem

I am not sure why this year I have seen a huge increase is nurses contacting me soon after they have signed an Agreed Order with the Texas BON wanting the Order changed or removed.  Most of these nurses were not represented by an attorney, but there were also a few who were represented by an attorney who did not regularly represent nurses before the Board.  It is important to realize that an Agreed Order is a settlement agreement or contract between the Board and the nurse.  Like other agreements/contracts in life, the time to negotiate and question the Order is prior to signing.  It is very difficult to obtain a change in an Order and if that request occurs soon after signing, the likelihood of success is decreased immensely.

 Some of the nurses explained the reason they signed was the pressure the investigator was placing on them to sign.  Once again, an attorney can help with this by inserting themselves into the communication with the Board and freeing the nurse up to work and not having to stress over the Board.  A good lawyer will keep you informed of what is happening and also provides you with copies of all documents from and to the Board.  The attorney should also obtain approval for all agreements with the Board.

TPAPN Board Orders are now Confidential

As of September 1, 2013, TPAPN Board Orders are now confidential.  This is a vast improvement since the statute was changed a few sessions ago requiring the Board to be involved anytime there was a practice issue associated with a substance abuse/addiction issue.  This corrects situations where nurses had sensitive personal information available online for all to see.  Nurses who were referred to TPAPN by the Board and had a mental health  diagnosis or who had an evaluation detailing sensitive personal information had limited choices when they were referred to the Board.  It appears there will be further changes or polishing of the TPAPN process in the near future, so be sure to watch for information and remember it may be in your best interests to consult with an attorney who knows the Board and TPAPN.

To Clarify:  only new TPAPN Board Orders are confidential; the Board is not going back and changing previous Board TPAPN Orders from public to non-public orders.  Since the TPAPN orders are confidential they are not reported to the databank/NURSYS.