TX: Jurisprudence and Ethics for NursesPage 6 of 9

4. Board of Nursing Position Statements

Board Position Statements do not have the force of law, but are a means of providing direction for nurses on issues of concern to the Board relevant to protection of the public. Board position statements are reviewed annually for relevance and accuracy to current practice, the Nursing Practice Act, and Board rules. The Board’s last review was performed January 2014.

A brief summary of the BON Position Statements is available online and in PDF form, but the Board emphasizes that the summary does not provide any of the details that are found in each Position Statement. The summary is best used to obtain a glimpse of the content in order to decide which Position Statement is applicable to the topic or topics you are seeking information about.

Texas BON Position Statement Synopsis (2014)

The current summary list of BON Position Statements contains 28 items (numbered 15.1–15.29, although 15.21 has been deleted). All items are listed below with summary information given for some widely applicable issues as examples.

15.1 Nurses Carrying Out Orders from Physician’s Assistants

15.2 Role of the Licensed Vocational Nurse in the Pronouncement of Death

15.3 LVNs Engaging in IV Therapy, Venipuncture, or PICC Lines

15.4 Educational Mobility

15.5 Nurses with Responsibility for Initiating Physician Standing Orders

15.6 Board Rules Associated with Alleged Patient “Abandonment”

  • Differentiates employment vs. licensure issues; addresses relevant Board rules when a nurse engages in unprofessional conduct with regard to being unavailable to provide care to assigned patients (such as sleeping on the job). New for 2014: guidance related to emergency preparedness and workplace violence.

15.7 The Role of LVNs and RNs in Management and/or Administration of

  • Medications via Epidural or Intrathecal Catheter Routes

15.8 The Role of the Nurse in Moderate Sedation

15.9 Performance of Laser Therapy by RNs or LVNs

15.10 Continuing Education: Limitations for Expanding Scope of Practice

  • Clarifies that expansion of an individual nurse’s scope of practice has licensure-related limitations. Informal continuing education or on-the-job training cannot be substituted for formal education leading to the next level of practice/licensure.

15.11 Delegated Medical Acts

  • Specifies criteria which must be met for a nurse to carry out a delegated medical act. This includes documentation of individual training and competency, procedures to be performed, physician order to initiate, and appropriate medical and nursing back up.

15.12 Use of American Psychiatric Association Diagnoses by LVN, RNs, or APRNs

15.13 Role of LVNs and RNs in School Health

15.14 Duty of a Nurse in Any Practice Setting

  • Establishes that a nurse has a responsibility and duty to a patient to provide and coordinate the delivery of safe, effective nursing care, through the NPA and Board Rules. This duty supersedes any facility policy or physician order.

15.15 Board’s Jurisdiction Over A Nurse’s Practice in Any Role and Use of the Nursing Title

  • If an RN or LVN functions in role lower than that for which licensed, or in another area with an overlapping scope of practice, the nurse is still held to the level of education and competency of their highest licensure. Also restricts use of the titles LVN or RN or any designation implying nursing licensure by non-nurses (Rule 217.10 and NPA Section 301.351 and new NPA Section 301.004(a) (5))

15.16 Development of Nursing Education Programs

  • Judicious development of new nursing programs is urged, as adding programs alone will not address the growing nursing shortage. Key considerations are delineated.

15.17 BON/ Board of Pharmacy Joint Position Statement on Medication Errors

15.18 Nurses Carrying Out Orders from Advanced Practice Registered Nurses (APRN)

15.19 Nurses Carrying Out Orders from Pharmacists for Drug Therapy Management

15.20 Registered Nurses in the Management of an Unwitnessed Arrest in a Resident in a Long-Term Care Facility

15.21 [Deleted 01/2005]

15.22 APRNs Providing Medical Aspects of Care for Others with Whom There is a Close Personal Relationship

  • The BON is concerned that when APRNs provide medical aspects of care for other individuals with whom they have a close personal relationship the APRNs risk allowing their personal feelings to cloud their professional judgment. Thus APRNs should not provide medical treatment or prescribe medications for individuals with whom they have a close personal relationship.

15.23 The RN’s Use of Complementary Modalities

  • Regardless of practice setting, RNs who incorporate complementary modalities into their practice are accountable and responsible for adherence to the NPA and BON Rules and Regulations. Specific regulations of particular relevance are identified in the position statement, including a reference to the BON’s Six-Step Decision-Making Model for Determining Nursing Scope of Practice. Also, a list of criteria is included in order for RNs to show accountability for the care they provide. Lastly, RNs are accountable to hold proper credentials (eg, license, certification, registration) to safely engage in specific practices, where applicable.

15.24 Nurses Engaging In Reinsertion of Permanently Placed Feeding Tubes

15.25 Administration of Medication & Treatments by LVNs

15.26 Simulation in Prelicensure Nursing Education

15.27 The Licensed Vocational Nurse Scope of Practice

  • The LVN scope of practice is a directed scope of practice and requires appropriate supervision. The LVN is responsible for providing safe, compassionate and focused nursing care to assigned patients with predictable healthcare needs.

15.28 The Registered Nurse Scope of Practice

  • The RN takes responsibility and accepts accountability for practicing within the legal scope of practice and is prepared to work in all healthcare settings, and may engage in autonomous nursing practice without supervision by another healthcare provider. The RN is responsible for providing safe, compassionate, and comprehensive nursing care to patients and their families with complex healthcare needs.

15.29 Use of Social Media by Nurses

  • The use of social media can be of tremendous benefit to nurses and patients alike. However, nurses must be aware of the potential consequences of disclosing patient-related information via social media. Nurses must always maintain professional standards, boundaries, and compliance with state and federal laws as stated in Board Rule 217.11, Standards of Nursing Practice. All nurses have an obligation to protect their patient’s privacy and confidentiality [as required by Board Rule 217.11(E)] which extends to all environments, including the social media environment.
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