Many nursing professionals know less than they should about the rules and laws that govern their profession. Certainly, as nurses take on more responsibilities within the healthcare system, it is imperative that they know where to find information about their practice act and their scope of practice. They also must know what to do if a complaint is filed against them, what is involved when a nurse is disciplined, and what is considered incompetent or unethical practice.
The Texas Legislature convenes every two years in odd-numbered years. Bills that are passed and signed by the governor, are codified as law in the Texas Statutes and can be found online here (TSLL, 2015).
During the most recent session (2013), the Legislature passed four bills that amended the Nursing Practice Act (NPA), and in the introduction to the current version of the NPA, available online, the Board of Nursing notes:
As you continue to practice as a nurse in Texas, it is your responsibility to be aware of changes to the law and the Board’s rules and regulations. Changes are reported in the Board’s quarterly newsletter mailed to all nurses licensed in Texas as well as posted on the BON website.
Chapter 301 of the Texas Occupations Code (TOC) contains the Nursing Practice Act (NPA) which creates the BON and defines its responsibility for regulating nursing education, licensure and practice. Chapter 303 relates to Nursing Peer Review and Chapter 304 relates to the Nurse Licensure Compact. These chapters of the TOC define nursing practice and give the Board the authority to make rules which implement and interpret the NPA. Licensees are required to comply with the NPA and the Board’s rules. The NPA and the Rules are amended from time to time. Only the Legislature can change the NPA, so statutory changes only occur every two years. The Board makes rule changes as needed to assist in the application of the NPA to evolving practice conditions and settings. It is necessary, therefore, that you keep up with the changes (BON, 2013).
The subchapters of the Nursing Practice Act comprise the following:
Subchapter G. License Renewal contains the requirements for continuing competency, including the new requirement on Nursing Jurisprudence and Ethics by which: “all nurses are required to complete at least two contact hours in nursing jurisprudence and ethics prior to the end of every third licensure renewal cycle” (BON, 2014; 2013). Information for calculating when you must take the course can be found on the BON website.
Chapters 303, 304, and 305 of the Texas Occupations Code address additional material for nurses, which are:
Chapter 303 addresses peer review and requires employers of ten or more vocational or professional nurses to establish a peer review committee. It provides guidance for establishing and utilizing the committee, and specifies when a nurse or group can or must avail themselves of a peer review determination.
Chapter 304 governs Texas’ participation in the Nurse Licensure Compact (NLC), which “allows nurses to have one multistate license, with the ability to practice in both their home state and other compact states” (NCSBN, 2015).
Texas put Chapter 305 in place in 2007 in anticipation of the NCSBN Advanced Practice Registered Nurse (APRN) Compact, which is expected to become operational on January 1, 2016 (NCSBN, 2012).
The Texas Administrative Code (TAC) is a compilation of all state agency rules in Texas. There are sixteen titles in the TAC. Each title represents a subject category, and related agencies are assigned to the appropriate title. The Office of the Secretary of State compiles, indexes, and makes the Code available online here (TX SOS, n.d).
The organization, structure, and responsibilities of the Texas Board of Nursing are contained in Title 22, Part 11, Chapters 211–228. Generally referred to as the BON Rules, they will be discussed in the next section, most notably Rule 217.11.