The Texas Board of Nursing (BON) licenses and regulates nurses in Texas. This entity ensures that nurses follow the rules and laws that govern them. Any violations of those rules or laws can lead to disciplinary proceedings before the BON. The potential sanctions from a disciplinary violation can be harsh, including a license suspension or revocation in the most grievous cases.
A Texas nursing license defense attorney can help if you are facing disciplinary proceedings. Contact the offices of Bertolino LLP at (512) 980-3751 or visit us online today to schedule an appointment.
Potential Sanctions for Nurses in Disciplinary Proceedings
If, following an investigation, the BON determines that a nurse has violated the laws or rules that apply to the nursing profession, then it may enter an order imposing disciplinary action. The BON has the authority under Tex. Occ. Code §301.453 to impose one or more of the following disciplinary actions in response to a disciplinary complaint:
- Revocation of a nursing license;
- Refusal to renew a nursing license;
- Suspension of a nursing license
- Restrictions placed on a nursing license, including limiting the areas of practice and requiring periodic BON review;
- A public reprimand;
- Assessment of a fine;
- A warning letter;
- Placement on probation, with one or more of the following conditions:
- submit to care, counseling, or treatment by a health provider designated by the board as a condition for the issuance or renewal of a license;
- participate in a program of education or counseling prescribed by the board, including a program of remedial education;
- practice for a specified period under the direction of a registered nurse or vocational nurse designated by the board;
- perform public service the board considers appropriate; or
- abstain from the consumption of alcohol or the use of drugs and submit to random periodic screening for alcohol or drug use; and
- Require a temporary and/or probationary license.
BON’s Disciplinary Matrix
22 Tex. Admin. Code §213.33 contains a Disciplinary Matrix that BON and administrative law judges from the State Office of Administrative Hearings must use in determining the appropriate sanctions for a licensee who has violated the Nursing Practice Act (NPA) or BON rules. If a licensee has more than one violation in the same case, BON and SOAH must consider the most severe sanction under the Matrix for any one of the individual offenses, as per Tex. Occ. Code §301.4531.
The Matrix divides common violations of the NPA into separate sections, and for each violation, breaks down violations of each NPA provision into First, Second, and Third Tier Offenses. First Tier Offenses are less serious violations of the provision at issue, Second Tier Offenses are more serious violations, and Third Tier Offenses are the most serious violations. Furthermore, each tier contains two levels of sanctions. Sanction Level I contains more lenient sanctions for each violation, and Sanction Level II contains more severe sanctions for each violation. Finally, the Matrix contains aggravating and mitigating factors that specifically apply to each violation.
Factors Affecting the Determination of Sanctions in a Disciplinary Case
22 Tex. Admin. Code §213.33 also lists other factors that BON and SOAH must consider in determining the appropriate sanction in a disciplinary case, which are in addition to the mitigating and aggravating factors specific to each violation. These factors are as follows:
- evidence of actual or potential harm to patients, clients, or the public;
- evidence of a lack of truthfulness or trustworthiness;
- evidence of misrepresentation(s) of knowledge, education, experience, credentials, or skills which would lead a member of the public, an employer, a member of the health-care team, or a patient to rely on the fact(s) misrepresented where such reliance could be unsafe;
- evidence of practice history;
- evidence of present fitness to practice;
- whether the person has been subject to previous disciplinary action by the BON or any other health care licensing agency in Texas or another jurisdiction and, if so, the history of compliance with those actions;
- the length of time the person has practiced;
- the actual damages, physical, economic, or otherwise, resulting from the violation;
- the deterrent effect of the penalty imposed;
- attempts by the person to correct or stop the violation;
- any mitigating or aggravating circumstances, including those specified in the Disciplinary Matrix;
- the extent to which system dynamics in the practice setting contributed to the problem;
- whether the person is being disciplined for multiple violations of the NPA or its derivative rules and orders;
- the seriousness of the violation;
- the threat to public safety;
- evidence of good professional character as set forth and required by 22 Tex. Admin. Code §213.27 (relating to Good Professional Character);
- participation in a continuing education course described in §216.3(f) of this title (relating to Requirements) completed not more than two years before the start of the Board’s investigation, if the nurse is being investigated by the Board regarding the nurse’s selection of clinical care for the treatment of tick-borne diseases; and
- any other matter that justice may require.
BON also has published various disciplinary policies that decision-makers must consider in their determination of the appropriate sanction in a disciplinary case. These policies relate to:
- Sanctions for Behavior Involving Fraud, Theft, and Deception;
- Sanctions for Behavior Involving Lying and Falsification;
- Sanctions for Sexual Misconduct; and
- Sanctions for Substance Use Disorders and Other Alcohol and Drug Related Conduct.
All policies are published in the disciplinary section of the BON website.
We Are Here to Represent Your Interests Before BON
We know how much is at stake if you are facing a disciplinary complaint against your nursing license. We invite you to meet with us to discuss your case and learn how we can help. You’ll meet with one of our experienced nursing license defense attorneys to discuss the details of the allegations filed against you. If you have received a licensing complaint, BERTOLINO LLP can help. Contact us today or call (512) 980-3751 and schedule a case evaluation.
Call or text (512) 476-5757 or complete a Case Evaluation form
