The Texas Board of Nursing (BON) regulates and monitors all levels of nurses. As a result, if BON receives a complaint against a nurse for violating an applicable rule or law, it must investigate and prosecute that complaint, if merited. If BON ultimately decides that you have violated a rule or law, you could face sanctions that are extremely damaging to your license and career. A nursing license defense lawyer can guide you through any disciplinary proceedings that you may be facing and help you fight to safeguard your license and career.
TBON’s Range of Disciplinary Sanctions
Under Tex. Occ. Code §301.453, TBON may impose various sanctions against a licensed nurse based on a finding that they have violated a rule or law that governs the nursing profession. Potential sanctions include the following:
- denial of the person’s application for a license, license renewal, or temporary permit;
- issuance of a written warning;
- administration of a public reprimand;
- limitation or restriction of the person’s license, including:
- limiting to or excluding from the person’s practice one or more specified activities of nursing; or
- stipulating periodic board review;
- suspension of the person’s license;
- revocation of the person’s license; or
- assessment of a fine.
Texas Board of Nursing (BON) may also include additional or alternative terms and conditions in a disciplinary order. These sanctions include:
- 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 TBON, including a program of remedial education;
- practice for a specified period under the direction of a registered nurse or vocational nurse designated by TBON;
- perform public service TBON 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.
License suspensions can result in a nurse being unable to practice for a set period, or probated. If a suspension is probated, the nurse can still practice under whatever conditions and restrictions TBON has set in their disciplinary order. If TBON issues a license suspension or revocation, it also can impose conditions for reinstatement that the individual must satisfy before they can obtain a license without restrictions or conditions.
TBON’s Disciplinary Matrix
TBON has established a disciplinary matrix for common violations, similar to the Texas Medical Board. 22 Tex. Admin. Code §213.33(b) outlines the potential sanctions for each violation. Furthermore, the matrix lists aggravating and mitigating factors for TBON to consider in determining the appropriate sanction for a violation. TBON also must weigh relevant aggravating and mitigating factors listed in Tex. Occ. Code §301.4531. TBON also may consider other relevant factors as appropriate.
Under the matrix, each violation of the Nursing Practice Act is categorized as a first or second tier offense. First tier offenses generally involve less serious violations, while second tier offenses typically involve more serious violations. Within each tier, the violation at issue may result in TBON imposing either of two available sanctions: Level I or II. Predictably, a Level II sanction is more severe than a Level I sanction.
Mitigating and Aggravating Factors
Aggravating and mitigating factors, as outlined in Tex. Occ. Code §301.4531, can result in a higher or lower sanction for a violation than recommended in the matrix. These factors include:
- whether the person:
- is being disciplined for multiple violations of either this chapter or a rule or order adopted under this chapter; or
- has previously been the subject of disciplinary action by the Board and has previously complied with board rules and this chapter;
- the seriousness of the violation;
- the threat to public safety; and
- any mitigating factors.
Based on this section, multiple violations and/or a history of previous disciplinary action can act as aggravating factors that could result in more severe sanctions. Potential sanctions can include a license revocation in appropriate cases.
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Administrative Penalties
In addition or instead of other penalties discussed above, Tex. Occ. Code §301.501 permits TBON to impose an administrative penalty for a violation. Every day that a violation continues is a separate violation for administrative penalties. Each day that a violation continues or occurs constitutes a separate violation for the purposes of assessing administrative penalties. The maximum administrative penalty is $5,000 per violation.
As with other sanctions, Tex. Occ. Code §301.502 outlines aggravating and mitigating factors for TBON to consider in setting the penalty amount in a disciplinary case. These factors include the following:
- the seriousness of the violation, including:
- the nature, circumstances, extent, and gravity of any prohibited acts; and
- the hazard or potential hazard created to the health, safety, or economic welfare of the public;
- the economic harm to property or the environment caused by the violation;
- the history of previous violations;
- the amount necessary to deter a future violation;
- efforts made to correct the violation; and
- any other matter that justice may require.
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Mandatory Sanctions
A few violations are so severe that under Tex. Occ. Code §301.4535, TBON must suspend or revoke a nursing license. These violations involve criminal convictions that are quite severe, including murder, kidnapping, most sex crimes, crimes of violence, and crimes against children. The conviction can occur in Texas or another jurisdiction.
Texas law places automatic restrictions on reinstating their license if a nurse loses their license because of a mandatory revocation for a criminal conviction. For instance, the nurse is ineligible to request reinstatement until at least five years have passed since the date that they are released from community supervision or parole.
Get Legal Advice and Protect Your Nursing License
A Bertolino LLP nursing license defense lawyer can review your case and help you determine the best strategy to oppose the allegations against you. We can work to protect your license and minimize the impact of the disciplinary complaint that you are facing. Call us today at (512) 980-3751 or get more information about us online.
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