Health License Defense » Texas Board of Nursing

Nursing Board Renewals-What to answer?

Taralynn Mackay — Tue, 24 Aug 2010 14:44:33 +0000

If a nurse is currently under investigation by the Texas BON and is renewing his/her license, what does the nurse answer to the question: “Are you currently the target or subject of a grand jury or governmental agency investigation?” According to the Board, the answer is “yes” even though the BON knows about the investigation since they are conducting it, a nurse still needs to answer “yes.”

This is a change from what we have always thought–that since the questions are meant to disclose unknown situations or occurrences, an investigation by the BON does not need to be disclosed to the BON. But the Board wants to make sure there are no areas of confusion and they want everything disclosed to them even if the nurse thinks the Board knows about an issue, the nurse should disclose it. The only exception is when the nurse receives a letter from the Board informing the nurse he/she no longer has to disclose a specific listed occurrence (Hint-Make sure you keep this letter forever in case it becomes an issue later on).

Don’t forget to disclose pending charges for criminal incidents as well as needing to disclose deferred adjudications, pleas of nolo contendere, or no contest. These questions continue to trip up nurses. Above all, read the questions carefully EACH time you renew. Questions change and a failure to answer truthfully will result in a BON investigation. Also, don’t wait until the last few weeks to renew. A nurse can renew up to 60 days prior to the end of the renewal period–early is better.

Live in one state and practice in another? BEWARE

Taralynn Mackay — Wed, 09 Jun 2010 21:37:11 +0000

Multistate Compact Licensure rules can impact a nurse even if the nurse is not working under a compact license. If you have a license in the state in which you practice, but live in another state, you may be affected by the compact rules for multistate licensing even if you are not working under a compact license. If a nurse moves to a compact party state, the nurse must obtain a nursing license in that state. The nurse has 30 days to obtain the new license. Wherever the nurse’s legal residence is located is where the nurse is considered to be living. For example, a nurse has a Texas nursing license and is working in El Paso. The nurse moves to New Mexico, but continues to work in Texas. Because Texas and New Mexico are both compact license states, the nurse would have 30 days to obtain a New Mexico license. The nurse would then work in Texas under the nurse’s New Mexico multistate nursing license. There are many nurses that live and work near Texas borders and they need to be aware of these rules (this also applies to other compact states as well). The compact states are found at the National Council of State Boards of Nursing

I have an arrest in my background criminal history, what do I do?

Taralynn Mackay — Mon, 12 Apr 2010 20:46:42 +0000

There is not a simple answer to this question because there can be so many variables. The one sure thing is – DO NOT LIE TO THE BOARD!! Many nurses answer the Board’s application/renewal questions based on what they think a criminal background shows or what other employers/agencies/etc. have found when they ran criminal background checks. This is a dangerous decision because the Board can obtain criminal background information that other entities cannot seem to find. Do NOT assume that your background is clear because: someone told you that it would be (even if it was your attorney), that the criminal incidents occurred while you were a juvenile, that you completed deferred adjudication or pre-trial diversion or that your case has been expunged/sealed (unless you have the actual court paperwork showing the expunction/sealing of the records in your hand). Also, don’t think that the Board will not want to know about a particular incident because you think it has nothing to do with nursing practice–the BON wants to know about everything in your criminal background even if they decide not to take any action in response to the incident(s), the BON still wants to know. Remember that even if your non-disclosure to the Board is a mistake, you will still be found to have been deceptive to the Board and disciplinary action can be the result.

There are so many pitfalls associated with the questions posed on the Board’ s renewal/application paperwork, that it is prudent to speak to an attorney who has experience working with the Texas Board of Nursing before you complete the questions.

A Disciplinary Action or Agreed Order Is Forever

Taralynn Mackay — Mon, 01 Mar 2010 15:10:11 +0000

Disciplinary actions or Agreed Orders remain on a nurse’s license forever. When stipulations/restrictions are placed on the license, the nurse’s license is encumbered and those restrictions show up on the license when the license is verified (for example, the verification page will show “Warning with Stipulations” or “Remedial Education”). Once the stipulations/restrictions are completed and the Board sends a letter of completion to the nurse, the verification page will show clear; however, the disciplinary history remains. If asked if the nurse has ever been sanctioned or disciplined*, the nurse will have to answer “yes.”

Recently, I have received several inquiries regarding “setting aside board orders.” This cannot be done and this is misinformation. While criminal incidents can sometimes be expunged or sealed, administrative actions currently cannot be removed from one’s license. Once a disciplinary action occurs, the history remains even once the “probation” is complete.

* The Texas BON currently asks, “Has any licensing authority refused to issue you a license or ever revoked, annulled, cancelled, accepted surrender of, suspended, placed on probation, refused to renew a professional license, certificate or multi-state privilege held by you now or previously, or ever fined, censured, reprimanded or otherwise disciplined you?” to obtain information about past disciplinary actions.

Trying to find a job while under a Board Order

Taralynn Mackay — Wed, 03 Feb 2010 16:30:09 +0000

I have heard from another nurse who is having a difficult time obtaining a job while under a Board Order. This is an ongoing problem especially in this economy. Some employers are refusing to hire a nurse no matter what the basis for the Order. Most nurses cannot afford to fight an Order in court or the facts of the nurse’s case are such that there is a definite violation and fighting in an administrative law court may not gain the nurse much. There are some solutions that can help:

1. Make sure you have malpractice insurance so that you have the financial resources to go to a hearing if you do not agree with the BON’s decision in your case.

2. When looking for a job, ask everyone you know for help in finding a job. It tends to be easier to get a job if someone is on the “inside” vouching for you and your skills. There are also employers out there that understand that most nurses with a Board Order are not “bad” nurses; that the nurse just made a mistake, or was overworked/understaffed, or had a disease relapse etc. These employers recognize that most nurses that have had a Board Order become extremely cautious nurses and become definite assets to the facility.

3. Make sure that you have an experienced and BON knowledgeable attorney assist you with your case before the BON so that you get the best outcome possible.

4. You must present a professional appearance (this includes your resume, your social networking site pages, and any application you complete).

5. Contact your state senators and representatives and ask them to make some changes for the next legislative session in 2011. Some areas that need changes: expand the corrective action provisions to apply to minor practice violations, allow non-public orders for mental health issues and substance abuse (these are diseases, so why allow the publicity?), allow deferred adjudications to be just that and not be considered a conviction by the BON, and change the language in the NPA from shall to may to allow the BON leeway to make determinations based on mitigating factors. As 2010 progresses, I will probably think of more…

I also have more info here: http://nursinglaw.blogspot.com/2009/07/how-to-explain-past-board-orders-to.html

Additions to BON’s website

Taralynn Mackay — Wed, 13 Jan 2010 00:06:26 +0000

The Board reports online that they have some new options to help nurses obtain information needed from the Board: 1) the ability to track application status online, so that applicants can track what the Board has received and what is still required and 2)a “Live Help” function that allows individuals to chat online with BON staff during normal working hours. Hopefully, these changes will help to move the various processes more quickly and efficiently.

New Nursing Jurisprudence Course Set

Taralynn Mackay — Mon, 04 Jan 2010 16:25:02 +0000

I just received the Texas Board of Nursing’s brochure for their upcoming Nursing Jurisprudence course. It looks like instead of having a course in August in Austin (which is what has happened the past few years), the Board is having the course for central Texas in San Antonio on February 25 or February 26, 2010. So, if you were going to wait for the Austin course to complete your stipulation, you should consider taking the upcoming San Antonio course. Likewise, the other typical dates have been changed as well, so plan accordingly.

The other posted dates for the Nursing Jurisprudence course by the Board (the formal title is “Texas Board of Nursing: Protecting Your Patients and Your Practice”, the course is only one day and is offered on two consecutive days):

June 23/24, 2010 – Arlington, Texas
August 18/19, 2010 – Houston, Texas

Temporary Suspension of License for a Postive Drug Screen

Taralynn Mackay — Tue, 15 Dec 2009 17:45:07 +0000

Nurses that are on Board Orders for monitoring due to substance abuse or on a Board Order sending the nurse to TPAPN must be extremely careful with complying with their Board Order and with what they ingest because of the following section of the Nurse Practice Act (taken from the Board’s website at www.bon.state.tx.us). There is no provision to allow for an explanation that you mistakenly took a medication or that you were only taking cough medicine or whatever explanation is given for the positive screen. The Board will temporarily suspend your license and then you and your attorney will work on getting the issue resolved and your license unsuspended; so, it is much better to be careful to begin with.

Sec. 301.4551. Temporary License Suspension for Drug or Alcohol Use.

The board shall temporarily suspend the license of a nurse as provided by Section 301.455 if the nurse is under a board order prohibiting the use of alcohol or a drug or requiring the nurse to participate in a peer assistance program, and the nurse:

(1) tests positive for alcohol or a prohibited drug;

(2) refuses to comply with a board order to submit to a drug or alcohol test; or

(3) fails to participate in the peer assistance program and the program issues a letter of dismissal and referral to the board for noncompliance.

[Added by Acts 2009 (H.B. 3961), 81st Leg., eff. June 19, 2009]

Impairment Issues before the Nursing Board

Taralynn Mackay — Mon, 07 Dec 2009 16:49:28 +0000

The Texas Board of Nursing’s E&D Committee is discussing the following issues today:

1. Discussion and review of the Board¿s policies and rules relating to physical and psychological evaluations for mental impairment, physical impairment, and/or chemical dependency/abuse of drugs or alcohol, including review and discussion of the Occupations Code §301.4521; 22 Tex. Admin. Code §§213.20, 213.29, and 213.30; proposed amendments to 22 Tex. Admin. Code §213.33; and the Eligibility and Disciplinary Sanctions for Nurses with Substance Abuse, Misuse, Substance Dependency, or Other Substance Use Disorder.

2. Presentation by Dr. A. David Axelrad, M.D., relating to physical and psychological evaluations, including information regarding objective testing, evaluation criteria, and qualifications of evaluators.

3. Committee recommendations regarding proposed amendments to 22 Tex. Admin. Code §213.33 and guidelines for physical and psychological evaluations for mental impairment, physical impairment, and/or chemical dependency/abuse of drugs or alcohol.

4. Continued discussion and review of SB 1415, enacted by the 81st Legislature, Regular Session, effective September 1, 2009, and Pilot Program on Deferral of Final Disciplinary Actions, including discussion of the feasibility of conducting a pilot program to determine the efficacy of deferring disciplinary actions.

5. Committee recommendations regarding the feasibility of conducting a pilot program to determine the efficacy of deferring disciplinary actions pursuant to SB 1415.

This means that we should see some new rules or guidelines or policies coming from the Board regarding psychological evaluations and something regarding how the Board plans to implement SB 1415. So, more to come….