FAQ’s – How to Break Down a Texas Nursing Board Complaint

Understanding a Nursing Board Complaint and the Disciplinary Process

1. What Is a Nursing Board Complaint?

A nursing board complaint arises when the nursing board receives information about a nurse who allegedly violated the Nursing Practice Act. These violations can include but are not limited to: failure to document the medical record, unnecessarily exposing patients or others to harm, drug diversion, unprofessional conduct, boundary violations, failure to adequately care for a patient, failure to conform to minimum standards of acceptable nursing practice, impairment or suspected impairment of chemical dependency, alcohol, etc.

2. Who Can File a Complaint With the Nursing Board?

Anyone who has knowledge of conduct that may have violated a nursing law or rule. That means, it can be the patient, patient’s family member or friend, fellow co-worker, or supervisor, just to name a few.

Once the nursing board receives the complaint, they will verify whether the complaint should be opened for further investigation.

3. What Is a Nursing Board Investigation?

If the nursing board determines that there is a possible violation of the Texas Nurses Practice Act they will open an investigation into the merits of the allegation. The nursing board investigator generally interviews witnesses and gathers evidence to see if there is any evidence to substantiate the allegations. The nurse is typically requested to give the nursing board a written response to the allegations.

4. What Is a Violation of the Texas Nurses Practice Act?

The Texas Nurses Practice Act governs the practice of nurses. The law is found in Chapter 301 of the Texas Occupations Code. The Nursing Practice Act creates the Board of Nursing and defines the nursing board’s responsibility for regulating nursing education, licensure and the practice of nursing.

A copy of the Texas Nurses Practice Act can be found here. (https://www.bon.texas.gov/pdfs/law_rules_pdfs/nursing_practice_act_pdfs/npa2013.pdf)

5. How Does the Nursing Board Prioritize Cases?

The nursing board uses what is called the Texas Board of Nursing Disciplinary Matrix, 22 Tex. Admin. Code §213.33 (https://www.bon.texas.gov/pdfs/disciplinaryaction_pdfs/discp-matrix.pdf)

If the nursing board believes the claim or complaint rises to a priority one level claim, which means it is especially egregious, the board may decide to take an emergency action and immediately limit or suspend the nurse’s license.

6. How Is a Nurse Notified When They Are Under Investigation?

The nursing board will usually notify the nurse with a letter sent in the mail. It is required that the letter provide a summary of the allegations and notifies the nurse that an investigation has been initiated. Sometimes the board will not immediately notify the nurse if providing notice to the nurse would compromise the board’s investigation.

7. How Should a Nurse Respond to a Complaint or Investigation? Is It Really Necessary to Seek the Advice of an Attorney?

It is strongly recommended that nurses who receive a board complaint immediately contact experienced legal counsel for advice and/or full representation. It is a big a mistake to downplay the significance of a nursing board complaint. Any complaint can have a negative effect on your license and career as a nurse, so contact us to help you navigate the process.

8. What Disciplinary Action May Be Taken Against a Nurse?

Disciplinary action against a nurse may include the following: revocation of nursing license, reprimand, warning, corrective action, denial of a license, probation, suspension of license. The board may also add stipulations to your nursing license, including, but not limited to, a fine, board monitoring, remedial education classes, stipulations on dispensing medications, random drug testing, etc.

9. What Happens If a Nurse Fails to Respond to the Complaint and/or Fails to Attend a Hearing With the Nursing Board?

If a nurse fails to respond to the complaint or fails to attend the scheduled hearing, the nursing board will more than likely consider the matter as a default and suspend the nurse’s license. This means that the nurse will no longer be able to practice nursing until they get board approval to reinstate their nursing license.

10. Will the Public Be Able to See Any Disciplinary Action Against a Nurse by the Nursing Board?

Yes. The nursing board is a government agency, and is subject to the Open Records Act. In other words, disciplinary action is typically available to the public.

11. Will a Nurse Who Has Been Disciplined by the Nursing Board Continue to Work as a Nurse?

This is determined on a case by case basis, the Board may allow a nurse who is reprimanded, suspended or probated to continue to practice. However, the Board may also suspend the nurse’s license until a specified period of time has passed and the nurse has met all of the guidelines and stipulations set forth by the board. Once again, that is why it is so incredibly important to contact a knowledgeable attorney that can guide you through the process and help protect your license.

12. What Happens If the Nurse Requests an Informal Settlement Conference?

Do not be fooled by the term “informal”. These hearings are highly charged and consist of a panel of board members firing questions at you. The nursing board has the discretion to allow a nurse to attend an informal settlement conference. These are held at the Nursing Board’s offices in Austin, Texas. Informal conferences are conducted by the Executive Director, or his/her designee, and are attended by the Director of Enforcement, one of the Board’s attorneys, and the assigned investigator, as well as other Board staff. The meeting is held to try to resolve and settle the case. Typically, nurses are informed of the panel’s recommended resolution to their case. If the panel determines disciplinary action is warranted to protect the public, the board will issue a new proposed agreed order to nurses.

Alternatively, the board may determine that a formal hearing is necessary. The case then gets forwarded to the State Office of Administrative Hearings for more formal action. Potential sanctions and penalties can include warnings, probation, monitoring, fines, education and/or license suspension or revocation. The board’s actions are likely a matter of public record and can also be reported to national license databanks.

13. What Is a Formal Hearing With the State Office of Administrative Hearing?

A formal hearing is a public disciplinary hearing, which is conducted before an Administrative Law Judge (ALJ) at the State Office of Administrative Hearings (SOAH) in Austin, Texas. These hearings take place when the nurse and the board are unable to reach a settlement. At the SOAH hearing the nursing board and the nurse will be allowed to present their side of the case to the judge. After the SOAH hearing, the judge will submit a proposal for decision (PFD) to the nursing board. The PFD contains the Judge’s findings of fact and conclusions of law. The nursing board will then review each PFD and then determine the appropriate penalties or they will close the case with no action.

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