Nursing Jurisprudence and Ethics for Texas
Standards of Nursing Practice

CONTACT HOURS: 2

BY: 

Christina J. McDaniels, BSN, BA, RN, PCCN; Persis Mary Hamilton, EdD, MSN, BSN, PHN, PMHN

LEARNING OUTCOME AND OBJECTIVES:  Upon completion of this course, you will be prepared to comply with the ethics, laws, and rules that govern nursing practice in the state of Texas, including those from the Texas Statutes (Occupations Code), the Texas Board of Nursing Rules (Administrative Code), and Texas Board of Nursing position statements. Specific learning objectives to address potential knowledge gaps include:

  • Discuss the Texas Board of Nursing and the Texas Nursing Practice Act.
  • Identify the levels of nursing practice in Texas.
  • Discuss the factors for safe delegation to unlicensed assistive personnel.
  • Define the standards and scope of nursing practice in Texas.
  • Discuss Texas nursing law violations and disciplinary actions.
  • Summarize the principles of nursing ethics.
  • Describe professional boundaries as related to nursing practice.

TABLE OF CONTENTS

  • Texas Board of Nursing and Nursing Practice Act
  • Levels of Nursing Practice in Texas
  • Delegation to Unlicensed Personnel
  • Standards of Nursing Practice
  • Peer Review and Discipline Related to Nursing Practice
  • Nursing Ethics
  • Professional Boundaries
  • Conclusion
  • Resources
  • References

TEXAS BOARD OF NURSING AND NURSING PRACTICE ACT


"All states and territories legislate a nurse practice act (NPA) which establishes a board of nursing (BON) with the authority to develop administrative rules or regulations to clarify or make the law more specific. Rules and regulations must be consistent with the NPA and cannot go beyond it. These rules and regulations undergo a process of public review before enactment. Once enacted, rules and regulations have the full force and effect of law." (NCSBN, 2023)

The purpose of nurse practice acts is to:

  • Outline guiding principles to which nursing regulations refer
  • Define terminology used in the law
  • Describe what type of members should serve on the board
  • Outline standards for nursing school education programs
  • Delineate the scope of nursing practice
  • Regulate the process of licensure
  • Outline reasons for disciplinary action
    (Boehning & Haddad, 2022)

Texas Board of Nursing

The Texas Nursing Practice Act (NPA) defines responsibilities of the Texas Board of Nursing (BON) for regulating nursing education, licensure, and practice. Chapters of the Texas Occupational Code define nursing practice and give the BON the authority to make rules that implement and interpret the NPA. The BON makes rule changes as needed to assist in the application of the NPA to evolving practice conditions and settings. These rules may be found in the Texas Administrative Code, Title 22, Part 11 (TX BON, 2019a).

The purpose of the Board (Texas Board of Nursing, or BON) is to protect and promote the welfare of the people of Texas. This purpose supersedes the interest of any individual, the nursing profession, or any special interest group. The board fulfills its mission through two principle areas of responsibility, regulation of the practice of professional and vocational nursing and the accreditation of schools of nursing (TX SOS, n.d.-a).

The BON is funded and supported by mandatory licensure fees paid by nurses wishing to practice legally in the state of Texas.

Texas Nursing Laws and Rules

In Texas, nursing standards are codified in the Texas Statutes, a permanent collection of state laws. Only the Legislature can change the NPA, so statutory changes only occur every two years.

The Texas Occupations Code (TOC) is updated by laws that create, amend, transfer, or repeal statutory material. The TOC has three chapters related to nursing. These chapters define nursing practice and give the BON the authority to make rules that implement and interpret the NPA.

  • Chapter 301, Nursing Practice Act (NPA)
  • Chapter 303, Nursing Peer Review
  • Chapter 304, Nursing Licensure Compact
    (TX BON, 2019a)
CH. 301. TEXAS NURSING PRACTICE ACT
A. General Provisions
B. Texas Board of Nursing
C. Executive Director and Personnel
D. General Powers and Duties of Board
E. Public Interest Information and Complaint Procedures
F. License Requirements
G. License Renewal
H. Practice by License Holder
I. Reporting Violations and Patient Care Concerns
J. Prohibited Practices and Disciplinary Actions
K. Administrative Penalty
L. Other Penalties and Enforcement Provisions
M. Anesthesia in Outpatient Setting
N. Corrective Action Proceeding and Deferred Action
(TX BON, 2019a)

The Texas Administrative Code (TAC) is the official compilation of all state agency rules for Texas. The Office of the Secretary of State oversees the publishing of the TAC. Title 22, Part 11, of the TAC outlines rules related to nursing (TX SOS, n.d.-b).


TEXAS ADMINISTRATIVE CODE, TITLE 22, PART 11, TEXAS BOARD OF NURSING
Chapter 211. General Provisions
Chapter 213. Practice and Procedure
Chapter 214. Vocational Nursing Education
Chapter 215. Professional Nurse Education
Chapter 216. Continuing Competency
Chapter 217. Licensure, Peer Assistance, and Practice
Chapter 219. Advanced Practice Registered Nurse Education
Chapter 220. Nurse Licensure Compact
Chapter 221. Advanced Practice Nurses
Chapter 222. Advanced Practice Registered Nurses with Prescriptive Authority
Chapter 223. Fees
Chapter 224. Delegation of Nursing Tasks by Registered Professional Nurses to Unlicensed Personnel for Clients with Acute Conditions or in Acute Care Environments
Chapter 225. RN Delegation to Unlicensed Personnel, and Tasks Not Requiring Delegation in Independent Living Environments, for Clients with Stable and Predictable Conditions
Chapter 226. Patient Safety Pilot Programs on Nurse Reporting Systems
Chapter 227. Pilot Programs for Innovative Applications to Professional Nursing Education
Chapter 228. Pain Management
(TX SOS, n.d.-a)