Jurisprudence & Nurse Practice Act/Professional Nursing

practice of professional nursing

"The performance of an act that requires *substantial specialized judgment and skill*, the proper *performance* of which is based on knowledge and application of the principles of biological, physical and social science as acquired by a *completed course in an approved school of professional nursing*. The term does not include acts of medical diagnosis or the prescriptive of therapeutic or corrective measures".

6 members

-2 RN's who are not APN's -1 APN from practice or education -3 LVN's

Texas Board of Nursing Membership

-6 members from nursing practice -3 members from nursing education -4 members who are consumers

3 members

-Baccalaureate education -Associate Degree education -LVN education

Peer Review

-Incident Based (IBPR) -Safe Harbor (SHPR)

Mandatory Continuing Education

-Requirement: to have 20 hours of continuing education every 2 years -You will be asked on license renewal if you have down required CE -BON randomly audits nurses for verification

Role of Legislature & BON

-The legislature passes changes to the nursing practice act. -The Board of Nursing interprets the NPA and develops rules and regulations to implement the nursing practice act

Jurisprudence Prep Course

-cost: $25 -3 weeks to complete -The course is delivered online with the ability to bookmark "Hot Topics" for a quick review. The course, complete with training on how to locate information for further review, printable resources that will aid study and practice questions, will be useful not only for exam preparation but for future nursing practice.

Unprofessional Conduct

-intended to protect clients and the public from incompetent, unethical, or illegal conduct of licensees. -The purpose of these rules is to identify unprofessional or dishonorable behaviors of a nurse which the board believes are likely to deceive, defraud, or injure clients or the public.

Standards of Practice

-serve as a framework for what a reasonably prudent nurse would do in similar situations -Guide professional behavior of nurses -Used as standard in issues related to practice and malpractice -Nurses must know and conform to: NPA, Rules & Regulations, Federal, state, local laws affecting their area of practice`

when should you report another nurse?

-violating NPA or BON rules or contribute to death or serious injury of a pt -they are working impaired by drugs or alcohol -who's conduct constitutes abuse, exploitation, fraud, or a violation of professional boundaries -who lack knowledge, skill, judgment, or conscientiousness and could result in harm to a pt

Functions of the BON

1. Establishes standards of practice 2. Interprets NPA & Rules & Regulations to nurses and the public 3. Investigates possible violations of NPA 4. Disciplines violators through legal action 5. License qualified applicants to practice nursing - RN, LVN, APN

Safe Harbor Peer Review (SHPR)

A process that protects a nurse from employer retaliation and licensure sanction when a nurse makes a good faith request for peer review of an assignment or conduct the nurse is requested to perform and that the nurse believes could result in a violation of the NPA or Board rules.

does a nurse who reports another nurse get in trouble?

NO! A person may not suspend or terminate the employment of, or otherwise discipline or discriminate against, a nurse who reports another nurse.

Law Governing Nursing in Texas

Nurse Practice Act

Whistleblower

Passage in 2007 of whistleblower protections for nurses in Texas solidified and clarified incremental approaches taken in previous years. The protections permit nurses to enforce their role as patient advocates as well as advocates for peers without fear of retaliation. Refusal to engage in conduct relating to patient care that would violate the NPA or BON, making a lawful report of unsafe practitioners and unsafe patient care practices or conditions.

Who is Pearson Vue

Pearson VUE is the global leader in computer-based testing for IT, academic, government and professional programs. In 2011, Pearson VUE delivered over 10 million tests worldwide. A business of Pearson, the company manages the world's largest, most secure test center network which is comprised of over 5,000 centers in more than 175 countries.

Chapter 304

The Nurse Licensure Compact (NLC) allows nurses to have one multistate license, with the ability to practice in both their home state and other compact states.

Professional Nursing

The RN takes *responsibility* and accepts *accountability* for practicing within the legal *scope of practice* and is prepared to work in all healthcare settings, and may engage in independent nursing practice without supervision by another healthcare provider. The RN, with a focus on *patient safety*, is required to function within the parameters of the legal scope of practice and in accordance with the federal, state, and local laws: rules and regulations and policies, procedures and guidelines of employing healthcare institution or practice setting. The RN is responsible for providing *safe*, *compassionate* and *comprehensive* nursing care to patients and their families with complex healthcare needs".

1st standard of practice

The first standard listed is knowing and conforming to the provisions of the NPA and Rules and Regulations as well as all federal, state, and local laws that affect the nurse's area of practice.

Nurse Licensure Compact States

The mutual recognition model of nurse licensure allows a nurse to have one license (in his or her state of residency) and to practice in other states (both physical and electronic), subject to each state's practice law and regulation. Under mutual recognition, a nurse may practice across state lines unless otherwise restricted. You must legally reside in a Nurse Licensure Compact state to be eligible to have a multi-state license.

NPA

These laws and rules form the basis for the legal practice of nursing and regulation of nursing in Texas.

If no advance directive, and person is incapable or incompetent of communication:

Treatment decision can be made by physician and one of these in order listed: (1) the patient's spouse; (2) the patient's reasonably available adult children; (3) the patient's parents; or (4) the patient's nearest living relative.

can a nurse report a student?

YES! A nurse can report a student to the BON if it is reasonable believed that the students ability to perform the services of the nursing profession would be, or would reasonable be expected to be, impaired by chemical dependency.

The mission...

derived from the Nursing Practice Act, supersedes the interest of any individual, the nursing profession, or any special interest group.

when does the legislature meet for the Texas Nursing Practice Act?

every two years in the ODD numbered years

Nursing Associations

generally promote the welfare of nursing and practice; have VOLUNTARY membership

BON

has authority over all nurses licensed in state

Incident-Based Peer Review (IBPR)

in which case peer review is initiated by a facility, association, school, agency, or any other setting that utilizes the services of nurses. This is generally because of actions or inactions of a nurse

Chapter 301

includes laws and rules regulating nursing education, licensure and practice

Chapter 303

nursing peer review

Definition of Nursing

the legal guide for what constitutes nursing in Texas

Due Process

•An incident-based peer review committee's decision cannot be overruled, changed, or dismissed. •A nurse has the right to be accompanied by a nurse peer or an attorney.

Jurisprudence Exam Info

•Applicants by examination must PASS the Texas Nursing Jurisprudence Exam prior to issuing the Authorization to Test •BON will not remind students of this requirement. •Effective as of March 2, 2015 •Register for Jurisprudence at: http://www.bon.texas.gov/olv/je.html •50 questions - you must answer 38 correctly

Licensure Information

•Application by NCLEX-RN® •http://www.bon.state.tx.us/licensure_examination.asp •Fingerprinting - http://www.identogo.com , Fee of $125.00 made payable to the Texas Board of Nursing (BON) in the form of a personal check, cashier's check or money order. •Affidavit of Graduation from Nursing Program (Form must be completed by the Dean/Director and will not be accepted if signed prior to completion of program or graduation). •Registration with NCS Pearson/VUE to take NCLEX-RN® examination. (DO NOT SEND $200.00 NCLEX-RN ® FEE TO THE BOARD) •Pass the Nursing Jurisprudence Examination (required before Texas licensure will be issued)

Licensure with History of Criminal Convictions: Examples of Absolute Bars to Licensure

•Child Endangerment or Abandonment •Murder •Kidnapping •Sexual Assault •Aiding Suicide •Robbery - Aggravated •Cruelty to Animals •Prostitution - 3 or more counts •Use of Deadly Weapon •Online Solicitation of a Minor •Child Pornography •Improper relationship between Educator and Student

Major Provisions of the NPA

•Definition of Nursing •Establishes the BON and sets administrative functions and process •Requirements for licensure and renewal of licensure •Whistleblower protection for nurses

Possible Disciplinary Actions of BON

•Denial of application for a license •Issue a written warning •Administer a public reprimand •Limitation on the license that might limit practice or specific activities or stipulate periodic BON review •Suspension of the license •Assessment of a fine •Require counseling, continuing education, practice be under supervision of another RN, or public service

Nursing Incident-Based Peer Review

•Evaluate the nursing services of a nurse •Evaluate qualifications •Evaluate quality of care given by nurse •Evaluate complaints concerning a nurse or given care •Conclude with recommendation

Medical Durable Power of Attorney

•Grants another person the right to act as legal representative for you to make decision related to medical care

Functions of BON pt. 2

•Grants licensure to nurses from other states •Recommends to legislature appropriate changes in NPA •Establishes standards for nursing education and approves nursing education programs •Provides consultation to nursing education programs •Provides advice and counsel to faculty, staff of health agencies utilizing nurses, and to nurses to improve professional service

Temporary Permit

•Issued with application received, background check complete, director affidavit received and Pearson Vue paid •Good until: 75 days of issuance

Advanced Directive

•Legal document that allows person to make decision about end-of-life care •Directs physician about preferences at end-of-life: All treatments be discontinued & All treatments to be continued ***Go into effect when person cannot make own healthcare decisions

DNR

•Order by physician stating you are not to be resuscitated if cardiac arrest •Must be in chart and progress notes •Either patient or family must agree to order

License Renewal

•Renew license every 2 years •Must renew by end of month of your birth month •If 90 days late, renewal fee plus late charge •If more than 90 days late, renewal fee plus double late charges •If more than a year late, BON will investigate

Licensure

•To practice nursing, you must have a license •You may not wear jewelry or other insignias with RN or LVN on it unless you are licensed •Name Badge: must have name and RN after the name •Licensure protects the title of the nurse

Jurisprudence Exam

•an examination based on the Texas Nursing Practice Act (NPA) and the Texas Board of Nursing Rules and Regulations •designed to cover information which will facilitate your practice in the state of Texas •a maximum of two (2) hours in length •"open-book" in nature in that you will have access to our website and other resource material while taking the test •available for 3 attempts within a 24 hour period (applicants must wait 24 hours if needing a 4th attempt) •included in your endorsement application fee •NOT the same exam as the NCLEX. •must be completed prior to receiving an Authorization To Test (ATT)

Mission of the BON

Is to protect and promote the welfare of the people of Texas by ensuring that each person holding a license as a nurse in this state is competent to practice safely.

Chapter 305

Advanced Nursing Practice Compact

Ch. 301.402

Duty to report other nurses