The Texas Board of Nursing (BON) protects and promotes the welfare of the people of Texas through regulating nursing practice and placing an emphasis on a nurse’s responsibility and duty to provide safe, effective nursing care. Through the Nursing Practice Act, BON Rules, and publishing position statements, the Board delineates the duties and responsibilities that Texas LVNs and RNs owe to their patients.
The Board addresses the duty of a nurse in any practice setting in its Position Statement 15.14. This BON Position Statement lists the portions of the Board rule and supporting documents that underscore the duties and responsibilities that Texas licensed LVN’s and RN’s owe to their patients.
Under the Standards of Nursing Practice, nurses should differentiate the roles of an LVN and an RN in accepting nursing care assignments, assuring a safe environment for patients, and obtaining instruction and supervision as needed. 22 Tex. Admin. Code §217.11. Nurses are to implement the appropriate aspects of care within their scope of practice.
Each nurse must be able to support how his or her clinical judgments and nursing actions align with the Nursing Practice Act and Board Rules.
RN’s are to follow BON delegation rules for the delegation of tasks to unlicensed assistive personnel, which should be performed under the RN’s supervision. Ultimately the RN retains responsibility for the care given.
Based on case law, a nurse has a duty to the patient which cannot be superseded by hospital policy or physician’s order. In the landmark case Lunsford v. Board of Nurse Examiners, Nurse Lunsford turned away a patient who was experiencing the hallmark symptoms of a heart attack by instructing his friend to drive the patient to the nearest facility equipped to handle heart attack victims, which was 24 miles away. 648 S.W. 2d 391 (Tex. App.–Austin, 1983). The patient died a few miles away from the rural hospital where Nurse Lunsford worked.
In response to sanctions from the Board, the nurse argued that the ER physician (who never saw the man having the heart attack) told her the patient needed to be transported to the facility equipped to handle heart attacks. Further, the facility policy was to transfer patients experiencing heart attacks, via ambulance, to the facility that was equipped to provide a broader range of medical care that might be needed.
The court affirmed the disciplinary action of the Board and agreed that the nurse had the knowledge, skills, and abilities to recognize the life-threatening nature of the patient’s symptoms. Because of this knowledge, the court found the nurse had a duty to act in the best interest of the patient by taking measures to stabilize him and communicating his condition to other staff to enlist appropriate medical care. Based on Lunsford, Texas nurses have a duty to patients that cannot be superseded by hospital policy or physician’s orders.
Read the Board of Nursing’s full position statement here. Every nurse in Texas is expected to ensure that the nursing care they provide meets standards of safety and effectiveness.
Hire an Experienced Nursing License Defense Attorney
If you have been notified of a complaint filed against you with the Texas Board of Nursing, BERTOLINO LLP can help. We are experienced BON license defense attorneys and we know how to navigate BON’s complaint process. We are prepared to represent you at any legal hearing or proceeding regarding your professional license.
Our Firm believes that immediately consulting an experienced Board of Nursing license defense attorney to review allegations of misconduct helps ensure the most favorable outcome in your case. Our results speak for themselves.
BERTOLINO LLP represents licensed professionals across the entire State of Texas. If you are facing disciplinary action from a professional licensing board, contact us today or call (512) 476-5757 and schedule a case evaluation.
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