- What is the Texas Board of Nursing? Who do they work for?
- Does the Texas Board of Nursing regulate Registered Nurses and Vocational Nurses?
- I have received a letter from the Texas Board of Nursing informing me that I am being investigated or a letter titled “Formal Complaint.” What does this mean?
- What sort of things does the Texas Board of Nursing investigate?
- Can I find out who filed a BON complaint against me?
- The Texas Board of Nursing sent me something called a proposed “Agreed Order.” What does that document mean?
- Should I sign the Texas Board of Nursing’s proposed Agreed Order?
- I work in a home-care setting. How can the Texas Board of Nursing control what I do in someone else’s home or in my own home?
- It is now time to renew my license or I am moving to Texas from another state and wish to obtain a license by reciprocity. I have been ticketed or arrested for something that did not happen at work. Do I need to inform the BON?
- Do I really need an attorney?
- What can an attorney do to help me?
- While I consider my options, should I call the BON and explain myself?
- Should I call the Board to ask questions about what happens next?
- What happens if I don’t respond at all to the Texas Board of Nursing’s Complaint Letter or Notice?
- I am currently in the Texas Peer Assistance Program for Nurses (TPAPN) and am being threatened with discipline or expulsion from the program. Can an attorney help me?
1. What is the Texas Board of Nursing? Who do they work for?
The Texas Board of Nursing is a state-level administrative agency. The state government of Texas has empowered the Texas Board of Nursing to regulate and otherwise oversee the practice of nursing in Texas.
The Texas Board of Nursing is part of the Texas state government so it can be said that they work on behalf of the government or “the public”. Part of the mission of the Board is to protect the public from dangerous nursing practices. In an action against a license, the Texas Board of Nursing’s role is similar to that of a criminal prosecutor. It will gather evidence, make a decision about whether to file charges, and then respond to any attempt to defend your license before imposing penalties or taking away the license entirely.
2. Does the Texas Board of Nursing regulate Registered Nurses and Vocational Nurses?
Yes. The Board regulates both Registered and Vocational Nurses. The Board also regulates Advanced Practicing Nurses (APN’s). The Board has the authority to regulate the entire practice of nursing within Texas.
3. I have received a letter from the Texas Board of Nursing informing me that I am being investigated or a letter titled “Formal Complaint.” What does this mean?
If the letter informs you that you are being investigated, this means that the Texas Board of Nursing is attempting to uncover information relating to your practice in order to determine whether or not to file a formal complaint against you. It is prudent, even at this stage, to retain an attorney who can communicate with the Board of Nursing on your behalf. It is also prudent, even at this stage, to be extremely careful if you choose to respond to the letter or otherwise contact the investigator. An inaccurate statement, even made in all sincerity, could severely damage your case. You should be aware that an investigation may last for many months and become disruptive to your practice and personal life.
If the letter is titled “Formal Complaint”, the Texas Board of Nursing has decided to file forma; charges against your license. At this point, there are immediate deadlines which must be met in response to that letter. You are allowed to respond to the formal charges yourself. An attorney may also respond to the Texas Board of Nursing on your behalf. An attorney with experience in Texas Board of Nursing matters will likely know the best course of action to take.
4. What sort of things does the Texas Board of Nursing investigate?
The Texas BON investigates anything that relates to the practice of nursing. Common matters include problems with the dispensing of controlled substances, failure to accurately document work hours, or failure to provide adequate care.
5. Can I find out who filed a BON complaint against me?
Generally no. The identity of a complainant is considered confidential.
6. The Texas Board of Nursing sent me something called a proposed “Agreed Order.” What does that document mean?
After conducting an investigation, the Texas BON will often send the license-holder a letter called a proposed “Agreed Order.” This order will contain terms and conditions to be imposed upon your license if you agree by signing the document. Signing an Agreed Order essentially admits the truth of all the “statements of fact” and “conclusions of law” within it. It is appropriate to think of it as akin to a criminal “plea bargain” agreement.
7. Should I sign the Texas Board of Nursing’s proposed Agreed Order?
Every case is different and without knowledge of the specific facts surrounding yours it is impossible to advise you to sign or not to sign. You should note that if you sign the order, it will be part of your nurse license record. This mark on your record can have adverse employment effects either now or in the future.
8. I work in a home-care setting. How can the Texas Board of Nursing control what I do in someone else’s home or in my own home?
The Board has wide latitude to oversee the practice of nursing. This includes the practice of nursing outside of hospitals, doctor’s offices, or clinics. This latitude is granted to the Board by the state government.
9. It is now time to renew my license or I am moving to Texas from another state and wish to obtain a license by reciprocity. I have been ticketed or arrested for something that did not happen at work. Do I need to inform the BON?
On your re-licensure or reciprocity form, you must answer all questions truthfully. If the question calls for you to disclose the ticket or arrest then you must answer the question in order to obtain or renew your license. Answering untruthfully or making a mistake can result in a Board of Nursing investigation and sanction even if the ticket or arrest is for something minor. The BON takes these matters very seriously. An attorney can advise you on the best course of action to take to ensure that you do not put your license at risk.
10. Do I really need an attorney?
Absolutely. For assistance in defending your license, do not seek help from the investigator or any other BON personnel. Our recommendation is to seek the advice of an experienced and dedicated license defense attorney as soon as possible. Do not respond to the Board on your own. The Texas Board of Nursing has experienced staff attorneys who are very knowledgeable about the law. With that said, you will also need a defense attorney with experience.
11. What can an attorney do to help me?
While the particular strategy that your license defense attorney will implement depends on the nature of the case, attorneys have several options for contesting the BON’s claims. At the investigation stage, it is important to communicate to your attorney exactly what happened and disclose any witnesses that can corroborate your story. Your attorney can then speak with the investigator on the case in order to uncover the specific basis for the BON’s allegations. This may involve reviewing documentation or witness statements that the BON claims substantiate its allegations in the Complaint. After gathering this information, your attorney will be better able to assess the merits of your case and determine the best course of action as to how to argue your case before the board. This can be helpful in preparing for an informal settlement conference and hopefully settling the matter at that stage. While the investigation stage appears fairly informal, it can be one of the most important stages for the attorney to defend you. This is the point that the Texas BON is assessing if and to what extent it should seek further disciplinary proceedings.
If the matter proceeds beyond the investigation stage to the State Office of Administrative Hearings (SOAH), an attorney can navigate the procedures and requirements of formal legal proceedings. While SOAH is an administrative court, the procedure is still quite formal and involves specific adherence to the SOAH rules of procedure as well as special procedural rules specific to the BON’s cases. This is another reason an attorney with experience in Texas Board of Nursing cases can be especially helpful. Attorneys who are unfamiliar with these cases can often make mistakes that could result in missing important deadlines and possibly prejudicing your case. For instance, many attorneys that are unfamiliar with the SOAH rules may not realize that discovery requests in SOAH proceedings are due in twenty days instead of thirty as required in Texas district courts. There can be very harsh penalties for missing such a deadline. For instance, the BON can seek a court order stating that you have admitted all of the requests that were unanswered. While this is just one example, but the SOAH rules are full of similar pitfalls. While the staff attorney for the BON may be lenient and understanding, that is not something you want to count on. At the SOAH stage, several discovery tools are available to your attorney under Texas law. These tools generally include five components:
Request for Disclosure: these requests seek basic information regarding the other party’s legal and factual basis for the case as well as contact information for any witnesses or experts that party plans to utilize in the matter.
Request for Production: these requests require the other party to provide documents and other evidence that the other party possesses that are relevant to the case. Production requests can be quite broad and request documents, photographs records, bank statements, logs, emails, and other tangible evidence.
Request for Admissions: These requests require the other party to either “admit or deny” a particular statement.
Written Interrogatories: These requests are written questions that require an open answer. These can be especially helpful in requiring detailed responses on pivotal points of the case.
Depositions: Oral questions that are asked and answered under oath in front of a court reporter or stenographer.
Once the attorney has propounded sufficient discovery to have a strong grasp of the case, the attorney can seek to settle the matter either through informal negotiations with the BON’s staff attorney or by setting up a mediation or other alternative dispute resolution. The prospects of a settlement are based primarily on the strength of the BON’s case and legal arguments that can be made against it. If the Board of Nursing is confident in its case, negotiating a settlement can be difficult with the knowledge and expertise necessary to understand what the Board is seeking and how these matters are generally dealt with.
If settlement with the BON is not feasible, the attorney can begin to prepare for trial before an Administrative Law Judge at SOAH. This process can be extremely difficult for the inexperienced as the Texas Rules of Evidence are quite strict. While SOAH proceedings involve a relaxed evidentiary standard, the staff attorney will seek to have the license-holder’s evidence thrown out because it will make the BON’s stance much stronger if there is no controverting evidence. An attorney experienced in licensure defense is best prepared to fight these motions and provide the best case going into trial.
At the final trial, your attorney can represent you in questioning witnesses and making your arguments before the Administrative Law Judge. After the Administrative Law Judge issues its order and findings of fact, the Board will consider the record to determine an appropriate order against the license-holder. This decision can be appealed to a Texas district court which the attorney can further represent you if necessary.
12. While I consider my options, should I call the BON and explain myself?
Until you are ready to respond in full to the complaint notice or letter of investigation, you should not directly respond to the Texas Board of Nursing at all. Responses made to the BON before you hire an experienced attorney may still be held against you as admissions of guilt. These initial responses, often made out of fear and confusion, can significantly harm you and your nursing license. Based on our experience with these matters, the most prudent action is to have the complaint or letter of investigation reviewed by an experienced defense attorney. The attorney can then assist you in making a response that fully conveys your side of the events and gives the BON no unfair advantage over you.
13. Should I call the Board to ask questions about what happens next?
No. Oftentimes, nurse licensees will call the BON investigator to ask questions about what to do next. However, their urge to express to the BON their innocence often leads them to make responsive statements in connection with their questions. Once again, these statements may be construed as admissions and could severely damage your case and your nursing license.
14. What happens if I don’t respond at all to the Texas Board of Nursing’s Complaint Letter or Notice?
Failure to respond to a BON complaint may result in adverse action against your nursing license. In many cases, ignoring the BON permits them to take action against you. Ignoring the issue does not make it go away. In many cases, not responding is treated as essentially admitting guilt.
15. I am currently in the Texas Peer Assistance Program for Nurses (TPAPN) and am being threatened with discipline or expulsion from the program. Can an attorney help me?
Yes. An attorney can be extremely helpful in your situation. An attorney can communicate with TPAPN on your behalf and ensure you are given an opportunity to continue on in the program on fair terms. Also, TPAPN nurses are sometimes transferred out of the TPAPN program and into the disciplinarian department at the Texas Board of Nursing. If that happens, an experienced attorney may be able to assist in defending against any licensing sanctions.
