Welcome to the Texas Board of Nursing

General Nursing Practice Information

Board staff receive phone calls and emails regularly regarding nursing practice issues and questions.  This section of the Texas Board of Nursing (BON or Board) website contains nursing practice topics and various resources for vocational nurses (LVNs), registered nurses (RNs), advanced practice registered nurses (APRNs), and those who work with licensed nurses in the State of Texas.


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RN Scope of Practice

Nursing Practice Act (NPA) Section 301.002(2): Definition of Professional Nursing (RN Level of Licensure) Scope - Registered Nurse Practice
Board Rule 217.11 - Standards of Nursing Practice
See: Paragraph (1) Standards Applicable to All Nurses and Paragraph (3) Standards Specific to Registered Nurses
Differentiated Essential Competencies (DECs) for Educational Requirements
Board Rule 217.18 - Assisting at Surgery: rule related to a registered nurse who wishes to function as a first assist (RNFA)

Board Rule 217.14 - Registered Nurses Performing Radiologic Procedures

Frequently Asked Questions (FAQs): Nurses Performing Radiologic Procedures
Position Statement 15.28, The Registered Nurse Scope of Practice

Frequently Asked Questions (FAQs): Regarding Position Statements 15.27, The LVN Scope of Practice and 15.28, The RN Scope of Practice
- Scope of Practice Decision-Making Model (DMM)

- Scope of Practice Decision-Making Model (DMM) Poster

Frequently Asked Questions (FAQs): Decision Making for Determining Nursing Scope of Practice
Position Statement 15.14, Duty of a Nurse in Any Practice Setting
Position Statement 15.27, The Role of LVNs and RNs in Management and/or Administration of Medications via Epidural or Intrathecal Catherter Routes Position Statement 15.8, Role of the Nurse in Moderate Sedation
Position Statement 15.9, Performance of Laser Therapy by RNs or LVNs Position Statement 15.13, Role of LVNs and RNs in School Health
Position Statement 15.20, Registered Nurses in the Management of an Unwitnessed Arrest in a Resident in a Long Term Care Facility Position Statement 15.23, The Use of Complementary Modalities by the LVN or RN
Position Statement 15.24, Nurses Engaging in Reinsertion of Permanently Placed Feeding Tubes Frequently Asked Questions (FAQs): RN Pronouncement of Death
Rules and Guidelines Governing the Graduate Vocational and Registered Nurse Candidates or Newly Licensed Vocational or Registered Nurse A Nurse's Duty: Initiation of CPR (BON Quarterly Newsletter, January 2017, Page 4)

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LVN Scope of Practice

Nursing Practice Act (NPA) Section 301.002(5), Definitions: Definition of Vocational Nursing (LVN Level of Licensure)

Nursing Practice Act (NPA) Section 301.353, Supervision of Vocational Nurse
Scope - Vocational Nurse Practice
Board Rule 217.11 - Standards of Nursing Practice
See: Paragraph (1) Standards Applicable to All Nurses and Paragraph (2) Standards Specific to Vocational Nurses
Differentiated Essential Competencies (DECs) for Educational Requirements
Position Statement 15.27, The Licensed Vocational Nurse Scope of Practice

Frequently Asked Questions (FAQs): Regarding Position Statements 15.27, The LVN Scope of Practice and 15.28, The RN Scope of Practice
Position State 15.3, LVNs Engaging in IV Therapy, Venipuncture, or PICC Lines
Position Statement 15.13, Role of LVNs and RNs in School Health Position Statement 15.14, Duty of a Nurse in Any Practice Setting
Position Statement 15.25, Administration of Medication & Treatments by LVNs Position Statement 15.2, Role of the Licensed Vocational Nurse in the Pronoucement of Death
- Scope of Practice Decision-Making Model (DMM)

- Scope of Practice Decision-Making Model (DMM) Poster

Frequently Asked Questions (FAQs): Decision Making for Determining Nursing Scope of Practice
Frequently Asked Questions (FAQs): LVNs and Nursing Care Plans
Frequently Asked Questions (FAQs): LVNs Performing Initial Assessments Frequently Asked Questions (FAQs): LVNs Performing Triage/Telephonic Nursing/Being On-Call
Frequently Asked Questions (FAQs): LVNs "Supervision of Practice Rules and Guidelines Governing the Graduate Vocational and Registered Nurse Candidates or Newly Licensed Vocational or Registered Nurse
A Nurse's Duty: Initiation of CPR (BON Quarterly Bulletin, January 2017, Page 4)

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Communication/Documentation

Board Rule 217.11 - Standards of Nursing Practice
See: Paragraph (1) Standards Applicable to All Nurses
Frequently Asked Questions (FAQs): Co-Signature on Documentation
Frequently Asked Questions (FAQs): Co-Signature on LVN Actions/Documentation Frequently Asked Questions (FAQs): Nurses Have a Duty to Report Confidential Health Information
Nursing and Electronic Communication (BON Quarterly Newsletter, October 2020, Page 9) Checklist in Healthcare (BON Quarterly Newsletter, October 2013, Page 4)
When Do Nurses Have a Duty to Report Confidential Health Information? (BON Quarterly Newsletter, April 2013, Page 6) Professional Communication on Interdisciplinary Teams and a Nurse's Duty (BON Quarterly Newsletter, July 2012, Page 5)
Designated Agent (BON Quarterly Newsletter, January 2004, Page 6)

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Duty to a Patient

Board Rule 217.11 - Standard of Nursing Practice
See: Paragraph (1) Standards Applicable to All Nurses
Position Statement 15.14, Duty of a Nurse in Any Practice Setting
Position Statement 15.6, Board Rules Associated with Alleged Patient "Abandonment" Frequently Asked Questions (FAQs): When Does a Nurse's Duty to the Patient Begin and End?
Frequently Asked Questions (FAQs): Floating to Unfamilar Practice Settings Frequently Asked Questions (FAQs): Nurse's Role with the Emergency Medical Treatment & Labor Act: Performance of Medical Screening Exams
Ethical Responsibility in Nursing (BON Quarterly Newsletter, July 2020, Page 5) A Nurse's Duty: Initiation of CPR (BON Quarterly Newsletter, January 2017, Page 4)
Nursing Fatigue: Avoiding Patient Safety Risks (BON Quarterly Newsletter, April 2015, Page 1) When Do Nurses Have a Duty to Report Confidential Health Information? (BON Quarterly Newsletter, April 2013, Page 6)
Patient Advocacy (BON Quarterly Newsletter, April 2010, Page 14)

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Employment/Workplace

Position Statement 15.6, Board Rules Associated with Alleged Patient "Abandonment" Position Statement 15.29, Professional Boundaries including Use of Social Media by Nurses
Positition Statement 15.30, Workplace Violence Frequently Asked Questions (FAQs): Workplace and Employment - General Information
Frequently Asked Questions (FAQs): Floating to Unfamilar Practice Settings Frequently Asked Questions (FAQs): Mandatory Overtime
Frequently Asked Questions (FAQs): Staffing Ratios Frequently Asked Questions (FAQs): Consecutive Shifts
Bullying in the Workplace (BON Quarterly Newsletter, January 2016, Page 4)

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Medications/Orders

Nursing Practice Act (NPA) Section 301.002(2)&(5):
See the definition of Professional Nursing (RN Level of Licensure) and Vocational Nursing (LVN Level of Licensure); note the terms do not include acts of medical diagnosis or the presciption of therapeutic or corrective measures.
Board Rule 217.11 - Standards of Nursing Practice
See: Paragraph (1) Standards Applicable to All Nurses
Position Statement 15.1, Nurses Carrying Out Orders from Physician Assistants Position Statement 15.5, Nurses with Responsibility for Initiating Physician Standing Orders
Position Statement 15.7, The Role of LVNs and RNs in Management and/or Administration of Medications via Epidural or Intrathecal Catheter Routes Position Statement 15.11, Delegated Medical Acts
Position Statement 15.17, Texas Board of Nursing/Board of Pharmacy, Joint Position Statement, Medication Error Position Statement 15.18, Nurses Carrying Out Orders from Advanced Practice Registered Nurses
Position Statement 15.19, Nurses Carrying Out Orders from Pharmacists for Drug Therapy Management Position Statement 15.25, Administration of Medication & Treatments by LVNs
Frequently Asked Questions (FAQs): Off Label Use of Medications Institute of Safe Medication Practices (ISMP) Top 10 Medication Errors and Hazards of 2020
Heparin Label Alert and CDC Health Advisory Related to Synthetic Opioid Overdose (BON Quarterly Newsletter, October 2013, Page 5) Texas Pill Mill Clinics and Prescription Drug Abuse (BON Quarterly Newsletter, October 2012, Page 4)
Off-Label Administration of Ketamine for Pain Management by a Nurse (BON Quarterly Newsletter, October 2012, Page 5) Minimizing Disruptions in Medication Administration (BON Quarterly Newsletter, January 2010, Page 5)
Medication Administration Issue: Promethazine (Phenergan) (BON Quarterly Newsletter, July 2010, Page 5) Drug Errors  (BON Quarterly Newsletter, January 2008, Page 6)
Rights of Medication Administration (8) (BON Quarterly Newsletter, October 2007, Page 7)

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Nursing Delegation

Board Rule 224 Delegation of Nursing Tasks by Registered Professional Nurses to Unlicensed Personnel for Clients with Acute Conditions or in Acute Care Environments Board Rule 225 RN Delegation to Unlicensed Personnel and Tasks Not Requiring Delegation in Independent Living Environments for Clients with Stable and Predictable Conditions 
Delegation Resource Packet Frequently Asked Questions (FAQs): Delegation
Position Statement 15.5, Nurses with Responsibility for Initiating Physician Standing Orders Position Statement 15.11 – Delegated Medical Acts
Frequently Asked Questions (FAQs): Role of the School Nurse With Unlicensed Diabetes Care Assistants (UDCAs) (HB984) Frequently Asked Questions (FAQs): Delegation and the Advanced Practice Registered Nurse
Frequently Asked Questions (FAQs): Delegation to Emergency Medical Technicians/Paramedics Delegation Versus Assignment (BON Quarterly Newsletter, July 2011, Page 5)

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Professional Boundaries/Electronic Communication/Social Media

Board Rule 217.11 - Standards of Nursing Practice
See: Paragraph (1) Standards Applicable to All Nurses
Position Statement 15.29, Professional Boundaries including Use of Social Media by Nurses
Nursing and Electronic Communication (BON Quarterly Newsletter, October 2020, Page 9) Caring Does Not Always Mean Sharing (BON Quarterly Newsletter, October 2020, Page 15)
Maintaining Patient Confidentiality - Social Media Case Scenarios (BON Quarterly Newsletter, April 2012, Page 4) Establishing Professional Boundaries in the Community (BON Quarterly Newsletter, January 2011, Page 4)
Social Media: How Nurses Can Protect Their Patient's Privacy (BON Quarterly Newsletter, April 2011, Page 6) Boundary Violations via the Internet (BON Quarterly Newsletter, July 2010, Page 6)
Maintaining Professional Boundaries (BON Quarterly Newsletter, January 2008, Page 4)

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Reporting/Complaints

Nursing Practice Act (NPA) Subchapter I.
Reporting Violations and Patient Care Concern

(PDF document bottom of page 35 to page 43)
Board Rule 217.11 – Standards of Nursing Practice See: Paragraph (1) Standards Applicable to All Nurses
Discipline & Complaints – How to File a Complaint Discipline & Complaints – What Happens When a Complaint Gets Filed
Making the Distinction: Reporting a Nurse to the Board of Nursing or Referring a Nurse to the Texas Peer Assistance Program for Nurses (TPAPN) (BON Quarterly Newsletter, April 2019, Page 14) FAQ: How do I meet my reporting requirement when I suspect a nurse’s practice is impaired? (BON Quarterly Newsletter, July 2019, Page 9)
Practice Q & A: Nurse Reporting Responsibility (BON Quarterly Bulletin, July 2018, Page NDA-5) Minor Incidents & Reporting Requirements of the Texas Board of Nursing (BON Quarterly Newsletter, July 2018, Page 4)
Imposter Warnings: Who is an Imposter (BON Quarterly Newsletter, October 2010, Page 6)

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School Nursing

Position Statement 15.13, Role of the LVNs & RNs As School Nurses Frequently Asked Questions (FAQs): Role of the School Nurse With Unlicensed Diabetes Care Assistants (UDCAs) (HB984)

Other UDCA resources:
- School Nurse Quick Card Review

- Texas Department of State Health Services (DSHS): Guideline for Training School Employees who are not Licensed Health Care Professionals
New Resource for Registered Nurse Delegation in the School Setting (BON Quarterly Newsletter, January 2019, Page 1) Herbals (BON Quarterly Newsletter, April 2001, Page 6)

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(Revised 03/2021)