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.
- Nursing Practice Quick Links and Popular Topics
- COVID-19 and Nursing Practice Settings
- Continuing Nursing Education (CNE)
- APRN Scope of Practice
- RN Scope of Practice
- LVN Scope of Practice
- Aesthetic Nursing/Complementary Modalities/IV Hydration Therapy
- Communication/Documentation
- Duty to a Patient
- Employment/Workplace
- Graduate Vocational Nurse, Graduate Nurse, Newly Licensed Nurse, and Experienced Nurses Returning to Practice
- Licensure
- Medications/Orders
- Nursing Delegation
- Nursing Peer Review - Incident Based
- Nursing Peer Review - Safe Harbor
- Professional Boundaries/Electronic Communication/Social Media
- Pronoucement of Death
- Reporting/Complaints
- School Nursing
- Substance Abuse Disorder/Fitness to Practice/Texas Peer Assistance Program for Nurses (TPAPN)
Nursing Practice Quick Links and Popular Topics |
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| COVID-19 Information - Announcements - COVID-19 Nursing Licensing - COVID-19 APRN Licensing |
COVID-19 Information - COVID-19 Nursing Practice - COVID-19 APRN Practice |
| APRN General Page
Registered Nurse General Page Licensed Vocational Nurse General Page |
BON 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 |
| Board Rule 217.11 - Standards of Nursing Practice | Continuing Nursing Education and Competency Webpage |
| Board Position Statements | Guidelines |
| Guidance for Nurses Returning to Practice or Transitioning to a Different Area of Practice in Response to the COVID-19 Pandemic Recorded Presentation - April 30, 2020 | |
| Frequently Asked Questions (FAQs): APRN, Nursing Practice, Nursing Peer Review, Delegation, Telehealth, and Licensure | |
Continuing Nursing Education (CNE) |
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| Board Rule Chapter 216 - Continuing Competency | The Board's Workshop, Webinars, and Online Courses: Continuing Education Course Catalog |
| Continuing Nursing Education and Competency Webpage | Targeted Continuing Education Health and Human Services Commission's: Health Care Practitioner Human Trafficking Training |
| Frequently Asked Questions (FAQs): Continuing Education and Competency | Board's list of approved CNE providers
Board Approved National Nursing Certifications |
| Position Statement 15.10, Continuing Education: Limitation for Expanding Scope of Practice | Frequently Asked Questions (FAQs): Requirements for Refresher Programs, Extensive Orientations and Nursing Academic Courses |
| CNE & Me: Understanding the Board's Continuing Competency Requirements (BON Quarterly Newsletter, January 2019, Page 7) | The Benefits and Limitations of Nursing Continuing Education (BON Quarterly Bulletin, January 2017, Page 6) |
APRN Scope of Practice |
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| APRN Practice Information | Scope - Advanced Practice Registered Nurse Practice |
Aesthetic Nursing/Complementary Modalities/IV Hydration Therapy |
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| Frequently Asked Questions (FAQs): Cosmetic Procedures for APRNs | Position Statement 15.3, LVNs Engaging in IV Therapy, Venipuncture, or PICC Lines |
| Frequently Asked Questions (FAQs): Cosmetic Procedures for LVNs | Position Statement 15.9, Performance of Laser Therapy by RNs and LVNs |
| Frequently Asked Questions (FAQs): Cosmetic Procedures for RNs | Position Statement 15.10, Continuing Education: Limitations for Expanding Scope of Practice |
| IV Hydration: What Texas Nurses Need to Know (BON Quarterly Newsletter, July 2020, Page 8) | Position Statement 15.15, Board's Jurisdiction over a Nurse's Practice in Any Role and Use of the Nursing Title |
| - 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 15.23, The RNs Use of Complementary Modalities |
Communication/Documentation |
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| 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) | |
Employment/Workplace |
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| 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) | |
Graduate Vocational Nurse, Graduate Nurse, Newly Licensed Nurse, and Experienced Nurses Returning to Practice |
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| Board Rule 217.3 - Temporary Authorization to Practice/Temporary Permit | Board Rule 217.11 - Standards of Nursing Practice See: Paragraph (1) Standards Applicable to All Nurses |
| Guideline for Transitioning of the Experienced Nurse back into Clinical Practice or into a New Practice Setting | Rules and Guidelines Governing the Graduate Vocational and Registered Nurse Candidates or Newly Licensed Vocational or Registered Nurse |
| Frequently Asked Questions (FAQs): GNs, GVNs, and Newly Licensed Nurses Practicing in Home Health Settings | Frequently Asked Questions (FAQs): Practice Recommendations for Newly Licensed Nurses |
| Frequently Asked Questions (FAQs): Floating to Unfamilar Practice Settings | Guidance for Nurses Returning to Practice or Transitioning to a Different Area of Practice in Response to the COVID-19 Pandemic Recorded Presentation - April 30, 2020 |
Licensure |
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| Board Rule 217.5 - Temporary License and Endorsement | Board Rule 217.6 - Failure to Renew License |
| Board Rule 217.7 - Change of Name and/or Address | Board Rule 217.9 - Inactive and Retired Status |
| Board Rule 217.10 - Restrictions to Use of Designations for Licensed Vocational or Registered Nurse Frequently Asked Questions (FAQs): Doctoral Degree in Nursing and Using the Title "Doctor" |
Board Rule 217.11 - Standards of Nursing Practice Board Rule 217.12 - Unprofessional Conduct |
| Board Rule 220 - Nurse Licensure Compact (NLC) | Position Statement 15.15, Board's Jurisdiction over a Nurse's Practice in Any Role and Use of the Nursing Title |
| NLC Facts and Tips (BON Quarterly Newsletter, January 2020, Page 6) | Frequently Asked Questions (FAQs): Licensure |
| Frequently Asked Questions (FAQs): Differentiating the Role of the Texas Board of Nursing from the Role of Professional Nursing Associations | Frequently Asked Questions (FAQs): Practice of Nursing |
Medications/Orders |
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| 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) | Poison Control and Prevention The Texas Nursing Practice Act (NPA) requires the Board of Nursing to provide license holders with information regarding the services provided by poison control centers (Sec. 301.1582). According to the Health Resources & Services Administration (HRSA), there are 55 poison centers in the US. The Texas Poison Center Network (TPCN) is made up of six regional poison centers. These poison centers provide the following services: • Help with a poisoning emergency, which can often be solved over the phone rather than calling 911 or going to the emergency room; • Advice to healthcare professionals and the general public; • Poison prevention and treatment education materials; • Real-time data collection that aids in detecting public health emergencies; and • Free and confidential help. Service is available throughout the entire US and many territories, along with interpretation services in over 100 languages. In case of a poison emergency, contact poison control toll-free at 1-800-222-1222 to be routed to the poison center designated to serve your area. Help is available 24/7. |
Nursing Delegation |
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| 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) |
Nursing Peer Review - Incident Based |
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| Board Rule 217.16, Minor Incidents - Flow Chart for Determining if an Error is a Minor Incident |
Board Rule 217.19, Incident-Based Nursing Peer Review and Whistleblower Protections |
| Nursing Peer Review/Incident-Based and Safe Harbor Webpage | Nursing Peer Review Evaluation of Practice-breakdown (N-PREP) |
| Nursing Practice Breakdown - TERCAP Nursing Practice Breakdown: TERCAP Pilot Project Summary (BON Quarterly Newsletter, October 2018, page 6) | Frequently Asked Questions (FAQs): Nursing Peer Review |
| Nurse Responsibilities when an Error Occurs: flow chart to help the nurse understand what to do and what may happen following a nursing error. | Identification and Monitoring of Minor Incidents in Texas Long-Term Care Facilities (BON Quarterly Newsletter, January 2020, Page 4) |
| Minor Incidents & Reporting Requirements of the Texas Board of Nursing (BON Quarterly Newsletter, July 2018, Page 4) | |
Nursing Peer Review - Safe Harbor |
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| Board Rule 217.20 - Safe Harbor Nursing Peer Review and Whistleblower Protections | Nursing Peer Review/Incident-Based and Safe Harbor webpage |
| BON Safe Harbor Nursing Peer Review Forms | Frequently Asked Questions (FAQs): Nursing Peer Review |
| Updated Safe Harbor Forms: Recorded Audio | Practice Question and Answer-Safe Harbor: The Who, What, When, Where, and How (BON Quarterly Newsletter, January 2021, Page 6) |
| Safe Harbor Nursing Peer Review (SHNPR) Forms Updated (BON Quarterly Newsletter, July 2020, Page 6) | BON Safe Harbor Nursing Peer Review Resource for Nurses |
Professional Boundaries/Electronic Communication/Social Media |
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| 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) | |
Reporting/Complaints |
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| 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) | |
School Nursing |
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| 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) |
(Revised 03/2021)