Obtaining a professional nursing license (LVN, RN, or APRN) in the State of Texas is a challenging endeavor. It demands relentless dedication, countless hours of academic and practical training, and the successful completion of your NCLEX exam. The fact that you've earned a license is a testament to your commitment to your profession and your tenacity. Now, that license is the key to your livelihood, enabling you to work as a nurse in various healthcare settings such as clinics, doctor's offices, and hospitals.
That said, despite all the work you've put into building a nursing career, it's ironic that a single complaint could derail everything you've worked for. Whether the complaint is a result of a misunderstanding, a false accusation, or a momentary lapse in judgment, the Texas Board of Nursing (BON) is obligated to launch an investigation that could ultimately result in having your license suspended or revoked. This could signify a drastic setback in your career.
The key to protecting yourself from this kind of outcome is to hire a professional license defense attorney with specific experience with the BON and other Texas licensing boards. Attorney Joseph D. Lento and his Professional License Defense Team have provided significant assistance to nurses around the country (including Texas) who have faced the threat of losing their licenses. They will work tirelessly to get you the favorable resolution you deserve. Call the Lento Law Firm today at 888-535-3686 to schedule a consultation.
Common Issues That Can Put a Nurse's License at Risk
Nurses in Texas are expected to comply with the Board's standards of behavior and practice in accordance with the Texas Nursing Practice Act and the BON's Rules and Regulations. Most issues that can jeopardize a nurse's license involve some sort of violation of these rules. Common examples include:
- Sexual misconduct. Since nurses routinely interact with patients at an intimate level, any form of inappropriate sexual contact with a patient (whether consensual or not) is frequently grounds for suspending or revoking a license. Likewise, romantic relationships between nurses and patients are highly unethical and are grounds for discipline.
- Improper handling or misuse of drugs. Nurses are responsible for the correct administration of medications to their patients. Actions such as diverting patient-intended medications, medication abuse, incorrect documentation, or submitting unauthorized or forged prescriptions to pharmacies can lead to disciplinary action.
- Patient abuse or neglect. If you're accused of mistreating a patient physically, verbally, sexually, or mentally, or if you otherwise engage in behavior that puts a patient at unnecessary risk, your license could be in jeopardy.
- Fraud. Fraudulent activities such as altering patient records or work hours, exaggerating credentials, or sending inaccurate or inflated bills to insurance companies can result in the loss of license and possibly imprisonment.
- Criminal convictions. Being convicted of certain crimes (e.g., theft, DUI, or drug possession) may disqualify you from practicing as a nurse.
Does every disciplinary action result in loss of license?
No, it doesn't. The Board generally reserves this penalty for the most egregious offenses and for nurses who fail to respond or cooperate. Depending on the circumstances, the evidence at hand, and the severity of the offense, the BON can impose a variety of sanctions without completely stripping you of your right to practice. These might include:
- License suspension. Having your nurse's license suspended bars you from working as a nurse for a definite or indefinite period of time.
- Practice restrictions. The BON may impose certain limitations on your practice, like limiting your work hours or barring you from performing certain tasks.
- Fines. The board might levy a financial penalty, often referred to as a civil penalty.
- Remediation. The BON may mandate some form of continuing education to
- address perceived gaps in your training.
- Alternative-to-discipline program. For cases involving substance abuse, the BON might refer you to a recovery program or to supervised monitoring as an alternative to restricting your practice.
- Reprimand. For less severe offenses, the BON might issue a formal reprimand to be placed on your record, with no restrictions to your license.
Please note that even if your license isn't suspended or revoked, these lesser sanctions can still adversely impact your career, as they often become a matter of public record. For example, a potential employer researching your professional background can discover that you've faced disciplinary action, which may impact their willingness to hire you. A skilled professional license defense attorney can often negotiate for certain sanctions to remain non-public, so these items don't reflect badly on your professional record.
How the Texas Board of Nursing Handles the Disciplinary Process
The Texas BON follows a well-defined process for enforcing proper nursing practices and administering disciplinary action when needed. If you're a Texas nurse accused of wrongdoing, you can expect the process to move through the following stages.
Complaint
Any disciplinary process begins when someone files a complaint against you with the BON. Complaints may be filed by any member of the public, including patients, patient family members, colleagues/coworkers, other practitioners—basically anyone who has knowledge that your alleged conduct was in violation of nursing regulations.
Initial Review
The BON evaluates the complaint to determine the nature of the complaint (e.g., drug-related, practice-related, sexual misconduct) and to determine whether it has jurisdiction over the alleged violation. (For example, the BON actively pursues allegations of sexual misconduct involving patients but may defer to the employer regarding sexual misconduct with members of the staff.)
Investigation
Once the BON verifies the complaint and concludes it has the authority to pursue it, it launches an official investigation into the matter. The investigation phase may take months to complete and may involve requests for additional information from you, documentation from complainants, site visits, interviews, etc. If the investigation turns up insufficient evidence to move forward, the BON may close the case at this point; otherwise, it moves to the next stage.
Agreed Order Offer
If the investigation reveals evidence that the BON believes warrants disciplinary action against you, they will write up an Order of the Board indicating recommended disciplinary actions and any conditions or stipulations for keeping your nurse's license intact. If you agree with the order, the matter is considered resolved. If you dispute it, the matter proceeds to the next steps.
Settlement Process
At this point, the Board may opt for one of two alternatives in resolving the complaint: an informal settlement conference or a formal hearing.
- Informal settlement conference. You're invited to negotiate (along with your attorney) with the BON informally to come to a voluntary agreement on resolving the complaint, including disciplinary actions, at which point another Agreed Order Offer is made.
- Formal hearing. If the Board opts not to negotiate informally (or if you can't come to agreement in informal talks), the BON will file formal charges against you. You'll then be summoned to a hearing in front of an Administrative Law Judge to show cause why you should be allowed to keep your nurse's license. At the hearing's conclusion, the Judge will make a ruling and issue a Proposal for Decision to the Board for final review.
Final Board Action
If you are found to have violated the terms of your licensure through one of these processes, the BON will then determine which disciplinary actions to take as listed above—from a formal reprimand all the way to revoking your license.
Appeal
You have the right to appeal any adverse decision rendered by the BON against your license. The State of Texas gives you 20 days to file a motion of rehearing with the Board, and the Board has 45 days to consider the motion. If they don't rule within 45 days (or if they decline the motion), you then have 30 days to file an administrative appeal to your county's District Court. If you don't file in time, you lose your right to challenge the ruling. Because appeals in Texas are a complex process, having an experienced attorney is key to your success.
Even though the disciplinary process appears complicated, remember that the BON can resolve the complaint against you at any stage through adept negotiations or by demonstrating that the claims are baseless. The Professional License Defense Team at the Lento Law Firm has extensive experience with these types of negotiations and frequently helps clients resolve complaints well before they reach the later stages of the process.
Consequences of Ignoring the Complaint
Regardless of how serious or "minor" the complaint against you may be, the worst thing you can do is nothing. Failure to respond to a complaint is generally viewed by the BON as an implicit admission of guilt, and it usually results in forfeiture of your nurse's license. Specifically, if the Board calls a formal hearing and you decline to attend, they will typically revoke your license by default. For this reason, it's never a good idea to ignore a complaint or a notice from the Board of Nursing.
Disciplinary Issues With the Nurse Licensure Compact and Multistate Licensing
Texas is one of 39 states that has ratified participation in the nationwide Enhanced Nurse Licensure Compact (eNLC), a multistate licensing agreement that has set uniform practice standards and simplified the process for nurses to practice in multiple states. If you hold a nursing license in Texas, you can also apply for a multistate license under the eNLC, which enables you to practice in any other state that participates in the compact.
Unfortunately, the eNLC is a double-edged sword when it comes to license discipline issues. You are subject to the rules and regulations for conduct in any other state where you practice, which means any of those other states can issue disciplinary action against you.
If disciplinary action has been taken against your license by the Texas Board of Nursing or another compact-participating board, that information will be shared with other participating states via Nursys, the national nursing licensure and discipline database for the eNLC. Likewise, if you're disciplined in another state where you practice, that action will be shared with your Primary State of Residence (PSOR)--in this case, Texas. Special rules apply for nurses holding a multistate license. The Board may revoke or suspend your multistate privileges if you've been disciplined in another state--and in some cases, may even revoke your license to practice entirely.
The complexities of disciplinary actions across multiple states can make license defense more complicated, which is why your best option is to hire a professional license defense firm with a national reach. Attorney Joseph D. Lento and his Professional License Defense Team have nationwide experience with license defense for nurses, and they can assist with even the most complex eNLC issues.
The Importance of Having Legal Representation to Safeguard Your Nursing License
While you have the right to defend yourself against complaints made to the BON, it is generally unwise for most nurses to do so. The Board's primary mandate is to regulate your actions and protect the public, which means the Board is not working in your favor when a complaint is filed. The burden of proof lies with you, and while Texas law seeks to extend due process to nurses under investigation, you can still be disciplined based only on a preponderance of the evidence.
Engaging an attorney when your nursing license is under threat is crucial for a couple of important reasons:
- The Board of Nursing possesses a deeper understanding of the disciplinary process than you do. This puts you at a disadvantage unless you have a knowledgeable attorney to guide you.
- The challenge to your nursing license constitutes a legal matter. Your license is a legal agreement with the state, and any alleged misconduct constitutes a legal breach under the Nursing Practice Act. When dealing with legal matters, hiring a lawyer simply makes sense.
Selecting the Right Attorney to Defend Your Nursing License
Although any attorney who has passed the Bar is legally eligible to represent you, it doesn't mean every attorney is qualified to help you when your license is under attack. For instance, a divorce attorney, despite being legally qualified, may lack the necessary knowledge about Administrative Law, leaving them as unprepared as you during the disciplinary process. Therefore, for the best outcomes, it's advisable to engage an attorney with specific knowledge and experience in professional licensure defense. This type of lawyer will have a comprehensive understanding of licensing boards, their procedures, and the intricacies of administrative hearings.
The Role of a Professional License Attorney
Having an experienced nursing license defense attorney can significantly enhance your chances of retaining your nursing license and minimizing or eliminating any penalties. A good attorney will review the facts and evidence, assess the strength of the complaint against you, assist in gathering evidence and securing witnesses, if necessary, and negotiate for the best terms of resolution with the BON, possibly circumventing a hearing altogether. Moreover, they will zealously represent your interests if the matter escalates to a formal hearing. In short, if your professional nursing license is at risk, employing a competent attorney is your best bet.
Areas in Texas Where We Offer Nursing License Defense
The State of Texas is not only large in area--it's large in population. More than 29.5 million people live in the state, and the demand for quality healthcare is high statewide. This means there are many large healthcare facilities across Texas where nurses can find employment. Although the Lento Law Firm can help nurses with licensing issues in any city or municipality in the state, most of our nurse clients work in the following parts of Texas.
Houston
Home to 2.3 million people (and many more in the outlying areas), Houston is the largest city in Texas and the fourth-largest in the United States. Not only does Houston serve as a global hub for energy, biomedical research, and aeronautics, but it's also known for the NASA Johnson Space Center, which houses the training facilities for astronauts and the Mission Control Center. Houston serves as home to the Texas Medical Center, the largest medical complex in the world, hosting 9200 hospital beds and employing more than 120,000 employees. Other healthcare systems in the area include Houston Methodist and HCA Houston Healthcare.
San Antonio
Located in south-central Texas, San Antonio is widely known for its rich history and cultural heritage. Home to the famous site of the famous Battle of the Alamo in 1836, this city of 1.5 million hosts a strong military presence today, with several major military bases dotting the area. San Antonio also boasts a beautiful River Walk, a winding network of walkways along the San Antonio River lined with shops, restaurants, and entertainment venues. Among the larger healthcare employers in San Antonio are University Health, CHRISTUS Health, and the Baptist Health System.
Dallas-Fort Worth
Encompassing 13 counties in northeastern Texas, the Dallas-Ft. Worth Metroplex (DFW) is the largest landlocked metropolitan area in the U.S., home to about 8 million people. DFW hosts a variety of industries, including technology, defense, logistics, and financial services, along with renowned educational institutions, vibrant arts scenes, and several professional sports teams. The area is also home to two of the largest healthcare organizations in Texas, Medical City Healthcare and Baylor Scott & White Health, which administers Baylor University Medical Center.
Austin
Located in south-central Texas, Austin is the state capital and home to nearly 1 million people. The city is known for its vibrant music scene (it's nicknamed the "Live Music Capital of the World"--and it's South by Southwest (SXSW) festival draws thousands of visitors each year to experience the best of independent film, music, and comedy. Primary healthcare employers in this area include St. David's Healthcare, Baylor Scott & White, and Ascension.
El Paso
Situated in the far western corner of Texas along the Rio Grande River, El Paso is a large city with an estimated population of more than 860,000. El Paso is distinct for its binational and bilingual character, serving as a major point of connection between the U.S. and Mexico. The city's economy is primarily driven by sectors such as international trade, military, healthcare, and education. Among the city's largest healthcare employers are Las Palmas Del Sol, University Medical Center of El Paso, and The Hospitals of Providence.
Corpus Christi
Often referred to as the "Sparkling City by the Sea," Corpus Christi is located in the South Texas region, home to about 325,000. Corpus Christi is known for its stunning Gulf of Mexico shoreline, which encompasses numerous beaches, marinas, and the Padre Island National Seashore. The city is known for its white-sand beaches, wildlife reserves, fishing spots, and other outdoor activities. Major healthcare employers in this area include the CHRISTUS Spohn Health System and Corpus Christi Medical Center.
When to Hire a Skilled Professional License Attorney
If you're a nurse in Texas facing allegations of misconduct, you'll improve your chances of a favorable outcome by hiring a professional license attorney as early in the process as possible. Some nurses delay hiring an attorney until a formal hearing is scheduled, not realizing that they may have already compromised their opportunity for a more lenient resolution. The earlier an attorney is involved, the more opportunities there are to negotiate a more favorable outcome, possibly even avoiding a formal hearing altogether.
The stakes are high when your nursing license is called into question by a formal complaint or accusation of wrongdoing. Your entire career and livelihood hang in the balance. Each step you take in this process without legal advice is essentially a risky gamble with your future. Securing experienced legal counsel promptly can spare you considerable distress down the line, not to mention potentially saving your income and your career.
Attorney Joseph D. Lento and his Professional License Defense Team possess many years of experience in professional license defense cases nationwide, helping many professionals like you to safeguard their careers. For the help you need at this difficult time, call Lento Law Firm at 888-535-3686 or online to discuss your case and explore your options.
