| (a) Each individual who seeks to practice nursing in
Texas must possess current fitness to practice. This requirement includes
all individuals seeking to obtain or retain a license or privilege
to practice nursing in Texas and applies in all eligibility and disciplinary
matters. Each individual has a duty to self-evaluate to ensure that
he/she is fit to practice before providing nursing care.
(b) An individual's fitness to practice will be determined
by evaluating the individual's ability to consistently comply with
the requirements of the Nursing Practice Act, the Board's rules and
regulations, and generally accepted standards of nursing practice.
An individual's fitness to practice may be subject to Board review
due to an individual's substance use disorder; possession, abuse,
or misuse of alcohol or drugs, prescribed or otherwise; or physical
or mental health condition. This is not an exhaustive list. If an
individual exhibits any conduct that may prevent him/her from practicing
nursing with reasonable skill and safety, the Board will review the
individual's conduct to determine if he/she possesses current fitness
to practice.
(c) Evaluations. If an individual exhibits conduct
that raises questions about his/her fitness to practice, the Board
may require the individual to undergo a physical and/or psychological
evaluation that meets the criteria of the Occupations Code §301.4521
and §213.33 of this chapter (relating to Factors Considered for
Imposition of Penal-ties/Sanctions). Pursuant to §301.4521, an
individual subject to this rule is responsible for paying the costs
of the evaluation. Utilizing the results of the evaluation and the
individualized facts of the case, the Board may deny licensure (including
renewal, reinstatement/reactivation, or the return to direct patient
care from a limited license); suspend or revoke the individual's license
or privilege to practice nursing in this state; or impose probationary
conditions or restrictions on the individual's ability to practice
nursing in this state.
(d) Substance Use Disorders and Abuse/Misuse of Alcohol
or Drugs.
(1) Individuals who have been diagnosed, treated, or
hospitalized for a substance use disorder that may impair their ability
to practice nursing safely, will, at a minimum, be required to demonstrate
sobriety and abstinence from drugs and alcohol for a minimum of twelve
consecutive months, through verifiable and reliable evidence, in order
to obtain or retain licensure. Verifiable and reliable evidence of
sobriety and abstinence from drugs and alcohol may include evidence
of the completion of inpatient, outpatient, or aftercare treatment,
random drug screens, individual or group therapy, and/or support group
attendance. Depending upon the individualized facts of each case,
an individual may be required to establish this period of sobriety
and abstinence prior to being permitted to practice nursing in this
state. If appropriate, based upon the individualized facts of the
case, an individual may also be eligible to obtain or retain licensure
and practice nursing under an en-cumbered license with conditions/restrictions
determined by the Board or through participation in a Board-approved
peer assistance program created pursuant to the Texas Health and Safety
Code Chapter 467 or other lawfully authorized peer assistance program.
Licensure conditions/restrictions may include the completion of inpatient,
outpatient, or aftercare treatment, random drug screens, individual
or group therapy, and/or support group attendance. The outcome of
any particular case will be based upon an evaluation of the individualized
factors of the case and the potential risk of harm the individual's
practice may pose to patients/clients and/or the public.
(2) Individuals who have not been diagnosed, treated,
or hospitalized for a substance use disorder, but have nonetheless
exhibited behaviors raising concerns about the individual's ability
to practice nursing with reasonable skill and safety due to the possession,
misuse, or abuse of alcohol or drugs, prescribed or otherwise, including
related criminal conduct, may be required to demonstrate sobriety
and abstinence from drugs and alcohol for a minimum of twelve consecutive
months, through verifiable and reliable evidence, in order to obtain
or retain licensure. Verifiable and reliable evidence of sobriety
and abstinence from drugs and alcohol may include evidence of the
completion of inpatient, outpatient, or aftercare treatment, random
drug screens, individual or group therapy, and/or support group attendance.
If appropriate, and depending upon the individualized facts of each
case, an individual may be eligible to obtain or retain licensure
and practice nursing under an encumbered license with conditions/restrictions
determined by the Board, which may include the completion of inpatient,
outpatient, or aftercare treatment, random drug screens, individual
or group therapy, and/or support group attendance. The outcome of
any particular case will be based upon an evaluation of the individualized
factors of the case and the potential risk of harm the individual's
practice may pose to patients/clients and/or the public.
(3) An individual's prior substance use disorder diagnosis
or history of prior criminal conduct involving drugs or alcohol, prescribed
or otherwise; or misuse or abuse of alcohol or drugs, prescribed or
otherwise; will be considered by the Board only to the extent that
it may be indicative of the individual's current lack of fitness to
practice nursing.
(e) Mental Health Conditions and Diminished Capacity.
(1) Individuals who have been diagnosed, treated, or
hospitalized for a mental health condition that may impair their ability
to practice nursing safely, will, at a minimum, be required to demonstrate
controlled behavior and consistent compliance with recommended treatment,
including compliance with a prescribed medication regime, for a reasonable
amount of time, through verifiable and reliable evidence, in order
to obtain or retain licensure. Depending upon the individualized facts
of each case, an individual may be required to establish controlled
behavior and compliance with recommended treatment, including compliance
with a prescribed medication regime, prior to being permitted to practice
nursing in this state. If appropriate, and depending upon the individualized
facts of the case, an individual may also be eligible to obtain or
retain licensure and practice nursing under an encumbered license
with conditions/restrictions determined by the Board or through participation
in a Board-approved peer assistance program created pursuant to the
Texas Health and Safety Code Chapter 467. The outcome of any particular
case will be based upon an evaluation of the individualized factors
of the case and the potential risk of harm the individual's practice
may pose to patients/clients and/or the public.
(2) Individuals who have not been diagnosed, treated,
or hospitalized for a mental health condition, but have nonetheless
exhibited behaviors raising concerns about the individual's fitness
to practice due to a mental health condition or diminished capacity
may be required to demonstrate controlled behavior and compliance
with recommended treatment, including compliance with a prescribed
medication regime, for a reasonable amount of time, through verifiable
and reliable evidence, in order to obtain or retain licensure. If
appropriate, and depending upon the individualized facts of each case,
an individual may also be eligible to obtain or retain licensure and
practice nursing under an encumbered license with conditions/restrictions
determined by the Board. The outcome of any particular case will be
based upon an evaluation of the individualized factors of the case
and the potential risk of harm the individual's practice may pose
to patients/clients and/or the public.
(3) An individual's prior mental health diagnosis or
behavioral history will be considered by the Board only to the extent
that it may be indicative of the individual's current lack of fitness
to practice nursing.
(f) Other Medical Conditions.
(1) The Board recognizes that individuals may have
a variety of medical conditions that require medical treatment and/or
a medication regime that includes prescription drugs. Although authorized
by law and medically necessary, prescription drugs may affect an individual's
fitness to practice. An individual must be able to function safely
while under the effects of prescription drugs. An individual who abuses
his/her prescription drugs or who has been unable to stabilize the
synergistic effect of his/her medications may not possess current
fitness to practice. Further, some prescription medications may cause
side effects that affect an individual's fitness to practice, even
when taken properly. In some cases, an individual's physical condition
may prevent the individual from practicing nursing safely. In addition
to an individual's medication regime, the Board will review an individual's
behavior, diagnosis/condition, and treatment plan to determine if
he/she possesses current fitness to practice. Based upon the individualized
facts of the case, including the results of a required evaluation,
if any, the Board may deny licensure (including renewal, reinstatement/reactivation,
or the return to direct patient care from a limited license); suspend
or revoke the individual's license or privilege to practice nursing
in this state; or Cont'd... |
