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FAQ: How do I meet my reporting requirement when I suspect a nurse's practice is impaired?

When a nurse accepts an assignment, the nurse must have the education, experience, and knowledge to deliver safe patient care, and the emotional and physical ability to carry out the assignment safely [22 TAC [section]217.11(1)(T)]. There are a number of factors that may impair a nurse's practice. Life events may impact a nurse's emotional ability to accept an assignment and factors such as fatigue or physical injuries can impact a nurse's physical ability to accept an assignment. Some circumstances may impact the nurse's ability to self-assess fitness to practice including substance use disorders, mental health condition, or diminished mental capacity.

Conduct subject to reporting includes a suspicion "that the nurse's practice is impaired by chemical dependency or drug or alcohol abuse" [Tex. Occ. Code, Sec. 301.401(1) (B)]. A nurse is required to report when the nurse suspects that another nurse has engaged in conduct subject to reporting [Tex. Occ. Code, Sec. 301.402 (b)(1)].

The reporting requirements for nurses, employers, and others are addressed in the Nursing Practice Act (Texas Occupations Code, Chapter 301, et. seq.). There are three pathways that a report related to an impaired nurse's practice may potentially take.

* A report to the Board of Nursing (Board or BON) is required if the nurse is impaired or suspected of being impaired by chemical dependency or diminished mental capacity and there is a belief that the nurse in question committed a practice violation [Tex. Occ. Code, Sec. 301.410(b)].

* A report may be made to a nursing peer review committee (please see Tex. Occ. Code, Chapter 303) instead of to the Board [Tex. Occ. Code, Sec. 301.402(e)(1)].

* A report may be made to the Texas Peer Assistance Program for Nurses (TPAPN) instead of to the Board or to a nursing peer review committee if the nurse has not committed a practice violation [Tex. Occ. Code, Sec. 301.410(a)].

If a person is required to report and is unsure whether there is a practice violation, the report may be made to both the BON and to TPAPN.

For information on filing a complaint to the Board, please click on the link below:

Discipline & Complaints--How to File a Complaint:

For information on filing a complaint (referral) to TPAPN, please click on the link below:

Save the Date: TPAPN Social Peer Support Workshop on November 1, 2019

The Texas Peer Assistance Program for Nurses (TPAPN) conducts Social Peer Support Workshops twice a year. The workshop is designed to give the peer support partner, or potential peer support partner (formerly referred to as TPAPN advocate), information about the social peer support role of the TPAPN volunteer peer support partner. The workshop will include content on the following areas:

* Recovery from mental illness and/or substance use disorders,

* Principles of peer support,

* Practices of peer support, and

* Overview of TPAPN

The fall workshop is November 1, 2019. The location for the workshop is the Texas Nurses Association office, 4807 Spicewood Springs Rd., Bldg. 3, Ste. 100, Austin TX 78759. Space is limited; therefore, registration is required prior to attendance. The registration information for the fall workshop will be accessible on the TPAPN website prior to the event. If you are interested in learning more about the TPAPN peer support partner role, please visit the TPAPN website ( and click on the page: for advocates.
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Publication:Texas Board of Nursing Bulletin
Geographic Code:1U7TX
Date:Jul 1, 2019
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