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Making the Distinction: Reporting a Nurse to the Board of Nursing or Referring a Nurse to the Texas Peer Assistance Program for Nurses (TPAPN).

There are a number of factors that may impair a nurse's practice. Patient safety must be considered when a nurse accepts an assignment. Additionally, 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)]. 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 perception related to the nurse's fitness to practice including substance use disorders, mental illness or diminished mental capacity.

There are reporting requirements for nurses, employers, and others addressed in the Nursing Practice Act (Texas Occupations Code, Chapter 301, et. seq.). Every nurse has a mandatory reporting requirement when there is a suspicion that another nurse has engaged in conduct subject to reporting [Tex. Occ. Code, Sec. 301.402 (b)(1)]. A nurse meets the definition of "conduct subject to reporting" when a person suspects "that the nurse's practice is impaired by chemical dependency or drug or alcohol abuse" [Tex. Occ. Code, Sec. 301.401(1)(B)]. When a nurse is impaired or suspected of being impaired by chemical dependency (or substance use disorder), mental illness or has diminished mental capacity, a report is required to be made to the Board of Nursing (BON or Board) when there is a belief that the nurse committed a practice violation [Tex. Occ. Code, Sec. 301.410(b)]. Practice settings that employ, hire, or contract for the services of eight or more nurses are required to establish a nursing peer review committee [Tex. Occ. Code, Sec. 303.0015(a)]. A nurse who is required to report another nurse to the BON may meet the reporting requirement by reporting to a nursing peer review committee [Tex. Occ. Code, Sec. 301.402(e)(1)]. The nursing peer review committee suspends peer review to make the required report when the practice of the nurse under review is impaired or suspected of being impaired by substance use disorder (chemical dependency, drug or alcohol abuse, substance abuse/misuse, "intemperate use"), mental illness or diminished mental capacity [22 TAC [section]217.19(g) & Tex. Occ. Code, Sec. 301.403]. When there is no suspected practice violation by a nurse who is impaired or suspected of being impaired the nurse may be reported to TPAPN [Tex. Occ. Code, Sec. 301.410(a)].

There may be circumstances where there is not enough information to know if a nurse who is impaired, or suspected of being impaired, committed a practice violation. The information may be submitted to both the BON and TPAPN.

Information on reporting (filing a complaint) to the Board may be found on the BON website ( under Discipline & Complaints and "How to File a Complaint" or:

For information on reporting (referring a nurse) to TPAPN, please visit the TPAPN website ( and click on the TPAPN Referral Form or:

Save the Date: TPAPN Spring Advocate Workshop

The Texas Peer Assistance Program for Nurses (TPAPN) will be conducting an Advocate Workshop this spring. The workshop date is April 12, 2019 at 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 confirmed date, location, and registration information will be accessible on the TPAPN website, (, prior to the event.
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Publication:Texas Board of Nursing Bulletin
Date:Apr 1, 2019
Next Article:BON Board Members Recognized for Their Service.

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