Texas Board of Nursing vs. Professional Nursing Associations

[Audio] Hello Dr Wyss My Name Olariyike Buoye and I will be presenting on the Texas board of Nursing Vs Professional Nursing Association. Since I reside in Texas..

[Audio] To ensure safe and effective nursing practice, it is essential to understand the roles of different regulatory and support organizations within the profession. The Board of Nursing (BON) is a government-established regulatory body that oversees the licensing, practice standards, and disciplinary actions for nurses. Its primary mission is to protect public health by ensuring that all practicing nurses meet the required competencies and adhere to established ethical and legal standards. (National Council of State Boards of Nursing [NCSBN], 2020). In contrast, professional nursing associations—such as the American Nurses Association (ANA) or the Texas Nurses Association (TNA)—are member-based organizations that support the profession by promoting advocacy, professional development, continuing education, and advancement of nursing practice. (American Nurses Association, 2021). These associations do not regulate nurses but rather represent their interests, provide leadership opportunities, and influence policy to improve healthcare outcomes.Understanding the distinct yet complementary roles of the BON and professional nursing associations is critical for nurses to navigate their responsibilities, uphold standards, and contribute meaningfully to the profession and patient care..

[Audio] The mission of the Texas Board of Nursing is "to protect and promote the welfare of the people of Texas by ensuring that each person holding a license as a nurse in the State of Texas is competent to practice safely" (Texas Board of Nursing, 2024). Licensing: BON issues licenses to qualified Registered Nurses (RNs), Licensed Vocational Nurses (LVNs), and Advanced Practice Registered Nurses (APRNs) to ensure public safety. Enforcing the Nursing Practice Act (NPA): The BON interprets and enforces the NPA, which governs nursing practice in Texas. Setting Educational and Practice Standards: BON approves nursing education programs and defines standards to maintain quality and competence in nursing practice. Disciplinary Actions: The Board investigates complaints and takes disciplinary actions when nurses violate laws or professional standards, ensuring accountability..

[Audio] The Texas Board of Nursing (BON) is composed of 13 members appointed by the Governor of Texas, representing a mix of nursing professionals and public interests. This includes six nurse members: two Registered Nurses (RNs), three Licensed Vocational Nurses (LVNs), and one Advanced Practice Registered Nurse (APRN). Additionally, three members are nursing faculty—one each from an Associate Degree in Nursing (ADN) program, a Bachelor of Science in Nursing (BSN) program, and a Vocational Nursing program. The remaining four members are public representatives, ensuring that the community's perspective is incorporated into board decisions (Texas Board of Nursing, 2024)..

[Audio] The appointment process for the Texas Board of Nursing (BON) involves selection by the Governor of Texas, followed by confirmation by the Texas Senate. Nurse members must possess a current and valid nursing license in Texas and demonstrate professional competence through education, experience, and ethical practice. Public members, on the other hand, must not have financial or professional ties to the healthcare industry to maintain impartiality. Each board member serves a staggered six-year term, promoting stability and continuity in board governance (Texas Occupations Code, §301.051). Texas Board of Nursing. (n.d.).

[Audio] The Texas Administrative Code, Title 22, Part 11, Chapter 217.11, outlines the Standards of Nursing Practice, serving as the foundation for all licensed nurses in Texas. This regulation mandates that nurses maintain accurate and complete documentation to ensure continuity of care and legal accountability. It emphasizes the nurse's responsibility in promoting patient safety and confidentiality, aligning with ethical and legal standards. Additionally, it provides clear criteria for the safe and effective delegation of nursing tasks, ensuring that responsibilities are assigned based on the competence of assistive personnel and the condition of the patient (Texas Board of Nursing, 2024)..

[Audio] Ensures nurses adhere to consistent standards, enhancing patient trust. Provides clear guidelines for clinical judgments and interventions. Empowers nurses to act in the best interest of patients, including questioning inappropriate orders. Nursing regulations set by boards like the Texas Board of Nursing ensure safe, ethical, and competent care by defining the scope of practice, licensing requirements, and standards of conduct. These rules protect public health and guide nurses in clinical decision-making. Texas Board of Nursing. (2024).

[Audio] Influence on Healthcare Delivery Ensures Safe Practice: By setting licensure requirements and enforcing nursing standards, the Texas BON ensures that nurses provide safe and competent care, which directly impacts patient outcomes and quality of care. Scope of Practice Definition: The BON defines what nurses are legally allowed to do. Expanding or restricting scope of practice (e.g., for APRNs) can change how healthcare is delivered, especially in rural or underserved areas. Workforce Regulation: By monitoring nurse supply through licensure data and regulation, the BON indirectly shapes how and where nurses practice. Influence on Healthcare Cost Efficient Use of Resources: Allowing nurses—especially advanced practice nurses—to practice to the full extent of their training can reduce costs by minimizing reliance on more expensive providers (e.g., physicians).Reducing Errors and Liability: BON oversight and disciplinary actions help reduce medical errors, which can lower malpractice claims and related healthcare costs. Regulatory Compliance: Facilities must invest in compliance with BON standards, which can both increase administrative costs and reduce costly legal issues. Influence on Healthcare Access Licensure Portability and Compacts: The BON's participation in the Nurse Licensure Compact (NLC) improves access by allowing nurses to practice across state lines, especially useful in telehealth and during emergencies. APRNs and Access Expansion: BON rules around prescriptive authority and APRN independence can either expand or limit access, especially in underserved or rural communities. Disciplinary Action and Public Safety: Ensuring only qualified nurses remain in practice helps maintain public trust and access to safe care..

[Audio] Nurses must provide culturally competent care, respecting diverse beliefs and practices. Essential when language barriers exist to ensure accurate communication. ​Nurses are required to provide care to all patients, regardless of personal discomfort, while upholding professional standards. Cultural competence is essential in nursing practice to ensure holistic, patient-centered care. Nurses must recognize and respect the diverse beliefs, values, and customs of patients from different cultural backgrounds. This includes understanding cultural variations in communication styles, family dynamics, health beliefs, dietary practices, and end-of-life care. Culturally competent care improves patient satisfaction, adherence to treatment, and health outcomes while reducing health disparities. Leininger, M. M., & McFarland, M. R. (2006)..

[Audio] One key regulation affecting Advanced Practice Registered Nurses (APRNs) in Texas is Rule §222.5 – Prescriptive Authority Agreement under the Texas Administrative Code, Title 22, Part 11, Chapter 222. This regulation outlines the requirements for APRNs to prescribe medications, including the need for a Prescriptive Authority Agreement (PAA) with a supervising physician. It limits APRNs' autonomy by mandating physician oversight for prescribing medications, especially controlled substances. Texas Board of Nursing. (2024).

[Audio] The expansion of Advanced Practice Registered Nurse (APRN) roles has significantly impacted healthcare delivery by improving access to care, especially in underserved areas. Full practice authority allows APRNs to evaluate patients, diagnose, interpret diagnostic tests, and initiate treatment plans independently. This autonomy enhances patient outcomes, reduces healthcare costs, and addresses provider shortages. However, in states like Texas, APRNs still face regulatory restrictions that limit their full scope of practice, affecting their ability to respond to community health needs effectively. National Academy of Medicine. (2011).

[Audio] Influence on Healthcare Delivery Expanded Scope of Practice: APRNs (e.g., Nurse Practitioners, Clinical Nurse Specialists, Nurse Anesthetists, Nurse Midwives) often provide primary, acute, and specialty care—especially in underserved areas. Care Quality & Outcomes: Research shows APRNs deliver care that is comparable, and sometimes superior, in quality to that of physicians, especially in primary care. Team-Based Care: APRNs enhance interdisciplinary collaboration and contribute to integrated care models such as the Patient-Centered Medical Home (PCMH) and Accountable Care Organizations (ACOs).2. Influence on Cost Lower Cost of Services: APRN-provided care is typically more cost-effective due to lower salary costs compared to physicians, and fewer unnecessary tests or procedures. Reduced Hospitalizations: APRNs focus on preventive care and chronic disease management, which can reduce emergency room visits and hospital admissions. Efficient Use of Resources: With increased autonomy (especially in full practice authority states), APRNs can reduce dependency on physician oversight, optimizing the use of healthcare personnel.3. Influence on Access Provider Shortages: APRNs help fill provider gaps, particularly in rural and medically underserved areas where physicians may be scarce. Timely Care Access: Patients can often get appointments faster with APRNs, improving early detection and treatment of conditions. Telehealth Expansion: APRNs are increasingly involved in delivering virtual care, expanding access to patients with mobility, transportation, or location barriers.

[Audio] 2021-2022: Texas BON updated rules to allow APRNs to use telemedicine for certain services. Includes expanded remote prescribing for chronic condition management. During Covid 19 Emergency waivers temporarily expanded APRN authority, prompting push for more permanent change Also Increased access during lock downs. Paved the way for ongoing modernization of APRN practice rules..

References. American Nurses Association. (2021). About ANA. https://www.nursingworld.org/ana/about-ana/ American Nurses Association. (2021). https://www.nursingworld.org National Council of State Boards of Nursing. (2020). What you need to know about nursing licensure and boards of nursing. https://www.ncsbn.org/public-files/What-You-Need-to-Know.pdf National Academy of Medicine. (2011). The Future of Nursing: Leading Change, Advancing Health. Texas Board of Nursing. (2024). 22 Texas Administrative Code §222.5 - Prescriptive Authority Agreement. Retrieved from https://www.bon.texas.gov.

References. Agreement. Retrieved from https://www.bon.texas.gov Texas Administrative Code. (2024). Chapters 217 & 221. https://texreg.sos.state.tx.us Texas Dept. of State Health Services. (2023). Telehealth in Texas. The National Academies Press. https://doi.org/10.17226/12956 Texas Board of Nursing. (2024). Nursing Practice Act. https://www.bon.texas.gov Leininger, M. M., & McFarland, M. R. (2006). Culture care diversity and universality: A worldwide nursing theory (2nd ed.). Jones & Bartlett Learning..