This is the second part in an ongoing series reviewing some of the changes to Board of Nursing (BON) rules after its recent Sunset review. As we discussed previously, the BON was recently reviewed under the Sunset process, leading to several changes in its investigative and sanctioning processes. On December 8, 2017, the Board of Nursing proposed changes to Rule §213.27 regarding Good Professional Character. These rules became effective on February 25, 2018. The changes made were consistent with the Sunset Commission’s review that “the board’s use of subjective standards to link most any mistake, even off-the-clock conduct, to nursing can result in harsh sanctions for nurses.”
For example, subsection (a) was changed emphasize that good professional character was limited to the practice of nursing, rather than unrelated conduct, by including the underlined sentence:
Every individual who seeks to practice nursing in Texas must have good professional character related to the practice of nursing. This requirement includes all individuals seeking to obtain or retain a license or privilege to practice nursing in Texas.
Additionally, the BON added a provision to subsection (b) to clarify that “An individual who provides satisfactory evidence that he/she has not committed a violation of the Nursing Practice Act or a rule adopted by the Board is considered to have good professional character related to the practice of nursing.” This replaced the following subsection: “An individual must maintain good professional character to ensure that he/she is able to consistently act in the best interest of patients/clients and the public. In all cases, it is the individual’s burden to provide evidence of good professional character in order to obtain or retain licensure.” This language change ensures that good professional character is only considered in the context of the Nursing Practice Act (NPA) and the BON’s rules, not the “subjective standards” that concerned the Sunset Commission.
Likewise, subsection (c) was also changed to emphasize that sanctions are appropriate only in the context of violations of the NPA and BON rules and not subjective transgressions of good professional character:
A determination that an individual does not have good professional character related to the practice of nursing must be based on a showing by the Board of a clear and rational connection between a violation of the Nursing Practice Act or a rule adopted by the Board and the individual’s ability to effectively practice nursing.
Finally, the BON eliminated from subsection (c) a number of factors presumably not containing a “clear and rational connection between a violation” of the NPA or BON rules. The eliminated factors were
- the individual’s age, education, experience, and behavioral history;
- whether the individual is able to distinguish right from wrong;
- whether the individual is able to think and act rationally;
- whether the individual is able to keep promises and honor obligations;
- whether the individual is accountable for his/her own behavior and/or accepts responsibility for his/her actions;/her own behavior and/or accepts responsibility for his/her actions; and
- any other behaviors bearing on the individual’s honesty, accountability, trustworthiness, reliability, or integrity.
If you would like to read more about these rule changes, you can find more information at the Sunset website.