Sunset Staff Reports of Other Boards: Texas Board of Nursing
Written by Editor   
Thursday, November 10, 2016 12:00 AM

“In most respects, the Texas Board of Nursing is a shining example of how a health licensing agency should be run.  The board is a stable agency with experienced, capable staff that perform well and often help smaller licensing agencies meet their regulatory responsibilities,” says the Sunset Commission Staff Report and “with nursing being the most trusted profession, the board maintains high expectations for nurses, who often care for vulnerable patients.”

Nevertheless the staff, of course finds areas of improvement for the Board of Nursing.  You may read more of those details at the Sunset Staff Report found here.

The [nursing] board consists of 13 members: four public members, three LVNs, two RNs, one APRN, one member representing LVN education programs, one member representing bachelor’s degree in nursing education programs, and one member representing associate’s degree in nursing education programs.” The board employed 117 staff in 2015 and oversees 408,846 total licensees.

“In fiscal year 2015, the board resolved over 16,000 complaints, 4,294 of which were substantiated and resulted in action.”  Nearly 74% of all complaints were dismissed.

The report notes, "nurses can perform a wide array of difficult and risky tasks. For example, registered nurses can give therapeutic treatments and intravenous medications, conduct physical assessments, assist during surgery, and supervise vocational nurses, nurse aides, and other unlicensed assistive personnel. Vocational nurses can take a patient’s vital signs, apply dressing and change bandages, give medication, and document a patient’s condition and treatment. Advanced practice nurses collaborate with physicians and specialize in areas that allow them to perform such advanced medical tasks as delivering a baby or administering anesthesia. These nurses also perform physical examinations, prescribe medicine, order and read tests, and take patient histories. In some settings, advanced practice nurses may serve as the primary healthcare provider, as a physician is only present periodically.” 

“The [nursing] board regulates the largest number of health licensees and has more resources in staff and funding than most health licensing agencies. In fiscal year 2015, the board regulated more than three times as many practitioners as the next largest regulatory program at the Texas State Board of Pharmacy.”

Of interest in the Sunset Staff Report for those considering potential consolidation of TBCE with some other regulatory agency are the statements that “Texas Department of Licensing and Regulation …. the Legislature transferred 13 health- related regulatory programs to TDLR .… While this experience has introduced TDLR to the regulation of health professions, none of the programs transferred require the kind of technical expertise needed to regulate nursing, especially from an enforcement standpoint. In addition, the large expansion of authority may well have brought TDLR to its current capacity to take on a larger, more complex regulatory program with the level of risk associated with nursing,” and “while the Texas Medical Board is not a traditional umbrella agency, it regulates a number of health-related programs…. The Medical Board does not fit the traditional umbrella model because it regulates medical providers under a physician-oriented board instead of a structure that accounts for broader regulatory authority.  The Medical Board’s oversight structure would require significant adjustment to accommodate other healthcare professionals such as nurses. Potential benefits of other structures are not great enough to justify organizational change.”