While AFN and Board rules prohibit a NGVP from providing nursing care completely independently (i.e., without the appropriate advice and supervision of a registered nurse, RNPA, physician, PA, podiatrist or dentist), the required proximity of the registered supervisor to the LVNP and/or NVL practice is not indicated. The proximity of the LVN practice and the type of admission of the LVN supervisor should be determined on a case-by-case basis with input from the LVN and its authorized supervisor. However, a duly approved supervisor must be available to the LVN at all times, at least by telephone or similar. Initiate your own decisions and actions Experience your own power Nurses must take steps to prevent patient exposure to infectious pathogens and transmissible conditions in accordance with Council Rule 217.11(1)(O). Nurses may opt for vaccination to prevent patients from being exposed to the flu and to protect them from possible infection. A person can be contagious before developing symptoms with seasonal flu and thus expose others to the disease. The following websites contain information about seasonal flu: While BON has no authority in employment situations, the NPA and Board Rule 217.20, Safe Harbor Nursing Peer Review and Whistleblower Protections, offer protections to a nurse who invokes the Safe Harbour in good faith because she believes she will accept the job. e.g., overtime or overtime may result in a nurse`s breach of duty to a patient and be a violation of NPA or Board rules. In addition, Section 258.005 of the Texas Health and Safety Code prevents a hospital from suspending, terminating a disciplinary action, or discriminating against a nurse who refuses to work mandatory overtime. If adverse employment action has been taken against a nurse because she refused to work mandatory overtime or relied in good faith on the safe harbor, the nurse may choose to consult with a private lawyer. If a nurse has reason to believe that a facility is not complying with the regulatory requirements applicable to that facility and therefore compromises patient safety, such as unsafe hours of work for nurses, the nurse may submit an optional written report to the appropriate professional regulatory body or accreditation body under section 301.4025 of the NPA.
Optional report from nurse. For example, the Texas Health and Human Services Commission has authority over the licensing and regulation of hospitals. The difference between employment and admission issues can be confusing for many nurses and supervisors. It is important to note that removal from foster care, whether or not there is notice, is very different from leaving a foster care assignment. For example, a nurse notifies her employer that she is leaving a job at the end of an assigned shift. In keeping with the nurse`s duty to promote patient safety, the nurse is required to perform the agreed task during a scheduled shift and to ensure the transfer of patients that promotes continuity of care. Position Statement 15.6, Board Rules Associated with the Deemed Abandonment of a Patient, explains that resignation from a position is usually a matter of employment rather than a matter of admission, provided that the nurse does not leave during the period in which she is responsible for patients. If the employer has a policy that “requires a two-week notice period,” termination without notice is still considered an employment issue and not a violation of the Nursing Practice Act (NPA) or board rules and regulations. Abruptly leaving an assignment could be an approval issue, as it would not promote continuity of care and could pose an unnecessary risk of harm to patients. All documents and forms of documentation are considered legal documents.
The legal aspects of documentation, in addition to the legal requirements associated with confidentiality, include strict legal prohibitions on altering a record, deleting entries in the medical record, and falsifying documents. I am a nurse and would like to start an intravenous hydration clinic. What do I need to know? Is it in my practice? There is nothing in the Nursing Practice Act (NPA) or board rules that prohibit a nurse from owning her business. However, council staff recommend that nurses exercise caution and critical thinking when considering practicing in an environment that offers elective intravenous hydration and vitamin therapy. As new trends emerge in health care, nurses must rise to the challenge of ensuring safe care and must be aware of their responsibility to keep abreast of current evidence-based standards of practice, as well as all applicable laws and regulations relevant to their area of nursing practice. This ensures that patients receive the safe, high-quality healthcare they deserve. The NPA describes a defined limit to nursing practice because nursing practice “does not include acts of medical diagnosis or the prescription of therapeutic or corrective measures” [NPA 301.002(2)(5)]. Professional nursing (RN-level nurses of licensure) requires that the acts or procedures performed be within the scope of a particular nurse`s practice and that appropriate prescriptions be in place for actions beyond nursing practice. While the AFN and Board rules do not specifically address IV hydration therapy and/or vitamin therapy, if each AI is appropriately prescribed for a particular client by a provider licensed to prescribe such treatments, it should individually determine whether or not that particular measure falls within its scope of practice (see Scope of Practice Decision Model below).
A nurse must follow AFN and board rules when providing nursing care, regardless of hiring. There is a full description of the registered nurse`s area of practice (RN) on the CN website, which can be an additional help. IV therapy induction is a learned skill practiced by many Texas nurses. However, there are considerations necessary to safely perform this skill outside of a traditional facility. All nurses licensed to practice nursing in Texas must comply with the Nursing Practice Act (NPA) and board rules, as well as other hiring regulations. Therefore, intravenous hydration in a non-traditional setting, such as a mobile unit or wellness clinic, must comply with applicable regulations, current standards of care, and current national care guidelines for intravenous therapy. When initiating IV therapy services, including the administration of medications, such as isotonic IV fluids, a valid prescription from the provider is required. An IV therapy prescription may come from a provider who has examined the patient, or may be implemented in other settings where a physician uses permanent delegation assignments. If the nurse intends to provide these services under a permanent delegation order for physicians, she should review the Texas Medical Board (TMB) rules, which define the permanent delegation mandates included in Title 22 of the Texas Administrative Code, Chapter 193, and the Board`s position statement 15.5 Nurses with Responsibility to Initiated Physician Standing Orders.
Nurses practice their own licenses and take responsibility for the care they provide, as nurses do not practice medically. Even if all criteria for initiating medical delegation assignments are met, nurses are required to act in the best interests of their patients and this obligation supersedes any medical prescription or employer policy. In all practice settings, nurses must clarify any prescription or treatment regimen that they have reason to believe is inaccurate, ineffective or contraindicated by consulting the appropriate licensed physician and notifying the appointing physician if the nurse makes a decision not to administer the drug or treatment [Council rule 217.11(1)(N)]. Council Rule 217.11, Standards of Nursing Practice, outlines the minimum standards of nursing practice that apply to all levels of admission (LVN, RN and NPA). Commission staff recommend that the rule be reviewed in its entirety, but some specific standards are highlighted below. All caregivers must: Regardless of the number of years of practical experience, a home nurse does not have equivalent training to a registered nurse and is not trained or trained to analyze and synthesize symptoms or perform a comprehensive telephone assessment with a patient. If urgent action is required and the LVN is unable to identify this need due to limited assessment skills, interventions that may be required to save the patient`s life may be delayed. Even under supervision and guidance, LVNs cannot conduct comprehensive care assessments. Similarly, RNs cannot hire a nurse to conduct comprehensive care assessments under the supervision of an RN, with the intention that the RN assume “ultimate responsibility.” Every nurse has an independent duty and responsibility to comply with the laws and rules applicable to her licence [clause 217.11(1)(A)]. And each nurse (LVN, RN or APRN) is responsible for performing and/or accepting safe and appropriate duties in accordance with Council Rule 217.11(1)(S) and (1)(T). Good, E. & Bishop, P.
(2011). Ready to Go: A creative strategy to minimize the stress associated with hovering. The Journal of Nursing Administration, 41(5), 231-234. Excerpt from www.nursingcenter.com/pdfjournal?AID=1161969&an=00005110-201105000-00009&Journal_ID=54024&Issue_ID=1161688 If a nurse from another state provides nursing services to a patient in Texas, she must have a valid Texas nursing license or a valid nursing license with multistate privileges in another compact state to provide nursing care in the state of Texas and/or with Texas residents.