Which Statements Concerning Licensure As A Registered Nurse Are Correct

Lath Position Statements do not have the force of police, merely are a means of providing management for nurses on issues of business organisation to the Lath relevant to protection of the public. Each position argument is meant to provide guidance in the context of the totality of the position argument. Lath position statements are reviewed annually for relevance and accuracy to electric current practice, the Nursing Exercise Human activity, and Board rules. The Board'due south last review was performed Jan 2020.

A brief summary of Position Statement content is available, but does not capture the details contained inside each Position Statement. This cursory summary is provided to give a glimpse of the content to assist you in deciding which Position Argument is applicable to the topic or topics you may be seeking and is available in Adobe Acrobat PDF format, at this link: Texas Board of Nursing Position Argument Summary Document.

#	Title	Description Summary
15.1	Nurses Conveying out Orders from Doc Assistants	Nurses may carry out physician orders relayed past a physician assistant (PA) when the PA is compliant with laws regulating the exercise of the PA. The nurse is expected to clarify any order the nurse questions past communicating with the PA or the physician.
15.2	The Role of the Licensed Vocational Nurse in the Pronouncement of Decease	LVNs must initiate CPR in the absence of a clear do-not-resuscitate (DNR) order. Laws regarding the pronouncement of death are non in the NPA or Lath Rules. LVNs cannot pronounce death. The LVN may have a physician'due south guild regarding mail-mortem care, but cannot have a exact order to pronounce death.
fifteen.3	LVNs Engaging in Intravenous Therapy, Venipuncture, or Peripherally Inserted Primal Catheter (PICC) Lines	The LVN must complete mail service-licensure training to engage in Four Therapy/Venipuncture (non typically included in LVN curriculum). Insertion and removal of PICC lines is beyond the scope of practise for LVN.
15.4	Educational Mobility	The Board supports educational mobility for nurse's prepared at LVN, Diploma, ADN, and BSN levels without needless repetition of clinical experiences or time penalties. The Lath also supports educational mobility for armed services personnel and veterans.
fifteen.5	Nurses with Responsibility for Initiating Medico Standing Orders	Nurses may initiate physician's continuing medical orders or standing delegation orders by selecting specific tasks or functions for patient management. The nurse is accountable to assure his/her deportment are in accordance with the NPA and Board Rules, including that the standing orders do not require the nurse to engage in independent medical judgment. NOTE: RN's who lack Advanced Practice licensure and LVNs may non utilize "protocols" intended for utilise by APRN'southward or PA's (encounter definitions of protocols from the Texas Medical Board in this position statement).
fifteen.6	Board Rules Associated with Alleged Patient "Abandonment"	Differentiates employment vs. licensure issues; addresses relevant Board rules when a nurse engages in unprofessional conduct with regard to being unavailable to provide care to assigned patients (such as sleeping on the job. Provides guidance for nurses in relation to emergency preparedness (including disasters, infectious disease outbreaks, or bioterrorism).
15.7	The Role of LVNs and RNs in Direction and/or Administration of Medications via Epidural or Intrathecal Catheter Routes	LVNs may provide nursing care to patients with epidural or intrathecal catheters, simply should non be responsible for catheter management, including adminstration of drugs via these routes. Epidural & Intrathecal catheter management may be within the RN's scope of practice if the RN has current comptency in both the knowledge and skills required, with sure limitations recommended in the obstetrical setting. Appropriate Nursing policies and procedures must also be in place.
xv.eight	Function of the Nurse in Moderate Sedation	LVNs cannot administrate pharmacologic agents for the purpose of achieving moderate sedation to or monitor patients receiving moderate sedation. The administration of drugs and monitoring of patients for moderate sedation may exist inside the RN's scope of practice. If an RN elects to appoint in administration of pharmacologic agents classified as "anesthetic" agents to induce moderate sedation, the RN should either exist skilled in, or take immediate availability of other practitioners skilled in avant-garde airway management forth with appropriate equipment that might be necessary to rescue a patient from unintended deep sedation. The facility or physician'due south role needs to accept policies and procedures to guide the RN. Encounter show-based exercise standards of professional person anesthesia association guidelines listed in the position statement.
xv.9	Performance of Laser Therapy by RN's or LVNs	A nurse must take the appropriate pedagogy, noesis, and experience to appoint in light amplification by stimulated emission of radiation therapy. There are criteria to be followed by the nurse who accepts doc delegation in the apply of not-ablative laser therapy and there are specific regulations and educational requirements for a certificate related to laser hair removal (from the Texas Department of Licensing and Regulation).
xv.10	Standing Education: Limitations for Expanding Telescopic of Practice	Clarifies that expansion of an individual nurse's scope of practise has licensure-related limitations. Informal continuing nursing education or on-the chore training cannot be substituted for formal teaching leading to the next level of practice/licensure. A nurse functions under his/her own nursing license and as such has a duty to patients that is dissever from an employment relationship.
15.11	Delegated Medical Acts	Specifies criteria which must be met for a nurse to carry out a delegated medical human activity. This includes documentation of individual training and competency, procedures to be performed, physician order to initiate, and advisable medical and nursing back up.
15.12	Use of American Psychiatric Association Diagnoses by LVN, RNs, or APRNs	LVNs and RNs cannot determine medical diagnoses. Use of these multi-disciplinary psychiatric diagnoses is permitted past advanced practice nurses designated as Clinical Nurse Specialists (CNS) or Nurse Practitioners (NP'south) whose population focus area is psych/mental health. Patient issues beyond the scope of training and education of the psychiatric mental health CNS/NP are to be referred to an advisable psychiatric mental wellness or medical provider.
15.13	Role of LVNs and RNs in School Health	Discusses the office of the LVN and RN in school wellness. The Texas Education Code (TEC) defines a school nurse as a RN. The RN may consul routine, repetitive tasks in the school setting in compliance with the BON's Delegation Rules institute in Chapters (§224 & §225). As well addresses the RN'southward supervisory relationship to LVNs who provide nursing services in a school setting.
15.xiv	Duty of a Nurse in any Exercise Setting	Establishes that a nurse has a responsibility and duty to a patient to provide and coordinate the delivery of safety, effective nursing care, through the NPA and Board Rules. This duty supersedes whatsoever facility policy or physician order.
15.15	Board's Jurisdiction over a Nurse'south Practise in Any Role and Use of the Nursing Title	If a RN or LVN functions in a role other than current level of licensure, or in another expanse with an overlapping scope of practise, the nurse is still held to the level of educational activity and competency of the nurse's highest licensure. As well restricts use of the titles LVN or RN or whatever designation implying nursing licensure by non-nurses (NPA Section 301.351 and NPA Department 301.004(a) (5)and Rule 217.10).
15.16	Development of Nursing Education Programs	Judicious development of new nursing programs is urged as calculation programs alone volition not address the growing nursing shortage. Key considerations are delineated.
fifteen.17	Texas Lath of Nursing/ Board of Pharmacy Joint Position Statement, Medication Errors	Stresses the need to expect at "systems" and not just "individual competency" in determining root causes of medication errors and implementing strategies to effectively reduce errors, thus better protecting the public.
15.18	Nurses Carrying Out Orders from Advanced Do Registered Nurses	Nurses may carry out orders issued by APRN's as long as the orders are within the APRN's scope of practice in their role and population focus. The nurse is expected to question orders they believe are nonefficacious or contraindicated by consulting with the APRN or the physician.
xv.19	Nurses Conveying Out Orders from Pharmacists for Drug Therapy Management	There are rules that allow pharmacists to write orders for Drug Therapy Management (DTM) while working under dr. delegation. A nurse may carry out these orders provided the orders originate from a written protocol authorized by a md. The nurse is responsible and accountable for his/her actions every bit with any physician order.
fifteen.20	Registered Nurses In the Management of an Unwitnessed Abort in a Resident in a Long Term Care Facility	Guidance is provided concerning the appropriateness of initiating cardiopulmonary resuscitation (CPR) when the RN encounters an unwitnessed resident arrest without a do not resuscitate (DNR) social club in the long term care setting but. Presumptive and conclusive signs of expiry are delineated, to help the RN in making a decision that CPR would be futile. Documentation, RN obligation to the patient, care planning/advanced directives, and RN pronouncement of death are besides discussed.
15.21	[Deleted 01/2005]	In 2005, the Nursing Practice Act (NPA) expanded to include LVNs. This allowed LVNs to be included in the safety harbor provisions eliminating the demand for Position Argument 15.21, Awarding of Rubber Harbor Peer Review to LVNs.
xv.22	APRNs Providing Medical Aspects of Care for Individuals with whom at that place is a Close Personal Relationship	The BON is concerned that when APRNs provide medical aspects of care for individuals with whom they accept a shut personal relationship the APRNs risk allowing their personal feelings to deject their professional judgment. Thus APRNs should non provide medical treatment or prescribe medications for individuals with whom they have a close personal human relationship.
15.23	The Apply of Complementary Modalities by the LVN or RN	Regardless of practice setting, nurses who contain complementary modalities into their exercise are accountable and responsible for adherence to the NPA and BON Rules and Regulations. Specific regulations of particular relevance are identified in the position statement, including a reference to the BON's Telescopic of Practice Determination-Making Model (DMM). Also, a list of criteria is included in order for nurses to show accountability for the care they provide. Lastly, nurses are accountable to concord proper credentials (e.g., license, certification, registration) to safely appoint in specific practices, where applicable.
15.24	Nurses Engaging In Reinsertion of Permanently Placed Feeding Tubes	LVNs & RNs should receive post-licensure training and demonstrate competency in reinsertion of a displaced permanently placed feeding tube prior to engaging in this action. Verification of correct placement is essential to prevent life-threatening complications. Reinsertion past a nurse is non recommended prior to 8-12 weeks postal service-initial insertion; specific doc orders must exist obtained regarding reinsertion by a nurse.
15.25	Administration of Medication & Treatments by LVNs	LVNs are educationally prepared to administrate medications and treatments as ordered past a doc, podiatrist, dentist or any practitioner legally authorized to prescribe the ordered medication. LVNs may administer medications and treatments ordered past doc administration (PS 15.1) and advanced do registered nurses (PS fifteen.18). Besides see NPA 301.002(v), the definition of vocational nursing.
xv.26	[Deleted 01/2015]	Guideline 3.eight.6.a Simulation in Pre-Licensure Nursing Instruction has replaced Position Argument 15.26, Simulation in Prelicensure Nursing Education.
15.27	The Licensed Vocational Nurse Scope of Practice	The LVN scope of practice is a directed scope of practice and requires advisable supervision. The LVN is responsible for providing prophylactic, compassionate, and focused nursing intendance to assigned patients with predictable health care needs.
fifteen.28	The Registered Nurse Scope of Practice	The RN takes responsibility and accepts accountability for practicing within the legal scope of practice and is prepared to work in all wellness intendance settings, and may engage in independent nursing practice without supervision by another health care provider. The RN is responsible for providing safe, compassionate, and comprehensive nursing intendance to patients and their families with complex healthcare needs.
15.29	Professional Boundaries including Utilise of Social Media by Nurses	The purpose of this Position Statement is to provide guidance to nurses regarding expectations related to professional boundaries, inclusive of social media, and to provide nurses with guidance to prevent boundary violations.
15.30	Workplace Violence	As violence in the workplace has the potential to compromise collaboration and communication, which may pb to patient care errors, this Position Argument uses show-based practice enquiry and the standards of nursing practice found in Board Rule 217.eleven(1) to guide nurses in promoting a safe patient intendance environs.