Source: http://bon.state.tx.us/faq_education.asp
Timestamp: 2017-02-24 14:52:33
Document Index: 435026262

Matched Legal Cases: ['§217', '§217', '§217', '§301', '§301', '§224', '§301', '§217', '§301']

Background Checks NCLEX® PN/RN Examination	Becoming a Nurse Nurses Endorsing into Texas from another State	Clinical Experiences Out-of-State Programs/Online Programs/Correspondence Courses	Continuing Nursing Education & Competency	Providers of Refresher Programs, Extensive Orientations or Academic Nursing Courses Complaints to the BON About Nursing Programs	Program Appoval	Curriculum	Refresher Dean/Director/Coordinator Resources	Extension Site/Campus	Students	Faculty Total Program Evaluation
Guidelines for Resources Unapproved Nursing Educational Programs Operating in Texas Clinical Experiences
How can clinical evaluation tools show progression of students' cognitive, affective, and psychomotor achievements?
Clinical evaluation tools should clearly indicate the expected behaviors of students in each clinical course. The expected behaviors reflect the student growth in knowledge base and skill level as the student progresses through the curriculum to eventually fulfill the program objectives.... Some clinical objectives will be identified as critical behaviors, vital to completion of the program. Critical behaviors may include activities such as safe administration of medications, reporting changes in client condition, and use of a systematic approach to planning, implementing, and evaluating client care. All clinical objectives must sufficiently vary from course to course in order to demonstrate progression of expectations across the curriculum.
The clinical evaluation tools provide an excellent basis for measuring students’ achievement of the Differentiated Essential Competencies of Graduates of Texas Nursing Programs(DECs). The competencies may be broken down into levels of performance from simple to complex, demonstrating progression of the students’ abilities in nursing.
What tasks can a nursing student in a BON approved nursing education program perform during clinical learning experiences?
Under the supervision of faculty, the nursing student can perform tasks for which he/she has been prepared in the education program. Faculty are responsible for supervising... all initial nursing procedures performed by the student in the clinical area and shall ascertain that the student is competent before allowing the student to perform an actual nursing procedure independently.
According to the Standards of Nursing Practice, the nursing faculty member shall:
Supervise nursing care provided by others for whom the nurse is professionally responsible [§217.11(1)(U)];
Implement measures to promote a safe environment for clients and others [§217.11(1)(B)];
Comply with any limitations placed on student participation in specific clinical areas that may be part of the contractual agreement between the nursing program and the clinical affiliating agency.
Unprofessional conduct on the part of the nursing faculty would be:
Failure of a clinical nursing instructor to adequately supervise or to assure adequate supervision of student experiences [§217.12(1)(G)].
What distinguishes an "observational experience"?
Observation experiences are those clinical learning experiences where the student is assigned to follow a health care professional in a facility or on a unit to observe activities or to observe the role of nursing but where the student does not participate in patient care. Example: observing or following a respiratory therapist on a unit.
How may preceptors can be used in the clinical setting?
After a student has received clinical and didactic instruction in basic areas of nursing or instruction specific to a particular course, clinical preceptors may be used in a one-on-one relationship with a staff nurse to enhance clinical learning experiences. Preceptors serve as... faculty-extenders since a faculty member may then supervise 12 students (rather than 10) in the clinical course when 2 students are assigned to preceptors. If a course uses clinical preceptors as the sole method of student instruction in the clinical area, faculty shall coordinate the preceptorship for no more than 24 students.
A preceptor has the same responsibilities as a clinical instructor and provides input into the formal student evaluation by the assigned faculty member. The program should have guidelines developed for the preceptors and for the students (See Education Guideline 3.8.3.a.). The preceptor should be familiar with the clinical objectives for the student at the students’ level of education. The preceptor may supervise student clinical learning experiences without the physical presence of the faculty member in the affiliating agency or in the clinical practice setting. However, nursing faculty shall be readily available to students and clinical preceptors during the clinical learning experiences.
Are students practicing under the faculty member’s license during clinical learning experiences?
A nursing student enrolled in a Texas approved nursing program is not required to have a license because of the exemption in the Nursing Practice Act §301.004(6), but can practice in a student nurse role under the supervision of a qualified member of the nursing faculty for the purposes of meeting educational requirements for clinical practice. Since the nursing student is exempt, he/she is not practicing “under the faculty member’s license.”
Is it necessary for nursing faculty to co-sign nursing students’ documentation entries in patient records?
The BON does not have rules specifically related to faculty co-signing student documentation in patient records. The necessity for faculty co-signing student documentation will be dependent upon policies of the clinical agency and of the nursing program. Generally, when charting is co-signed, it implies that the “co-signer” actually witnessed the nursing activities. The BON does not recommend co-signing documentation unless the “co-signer” witnessed and supervised the activity.
How can a nursing education program increase the number of students in clinical settings?
Several options are included in the education rules to allow programs to expand the number of students under the supervision of a nursing faculty member. When a faculty member... uses a preceptor in a course, the ratio of faculty to student can increase from 1:10 to 1:12 with students assigned to preceptors. In a course where the use of preceptors is the sole method of student instruction and supervision in the clinical setting, the ratio of faculty to student increase to 1:24 with the faculty coordinating the preceptors. More details and suggestions about using preceptors may be found in Education Guideline 3.8.3.a.
In professional nursing (RN) education programs, clinical teaching assistants may work with students in the clinical area under a Master’s prepared faculty member and the ratio can be increased to 1:15.
How can a program utilize an MSN student majoring in nursing education and being mentored by a faculty member in a pre-licensure nursing program?
Since the MSN student usually holds a BSN, he/she may function as a clinical teaching assistant working under the supervision of the Master’s prepared clinical faculty member. He/she may provide guest lectures under the supervision of the Master’s prepared faculty member as long as the faculty member guides them and is in attendance at all times during didactic presentations.
How can vocational nursing educational programs meet the requirements of the rule to provide students with experiences in both acute and non-acute care settings for Nursing Care of Children and Maternity Nursing when acute clinical opportunities in these areas are scarce?
Rule 214.9(e)(1) describes the requirements regarding Nursing Care of Children. Didactic content includes (A) common health problems of children (not acute health problems) and implications for nursing care; (B) the normal care and needs of infants and children; (C) growth... and development of children from infancy through adolescence; and (D) influences of the family on the health of children. Examples of clinical settings for nursing of children include: day care settings, clinics, settings that provide care to infants; and facilities providing care to sick children. Acute care settings providing care to sick children are not specifically required in the rule. Major health problems of infants and children and the nursing care of seriously ill children are included in professional nursing education. Simulation experiences may be included.
Rule 214.9(e)(2) describes the requirements related to Maternity Nursing. Didactic content includes (A) psychological and physiological aspects of pregnancy, labor, and post-partum care; and (B) nursing care to assist mothers in the care of their newborn infants. Examples of clinical settings for maternity nursing include maternity clinics, units providing care for maternity patients, settings providing teaching for new mothers, settings providing infant care, and newborn nurseries. Simulation experiences may be included.
The rules do NOT REQUIRE:
a specific number of clinical hours in nursing of children or maternity nursing;
that clinical learning experiences in nursing of children and maternity nursing occur only in acute care settings; or
that all clinical learning experiences occur in an actual clinical setting.
The first consideration should be that the clinical learning experiences are planned to meet clinical objectives.
Do the education rules require a specific number of clinical hours in a nursing program?
The required number of clinical hours for vocational nursing education programs shall be sufficient to meet program of study requirements with a minimum of 840 hours. Clinical learning experiences include hours in nursing skills and computer laboratories, simulation laboratories, faculty... supervised hands-on patient care in a variety of clinical settings with associated clinical conferences, and observation experiences. Laboratory activities/instruction in the nursing skills or simulation laboratory may be considered as either classroom instruction hours or clinical learning experience hours.
Clinical learning experiences in professional nursing programs are not defined by a specific number of hours but are described as hours of practice in nursing skills and computer laboratories, simulated clinical experiences, faculty supervised hands-on clinical care, clinical conferences, and observation experiences. Hours in clinical learning experiences shall be sufficient to meet program of study requirements. There shall be a rationale for the determination of contact hours assigned to classroom and clinical learning experiences. The suggested ratio is one (1) contact hour of didactic to three (3) contact hours of related clinical learning experiences in courses with a clinical component.
The focus in clinical practice time in all nursing programs should be placed on providing or offering optimal experiences with carefully planned quality activities that meet clinical objectives and allow growth in clinical decision-making.
Do out-of-state programs wishing to conduct clinical learning experiences in Texas need to seek BON approval? Programs located in other states that are preparing their graduates to take the NCLEX-PN or NCLEX-RN examination for a license and who wish to conduct clinical learning experiences in Texas may need approvals from several Texas agencies, depending upon their program type:... All out-of-state programs should contact the Texas Workforce Commission (TWC) (www.twc.state.tx.us) for their approval to conduct business in Texas.
Degree-granting programs must contact the Texas Higher Education Coordinating Board (THECB) (www.thecb.state.tx.us) for approval to offer their program in Texas.
All pre-licensure nursing programs must go through an approval process with the BON (www.bon.texas.gov).
The BON approval process:
Ensures that the program has the necessary approvals from other Texas regulation agencies;
Ensures that the public is protected by requiring that the supervision of students is equivalent to that required of the BON approved nursing programs in Texas; and
Protects the nursing students in the out-of-state nursing program from violating the NPA since they will be in a program approved for clinicals in Texas by the BON and exempt from the NPA.
The BON approval process for out-of-state programs to conduct clinical learning experiences in Texas is outlined in Education Guideline 3.1.1.f. found on the BON Education - Guidelines web page. There is a one-time $500 fee for processing the application.
The BON does not approve post-licensure (RN-to-BSN and graduate programs) for clinical experiences in Texas. Post-licensure programs should contact the TWC and THECB for information about approvals to operate in the state.
All nursing faculty from the out-of-state programs, whether pre-licensure or post-licensure, must have a current Texas nursing license or privilege to practice in order to instruct or supervise students in Texas clinical experiences. Students engaged in clinical learning experiences in a post-licensure program that is the main campus outside Texas must have a Texas license or privilege to practice to avoid violating the NPA. Also, nurses who are precepting students from out-of state programs must hold a current Texas license or privilege to practice.
What basic content must be included in the program of study for a vocational program and for a professional program?
Rule 215.9 outlines program content for professional nursing education programs that includes:... Standards of Nursing Practice set forth in the Board’s Rules and Regulations;
Texas Nursing Practice Act, Unprofessional Conduct Rules, Delegation Rules, and other laws and regulations which pertain to various practice settings;
Differentiated Essential Competencies of Graduates of Texas Nursing Programs Evidenced by Knowledge, Clinical Judgment, and Behaviors (DECs);
a systematic approach to clinical decision making and safe practice;
nursing roles: biological, physical, social, behavioral, and nursing sciences, including body structure and function, microbiology, pharmacology, nutrition, signs of emotional health, human growth and development, and nursing skills;
laboratory activities/instruction in the nursing skills or simulation laboratory;
clinical learning experiences that include actual hours of practice in skills and computer laboratories, simulated clinical experiences, faculty supervised hands-on patient care, clinical conferences, and observation experiences;
non-nursing courses appropriate for collegiate study;
nursing courses in the four (4) content areas: medical-surgical, maternal/child health, pediatrics, and mental health nursing;
professional values, including ethics, safety, diversity, and confidentiality;
health promotion, illness prevention, rehabilitation, maintenance, restoration of health, and palliative and end-of-life care for individuals of all ages across the lifespan; and
in addition, baccalaureate and entry-level master’s degree programs in nursing shall include content in basic research, management/leadership, and community health nursing. Rule 214.9 outlines program content for vocational nursing programs that includes:
a minimum of 1398 clock hours: 558 hours for classroom instruction and 840 hours for clinical instruction;
Standards of Nursing Practice set forth in the Board’s Rules and Regulations;
Texas Nursing Practice Act, Unprofessional Conduct Rules, and other laws and regulations which pertain to various practice settings;
non-nursing courses appropriate for the study of vocational nursing;
nursing roles, biological, physical, social, behavioral, and nursing sciences, including body structure and function, microbiology, pharmacology, nutrition, signs of emotional health, human growth and development, vocational adjustments, and nursing skills;
nursing content in five (5) areas: nursing care of children, maternity nursing, nursing care of the aged, nursing care of adults, and nursing care of individuals with mental health problems; and professional values, including ethics, safety, diversity, and confidentiality. Back to Topics
What are the BON requirements regarding the use of standardized examinations (HESI, ATI)?
The BON does not have requirements related to programs using standardized examinations. Many nursing programs use remediation/testing packages in a variety of ways that are individualized to each program. Some programs use other processes or techniques to prepare students for the NCLEX examination.... Board Staff have prepared Education Guideline 3.7.4.a. related to the use of standardized examinations. This guideline emphasizes that programs should not use a standardized examination as a high-stakes examination with the exam score as a determinant for progression or graduation.
What is the difference between a major curriculum change and a minor curriculum change?
It is important to know if a curriculum change is a major change or a minor change because major changes require Board Staff approval. Minor curriculum changes do not require approval and include:... editorial updates of philosophy/mission and objectives/outcomes, or
redistribution of course content or course hours.
Major curriculum changes are different between vocational and professional programs as indicated below:
Professional Nursing Programs
changes in philosophy or objectives that result in a reorganization of the entire curriculum (i.e., changing from a block to an integrated curriculum)
revisions in program hours
addition of transition course(s), tracks/alternative programs of study (including MEEP) that provide educational mobility
Addition or reduction of course(s) in the program of study
Mobility programs desiring to establish a generic program are treated as a new program and the appropriate proposal should be developed
When a program makes a curriculum change, either major or minor, the faculty shall evaluate the effectiveness of the curriculum change in the Total Program Evaluation Plan through the graduation of the first class using the changed curriculum.
What should be included in an abbreviated proposal for a major curriculum change?
Nursing education programs that have full approval status and are seeking approval for a major curriculum change shall submit an abbreviated proposal (see Education Guideline 3.7.1.a.) to the Board office for approval at least four (4) months prior to implementation. The abbreviated proposal shall contain at least the following information:... New and old philosophy, major concepts, program objectives, and course objectives;
New and old curriculum plans;
Rationale for the curriculum changes;
Clinical evaluation tools for each clinical course; and
Additional information, as requested, in order to provide clarity for Board Staff.
Is it necessary to obtain BON approval to offer IV therapy in the vocational nursing curriculum?
Rule 214 does not specifically address incorporating IV therapy for the vocational nurse in the curriculum. It is not prohibited in vocational nursing curriculum.
What criteria are important when selecting an RN-to-BSN program?
Because of the Institute of Medicine (IOM) recommendation to increase the number of BSN-prepared nurses [bachelor’s of science in nursing (BSN)], many new RN-to-BSN programs... are being developed and existing ones are increasing enrollments in response to new interest. Board Staff take the position that RN-to-BSN programs should provide an education to advance nursing knowledge to a higher level that accommodates for the differences between competencies for Diploma/Associate Degree graduates and generic Baccalaureate Degree graduates as identified in the Differentiated Essential Competencies for Graduates of Texas Nursing Programs (DECs). A description of the differences in educational preparation between Diploma/ADN [associate’s degree in nursing (ADN)] and BSN graduates is discussed in Education Guideline 3.7.5.
Board Staff suggest that nurses consider the following criteria when choosing an RN-to-BSN program:
Is the RN-to-BSN program located in an accredited institution?
Is the program accredited by a national nursing accreditation agency?
Will the curriculum advance the student’s nursing knowledge and skills?
Does the curriculum match the nurse’s career goals?
Are the courses scheduled in a fashion that will enhance the educational experience?
How many qualified faculty participate in the teaching? What are the faculty credentials and contributions to nursing scholarship?
Does the program include clinical practice?
It is helpful to speak with a current or previous student of a program for the student perspective. Board Staff encourage all nurses to further their education and advise students to make choices that will optimize their careers.
Dean/Director/Coordinator
What are the required qualifications of a Dean or Director of a professional nursing education (RN) program?
The dean or director of a professional nursing (RN) education program shall:... Hold a current license or privilege to practice as a registered nurse in the State of Texas;
Hold a master’s degree or a doctoral degree in nursing;
Hold a doctoral degree, if administering a baccalaureate or master’s degree program;
Have a minimum of three (3) years teaching experience in a professional nursing education program; and
Have demonstrated knowledge, skills, and abilities in administration within a professional nursing education program.
What are the required qualifications of a Director or Coordinator of a vocational nursing education (LVN) program?
The director or coordinator of a vocational nursing education program shall:... Hold a current license or privilege to practice as a registered nurse in the State of Texas;
Have been actively employed in nursing for the past five (5) years, preferably in administration or teaching, with a minimum of one (1) year teaching in a pre-licensure nursing education program;
Have a degree or equivalent experience that will demonstrate competency and advanced preparation in nursing, education, and administration; and
Have had five (5) years of varied nursing experience since graduation from a professional nursing education program.
If the individual has not been actively employed in nursing for the past five (5) years, advanced preparation in nursing, nursing education, and nursing administration, and prior relevant nursing employment may be taken into consideration by Board Staff in evaluating qualifications for the position.
What is the difference between a program director and a program coordinator? What is the role of an assistant director or coordinator?
The individual who is the director of a professional nursing education (RN) program usually has the title of dean, director, or coordinator. The recognized director has the direct authority for... the program, signs official documents, is responsible for evaluation of the faculty, and is in the administrator role regardless of title. The Board-approved director is the Board contact person and the individual assigned for the NCLEX program code and has the legal responsibility to sign the Affidavit of Graduation. He/she shall meet the qualifications in Rule 215.6(f).
The individual recognized as the director of a vocational nursing education program may have the title of director or coordinator, and has the same responsibilities as the director of a professional nursing program (listed above). He/she shall meet the qualifications in Rule 214.6(f).
The director may assign some of the day-to-day managerial tasks to others in an assistive role and may give them the title of “assistant” or “coordinator,” but the program director is still the main person accountable for the program. Some individuals in the director role carry the title of “coordinator,” but they are still the individual responsible and accountable for the program.
LVN and RN programs may have different organizational structures but the program director (whether dean, director, or coordinator) is the qualified individual approved by the Board and ultimately responsible for the program. Back to Topics
What are the qualifications for nursing faculty in a professional nursing (RN) education program?
A faculty member in a professional nursing education program shall:... Hold a current license or privilege to practice as a registered nurse in the State of Texas;
Show evidence of teaching abilities and maintaining a current knowledge, clinical expertise, and safety in the subject areas of teaching responsibilities; and
Hold a master’s degree or doctoral degree, preferably in nursing.
If the faculty holds a master’s degree or doctoral degree in a discipline other than nursing, he/she shall hold a bachelor’s degree in nursing from an approved or accredited baccalaureate degree program in nursing; and graduate semester hours in nursing appropriate to type of program and assigned teaching responsibilities [See Rule 215.7(c)(D)].
The program director is permitted to waive required qualifications with appropriate rationale [See Rule 215.7(d)].
What are the qualifications for nursing faculty in a vocational nursing (LVN) education program?
A faculty member in a vocational nursing education program shall:... Hold a current license or privilege to practice nursing in the State of Texas;
Have been actively employed in nursing for the past three (3) years or have advanced preparation in nursing, nursing education, and/or nursing administration;
Have had three (3) years varied nursing experiences since graduation; and
Show evidence of teaching abilities and maintaining current knowledge, clinical expertise, and safety in the subject areas of teaching responsibility.
The program director is permitted to waive required qualifications with appropriate rationale [See Rule 214.7(d)].
Can licensed vocational nurses be used as faculty in LVN nursing education?
Program directors or coordinators may use licensed vocational nurses as faculty in LVN program using the following criteria as outlined in Education Guideline 3.5.3.a:... Licensed vocational nurses work under the supervision of a registered nurse.
Didactic courses taught by licensed vocational nurses are limited to Fundamentals and Vocational Nursing Skills.
Licensed vocational nurses teaching didactic courses other than Fundamentals and Vocational Nursing Skills must have the documented academic credentials to do so.
Licensed vocational nurses may act as clinical supervisors for student clinical rotations. Evidence or registered nurse supervision must be documented.
What are the qualifications for adjunct (part-time) faculty?
Requirements for adjunct or part-time nursing faculty are the same as for full-time nursing faculty.
How would a nursing program determine how many faculty members are needed?
The number of faculty members shall be determined by factors such as:... The number and level of students enrolled;
The curriculum plan;
Activities and responsibilities required of faculty;
The number and geographic locations of affiliating agencies and clinical practice settings; and
The level of care and acuity of clients.
Sufficient faculty are required to provide a ratio of one (1) faculty to ten (10) students in the clinical area. The ratio of faculty to students will vary if preceptors are used during the clinical experiences. The total number of faculty may include a mix of full-time and part-time faculty.
Vocational nursing education rules specifically call for at least (1) one full-time nursing instructor for the program and a director/coordinator without major teaching or clinical responsibilities.
What can clinical teaching assistants do?
Clinical teaching assistants (CTAs) may be used in professional nursing programs to extend the faculty: student ratio. When CTAs are used, the number of students supervised by the... faculty member may increase from ten (10) to fifteen (15). The CTAs function in the role of clinical supervisor, responsible for supervision of students’ skills performance, student evaluation, and other aspects of student learning in the clinical setting. The supervising faculty member must be physically present in the facility and available to the CTA if consultation is needed. CTAs are employed by the nursing program to assist the program faculty with clinical supervision of students. [See Rule 215.10(i) and (j)]. Back to Topics
What is the appropriate workload for full time and part time nursing faculty?
The nursing education rules do not specify workload or a method to calculate faculty workload for nursing faculty. Rules that provide guidance in determining workloads for nursing faculty state that:... There shall be written policies describing workload for director/coordinator and for faculty;
Written policies for nursing faculty shall be in keeping with accepted educational standards and consistent with the policies of the governing entity;
Written policies for nursing faculty workload shall allow sufficient time for faculty to accomplish those activities related to the teaching-learning process;
Teaching activities shall be coordinated among full-time faculty, part-time faculty, clinical preceptors, and clinical teaching assistants, as appropriate;
Workload will be determined by the number of faculty employed and their responsibilities; and
The program should employ sufficient faculty to enable the students to meet program objectives.
Can programs use laboratory assistants? What are their qualifications? What can they do? Are they considered faculty?
It is acceptable for nursing programs to utilize laboratory assistants to manage the nursing lab. The qualifications and expectations for the lab assistant should be provided in the job description. Some activities that might be included in their job description are:... Maintaining lab supplies and equipment;
Scheduling students’ lab times; or
Organizing the laboratory.
Lab assistants are not nursing faculty and they cannot teach students or evaluate students’ performance in the skills lab. However, if the lab assistant is a registered nurse, he/she may follow a pre-set lab procedure and check-off students’ practice in the lab. Checking-off differs from evaluation which is a more complicated activity and involves making a decision about a student’s performance.
The 1:10 clinical ratio requirements in Rule 214.10 and Rule 215.10 apply to clinical learning experiences involving direct patient care, and DO NOT apply to the skills lab setting.
(See Education Guideline 3.8.4.a.)
What faculty policies should be included in the Faculty Handbook?
Dean/director/coordinator workload;
Position descriptions (including qualifications and responsibilities);
Faculty orientation to the institution and to the nursing program;
Faculty development; and
Faculty evaluation criteria.
The Faculty Handbook should also include written policies and procedures and/or bylaws for the faculty organization that serves to guide the faculty and program’s activities, including:... Written faculty policies that guide decisions related to faculty, students, and the program of study;
Processes for enforcement of written student policies;
A plan for faculty meetings with all faculty participating in the planning, implementing, and evaluating of all aspects of the nursing program;
A plan for committee structure and functioning with duties and membership of each committee clearly defined in writing;
Processes for initiating and/or changing program policies, personnel policies, curriculum, utilization of affiliating agencies, and program evaluation; and
A plan for inclusion of part-time faculty in governance, such as lines of communication for program policies, objectives, and evaluative criteria.
Other suggested policies that may be included in the Faculty Handbook:
Policies for maintaining minutes of meetings;
Policies regarding supervision of clinical experiences;
Remediation policies;
Interrater reliability policies;
Library acquisition and weeding policies;
Policies for test blueprinting;
Policies for testing and test review;
Policies for advising students;
References to personnel policies in the institution;
Peer review committee policies;
Policies related to faculty with Board Orders;
Social media policies; Practice policies for faculty who are APRNs; and
Maintenance of faculty competence. Back to Topics
What are the requirements for non-nursing faculty teaching in a nursing program?
Non-nursing faculty are exempt from meeting the faculty qualifications as long as teaching assignments are not in courses with nursing content (having nursing objectives) or in... clinical nursing courses. Non-nursing faculty assigned to teach didactic courses that have nursing objectives must co-teach with nursing faculty in order to meet nursing course objectives. (Content with nursing objectives must be taught by qualified nursing faculty.) All nursing and non-nursing faculty who teach non-clinical nursing courses shall have sufficient graduate level educational preparation verified by the program dean, director, or coordinator as appropriate to the area of teaching responsibility.
Is it acceptable to employ a faculty member with a multistate license when the party state is their home state?
A nurse with a compact license moving from his/her home state to a remote state may continue to practice under the former home state license and multistate licensure privilege during... the processing of the nurse’s licensure application in the remote state for a period not to exceed ninety (90) days. A nurse licensed in a compact state with multistate privileges could be employed to teach in a Texas-approved program for ninety (90) days while he/she is endorsing into Texas. If they are changing residences to Texas, they must endorse into Texas and name Texas as their state of residence. If a nurse comes to Texas but maintains a residence in the party state, never intending to change residency to Texas, they may teach under the multistate privileges. Evidence that the nurse has maintained residency in the party state may be requested and may include:
A driver’s license with a home address (in the other state);
Voter registration card displaying a home address (in the other state);
Federal income tax return declaring the primary state of residence (in the other state);
Military Form No. 2058 – state of legal residence certificate (in the other state); or
W2 from US Government or any bureau, division or agency thereof indicating the declared state of residence (in the other state).
Other regulations related to Nurse Licensure Compact are found in Rule 220.
Can a faculty member continue to teach if they have a Board Order?
When a nurse receives a Board Order listing sanctions against the nurse’s license, he/she is required to show the Board Order to their nursing supervisor. If any sanctions affect the faculty member’s ability to supervise students, their teaching assignment will need to be changed. Any actions by the program toward the nurse faculty who has a Board Order are affected by program policies. Board Staff recommend that all programs develop policies regarding faculty with Board Orders.
Do nursing education programs need a Peer Review Committee?
A peer review committee is a committee established under the authority of the governing body of a national, state, or local nursing association; a school of nursing; the nursing staff of a hospital, health science center, nursing home, home health agency, temporary nursing service, or... other health care facility; or state agency or political subdivision for the purpose of conducting nursing peer review. The nursing peer review process is one of fact-finding, analysis, and study of events by nurses in a climate of collegial problem solving focused on obtaining all relevant information about an event.
Any person or entity that employs, hires, or contracts for the services of ten (10) or more nurses (RNs, LVNs or any combination thereof) must have a Peer Review Plan; however, peer review of RNs is not mandatory if the facility employs less than five (5) RNs. A person or entity required to have nursing peer review may contract with another entity to conduct nursing peer review. Nursing schools, therefore, are required to establish a Peer Review Committee and follow rules in Rule 217.19. Board Staff also refer the reader to an FAQ under Nursing Practice on the web site related to peer review.
How does the BON handle complaints about nursing programs?
There are two (2) types of complaint: signed complaints and anonymous complaints:... Complaints submitted to the BON that are signed by the complainant:
Board Staff request a response to the complaint from the director with a specific due date.
Further action may be taken depending upon: evidence of noncompliance with Board rules, the severity of the complaint, and the number of people included as complainants. Board Staff may find the issue resolved, file a report with Enforcement, make a survey visit, or refer to other regulatory or accreditation agencies.
Complaints submitted to the BON but are unsigned:
Board Staff may view the issue as resolved or determine that further investigation is needed. Back to Topics
Extension Site/Campus
When can a nursing education program start an extension site?
An extension site/campus is a location other than the program’s main campus where a portion or all of the curriculum is provided. (It does represent a place and requires that students engage in their education by attending the site for labs or didactic.)... Only programs that have full approval with an acceptable NCLEX examination pass rate are eligible to initiate or modify an extension site/campus. The curriculum for the extension site/campus is consistent with the curriculum at the main campus, and shall enable students to meet the goals, objectives, and competencies of the education program and the Board standards.
A nursing program that is fully approved and desiring to establish an extension site/campus shall submit an application form for approval of the extension site to Board Staff at least four (4) months prior to date of implementation. Information required in the application form may be found in Education Guideline 3.1.2.a. Initiating or Reactivating an Extension Nursing Education Program. Board Staff may request additional information.
When the curriculum of the extension site/campus deviates from the original program in any way, the proposed extension is viewed as a new program and Board Education Guidelines 3.1.1.a., 3.1.1.b., or 3.1.1.c. may apply.
Program Appoval
What goes into the determination of ongoing approval status of a Board-approved program?
Ongoing approval status is based upon:... NCLEX-PN/RN® examination pass rate for the examination year;
Review of the annual Nursing Education Program Information Survey (NEPIS);
Review of the biennial Compliance Audit for Nursing Education Programs (CANEP);
Program’s ongoing compliance with the education rules (Rule 214 and Rule 215);
Findings in survey visit, as appropriate;
Nursing accreditation status for programs holding national nursing accreditation; and
Factors which may jeopardize program approval include:
Deficiencies in compliance with the rule;
Utilization of students to meet staffing needs in health care facilities;
Failure to submit records and reports to the Board office within designated time frames;
Failure to provide sufficient variety and number of clinical learning opportunities for students to achieve stated objectives/outcomes;
Failure to comply with Board requirements or to respond to Board recommendations within the specified time;
Student enrollments without resources to support the program, including sufficient qualified faculty, adequate educational facilities, and appropriate clinical affiliating agencies;
Failure to maintain an 80% passing rate on the licensing examination by first-time candidates;
Failure of program dean/director/coordinator to verity the currency of faculty licenses; or
Other activities or situations that demonstrate to the Board that a program is not meeting Board requirements. Back to Topics
Does the BON have guidelines for currency of library, video and software holdings?
Generally, the accepted standard regarding currency of reference materials and other holdings is “no older than five (5) years” for educational purposes in nursing education programs. This is not a written standard, but is common policy in educational institutions. An exception may be classical documents or primary resources.... In most cases, the BON and Board Staff apply the “no older than five (5) years” standard in relation to the currency requirements in the BON rules regarding publications, reference holdings, video materials, and computer software programs utilized in nursing education programs. It is important to point out that the BON does not expect institutions/programs to eliminate all holdings, video materials and computer software just because the holdings are older than five (5) years. If the program wishes to retain older materials, they should be flagged or marked in some way so that students will know they are being retained for historical value and are not considered current for research and reference purposes.
Total Program Evaluation
What are "benchmarks indicators" of program and instructional effectiveness?
Benchmarks represent goals or measuring sticks for program objectives. They are also “indicators” of how the program is meeting the evaluative criteria. For example, one benchmark... for evaluating the program of study through course evaluations may be “90% of students reported satisfaction with nursing courses.” Satisfaction may be determined by students marking a 4 or 5 on a 5-point Likert scale on the course evaluation forms.
Benchmarks can be placed in a numerical rating for most evaluative criteria. Using a numerical rating provides a mechanism to measure each item.
NCLEX® PN/RN Examination When graduates from a Texas approved nursing education program take the NCLEX® in another state or country, are their results included with the exam results for the school from which they graduated?
The NCLEX® examination results of graduates from Texas nursing education programs, no matter where the NCLEX® examinations are taken, are calculated in the overall pass rate... for the program. Board staff has access to the pass rates of individuals testing in jurisdictions (states). When the nursing education program's overall pass rate is calculated for the NCLEX® examination year, the pass rate includes the statistics from all first-time test takers who graduated from the nursing education program. Back to Topics
Where can I find more information about the alternate format test items? The NCLEX examination will include questions other than multiple choice. Alternate test items will include:... fill in the blank
point and click to identify locations, and multiple response items. More information can be acquired at: https://www.ncsbn.org/pdfs/01_08_04_Alt_Itm.pdf
Where can I find a copy of the NCLEX test bulletin?
A copy of the NCLEX Examination Candidate Bulletin can be found at https://www.ncsbn.org/cps/rde/xchg/ncsbn/hs.xsl/1213.htm
How many times can I take the NCLEX Exam?
The exam can be taken every 45 days for a four year period of time. This is governed by Rule 217.2 which states in part:
(c) An applicant for initial licensure by examination shall pass the NCLEX-PN or NCLEX-RN within four years of completion of requirements for graduation.
(d) An applicant who has not passed the NCLEX-PN or NCLEX-RN within four years from the date of completion of requirements for graduation must complete a board approved nursing education program in order to take or retake the examination.
What specific courses are required to be eligible to take
the NCLEX-PN® or NCLEX-RN® Exam?
To be eligible to take the NCLEX-PN® examination, the student must have completed an approved program for educating vocational/practical nurses. Correlated theory and clinical practice shall have been completed in the following areas: nursing care of children; maternity nursing;... nursing care of the aged; nursing care of adults; and nursing care of individuals with mental health problems. It is expected that the graduate has completed a minimum of 1,398 clock hours of study with 558 hours for classroom instruction and 840 hours for clinical practice. The specific vocational nursing curriculum content is located in Rule 214.9. Other specifics about this eligibility may be found in Rule 217.2.
To be eligible to take the NCLEX-RN® examination, the student must have completed a Board approved professional nursing education program (associate degree program, baccalaureate degree program, master’s degree program, or diploma program). Other eligibility requirements and specifics can be found in Rule 217.2.
Can I take the NCLEX-PN® Exam if I have been a paramedic, Navy Corpsman, or Air Force Medic?
The State of Texas has no provision to allow challenge of the licensure examination based on experience. The requirement is that one be a graduate of an approved vocational nursing program to apply for licensure. The only approved military approved vocational nursing... program is the Army Practical Nurse Course (formerly 91C). If you have taken college classes or have health occupation experience you could inquire at a local vocational nursing education program to learn about transfer credit or advanced placement. They may give credit for previous courses, but that is the decision of each vocational nurse program.
Can I take the NCLEX-PN® if I have completed part of my RN education?
The Texas Board of Nursing (BON) does not allow RN students/graduates to take the NCLEX-PN/VN exam. Additionally, RN students/graduates who have challenged the exam in other states, are not allowed to endorse into Texas. Only graduates from approved schools of vocational nursing are eligible to take the NCLEX-PN/VN exam or endorse into Texas as an LVN.
The BON does not have statements or policies that specifically address students with disabilities in nursing education programs. Both Rules 214 and 215 require that the curriculum for a nursing education program be designed so that graduates are able to demonstrate the appropriate Differentiated Essential Competencies for Graduates of Texas Nursing Programs: Vocational (VN), Diploma/Associate Degree (DIP/ADN), Baccalaureate (BSN), also referred to as DECs.... It is also up to each nursing education program to determine the method(s) to ensure that each student/graduate is able to meet the program/course outcomes in the curriculum. It may require that policies be developed by the program to address the needs of the students with disabilities once enrolled in the program.
Any graduate from an approved vocational or professional nursing education program may apply to take the NCLEX examination in Texas. Eligibility for licensure in Texas as a nurse is determined on an individual basis. Eligibility questions on the Application for NCLEX examination do not address general physical disabilities.
Once licensed as a nurse, it is the nurse, taking into consideration client/patient safety, who must determine which client/patient care assignments can be accepted that are commensurate with the nurse’s educational preparation, experience, knowledge, and physical and emotional ability.
The BON may not speak to the employability of any nurse since that is a workplace issue.
Education rules require that the program have well-defined, written nursing student policies including student admission policies, however, the specifics of the admission requirements are left to the program.... Applicants to vocational nursing programs must present evidence of being able to meet objectives/outcomes of the program. In addition, vocational nursing programs are required to include pretesting (measuring reading comprehension and mathematical ability).
Nursing programs are to retain the following items for a minimum of two (2) years:... Student application and required admission documentation;
Evidence of student’s ability to meet objectives/outcomes of the program;
Final clinical evaluations;
Signed receipt of written student policies furnished by manual and/or electronic means;
Evidence of study receipt of the Board license eligibility information; and
Statement of withdrawal, if applicable.
Other records required by the institution will also be retained according to the institution's records retention policies.
Education rules require that students have mechanisms for input into the development of academic policies and procedures, curriculum planning, and evaluation of teaching effectiveness. One suggestion for student input into the program governance is for the inclusion of student policies that provide for student representation on program committees. Students should be encouraged to have a class organization that will allow for student feedback related to the program.
What can a nursing student do in his/her job as a nurse tech/medical tech when not functioning as a student in his/her nursing education program?
The exemption of nursing from the Nursing Practice Act (NPA) §301.004(6) does not apply to jobs in which the nursing student is employed outside of the educational experience. Students functioning as unlicensed assistive personnel (UPAs) for compensation may only perform tasks that do... not require the use of independent nursing judgment as described in §224.8(c) Nursing Tasks Prohibited from Delegation. Students employed as UAPs also cannot engage in prohibited tasks “by proxy” for the RN; for example, an RN co-signing a nursing assessment performed by a UAP who is also a nursing student. No student may hold herself/himself out an as “nurse” since this is a protected title (§301.351 and §217.10). In order for a person to hold him/herself out as a “nurse,” the person must possess a valid LVN or RN license.
When must a nursing student be reported to the BON?
A nursing education program shall report a student to the BON if the program has reasonable cause to suspect that the ability of the nursing student to perform the services of the nursing profession would be, or would reasonably be expected to be, impaired by chemical dependency (§301.404).
What do the rules say about nursing students working part-time
Rules 224 and 225 relating to delegation of unlicensed personnel by registered professional nurses apply to such nursing students. The definition of unlicensed personnel in Rule 224.4(4) and in Rule 225.4(12) includes nursing students enrolled in a professional nursing education program... who are providing care for monetary compensation which is not a part of their formal educational program. Basically, the registered nurse may delegate certain nursing tasks which the RN determines can be properly and safely performed by the unlicensed personnel under the supervision of the RN. In such a capacity, nursing students may not perform any tasks requiring independent nursing judgment such as care plans, assessments, etc. Please refer to further details about delegation in the Delegation Resource Packet.
Can LVNs who also hold licenses as RNs still work as vocational nurses?
There is nothing preventing licensed registered nurses from working in the capacity of licensed vocational nurses, however, when working as an LVN, they must stay within the parameters of their scope of practice. Exception: In the event of an emergency, the LVN would be expected to function at the highest level of their education (i.e. professional nurse) and their performance should reflect professional judgment inherent in that role.
Where may I complete the clinical hours? May I do the 80 hours in a school setting, home health care, hospice care, a physician's office, or must the hours be completed in an acute care facility?
The rules are not prescriptive as to the specific setting in which the clinical hours must be completed; however, the optimal setting would provide a wide range of opportunities for... the individual to develop a broad set of skills. The selection of the clinical site should be based on the learning opportunities available and the learning needs and competency level of the individual learner. Individuals desiring to re-enter nursing should search for clinical learning experiences that will assist them to acquire the skills necessary to provide nursing care in a competent and safe manner.
What should I look for in a preceptor?
The preceptor must be licensed to practice nursing in Texas. Board staff recommends that the preceptor have current knowledge and clinical expertise in the designated area of practice. Individuals applying to re-enter as an RN must have an RN clinical preceptor, and individuals applying to re-enter as an LVN may have either an LVN or RN clinical preceptor.
I am having difficulty finding a facility in which to complete the clinical component. Can the BON help me?
It is not within the purview of the Board of Nursing (BON) to recommend specific programs or possible clinical sites for refresher programs.
I live in a rural area and there are no courses in my area. What are my options?
You may participate in an extensive orientation which meets all required content criteria. For example, a potential employer may be willing to provide an in-depth comprehensive... orientation. Or you may enroll in an online refresher program for the didactic component. However, if you complete an online program, you will still need to locate a clinical preceptor to complete the clinical hour requirements. You may wish to explore the Distance Learning, Re-Entry Nursing Program available through many Texas Community Colleges. This program is designed to reconnect individuals with nursing practice. Their contact is information is http://nurserefresher.austincc.edu/index.html
Do I have to complete all 80 hours in one block of time, such as a two-week period, or may I do 10 hours per week for eight weeks or 20 hours per week for four weeks?
The rules are not prescriptive as to how the hours are to be structured within the six month temporary permit period. However, it is important to remember that the temporary permit is valid for only six months and is non-renewable.
May I administer medications or do I observe a currently licensed nurse administer medications?
Board staff recommends that you administer medications under the supervision of your preceptor or RN instructor, in alignment with the policies of the clinical learning site.
May I document in the medical record or do I observe a currently licensed nurse document?
Board staff recommends that you accurately and completely document the nursing care you provide according to the clinical learning site's policies.
How do I sign my name?
Board staff recommends, e.g.: Mary Smith, RN Temporary Permit.
May I be paid as a licensed nurse during the 80 hours of clinical learning experiences?
The BON does not have purview regarding this question. Financial compensation is at the clinical learning site's discretion.
Do I submit my CEUs and fee now or with the license renewal? What is the process?
You may submit CEUs and the applicable fees anytime during the process; however, these items must be submitted prior to the expiration of the temporary permit. Board staff recommends that you submit your 20 contact hours of CNE and the non-refundable fees as soon as possible. Remember the 20 contact hours should be for the two years immediately preceding your application for reactivation.
I completed a nursing educational program and never passed NCLEX-RN® or NCLEX-PN®. What type of refresher program do I need to complete?
If you have not passed the NCLEX-RN® or NCLEX-PN® within four years from the date of completion of requirements for graduation, you must re-educate by completing a board approved nursing educational program in order to take or retake the examination.
Am I obligated to accept nurses for the 80 hours of clinical learning experiences?
No. However, a CNO or DON may choose to open their place of employment as a clinical learning experience. Individuals seeking to reactivate their nursing license are a potential resource to bolster the nursing workforce.
My facility does not have a structured course in place, how do I ensure that I am providing the essential elements of the course?
The required content areas are listed on both the RN and LVN Applications for Six-Month Temporary Permit Forms. An overview of requirements provides a description of the general requirements for didactic and clinical content. Requirements include recommendations for time allotted to each content area. Home study and/or video-based programs are not acceptable as the primary or sole means of instruction. The 80 hours of clinical learning must be spent in direct patient care.
We will have individuals complete the clinical component of the refresher/re-entry course in our hospital. Do we keep them with the same preceptor the entire 80 hours or can we assign them to different preceptors on different days?
The BON does not have specific requirements for the number of preceptors an individual may be assigned to during the 80 hours of clinical. However, all nurses identified as preceptors must meet the BON's qualifications for preceptors and have been oriented to the objectives and expectations of the clinical learning experience.... Historically, the Board has recommended that individuals work with one preceptor if possible. With one preceptor monitoring the individual's progression through the program, there is greater opportunity to identify any weaknesses or need for immediate remediation. Back to Topics
Nurses Endorsing into Texas from another State
In what order do I complete the forms? Which comes first, endorsement or temporary permit?
The temporary permit is the first step in the process. The temporary permit allows an individual to begin a refresher course, extensive orientation to the practice of nursing, or a nursing program of study which meets the requirements prescribed by the Board. The temporary permit application is a step-by-step guideline that will walk you through the process. It is located on the Board's website, here.
What is the time frame for the endorsement process after I complete the refresher/re-entry course?
You may begin completing the endorsement application upon completion of the refresher program, extensive orientation, or program of study and subsequent receipt of the Verification of... Successful Completion form. If all the requirements are met for the endorsement process, a 120 day temporary license will be issued within ten business days of receipt of the online application. Endorsement information can be found under Endorsement Applicants and Licensure - Endorsement Information.
Providers of Refresher Programs, Extensive Orientations or Academic Nursing Courses
In light of the new rule revisions, when is the deadline for making changes to our program, orientation or academic nursing courses?
In keeping with the mission of patient safety, the Board adopted revisions to Rules 217.6 and 217.9 to ensure individuals seeking to reactivate their nursing license will be competent to safely practice nursing.... The application for temporary permit process and the general requirements for course content also contain revisions. These new changes became effective October 1, 2010. Refresher Program Providers will have until August 31, 2011 to comply with the new rules.
Guidelines for Resources
Does the BON have guidelines for currency of library, video, and software holdings?
Generally, the accepted standard regarding currency of reference materials and other holdings is "no older than 5 years" for educational purposes in nursing education programs. This is not written anywhere as a concrete standard. In most cases, the BON and Board staff apply the "no older than 5 years" standard in relation to the currency requirements in the BON rules... regarding publications, reference holdings, video materials, and computer software programs utilized in nursing education programs. Just as a matter of clarification, it is important to point out that the BON does not expect institutions/programs to eliminate these holdings, video materials and computer software just because the holdings are older than 5 years. What the BON asks is that holdings older than 5 years be flagged/marked in some way so that students can be aware these specific holdings are retained for historical value and are not considered current for research and reference purposes. That in no way diminishes the value or usefulness that older holdings may have for the students and faculty in nursing education programs.	Back to Topics	Unapproved Nursing Educational Programs Operating in Texas
Are there unapproved nursing educational programs operating in Texas?
The Board is aware of the following six schools operating in Texas without Board approval. Graduates from these programs would not be eligible to take the NCLEX licensure examination. Review the BON News posting for more information.... Career Advanced - UPDATE: On May 14, 2010, the Office of the Attorney General obtained a default judgment against Career Advanced. A permanent injunction was issued against Career Advanced operating in Texas. The court ordered $121,000 in civil penalties for violations of the Texas Education Code.
A student must graduate from an approved nursing educational program in order to be deemed eligible to take the NCLEX-PN® or NCLEX-RN® licensure examination. The purpose of the Board approval process is to protect the public from fraudulent programs that do not adequately prepare graduates to practice nursing safely and competently. The Board has worked collaboratively with the Texas Workforce Commission (TWC) in efforts to protect the public from fraudulent nursing educational programs, as the TWC has statutory authority to issue cease and desist orders against the schools. Pursuant to Texas Education Code Section 132.301, 303, upon a showing that a person is operating a career school or college without a certificate of approval or exemption issued by the Commission, the Commission may issue an order that requires the person to immediately cease and desist from the operation of that career school or college.	Additional Institutions Whose Degrees are Illegal to Use in Texas, have been identified by The Texas Higher Education Coordinating Board and posted on their website.
Are background checks required in Texas?
Applicants seeking licensure in Texas by Endorsement or Examination are required to submit a complete and legible set of fingerprints on a form prescribed by the board for the purpose of obtaining a criminal history from the Texas Department of Public Safety and the Federal Bureau of Investigations. (Section 301.252 (b) and Section 301.252 (e) of the Texas Occupations Code)... All NCLEX applicants with outstanding eligibility issues that could prevent them from taking the NCLEX examination upon completion of a nursing program are urged to complete a Declaratory Order application. The Declaratory Order process permits the Board to make decisions regarding an applicant's eligibility for licensure prior to entering or completing a nursing program.
Click here for more information, including Declaratory and Licensure applications.
What are the rules for becoming a nurse?
Rule 214 - Vocational Nursing Education Rule 215 - Professional Nursing Education Rule 219 - Advanced Nurse Practitioner Programs Rule 217 - Licensure, Peer Assistance and Practice Information for
Internationally Educated Nurses; Becoming a Licensed Nurse in the United
States pdf
What information do you have about Out-of-State Programs/Online Programs/Correspondence Courses?
For more information on these and other topics, use the search field at the top right corner of the page. Should you have further questions or are in need of clarification, please feel free to contact the Board. Information Related to Career Point College Closure