Texas Administrative Code › Title 22 - EXAMINING BOARDS › Part 11 - TEXAS BOARD OF NURSING › Chapter 213 - PRACTICE AND PROCEDURE › Section 213.29 - Fitness to Practice

Current through Reg. 49, No. 28; July 12, 2024
(a) Each individual
				who seeks to practice nursing in Texas must possess current fitness to
				practice. This requirement includes all individuals seeking to obtain or retain
				a license or privilege to practice nursing in Texas and applies in all
				eligibility and disciplinary matters. Each individual has a duty to
				self-evaluate to ensure that he/she is fit to practice before providing nursing
				care.
(b) An individual's fitness
				to practice will be determined by evaluating the individual's ability to
				consistently comply with the requirements of the Nursing Practice Act, the
				Board's rules and regulations, and generally accepted standards of nursing
				practice. An individual's fitness to practice may be subject to Board review
				due to an individual's substance use disorder; possession, abuse, or misuse of
				alcohol or drugs, prescribed or otherwise; or physical or mental health
				condition. This is not an exhaustive list. If an individual exhibits any
				conduct that may prevent him/her from practicing nursing with reasonable skill
				and safety, the Board will review the individual's conduct to determine if
				he/she possesses current fitness to practice.
(c) Evaluations. If an individual exhibits
				conduct that raises questions about his/her fitness to practice, the Board may
				require the individual to undergo a physical and/or psychological evaluation
				that meets the criteria of the Occupations Code § 301.4521 and §
									213.33
				of this chapter (relating to Factors Considered for Imposition of
				Penalties/Sanctions). Pursuant to §301.4521, an individual subject to this
				rule is responsible for paying the costs of the evaluation. Utilizing the
				results of the evaluation and the individualized facts of the case, the Board
				may deny licensure (including renewal, reinstatement/reactivation, or the
				return to direct patient care from a limited license); suspend or revoke the
				individual's license or privilege to practice nursing in this state; or impose
				probationary conditions or restrictions on the individual's ability to practice
				nursing in this state.
(d)
				Substance Use Disorders and Abuse/Misuse of Alcohol or Drugs.
(1) Individuals who have been diagnosed,
				treated, or hospitalized for a substance use disorder that may impair their
				ability to practice nursing safely, will, at a minimum, be required to
				demonstrate sobriety and abstinence from drugs and alcohol for a minimum of
				twelve consecutive months, through verifiable and reliable evidence, in order
				to obtain or retain licensure. Verifiable and reliable evidence of sobriety and
				abstinence from drugs and alcohol may include evidence of the completion of
				inpatient, outpatient, or aftercare treatment, random drug screens, individual
				or group therapy, and/or support group attendance. Depending upon the
				individualized facts of each case, an individual may be required to establish
				this period of sobriety and abstinence prior to being permitted to practice
				nursing in this state. If appropriate, based upon the individualized facts of
				the case, an individual may also be eligible to obtain or retain licensure and
				practice nursing under an encumbered license with conditions/restrictions
				determined by the Board or through participation in a Board-approved peer
				assistance program created pursuant to the Texas Health and Safety Code Chapter
				467 or other lawfully authorized peer assistance program. Licensure
				conditions/restrictions may include the completion of inpatient, outpatient, or
				aftercare treatment, random drug screens, individual or group therapy, and/or
				support group attendance. The outcome of any particular case will be based upon
				an evaluation of the individualized factors of the case and the potential risk
				of harm the individual's practice may pose to patients/clients and/or the
				public.
(2) Individuals who have
				not been diagnosed, treated, or hospitalized for a substance use disorder, but
				have nonetheless exhibited behaviors raising concerns about the individual's
				ability to practice nursing with reasonable skill and safety due to the
				possession, misuse, or abuse of alcohol or drugs, prescribed or otherwise,
				including related criminal conduct, may be required to demonstrate sobriety and
				abstinence from drugs and alcohol for a minimum of twelve consecutive months,
				through verifiable and reliable evidence, in order to obtain or retain
				licensure. Verifiable and reliable evidence of sobriety and abstinence from
				drugs and alcohol may include evidence of the completion of inpatient,
				outpatient, or aftercare treatment, random drug screens, individual or group
				therapy, and/or support group attendance. If appropriate, and depending upon
				the individualized facts of each case, an individual may be eligible to obtain
				or retain licensure and practice nursing under an encumbered license with
				conditions/restrictions determined by the Board, which may include the
				completion of inpatient, outpatient, or aftercare treatment, random drug
				screens, individual or group therapy, and/or support group attendance. The
				outcome of any particular case will be based upon an evaluation of the
				individualized factors of the case and the potential risk of harm the
				individual's practice may pose to patients/clients and/or the public.
(3) An individual's prior substance use
				disorder diagnosis or history of prior criminal conduct involving drugs or
				alcohol, prescribed or otherwise; or misuse or abuse of alcohol or drugs,
				prescribed or otherwise; will be considered by the Board only to the extent
				that it may be indicative of the individual's current lack of fitness to
				practice nursing.