|
The Texas Board of Nursing (BON) ensures that all Texas nurses comply with the rules and laws that apply to the nursing profession.
As a result, the BON receives complaints against a nurse for violating an applicable rule or law. When the BON receives a complaint against a licensed nurse, it must investigate whether enforcement action against the nurse is necessary. If the BON ultimately decides that you have violated a rule or law, you could face sanctions that are extremely damaging to your license and career. One possible sanction is to undergo a physical and/or psychological evaluation.
When the BON Orders a Physical or Psychological Evaluation
Under Texas law, the BON can order a licensed nurse to submit to a physical and/or psychological evaluation if it has probable cause to believe that the individual is unable to practice nursing safely because of a physical or mental impairment or due to chemical dependency or abuse of drugs and/or alcohol. “Probable cause” exists when the BON has a reasonable and objective basis to believe that the nurse can safely or effectively practice nursing due to a psychological or medical impairment. An “objective basis” refers to direct observation, a credible third-party report, or other reliable evidence.
The BON also can request an evaluation under Tex. Occ. Code §301.4521 if an individual’s criminal history, unprofessional conduct, or lack of good professional character is relevant to their fitness to practice nursing.
If the nurse refuses to submit to a required evaluation, the BON can initiate disciplinary proceedings against the nurse. If the BON has merely requested an evaluation, the nurse may be subject to restrictions on evidence concerning evaluations in any future proceedings.
Types of Evaluations
As per BON’s Guidelines for Physical and Psychological Evaluations, the BON’s required evaluations include the following:
- Medical Evaluation
- Pain Management Evaluation
- Mental health/psychological evaluation
- Neuropsychological Evaluation
- Anger Management Evaluation
- Sex Offender Evaluation
- Chemical Dependency (Substance Use Disorder) Evaluation
The BON also may request forensic psychological evaluations, either with or without a polygraph examination.
Standards for Evaluators and Evaluations
The BON must approve all evaluators at least every two years. Evaluators must have the appropriate education, training, and experience for the specified evaluation. Furthermore, the evaluator must have a license in good standing, at least five years’ clinical experience in a relevant field of practice, and the ability to administer and interpret the testing required by the BON for a particular examination. The evaluator must be able to provide treatment recommendations, other referrals if warranted, and any other information that the BON requests.
Ultimately, all evaluations must contain findings on whether a nurse can safely and effectively practice nursing based on the BON rules of professional conduct, minimum nursing practice standards, and good professional character.
Furthermore, all evaluations must contain:
A comprehensive clinical interview . . . relevant developmental and medical history; family history; academic history; psycho-social history; history with substance use and/or abuse; legal history; occupational history; psychiatric symptomology and treatment; dating/marital history; mental status and examination; and any other issues relevant to the Board's referral question.
The evaluation report must address all areas that the evaluator(s) cover in the clinical interview.
Any assessment measures that an evaluator uses must be empirically supported and well-normed. Evaluators should use updated/revised assessment tools within one year of their publication or explain why they are not using the updated tools. The evaluation should not contain test results, raw data, or evaluator notes, but those materials should be available to the BON upon request.
The evaluation report must give a clinical opinion on any discrepancies between assessment results and information obtained from the clinical interview or other source.
The evaluation must be reviewed and discuss any collateral records provided to the evaluator. Evaluators must make reasonable attempts to communicate with healthcare professionals who have previously treated the individual, and evaluators should address any prior diagnoses in their reports.
Individuals typically have 45 days to complete evaluations, which must contain at least 1 ½ hours of a clinical interview. The evaluator must send written findings to the BON within 30 days of completing the evaluation.
Conclusion
When the Texas Board of Nursing (BON) has reason to believe that a nurse may be impaired or otherwise unfit to safely practice, it has the legal authority to order a physical or psychological evaluation. These evaluations play a critical role in protecting public health and ensuring that licensed nurses meet professional standards. Failing to comply with an evaluation order can result in further disciplinary action, making it essential for nurses to fully understand their rights and responsibilities in this process. Evaluations must be conducted by qualified professionals and follow strict guidelines to ensure fairness, accuracy, and relevance.
Ultimately, the BON uses these evaluations to determine whether a nurse can continue to practice safely and ethically, emphasizing the importance of professional conduct and fitness in the nursing field.
| 
