Texas Medical Licensing Law Blog. Although initial arrests and convictions for Driving While Intoxictated DWI will not ordinarily result in the imposition of a disciplinary sanction against a Texas Nurse, they often do give rise to a stressful and searching investigation by Staff of the Board of Nurse Examiners. This result is due to, on the one hand, the legal fact that under the Nursing Practice Act, many DWIs do not relate to the practice of nursing, and on the other, the practical reality of the Nursing Boards zealous policing of what it deems unprofessional conduct Texas Occupation Code 3. A knowledgeable attorney can best secure a positive outcome by ensuring that the correct standard is applied and not substituted by the Boards personal opinions on what constitutes unprofessional or dishonorable conduct. Under the Nursing Practice Act the Board can take disciplinary action against a licensee if a nurse has been convicted or placed on deferred adjudication for either a felony or a misdemeanor involving moral turpitude. Texas Occupation Code 3. An individuals first two DWIs are misdemeanors under the Texas Penal Code with the third and all those thereafter rising to felonies. From a legal standpoint, however, the Nursing Boards broad discretion to take disciplinary action under the Nursing Practice Act is limited by the Texas Occupation Codes prescription that discipline can only be imposed if the felony or misdemeanor directly relates to the duties and responsibilities of the license holder. Texas Occupation Code 5. Images/Content/Family_and_Community_Health/thsteps/graphics/flu%20image.jpg' alt='Texas Department Of Health Nursing License' title='Texas Department Of Health Nursing License' />In deciding this issue, the Board must weigh certain factors such as the relationship of the crime to the purposes for requiring a license to engage in the occupation and the relationship of the crime to the ability, capacity, or fitness required to perform the duties and discharge the responsibilities of the licensed occupation. Board Staffs policy, however, is to initiate an investigation into a nurses fitness and character if they have two or more criminal arrests for alcohol or drug related offenses in a lifetime. Board Staff does not seem to differentiate between arrests, deferred probations, regular probations, dismissals and final convictions with respect to opening an investigation. Once the investigation is initiated, Board Staff tries to force the nurse into a forensic psychological evaluation and polygraph test in an effort to determine if the license holder suffers from a DSM IV diagnosis of chemical abuse or dependence. Unfortunately, any other conduct or psychiatric disorder discovered through this battery of questionable discovery is then utilized to stipulate the nurses registration. Board Staff is successful in this less than admirable procedure as many nurses think they do not need or can not afford an attorney. Competent, experienced counsel however, can put a halt to this process and mount a successful defense against Board Staffs position that all criminal conduct is unprofessional and therefore relates to the practice of nursing. Moreover, a knowledgeable attorney will know how to circumvent Board Staffs insistence that the Nurse undergo an evaluation with a Board Approved expert and then submit to the rigors of a qualifying polygraph examination. The Nursing Practice Act also requires that a license holder maintain good professional character throughout their licensure tenure. Any instance of professional misconduct that, in the Boards opinion, poses a risk to the public or patients can subject a nurse to a disciplinary sanction. The broad reach of this amorphous standard is utilized by Board Staff in an effort to discipline a nurse where no other statute applies. The final legal force of this rule, however, is restricted by the requirement that criminal convictions must be shown to relate to the practice of nursing in order to sustain a disciplinary action. An illustration of these two statutes in play can be seen in the 2. In the Matter of Charles Stephen Phillips. Here Board Staff initiated disciplinary action against Phillips due to his guilty plea to the felony offense of intoxication assault. Pursuant to the plea agreement Phillips prison sentence was probated and he was placed on felony community supervision. The defendant had struck and severely injured a pedestrian while driving home after playing pool and consuming numerous alcoholic beverages. Board Staff sought to revoke Phillips license on separate but related theories That his felony conviction related to the practice of nursing and For committing unprofessional or dishonorable conduct that is likely to deceive, defraud, or injure a patient or the public. Do you have a Professional or Technical Licenses, Permit, etc., that is required for this positionHowever, after reviewing the facts and testimony of several expert witnesses, the Administrative Law Judge recommended that Phillips should retain his nursing license due to the Boards failure to connect the unique criminal conduct and the criminal offense of intoxication assault with the practice of nursing. Moreover, the Boards own expert a forensic psychologist determined that the Phillips was not chemically dependent and in fact had quit drinking since the accident. Further, the Boards position that such conduct was unprofessional and likely to injure the public or patients was not substantiated due to Board Staffs failure to establish a nexus between the criminal offense of intoxication assault and the practice of nursing. My law firm has tried numerous similar matters. In Debra Ross vs. Board of Nurse Examiners, Board Staff denied the Registered Nurse reinstatement application of Ms. Ross due to four convictions for Driving While Intoxicated. Moreover, Board Staff insisted Ms. Ross was ineligible for licensure because she was on felony probation. Ms. Ross appealed Board Staffs decision and requested a hearing on the merits at the State Office of Administrative Hearings SOAH. The Administrative Law Judge ALJ recommended that Ms. Texas Department Of Health Nursing License' title='Texas Department Of Health Nursing License' />Ross license be reinstated, once again, because of the Nursing Boards failure to sufficiently relate her conviction to the practice of nursing. In Fact the ALJ made light of Board Staffs failure to relate Ms. Ross criminal conduct of DWI to the practice of nursing through opining Even Assuming one can practice nursing while driving, there was no showing in this case that Applicant was ever intoxicated while practicing nursing, on duty or on call as a nurse. How To Install Telephone Line In Home. There was no factual nexus established between Applicants performance of her professional duties as a nurse and her DWI arrests. Further, the record contains ample, persuasive evidence of her current sobriety. These cases show that, as a legal matter, many DWIs will not relate to the practice of nursing However this is not always the case. If, for example, a nurse is arrested while coming to or from work or is found intoxicated sufficiently close to their time on duty or on call, this could very well be found to relate to the practice of nursing and result in the discipline of the nurses license. There are two methods by which a Nurse may apply for a license with the Texas Board of Nursing BON 1 Online or 2 Paper. Upon receipt of your application. APRN-Regulatory-Model.png' alt='Texas Department Of Health Nursing License' title='Texas Department Of Health Nursing License' />Texas Department of State Health Services, Infectious Disease Control Unit Surveillance. Current State Influenza Surveillance Report. Previous State Influenza Surveillance Reports by Influenza Season. Other Influenza Data  Influenza associated pediatric mortality. Pandemic Data. U. S Outpatient Influenza like Illness Surveillance Network ILINetSurveillance. Key Points. The state of Texas participates in influenza surveillance by reporting the estimated level of influenza activity to the CDC every week during influenza season October to May. Influenza activity levels are reported as no activity, sporadic, local, regional, or widespread based on the definitions below. There are 1. 1 Health Service Regions in Texas. The Infectious Disease Control Unit IDCU of the Texas Department of State Health Services DSHS, in cooperation with the DSHS Medical Virology Laboratory, monitors influenza around the state. Each season, local and regional health departments recruit providers throughout Texas to participate in laboratory surveillance. Health care providers at participating sites collect and submit specimens from patients with influenza symptoms to the DSHS lab on a weekly basis during influenza season. Another portion of surveillance involves the CDC sponsored U. S. Outpatient Influenza Like Illness Surveillance Network ILINet. Texas ILINet has 1. CDC on a weekly basis some providers also submit influenza surveillance specimens to the DSHS lab. Other laboratories, regional and local health departments, facilities participating in influenza research, and private physicians around the state also participate in influenza surveillance. It is through the efforts of health care providers and laboratories in Texas and all other states that the CDC develops a national picture of influenza virus activity, the geographic distribution of influenza viruses, and the clinical impact of the circulating viruses. Influenza. Activity. Levels. No Activity. Overall clinical activity remains low and there are no lab confirmed cases Sporadic. Isolated cases of lab confirmed influenza in the state Influenza Like IllnessILI activity is not increased. OR A lab confirmed outbreak in a single institution in the state ILI activity is not increased. Local. Increased ILI within a single region AND recent within the past 3 weeks laboratory evidence of influenza in that region. ILI activity in other regions is not increased. OR Two or more institutional outbreaks ILI or lab confirmed within a single region AND recent within the past 3 weeks lab confirmed influenza in that region. Other regions do not have increased ILI and virus activity is no greater than sporadic in those regions. RegionalThis level of activity does not apply for small states with 4 or fewer regions. Increased ILI in 2 but less than half of the regions AND recent within the past 3 weeks lab confirmed influenza in the affected regions. OR Institutional outbreaks ILI or lab confirmed in 2 and less than half of the regions AND recent lab confirmed influenza in the affected regions. Widespread Increased ILI andor institutional outbreaks ILI or lab confirmed in at least half of the regions AND recent within the past 3 weeks lab confirmed influenza in the state. Lab confirmed case case confirmed by rapid diagnostic test, antigen detection, culture, or PCR. Care should be given when relying on results of point of care rapid diagnostic test kits during times when influenza is not circulating widely. The sensitivity and specificity of these tests vary and the positive predictive value may be low outside the time of peak influenza activity. Therefore, a state may wish to obtain laboratory confirmation of influenza by testing methods other than point of care rapid tests for reporting the first laboratory confirmed case of influenza of the season. During periods of elevated influenza activity, the positive predictive value of rapid point of care tests will be higher. Influenza Like Illness ILI activity can be assessed using a variety of data sources including surveillance providers, schoolworkplace absenteeism, and other syndromic surveillance systems that monitor influenza like illness. Institution includes nursing home, hospital, prison, school, etc. Region population under surveillance in a defined geographical subdivision of a state. A region could be comprised of 1 or more counties and would be based on each states specific circumstances. Depending on the size of the state, the number of regions could range from 2 to approximately 1. The definition of regions would be left to the state but existing state health districts could be used in many states. Allowing states to define regions would avoid somewhat arbitrary county lines and allow states to make divisions that make sense based on geographic population clusters. Focusing on regions larger than counties would also improve the likelihood that data needed for estimating activity would be available. Influenza surveillance questions may be directed to Johnathan Ledbetter, Influenza Surveillance Coordinator, at 5. Questions about the U. S. Outpatient Influenza Like Illness Surveillance Network ILINet may be directed to Robert Russin at 5.