In the state of Texas, “Chapter 301 of the Texas Occupations Code (TOC) contains the Nurse Practice Act (NPA) which creates the BON and defines its responsibility for regulating nursing education, licensure and practice” (Schmid). The purpose of the Board of Nursing is “to protect and promote the welfare of the people of Texas” (TBON, 2013). The Texas Board of Nursing (TBON) strives to ensure public safety by competent licensure of qualified individuals, investigation of violations and legal action when necessary. In order to achieve this TBON works closely with the Texas legislature, which meets every two years, to create bills to amend the NPA as they deem necessary (TBON, 2013). Only the Texas legislature can make changes to the NPA and in order to start the process of change, the TBON submits its proposed changes to the Texas Register, which creates a bulletin maintained by the Office of the Secretary of State and serves as a notice of state agency rulemaking (TBON,2013).
The scope of practice for registered nurses (RN) is outlined by the NPA and it sets the parameters of legal practice in accordance with federal, state, and local laws. In my area of specialty (Progressive Care Unit – step down ICU), the RN is an advocate for the patient and their family and utilizes the nursing process (assessment, diagnosis, planning, implementing, evaluating) to provide services that require specialized judgment and skill. Another large part of the RN’s scope of practice is knowing appropriate delegation. The RN accepts responsibility and demonstrates accountability in the quality of care provided to their patients (TBON, 2013). The entity I work for further adds to the scope of practice by determining which medications can be administered on our specific unit and the number of patients each RN is allowed to provide care for at any one time during a twelve-hour shift.