The responsibility of the Texas Board of Nurse Examiners (board) is to regulate the practice of professional nursing within the State of Texas. The purpose of defining standards of practice is to identify roles and responsibilities of the registered professional nurse (RN) in any health care setting. The standards for professional nursing practice shall establish a minimum acceptable level of professional nursing practice. The RN shall:

1. (1) know and conform to the Texas Nurse Practice Act and the board's rules and regulations as well as all federal, state, or local laws, rules, or regulations affecting the RN's current area of nursing practice;
2. (2) provide, without discrimination, nursing services regardless of the age, disability, economic status, gender, national origin, race, religion, or health problems of the client served;

3. (3) use a systematic approach to provide individualized, goal-directed nursing care by:

   1. (A) performing nursing assessments regarding the health status of the client;
   2. (B) making nursing diagnoses which serve as the basis for the strategy of care;
   3. (C) developing a plan of care based on assessment and nursing diagnosis;
   4. (D) implementing nursing care; and
   5. (E) evaluating the client's responses to nursing interventions;
4. (4) institute appropriate nursing intervention which might be required to stabilize a client's condition and/or prevent complications;
5. (5) clarify any order or treatment regimen that the nurse has reason to believe is inaccurate, non-efficacious, or contraindicated by consulting with the appropriate licensed practitioner and notifying the ordering practitioner when the RN makes the decision not to administer the medication or treatment;
6. (6) know the rationale for and the effects of medications and treatments and shall correctly administer the same;
7. (7) accurately report and document the client's symptoms, responses, and status;
8. (8) implement measures to promote a safe environment for clients and others;
9. (9) implement measures to prevent exposure to infectious pathogens and communicable conditions;
10. (10) respect the client's right to privacy by protecting confidential information unless obligated or allowed by law to disclose the information;
11. (11) promote and participate in client education and counseling based on health needs;
12. (12) collaborate with the client, members of the health care team, and, when appropriate, the client's significant other(s) in the interest of the client's health care;
13. (13) consult with, utilize, and make referrals to appropriate community agencies and health care resources to provide continuity of care;
14. (14) when acting in the role of nurse administrator, assure that adequate strategies are in place to verify the current Texas licensure and credentials of personnel for whom he/she is responsible;
15. (15) make assignments to others that take into consideration client safety and which are commensurate with the educational preparation, experience, knowledge, and ability of the persons to whom the assignments are made;
16. (16) supervise nursing care provided by others for whom the RN is administratively or professionally responsible;
17. (17) accept only those nursing assignments that are commensurate with one's own educational preparation, experience, knowledge, and ability;
18. (18) obtain instruction and supervision as necessary when implementing nursing procedures or practices;
19. (19) be responsible for one's own continuing competence in nursing practice and individual professional growth;
20. (20) report unsafe nursing practice by an RN which a nurse has reasonable cause to suspect has exposed or is likely to expose a client unnecessarily to risk of harm as a result of failing to provide client care that conforms to the minimum standards of acceptable and prevailing professional practice. The RN should report unsafe practice conditions or other practitioners to the appropriate authority or licensing board.

Source Note:The provisions of this §217.11 adopted to be effective December 16, 1992, 17 TexReg 8435.