October 2004 Board Minutes - Texas Board of Nursing item discussion action 204 call to order roll call introductions acceptance of agenda acceptance of minutes consent ... john darryle

203

BOARD OF NURSE EXAMINERS

Regular Meeting

Thursday, October 21, 20048:30 a.m. - 4:30 p.m.Friday, October 22, 20048:45 a.m. - 1:45 p.m.333 Guadalupe, Tower II, Room 225Austin, Texas

Present:Linda Rounds, PresidentJoyce AdamsDeborah BellVirginia CampbellPhyllis Caves Rawley Blanca Rosa GarciaRichard Robert GibbsRachel GomezBrenda JacksonBeverley NutallAnita Palmer

Staff present:Katherine A. Thomas, Executive DirectorMark Majek, Director of OperationsAnthony Diggs, Director of EnforcementJames “Dusty” Johnston, General Counsel Joy Sparks, Assistant General CounselMary Beth Thomas, Director of NursingJolene Zych, Nursing ConsultantVirginia Holmes, Nursing ConsultantBetty Sims, Nursing ConsultantRobbin Wilson, Nursing ConsultantCarol Marshall, Nursing ConsultantJanice Hooper, Nursing ConsultantDorothy Joy, Nursing ConsultantKaren Malloy, Nursing ConsultantPatricia Vianes-Cabrera, Executive AssistantBruce Holter, Information Specialist

AGENDA ITEM DISCUSSION ACTION

204

CALL TO ORDER

ROLL CALL

INTRODUCTIONS

ACCEPTANCE OFAGENDA

ACCEPTANCE OFMINUTES

CONSENT AGENDAITEMS

2.1. FinancialStatements

2.2 CE ComplianceReport

3.1.1. WorkshopReport

5.1.1. Eligibility andDisciplinaryCommittee Report

5.1.2. StrategicPlanning/4TH QuarterReport

Linda Rounds called the meeting to order at8:30 a.m, Thursday, October 21, 2004.

All members were present with the exception ofFrank Sandoval and a quorum was established.

Board members and staff introduced themselvesto the audience.

The board reviewed the agenda.

The board reviewed the minutes from the July22-23, 2004 meeting.

The board reviewed the minutes from the August11, 2004, Board Retreat.

The Agenda was amended to reflect theremoval of the following: Agenda Item#7.5. Revisions to Approval of NewDean and Director and Faculty WaiversPoliciesThe amended agenda was approved.

The Board approved the minutes fromthe July 22-23, 2004 meeting withcorrections.

The Board approved the minutes fromthe August 11, 2004, Board Retreat.

The Consent agenda was approved withthe following changes:Item 8.2 Agreed Orders:The following orders were removed fromthe consent agenda: Barbara Marie Burnett, LVN #71691;Karen M. Diaz, RN #525916;Donald Ray Hall, RN #567811;Sandra D. Blake Martin, RN #435310;Jamie Richelle Wakefield, RN #674310

Approved on Consent.

Approved on Consent





205

7.3.1. TPAPNQuarterly Report

8.1. ALJ Proposalsfor Decision

8.2. AGREEDORDERS

Cathy Denise Breckenridge, LVN #132259

Sharon Dell Foster Wray, LVN #053018

Kenyatta Monique Carter, LVN #174627

Arlene Marie Castillo, RN #565091


The board voted to ratify the ALJProposals for Decision on Consentwith the following results:

License Revoked. The proposal fordecision and the findings of fact andconclusions of the law of the ALJ wereadopted by the board.

License Revoked. The proposal fordecision and the findings of fact andconclusions of the law of the ALJ wereadopted by the board.

The board voted to ratify the AgreedOrders on Consent with the followingresults:Reprimand with Stipulations. Withinone year of entry of this orderRespondent shall successfully completea board approved course in nursingjurisprudence; and a board approvedcourse in nursing ethics. ShouldRespondent choose to practice as aLVN in Texas, Respondent will providedirect patient care and practice in ahospital, nursing home, or other clinicalsetting under the following stipulationsfor one year of employment:Respondent shall notify present/futureemployers of the board order; shallprovide notification of employment; shallprovide employer reports; Respondentshall have in-direct supervision withemployment restrictions for the durationof the stipulation period. It is furtheragreed, should Respondent practice asa LVN in the State of Texas,Respondent shall abide by the followingstipulation for the duration of hercommunity supervision: Respondentshall cause her probation officer tosubmit written reports regardingRespondent’s compliance with her courtordered probation until Respondent isreleased from community supervision.

Warning with Stipulations. Within oneyear of entry of this order Respondentshall successfully complete a boardapproved course in nurs ingjurisprudence; a board approved coursein physical assessment; and a boardapproved course in nurs ing


206

Susan Christine Chapman, RN #650897

Chanda Tynette Curlin, LVN #170336

documentation. Should Respondentchoose to practice as a RN in Texas,Respondent will provide direct patientcare and practice in a hospital, nursinghome, or other clinical setting under thefollowing stipulations for one year ofemployment: Respondent shall notifypresent/future employers of the boardorder; shall provide notification ofemployment; shall provide employerreports; and Respondent shall have in-direct supervision with employmentrestrictions for the duration of thestipulation period.

Warning with Stipulations. Within oneyear of entry of this order Respondentshall successfully complete a boardapproved course in nurs ingjurisprudence. Should Respondentchoose to practice as a RN in Texas,Respondent will provide direct patientcare and practice in a hospital, nursinghome, or other clinical setting under thefollowing stipulations for one year ofemployment: Respondent shall notifypresent/future employers of the boardorder; shall provide notification ofemployment; shall provide employerreports; Respondent shall have in-directsupervision with employment restrictionsfor the duration of the stipulation period;Respondent shall abstain from theconsumption of alcohol, Nubain, Stadol,Dalgan or other synthetic opiates, and/orthe use of controlled substances;Respondent shall submit to periodicscreens for controlled substances andalcohol; Respondent shall participate intherapy with a board approvedpsychiatrist or psychologist and shallcause quarterly written reports regardingher progress to be submitted to theboard; Respondents’s medical care shallbe monitored by her primary physicianand shall cause written reports regardingher progress to be submitted to theboard.

Suspend Probate. Respondent’slicense is hereby suspended with saidsuspension stayed and Respondentplaced on probation for one year withthe following agreed terms of probation:Within 45 days of entry of this orderRespondent shall pay a monetary fine inthe amount of $100. Within one year ofentry of this order Respondent shallsuccessfully complete a board approvedcourse in nursing jurisprudence; and a


207

Melony E. Hicks, RN #256312

John Marc Talosig Mabazza, RN #621491

board approved course in medicationadministration. The following terms ofthis probation may only be served whileRespondent is employed as a LVN in ahospital, nursing home, or other clinicalpractice setting for one year ofprobation: Respondent shall notifypresent/future employers of the boardorder; shall provide notification ofemployment; shall provide employerreports; and Respondent shall have in-direct supervision with employmentrestrictions for the duration of thestipulation period.

Warning with Stipulations. Within 45days of entry of this order Respondentshall pay a monetary fine in the amountof $500. Within one year of entry of thisorder Respondent shall successfullycomplete a board approved course innursing jurisprudence; and a boardapproved course in advanced obstetricsphysical assessment. It is further agreedthat should Respondent practice as anAdvanced Practice Nurse in the State ofTexas, Respondent will provide directpatient care and practice in a hospital,nursing home, or other clinical settingunder the following stipulations for oneyear of employment: Respondent shallnotify present/future employers of theboard order; shall provide notification ofemployment; shall provide employerreports; and for the duration of thestipulation period, Respondent shall beemployed as a Nurse Practitioner whosepractice shall be monitored for one yearby a Women’s Health Care NursePractitioner, Nurse Midwife, or anObstetrician who has been approved bythe Board; Respondent shall meet withthe monitor at least twice a month for atleast one hour duration each; Multipleemployers in Respondent’s capacity asa Nurse Practitioner are prohibited.

Reprimand with Stipulations. Withinone year of entry of this orderRespondent shall successfully completea board approved course in nursingjurisprudence; a board approved coursein physical assessment; a boardapproved course in nurs ingdocumentation; and a course in nursingethics. Should Respondent choose topractice as a RN in Texas, Respondentwill provide direct patient care andpractice in a hospital, nursing home, orother clinical setting under the following


208

Melinda Faye McLeod, RN #653335

John Darryle Metoyer, RN #552560

stipulations for one year of employment:Respondent shall notify present/futureemployers of the board order; shallprovide notification of employment; shallprovide employer reports; andRespondent shall have in-directsupervision with employment restrictionsfor the duration of the stipulation period.

Reprimand with Stipulations. Within45 days of entry of this orderRespondent shall pay a monetary fine inthe amount of $100. The order of theBoard issued to Respondent on August12, 2003, is still in effect in its entiretyand Respondent shall be responsible forcompleting the terms of that order.

Enforced Suspension. Respondent’slicense is hereby suspended with saidsuspension enforced until Respondentcompletes an inpatient treatmentprogram approved by the Board,provides documentation of successfulcompletion and has obtained 12consecutive months of sobriety. Anyrelapse prior to the completion of the 12consecutive months of sobriety willresult in an extension of the enforcedsuspension until such 12 consecutivemonths of sobriety and additionaltreatment have been attained. It isfurther agreed and ordered, subject toratification by the Board thatRespondent hereby VoluntarilySurrenders his authorization to practiceas a Nurse Anesthetist. It is furtheragreed that Respondent shall notpractice as an APN or use the titleCRNA, should Respondent desire toreturn to the practice as a NurseAnesthetist in Texas, Respondent shallpetition the Board for such authorization.Upon verification of successfulcompletion of twelve consecutivemonths of sobriety as set out in thisorder, the Suspension will be stayed andRespondent will be placed on probationfor three years with the following agreedterms of probation: Within one year ofthe stay of the suspension Respondentshall successfully complete a boardapproved course in nurs ingjurisprudence. Should Respondentchoose to practice as a RN in Texas,Respondent will provide direct patientcare and practice in a hospital, nursinghome, or other clinical setting under thefollowing stipulations for three years ofemployment: Respondent shall notify


209

Stacey Kay Vasser, LVN #177023

present/future employers of the boardorder; shall provide notification ofemployment; shall provide employerreports; Respondent shall have directsupervision with employment restrictionsfor the first year of employment underthis order; Respondent shall have in-direct supervision with employmentrestrictions for the remainder of thestipulation period; Respondent shallhave employment restrictions for the firstyear of employment; Respondent shallnot practice in any critical care area forthe first year of employment;Respondent shall not administer or haveany contact with controlled substances,Nubain, Stadol, Dalgan, Ultram, or othersynthetic opiates for the first year ofemployment as a RN; Respondent shallabstain from the consumption of alcohol,Nubain, Stadol, Dalgan or othersynthetic opiates, and/or the use ofcontrolled substances; Respondent shallsubmit to periodic screens for controlledsubstances and alcohol; Respondentshall attend at least two support groupmeetings each week, one of which shallbe for substance abuse and shallprovide acceptable proof of suchattendance; and Respondent shallparticipate in therapy with a boardapproved therapist and shall cause thetherapist to submit quarterly reportsregarding Respondent’s progress intherapy until released from therapy. It isfurther agreed and ordered that if duringthe period of probation an additionalallegation, accusation, or petition isreported or filed against theRespondent’s license, the probationaryperiod shall not expire and shallautomatically be extended until theallegation, accusation, or petition hasbeen acted upon by the Board.

Warning with Stipulations. Within oneyear of entry of this order Respondentshall successfully complete a boardapproved course in nurs ingjurisprudence; a board approved coursein physical assessment; and a boardapproved course in nurs ingdocumentation. Should Respondentchoose to practice as a LVN in Texas,Respondent will provide direct patientcare and practice in a hospital, nursinghome, or other clinical setting under thefollowing stipulations for one year ofemployment: Respondent shall notifypresent/future employers of the board


210

8.3.REINSTATEMENTAGREED ORDERS

Marisa Ann Webster, LVN #179400

Darin Gayle Banker, RN #666470

order; shall provide notification ofemployment; shall provide employerreports; and Respondent shall have in-direct supervision with employmentrestrictions for the duration of thestipulation period.

Warning with Stipulations. Within oneyear of entry of this order Respondentshall successfully complete a boardapproved course in nurs ingjurisprudence; a board approved coursein medication administration; a boardapproved course in nurs ingdocumentation; and a board approvedcourse in nursing ethics. ShouldRespondent choose to practice as aLVN in Texas, Respondent will providedirect patient care and practice in ahospital, nursing home, or other clinicalsetting under the following stipulationsfor one year of employment:Respondent shall notify present/futureemployers of the board order; shallprovide notification of employment; andshall provide employer reports.

Reinstated with Stipulations. Withinone year of relicensure Petitioner shallsuccessfully complete a board approvedcourse in nursing jurisprudence; and aboard approved course in nursing ethics.Should Petitioner choose to practice asa RN in the State of Texas, Petitionerwill provide direct patient care andpractice in a hospital, nursing home, orother clinical setting under the followingstipulations for three years ofemployment: Petitioner shall notifypresent/future employers of the boardorder; shall provide notification ofemployment; shall provide employerreports; Petitioner shall have directsupervision with employment restrictionsfor the first year of employment underthis order; Petitioner shall have in-directsupervision with employment restrictionsfor the remainder of the stipulationperiod; Peti t ioner shal l haveemployment restrictions for the first yearof employment; Petitioner shall notpractice in any critical care area for thefirst year of employment; Petitioner shall


211

Kolby Wayne Bass, RN #605982

not administer or have any contact withcontrolled substances, Nubain, Stadol,Dalgan, Ultram, or other syntheticopiates for the first year of employmentas a RN; Petitioner shall abstain fromthe consumption of alcohol, Nubain,Stadol, Dalgan or other syntheticopiates, and/or the use of controlledsubstances; Petitioner shall submit toperiodic screens for controlledsubstances and alcohol; and Petitionershall attend at least two support groupmeetings each week, one of which shallbe for substance abuse and shallprovide acceptable proof of suchattendance.

Reinstated with Stipulations. Withinone year of relicensure Petitioner shallsuccessfully complete a board approvedcourse in nursing jurisprudence; and aboard approved course in nursing ethics.Should Petitioner choose to practice asa RN in the State of Texas, Petitionerwill provide direct patient care andpractice in a hospital, nursing home, orother clinical setting under the followingstipulations for three years ofemployment: Petitioner shall notifypresent/future employers of the boardorder; shall provide notification ofemployment; shall provide employerreports; Petitioner shall have directsupervision with employment restrictionsfor the first year of employment underthis order; Petitioner shall have in-directsupervision with employment restrictionsfor the remainder of the stipulationperiod; Peti t ioner shal l haveemployment restrictions for the first yearof employment; Petitioner shall notpractice in any critical care area for thefirst year of employment; Petitioner shallnot administer or have any contact withcontrolled substances, Nubain, Stadol,Dalgan, Ultram, or other syntheticopiates for the first year of employmentas a RN; Petitioner shall abstain fromthe consumption of alcohol, Nubain,Stadol, Dalgan or other syntheticopiates, and/or the use of controlledsubstances; Petitioner shall submit toperiodic screens for controlledsubstances and alcohol; and Petitionershall attend at least two support groupmeetings each week, one of which shallbe for substance abuse and shallprovide acceptable proof of suchattendance.


212

Colleen Bernice Foley, RN #547340

Kathleen Ann Hammett, RN #649967

Reinstated with Stipulations. Withinone year of relicensure Petitioner shallsuccessfully complete a board approvedcourse in nursing jurisprudence; and aboard approved course in nursing ethics.Should Petitioner choose to practice asa RN in the State of Texas, Petitionerwill provide direct patient care andpractice in a hospital, nursing home, orother clinical setting under the followingstipulations for three years ofemployment: Petitioner shall notifypresent/future employers of the boardorder; shall provide notification ofemployment; shall provide employerreports; Petitioner shall have directsupervision with employment restrictionsfor the first year of employment underthis order; Petitioner shall have in-directsupervision with employment restrictionsfor the remainder of the stipulationperiod; Peti t ioner shal l haveemployment restrictions for the first yearof employment; Petitioner shall notpractice in any critical care area for thefirst year of employment; Petitioner shallnot administer or have any contact withcontrolled substances, Nubain, Stadol,Dalgan, Ultram, or other syntheticopiates for the first year of employmentas a RN; Petitioner shall abstain fromthe consumption of alcohol, Nubain,Stadol, Dalgan or other syntheticopiates, and/or the use of controlledsubstances; Petitioner shall submit toperiodic screens for controlledsubstances and alcohol; and Petitionershall attend at least two support groupmeetings each week, one of which shallbe for substance abuse and shallprovide acceptable proof of suchattendance; Petitioner shall participate intherapy with a board approved therapistand shall cause the therapist to submitquarterly reports regarding Petitioner’sprogress in therapy until released fromtherapy; and Petitioner shall cause herprobation officer to submit quarterlywritten reports indicating Petitioner’scompliance with the court orderedprobation until Petitioner is releasedfrom probation.

Reinstated with Stipulations. Withinone year of relicensure Petitioner shallsuccessfully complete a board approvedcourse in nursing jurisprudence; and aboard approved course in nursing ethics.Should Petitioner choose to practice asa RN in the State of Texas, Petitioner


213

Katahleen Marie Lipe, LVN #135537

Rebecca Jean Paul, LVN #149352

will provide direct patient care andpractice in a hospital, nursing home, orother clinical setting under the followingstipulations for two years ofemployment: Petitioner shall notifypresent/future employers of the boardorder; shall provide notification ofemployment; shall provide employerreports; Petitioner shall have directsupervision with employment restrictionsfor the first year of employment underthis order; Petitioner shall have in-directsupervision with employment restrictionsfor the remainder of the stipulationperiod; Peti t ioner shal l haveemployment restrictions for the first yearof employment; Petitioner shall notpractice in any critical care area for thefirst year of employment; Petitioner shallnot administer or have any contact withcontrolled substances, Nubain, Stadol,Dalgan, Ultram, or other syntheticopiates for the first year of employmentas a RN; Petitioner shall abstain fromthe consumption of alcohol, Nubain,Stadol, Dalgan or other syntheticopiates, and/or the use of controlledsubstances; Petitioner shall submit toperiodic screens for controlledsubstances and alcohol; and Petitionershall attend at least two support groupmeetings each week, one of which shallbe for substance abuse and shallprovide acceptable proof of suchattendance.

Reinstated with Stipulations.Petitioner shall successfully complete anaccredited nursing program forvocational nurses. Upon successfulcompletion of an accredited nursingprogram for vocational nurses Petitionershall be issued a coded license with thefollowing stipulations: Within 45 days ofentry of this order Petitioner shall appl toand be accepted into the TPAPNprogram, which shall include payment ofa non refundable participation fee in theamount of $350. Petitioner shall complywith all the requirements of the TPAPNcontract.

Reinstated with Stipulations. Withinone year of relicensure Petitioner shallsuccessfully complete a board approvedcourse in nursing jurisprudence; a boardapproved course in nurs ingdocumentation; and a board approvedcourse in nursing ethics. ShouldPetitioner choose to practice as a LVN


214

8.4 ELIGIBILITYAGREED ORDERS

Alaine Denise Vorheier, LVN #156661

Laurie Lynne Yarbrough, LVN #171263

Victorine Akuh Atiabet, Applicant forLicensure by Endorsement (LVN)

in Texas, Petitioner will provide directpatient care and practice in a hospital,nursing home, or other clinical settingunder the following stipulations for oneyear of employment: Petitioner shallnotify present/future employers of theboard order; shall provide notification ofemployment; shall provide employerreports; and Petitioner shall have in-direct supervision with employmentrestrictions for the duration of thestipulation period.

Reinstated with Stipulations.Petitioner shall be issued a codedlicense with the following stipulations:Within one year of relicensure Petitionershall successfully complete a boardapproved course in nurs ingjurisprudence; and a board approvedcourse in nursing ethics.

Reinstated with Stipulations. Withinone year of relicensure Petitioner shallsuccessfully complete a Board approvedcourse in nursing jurisprudence; a boardapproved course in medicationadministration; and a board approvedcourse in physical assessment. ShouldPetitioner choose to practice as a LVNin the State of Texas, Petitioner willprovide direct patient care and practicein a hospital, nursing home, or otherclinical setting under the followingstipulations for two years ofemployment: Petitioner shall notifypresent/future employers of the boardorder; shall provide notification ofemployment; shall provide employerreports; Petitioner shall have in-directsupervision with employment restrictionsfor the duration of the stipulation period;and Petitioner shall participate intherapy with a board approved therapistand shall cause the therapist to submitquarterly reports regarding Petitioner’sprogress in therapy until released fromtherapy.

Applicant for Licensure by Endorsement.Within one year of licensure byendorsement App l ican t sha l lsuccessfully complete a board approvedcourse in nursing jurisprudence; and aboard approved course in nursing ethics.Should Applicant choose to practice asa LVN in the State of Texas, Applicantwill provide direct patient care andpractice in a hospital, nursing home, or


215

Cheryl Lee Carson, Petitioner for InitialLicensure ((LVN)

Melissa Ann Gilliam, Petitioner for InitialLicensure (LVN)

other clinical setting under the followingstipulations for one year of employment:Applicant shall notify present/futureemployers of the board order; shallcause each employer to submitnotification of employment forms; shallcause employer(s) to submit periodicreports; Applicant shall have indirectsupervision with employment restrictionsfor the duration of the stipulation period;and Applicant shall cause her probationofficer to submit quarterly written reportsindicating Applicant’s compliance withthe court ordered probation untilApplicant is released from probation.

Petitioner for Initial Licensure. Uponmeeting the requirements for graduationand payment of any required fees,Petitioner is hereby ConditionallyEligible to sit for the NCLEX-PNexamination with conditions. Petitionershall not be eligible for temporaryauthorization to practice as a graduatenurse in the State of Texas. Petitionerupon attaining a passing grade on theNCLEX-PN shall be issued a license topractice nursing in Texas which shallbear the appropriate notation. Withinone year of initial licensure Petitionershall successfully complete a boardapproved course in nurs ingjurisprudence; and a board approvedcourse in nursing ethics. It is furtheragreed at the time of initial licensureshould Petitioner practice as a LVN inTexas, Petitioner will provide directpatient care and practice in a hospital,nursing home or other clinical settingunder the following stipulations for twoyears of employment: Petitioner shallnotify present/future employers of theboard order; shall cause each employerto submit notification of employmentforms; shall cause employer(s) to submitperiodic reports; and Petitioner shallhave indirect supervision withemployment restrictions for the durationof the stipulation period.

Petitioner for Initial Licensure. Uponmeeting the requirements for graduationand payment of any required fees,Petitioner is hereby ConditionallyEligible to sit for the NCLEX-PNexamination with conditions. Petitionershall not be eligible for temporaryauthorization to practice as a graduatenurse in the State of Texas. Petitionerupon attaining a passing grade on the


216

Raymond Lee Halstead, Jr., Petitioner forInitial Licensure (RN)

Antonia Lynnette Jones, Petitioner for InitialLicensure (RN)

NCLEX-PN shall be issued a license topractice nursing in Texas which shallbear the appropriate notation. Withinone year of initial licensure Petitionershall successfully complete a boardapproved course in nurs ingjurisprudence; and a board approvedcourse in nursing ethics. It is furtheragreed at the time of initial licensureshould Petitioner practice as a LVN inTexas, Petitioner will provide directpatient care and practice in a hospital,nursing home or other clinical settingunder the following stipulations for oneyear of employment: Petitioner shallnotify present/future employers of theboard order; shall cause each employerto submit notification of employmentforms; shall cause employer(s) to submitperiodic reports; and Petitioner shallhave indirect supervision withemployment restrictions.

Petitioner for Initial Licensure. Uponmeeting the requirements for graduationand payment of any required fees,Petitioner is hereby ConditionallyEligible to sit for the NCLEX-RNexamination with conditions. Petitionershall not be eligible for temporaryauthorization to practice as a graduatenurse in the State of Texas. Petitionerupon attaining a passing grade on theNCLEX-RN shall be issued a license topractice nursing in Texas which shallbear the appropriate notation andPetitioner shall be subject to thefollowing conditions. It is further agreedat the time of initial licensure shouldPetitioner practice as a RN in Texas,Petitioner will provide direct patient careand practice in a hospital, nursing homeor other clinical setting under thefollowing stipulations for one year ofemployment: Petitioner shall notifypresent/future employers of the boardorder; shall provide notification ofemployment; shall cause employer tosubmit periodic reports; and Petitionershall have in-direct supervision withemployment restrictions.

Petitioner for Initial Licensure. Uponmeeting the requirements for graduationand payment of any required fees,Petitioner is hereby ConditionallyEligible to sit for the NCLEX-RNexamination with conditions. Petitionershall not be eligible for temporaryauthorization to practice as a graduate


217

Twilla Youvonne Love, Petitioner for InitialLicensure (RN)

nurse in the State of Texas. Petitionerupon attaining a passing grade on theNCLEX-RN shall be issued a license topractice nursing in Texas which shallbear the appropriate notation. Withinone year of initial licensure Petitionershall successfully complete a boardapproved course in nurs ingjurisprudence; and a board approvedcourse in nursing ethics. It is furtheragreed at the time of initial licensureshould Petitioner practice as a RN inTexas, Petitioner will provide directpatient care and practice in a hospital,nursing home or other clinical settingunder the following stipulations for oneyear of employment: Petitioner shallnotify present/future employers of theboard order; shall cause each employerto submit notification of employmentforms; shall cause employer(s) to submitperiodic reports; and Petitioner shallhave indirect supervision withemployment restrictions.

Petitioner for Initial Licensure. Uponmeeting the requirements for graduationand payment of any required fees,Petitioner is hereby ConditionallyEligible to sit for the NCLEX-RNexamination with conditions. Petitionershall not be eligible for temporaryauthorization to practice as a graduatenurse in the State of Texas. Petitionerupon attaining a passing grade on theNCLEX-RN shall be issued a license topractice nursing in Texas which shallbear the appropriate notation. Withinone year of initial licensure Petitionershall successfully complete a boardapproved course in nurs ingjurisprudence; and a board approvedcourse in nursing ethics. It is furtheragreed at the time of initial licensureshould Petitioner practice as a RN inTexas, Petitioner will provide directpatient care and practice in a hospital,nursing home or other clinical settingunder the following stipulations for oneyear of employment: Petitioner shallnotify present/future employers of theboard order; shall cause each employerto submit notification of employmentforms; shall cause employer(s) to submitperiodic reports; and Petitioner shallhave indirect supervision withemployment restrictions.


218

Vladimir Victorovich Moroz, Petitioner forInitial Licensure (RN)

Michael Rodney Naggles, Petitioner for InitialLicensure (RN)

Petitioner for Initial Licensure. Uponmeeting the requirements for graduationand payment of any required fees,Petitioner is hereby ConditionallyEligible to sit for the NCLEX-RNexamination with conditions. Petitionershall not be eligible for temporaryauthorization to practice as a graduatenurse in the State of Texas. Petitionerupon attaining a passing grade on theNCLEX-RN shall be issued a license topractice nursing in Texas which shallbear the appropriate notation. It isfurther agreed at the time of initiallicensure should Petitioner practice as aRN in Texas, Petitioner will providedirect patient care and practice in ahospital, nursing home or other clinicalsetting under the following stipulationsfor two years of employment: Petitionershall notify present/future employers ofthe board order; shall cause eachemployer to submit notification ofemployment forms; shall causeemployer(s) to submit periodic reports;Petitioner shall abstain from theconsumption of alcohol, Nubain, Stadol,Dalgan or other synthetic opiates, and/orthe use of controlled substances; andPetitioner shall submit to periodicscreens for controlled substances andalcohol; and Petitioner shall attend atleast two support group meetings eachweek, one of which shall be forsubstance abuse and shall provideacceptable proof of such attendance.

Petitioner for Initial Licensure. Uponmeeting the requirements for graduationand payment of any required fees,Petitioner is hereby ConditionallyEligible to sit for the NCLEX-RNexamination with conditions. Petitionershall not be eligible for temporaryauthorization to practice as a graduatenurse in the State of Texas. Petitionerupon attaining a passing grade on theNCLEX-RN shall be issued a license topractice nursing in Texas which shallbear the appropriate notation. It isfurther agreed at the time of initiallicensure should Petitioner practice as aRN in Texas, Petitioner will providedirect patient care and practice in ahospital, nursing home or other clinicalsetting under the following stipulations


219

1.ADMINISTRATION1.1. ExecutiveDirector’s Report

Erin Daine Vercher, Petitioner for InitialLicensure (RN)

Katherine Thomas reviewed her written report tothe board including providing informationregarding the Sunset Advisory CommissionReport recommending consolidation of somelicensing agencies and a newspaper articleregarding the Office of Patient Protection.

for two years of employment: Petitionershall notify present/future employers ofthe board order; shall cause eachemployer to submit notification ofemployment forms; shall causeemployer(s) to submit periodic reports;Petitioner shall have indirect supervisionwith employment restrictions; andPetitioner shall participate in therapywith a board approved therapist andshall cause the therapist to submitquarterly reports regarding Petitioner’sprogress in therapy until released fromtherapy.

Petitioner for Initial Licensure. Uponmeeting the requirements for graduationand payment of any required fees,Petitioner is hereby ConditionallyEligible to sit for the NCLEX-RNexamination with conditions. Petitionershall not be eligible for temporaryauthorization to practice as a graduatenurse in the State of Texas. Petitionerupon attaining a passing grade on theNCLEX-RN shall be issued a license topractice nursing in Texas which shallbear the appropriate notation. It isfurther agreed at the time of initiallicensure should Petitioner practice as aRN in Texas, Petitioner will providedirect patient care and practice in ahospital, nursing home or other clinicalsetting under the following stipulationsfor one year of employment: Petitionershall notify present/future employers ofthe board order; shall cause eachemployer to submit notification ofemployment forms; shall causeemployer(s) to submit periodic reports;and Petitioner shall participate intherapy with a board approved therapistand shall cause the therapist to submitquarterly reports regarding Petitioner’sprogress in therapy until released fromtherapy.

No action.


220

1.2. Legal 1.2.1. Discipline andits effect on personswho are licensed asboth RN and LVN

1.3. Update on theLegislativeAppropriationsRequest andLegislative BudgetHearings

2. OPERATIONS2.3. Annual FinancialReports 2.3.1. LVN AnnualFinancial Report

2.3.2. RN AnnualFinancial Report

3. NURSING 3.2. EDUCATION 3.2.1. PublicHearing to ConsiderProposal to Establisha New VocationalNursing EducationProgram and Reportof Site Visit toCollege of theMainland, VocationalNursing Program

3.2.2. Considerationof Approval StatusBased on Review ofNCLEX-PNExamination PassRates and Report ofSurvey Visit-ValleyGrande Institute,Vocational NursingProgram

3.2.3 Report ofSurvey Visit

Dusty Johnston discussed the effect ofdisciplining licenses for Registered Nurses whoalso hold LVN licenses. In many cases thesimilarities in practice require the samedisciplinary sanction.

Staff presented a proposal to conduct DPS/FBIcriminal background checks on all nursesthrough license renewal through a modifiedrandom selection approach that would subject alllicensees to a background check during arenewal cycle by the end of 10 years. Thismodified proposal was made in response torequest of the staff of the Legislative BudgetBoard and the Governor’s office.

Mark Majek reviewed the LVN Annual FinancialReport.

Mark Majek reviewed the RN Annual FinancialReport.

The Board considered College of the Mainland’sProposal to Establish a New Vocational NursingProgram and the report of a survey visit to theproposed vocational nursing program.Dr. James Templer, Dr. Gay Reeves, and MistyJones were present to answer questions.

The Board considered the request of ValleyGrande Institute to be placed on full approvalstatus based on results of survey visit and reviewof the NCLEX-PN pass rate results for the 2004graduating class.Irene Elizade, Leo Galvan, Andrew Leonie, andGracie Almazon were present to answerquestions.

No action.

The board voted to approve thealternative proposal to conduct FBI/DPScriminal background checks on alllicensees through a modified randomselection approach that would subject alllicensees to a criminal backgroundcheck during a license renewal cycle bythe end of 10 years.

No action.

No action.

The board voted to grant initial approvalfor College of the Mainland VocationalNursing education program based uponthe Proposal and findings from thesurvey visit and issue the followingcommendations and recommendations.

The board voted to grant Valley GrandeInstitute Full Approval Status basedupon Survey Visit and results of theNCLEX-PN pass rates for fifteen ofnineteen graduates and issue therequirements as indicated in the letter ofapproval.


221

3.2.3.a. Report ofSite Visit Hill Collegeat Glen rose,Vocational NursingProgram

3.2.3.b. Report ofSite Visit Texas A&MInternationalUniversity, FNPProgram

3.2.3.c. Report ofSite VisitWeatherford College,Associate DegreeNursing Program

3.2.4. Review ofProgress Report,Computer CareerCenter, VocationalNursing Program

3.2.5. New Deanand Director Waiversand Faculty WaiversSummary Report for2003-2004

3.2.6. EducationActivities Summaryfor 2003-2004

3.2.7. Report onSeptember 24, 2004BNE New Dean andDirector Workshop

4. ENFORCEMENT 4.1. CriminalBackground CheckUpdate

5. COMMITTEEREPORTS 5.1. BoardCommittees

The board considered the report of the site visitof Hill College Vocational Nursing Program inGlen Rose, Texas and the results of the site visitby board staff.

The board considered the report of the site visitof Texas A&M International University, FNPProgram.Dr. Susan Baker and Dr. Louise Autio werepresent to answer questions.

The board considered the report of the site visitof Weatherford College Associate DegreeNursing Program.Cheryl Livengood was present to answerquestions.

The board considered the progress report forComputer Career Center in meetingrequirements placed prior to enrollment ofstudents.

The board considered the new dean and directorwaivers and faculty waivers summary report for2003-2004.

The board considered the summary of educationactivities for the academic year 2003-2004.

The board considered the report of theSeptember 24, 2004 new dean and directorworkshop.

The board reviewed the statistics providedregarding the criminal background checks.

The board voted to accept the stafffindings from the survey visit and issuerequirements and recommendations asindicated.

The board voted to accept the report ofthe survey visit, authorize a follow upsurvey visit in Spring 2005, issuedcommendations, recommendations andrequirements to include that a mentor beobtained for Dr. Autio.

The board voted to accept the report ofthe survey visit, to change the approvalstatus of Weatherford College AssociateDegree Nursing Program from Full toWarning based on review of the report ofthe October 8, 2004 survey visit, issuethe commendations, recommendationsand requirements to be met based onstaff recommendation and authorizedboard staff to conduct a survey visit inFall 2005, as indicated.

No action.

No action.

No action.

No action.

No action.


222

5.1.3. Developmentand Evaluation

5.2. AdvisoryCommittees/TaskForces 5.2.1. AdvancedPractice NursesAdvisory Committee

5.2.2. NursingPractice AdvisoryCommittee

5.2.3. AdvisoryCommittee onEducation

5.3. OutsideAgencyCommittees 5.3.1. Texas PeerAssistance Programfor Nurses AdvisoryCommittee

5.3.2. Texas NursesAssociation TaskForces on NursingPractice and NursingEducation Redesign

5.3.3. Texas HigherEducationCoordinating BoardProfessional NursingAdvisory Committee

5.3.4. SHCCNursing WorkforceData AdvisoryCommittee

5.3.5. Texas HigherEducationCoordinating BoardProfessional NursingInnovation GrantProgram-Category D

The board discussed having staff prepare apresentation regarding the regulation of APNeducation.

Jolene Zych reported that the committee willmeet on October 27, 2004. Staff will provide thecommittee with the information gathered at thepublic hearing held on October 20, 2004.

No report.

Brenda Jackson reported that the Committeemet in August, 2004.

Mary Beth Thomas gave a verbal report. At thistime TPAPN has decided to rescind its requestfor additional funding. TPAPN has implementedthe Webcentric program.

Katherine Thomas gave a verbal report on theNursing Practice Redesign Task Force and onthe Nursing Education Redesign Task Force.

No report.

Katherine Thomas gave a verbal report on theSHCC Nursing Workforce Data Center.

Robbin Wilson gave a verbal report on the TexasHigher Education Coordinating BoardProfessional Nursing Innovation Grant Program-Category D.

The board requested staff prepare apresentation for the January boardmeeting on the regulation of APNeducation.

No action.

No action.

No action.

No action.

No action.

No action.

No action.

No action.


223

OPEN FORUM:

6. OLD BUSINESS 6.1. Nurse LicensureCompact Update

6.2. Status ofProposal by M.D.Anderson MedicalCenter for PatientSafety Pilot Programon Nursing ReportingSystems

6.3. Follow up reporton Excelsior College

6.5. Update onRules 217.2, 217.4,217.5, 217.11 and217.12

7. NEW BUSINESS

Dr. Rounds announced the format and invitedparticipation from the audience.

Kathy Cox, CEO, Project ARRIBA (AdvancedRetraining & Redevelopment Initiative in BoarderAreas) spoke regarding the shortage of nurses inWest Texas.

James Willmann, Texas Nurses Associationspoke regarding Agenda Item 7.8. ProposedBoard Policy allowing the Executive Director toIssue Cease and Desist Order. Mr. Willmannurges the Board to carefully consider thisproposed policy because TNA believes it is areduction of nurses due process rights.

Kenneth Craycraft, Vice Chancellor for AcademicAffairs, Texas State University System spokeregarding Agenda Item 7.1.1. Proposal to repealChapter 233 and proposal to adopt new Chapter214. Mr. Craycraft requested that the Boardreconsider the proposed rule change thatreduces the requirement of one nursinginstructor for every 12 students to one nursinginstructor for every 10 students.

No one else came forward and the OpenForum was closed at 1:45 p.m.

Katherine Thomas gave a verbal report on thecompact which now includes twenty states. Ms.Thomas informed the board that the CompactSummit is scheduled for December 5-7, 2004, inWashington, DC.

Mary Beth Thomas gave a verbal report on theproposal. Ms. Thomas presented that theproposal has not been implemented yet and thatwe are in the process of drafting a contract toimplement the project.

Robbin Wilson provided the board withinformation on Excelsior College.Sharon Boni and Suzanne Yarbrough fromExcelsior College were present to answerquestions.

Joy Sparks reported that these rules havebeen adopted as no negative comments werereceived.

No action.

No action.

No action.

The board requested that Staff comparethe Excelsior program to BNE rules todetermine if it meets the criteria outlinedin Rule 215 and to provide the boardwith the results at the January boardmeeting.

No action.


224

7.2. InterpretiveGuideline for MinorIncidents, Rule217.16

7.3. Texas PeerAssistanceProgram for Nurses 7.3.2. TPAPN Auditfollow up

7.4. InterpretiveGuideline forDifferentiatingVocational NurseScope of PracticeUnder Rule 217.11,Standards of NursingPractice

7.6. Charge to theNPAC committee toreview andconsolidateContinuing Educationrules (22 TAC ch.237 [LVN] and 22TAC ch. 216 [RN])and consolidate intochapter 216

7.7. APN Petitioner,Jennifer Hain

ADJOURNMENT

Carol Marshall reported that the purpose of thisguideline is to clarify the board’s interpretation ofrule 217.16

The board reviewed the TPAPN Audit follow up.

Carol Marshall reported that the InterpretiveGuideline will be used to assist Staff withconcerns regarding LVN scope of practice.

The board reviewed the request that the Boardmake a charge to NPAC for review andrecommendations relating to continuingeducation rules for LVNs and RNs.

The board considered Jennifer Hain’s requestthat the Board waive the requirement that shecomply with Rule 221.3(d)(1). This section of therule includes a requirement that all nursepractitioner and clinical nurse specialistapplicants who complete their programs on orafter January 1, 1998 complete a separate,dedicated course in pathophysiology.

Having completed this day’s business themeeting adjourned at 4:30 p.m.

The board voted to adopt theInterpretive Guideline on rule 217.16,Minor Incidents

No action.

The board voted to adopt theInterpretive Guideline for DifferentiatingVocational Nurse Scope of PracticeUnder rule 217.11, Standards of NursingPractice, with provisions for board legalcounsel to make non-substantiativeedits for clarification as needed.

The board voted to charge the NursingPractice Advisory Committee to reviewcurrent continuing education Rule 216for RNs and Rule 237 for LVNs, and tomake recommendations to the board forconsolidation into one continuingeducation rule for nurses.

The board voted to deny JenniferHain’s request that the board waive therequirement that she comply with Rule221.3(d)(1).


225

RECONVENE

6. OLD BUSINESS 6.4. Consideration ofcomments receivedon APN Rules 221.2and 221.7 pertainingto titles

7. NEW BUSINESS 7.1. ProposedRules 7.1.1. Proposal torepeal Chapter 233and proposal toadopt new Chapter214, VocationalNursing Education

7.1.2. Proposal torepeal Chapter 215and Proposal toadopt new Chapter215, ProfessionalNursing Education

7.8. Policy forExecutive Director toenter Cease andDesist Order

7.9. Consideration ofBoard ApprovedChemicalDependencyEvaluators

The board reconvened at 8:45 am on Friday,October 22, 2004.

The board considered and discussed the writtenand verbal comments received relating toproposed revisions to advanced practice rules221.2 and 221.7, relating to advanced practicetitles.

The board considered the Advisory Committeeon Education’s recommendation to repeal theexisting Rule 233 (Vocational Nursing) Educationand to propose the adoption of the new Rule 214Vocational Nursing Education.

The board considered the Advisory Committeeon Education’s recommendation to repeal thecurrent Rule 215, Nurse Education and adopt thenew Rule 215, Professional Nursing Education.

The board considered the policy which isdesigned to give the Executive Director authorityto enter a Cease and Desist Order pursuant tothe authority provided in the Nurse LicensureCompact, Section 304.001, Article 6(a)(3).

The board requested staff prepare apresentation for the January boardmeeting on the regulation of APNeducation. No action.

The board voted to propose the repealof the existing Rule 233 (VocationalNursing) Education and propose theadoption of the new Rule 214 VocationalNursing Education with a friendlyamendment for the ACE committee toreview changes to Chapter 214 toeducation credentials of faculty and theuse of teaching assistants. The boardmoved to publish both in the TexasRegister for a 30 day comment periodand if no substantive, or negativecomments are received during theperiod, approve repeal of the existingRule 233 and the adoption of the newRule 214 as proposed.

The board voted to propose the repealof the current Rule 215, NurseEducation and the adoption of new Rule215, Professional Nursing Educationand moved to publish in the TexasRegister for a 30 day comment periodand if no substantive or negativecomments are received during theperiod, approve the repeal of the currentRule 215 and the adoption of the newRule 215 as proposed.

The board voted to approve the Policyfor Executive Director to enter Ceaseand Desist Order.

The board voted to adopt therequirements for the ChemicalDependency Evaluators as outlined.


226

7.10. Governor’sExecutive OrderRP36, Relating topreventing,detecting,, andeliminating fraud,waste and abuse 7.10.1. Initial Reportto the Governor’sOffice

7.10.2. Revisions tothe DisciplinaryPolicy on Fraud,Theft and Deceptionto include MedicareFraud

8. Proposed BoardOrders 8.2. Agreed Orders

The board discussed the qualifications,education and credentials that the individualsperforming Chemical Dependency evaluationson nurses should possess.

Katherine Thomas discussed the agency initialreport to the Governor’s office in response topreventing, detecting, and eliminating fraud,waste and abuse.

The board discussed the Disciplinary policy onFraud.

The board discussed Agreed Orders pulled fromthe consent agenda.Barbara Marie Burnett, LVN #71691

Karen M. Diaz, RN #525916

No action.

The board voted to amend the Board’sDisciplinary Policy on Fraud to supportthe Governor’s efforts in ExecutiveOrder RP36 issued on July 12, 2004, tohelp eliminate fraud in the health caresystem.

The board voted to ratify the AgreedOrders with the following results:Warning with Stipulations. Within 100days of entry of this order Respondentshall pay a monetary fine in the amountof $2,250. Within one year of entry ofthis order Respondent shall successfullycomplete a board approved course innursing jurisprudence; and a boardapproved course in nursing ethics.Should Respondent choose to practiceas a LVN in Texas, Respondent willprovide direct patient care and practicein a hospital, nursing home, or otherclinical setting under the followingstipulations for one year of employment:Respondent shall notify present/futureemployers of the board order; shallprovide notification of employment; andRespondent shall have indirectsuperv is ion wi th employmentrestrictions.

Enforced Suspension. Respondent’slicense is hereby suspended with saidsuspension enforced until Respondentsuccessfully completes a board


227

Donald Ray Hall, RN #567811

Sandra D. Blake Martin, RN #435310

approved course in nurs ingjurisprudence; a board approved coursein nursing ethics; and pays a monetaryfine in the amount of $350. Uponverification of successful completion ofthe required courses and payment of thefine, the Suspension will be stayed andRespondent will be issued a LimitedLicense. Respondent shall not providedirect patient care. Should Respondentdesire to return to a clinical practicesetting which would require her toprovide direct patient care, Respondentshall petition the Board for suchapproval. Respondent shall for one yearof employment, notify all futureemployers in nursing of this order of theBoard. The stipulations outlined andrequired herein shall supercede allprevious stipulations required by anyorder entered by the Board of NurseExaminers.

Warning with Stipulations. Within oneyear of entry of this order Respondentshall successfully complete a boardapproved course in nurs ingjurisprudence; a board approved coursein physical assessment; a boardapproved course in medicationadministration; and a board approvedcourse in nursing ethics. ShouldRespondent choose to practice as a RNin Texas, Respondent will provide directpatient care and practice in a hospital,nursing home, or other clinical settingunder the following stipulations for oneyear of employment: Respondent shallnotify present/future employers of theboard order; shall provide notification ofemployment; shall provide employerreports; and Respondent shall have in-direct supervision with employmentrestrictions for the duration of thestipulation period.

Reprimand with Stipulations. Withinone year of entry of this orderRespondent shall successfully completea board approved course in nursingjurisprudence; a course in advancedobstetrics physical assessment; and aboard approved course in nursingdocumentation. Should Respondentchoose to practice as a RN in the Stateof Texas, Respondent shall provide


228

9.MISCELLANEOUS 9.1 Board Items ofInterest for FutureBoard Meetings

9.2. ExecutiveSession Pursuant toTex. Gov’t CodeAnn. §551.074(Texas OpenMeetings Act)Regarding PersonnelMatters: Board Self-Evaluation

9.3. Appointment ofBoard Members for2005 Eligibility andDisciplinaryCommittee

9.4. Appointment ofBoard Members for2005 InformalConferences

Jamie Richelle Wakefield, RN #674310

No items were identified.

The board convened in Executive Session todiscuss the annual performance evaluation of theBoard.

The following board members were appointed toserve on the Committee from January, 2005through June, 2005: Deborah Bell, Chair, RosieGarcia and Rachel Gomez

The following board members were appointed toattend a day of Informal Conferences: January,2005-Deborah Bell; April, 2005-Richard Gibbs

direct patient care and practice in ahospital, nursing home, or other clinicalsetting under the following stipulationsfor two years of employment:Respondent shall notify present/futureemployers of the board order; shallprovide notification of employment; shallprovide employer reports; Respondentshall have direct supervision by a nursemidwife or an obstetrician who has beenapproved by the board, with employmentrestrictions for the first year ofemployment as an advanced practicenurse under this order; Respondent shallhave in-direct supervision by a nursemidwife or obstetrician who has beenapproved by the board, with employmentrestrictions for the remainder of thestipulation period.

Reprimand with Stipulations. Within45 days of entry of this orderRespondent shall pay a monetary fine inthe amount of $600. It is further agreedthat the order of the board issued toRespondent on January 22, 2004, is stillin effect in its entirety and Respondentshall be responsible for successfullycompleting the terms of that order.

No action.

No action.


229

9.5 BoardDevelopment: EthicsTraining

ADJOURNMENT:

The board participated in Ethics Training.

Having completed all business as listed on theagenda, the meeting adjourned at 1:45 pm.

Linda Rounds, PhD, RN, FNP, Board President

_______________________________Katherine A. Thomas, MN, RN,Executive Director

No action.

Documents

October 2004 Board Minutes - Texas Board of Nursing item discussion action 204 call to order roll call introductions acceptance of agenda acceptance of minutes consent ... john darryle