RN Update, Volume 26, Number 1, March 1995 Page: FRONT COVER
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"f~RN UP DATE
A Quarterly Pub/ication ofthe Boord of Nurse E xaminers For the State of Texas
Accreditation 0 Licensure Practice TSt C tfn em
1909 85& - 1994
March 1995 Volume 26, No. I
Board Adopts Position Statements: .
The Role ofthe Registered Nurse In the Restructured Health Car iu 9y' {
Board's Jurisdiction OverTitle and PracticeIn response to concerns about client safety and the RN's
responsibilities as a licensed practitioner, the Board charged
its Nursing Practice Advisory Committee to develop a
position statement regarding the RN's role in a restructured
health care delivery system. The Nursing Practice Advisory
Committee consists of representatives from nursing practice,
nursing administration, and nursing education. (For more
information on Lunsford vs. Board of Nurse Examiners, see
the Legal Eagle column.)
THE ROLE OFTHE REGISTERED NURSE
IN THE RESTRUCTURED HEALTH CARE
DELIVERYSYSTEM
In a time when cost consciousness and a drive for increasing
productivity have brought about the reorganization and restruc-
turing of health care delivery systems, the effects of these new
delivery systems on the safety of clients/patients have placed a
greater burden on the registered professional nurse (RN) to
consider the meaning of licensure and assurance of quality care
that it provides.
In the interest of fulfilling its mission to protect the health, safety
and welfare of the people of Texas through the regulation of
registered professional nurses, the Board of Nurse Examiners
(BNE), through the Nursing Practice Act and rules and regula-
tions, emphasizes the RN's responsibility and duty to the client/
patient to provide and coordinate the delivery of safe, effective
nursing care.
Specifically, the following portions of the law and rules and
regulations underscore the responsibilities of the RN:
* The Nursing Practice Act defines professional nursing to
include assessment of clients/patients and the evaluation of care
rendered (Article 451 8, Section 5);
* The delegation rules guide the RN in delegation of tasks to
unlicensed assistive personnel who are utilized to enhance the
contribution of the RN to the client's/patient's well being. Whenperforming nursing tasks, the unlicensed person cannot function
independently and functions only underthe RN's delegation and
supervision. Through delegation the RN retains responsibility
and accountability for care rendered (Rule 21 8). The Board may
take disciplinary action against the license of an RN or RN
administrator for inappropriate delegation;
* The Standards of Nursing Practice establish the role ofthe RN
in planning nursing care, assuring a safe environment making
appropriate assignments and supervising those to whom assign-
ments are made (Rule 217.I I); and
* In Lunsford vs Board of Nurse Examiners (648 S.W. 2d, 391,
Tex. App.-Austin, 1983), the court in affirming the disdplinary
action ofthe Board, held thatthere is a nurse-patient relationship
and that a nurse has a duty to the patient which cannot be
superseded by hospital policy or physician's order.
The RN, by virtue of a rigorous process of educat on and
examination leading to RN licensure, is accountable to the
employer and to the Board to assure that nursing care meets
standards of safety and effectiveness. The RN shoula assess,
make critical professional judgments, provide client/patient edu-
cation, evaluate delegated functions delivered by unlicensed
assistive personnel and remain accountable for patient care
rendered. It is only through his/her role as the coordinator of
care that the RN can assure the delivery of safe, effective client/
patient care. Therefore, it is the position of the Board -hat it is
essential that RNs must determine and coordinate the nursing
care needs of the people of Texas. (Board Action 1/95)
(continued on page 16)
INSIDE THIS ISSUE
GUEST COMMENTARY: Toni Inglis, MSN, RN,
CNS, on RNs In A Restructured Health Care
Delivery System
(Page 9)
Notice of Disciplinary Action
(Page 11)
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Texas. Board of Nurse Examiners. RN Update, Volume 26, Number 1, March 1995, periodical, March 1995; Austin, Texas. (https://texashistory.unt.edu/ark:/67531/metapth1543520/m1/1/: accessed July 1, 2024), University of North Texas Libraries, The Portal to Texas History, https://texashistory.unt.edu; crediting UNT Libraries Government Documents Department.