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The Texas Board of Nursing (BON) has the jurisdiction to hear and decide cases involving the practice of professional nursing in Texas. Any RN or LVN found guilty of violating the state laws and regulations may be subjected to a disciplinary case if not properly defended by a nurse attorney. 

At the time of the incidents, an RN was employed as a Family Nurse Practitioner at a hospital in Big Spring, Texas, and had been in that position for four (4) years and two (2) months.

On or about November 20, 2018, through May 7, 2019, the RN prescribed new thyroid medication for the Patient. Additionally, the RN failed to document his communication with the pharmacy regarding his effort to titrate this medication change and failed to document any discontinuation of the prior thyroid medication until May. The RN’s conduct could have exposed the patient to a risk of harın from adverse effects of excess thyroid hormone, including heart palpitations, tachycardia, and anxiety.

On or about November 20, 2018, through May 7, 2019, the RN prescribed hormone replacement therapy and a compounded arousal cream medication to the Patient, a female patient, for off-label purposes in a manner not fully supported in the medical records and inconsistent with the standard of care for the treatment of Patient’s diagnoses.

On or about November 7, 2018, through May 7, 2019, the RN failed to accurately document in the electronic medical record of the Patient. The RN’s conduct resulted in an inaccurate medical record and exposed the patient to a risk of harm in that subsequent caregivers would not have accurate and complete information on which to base their care decisions.

In response to the above findings, the RN states that all his assessments are documented accurately, and proper training and education are completed and documented for managing hormone therapy. The RN further states that the initial treatment plan for a patient with prior exposure to hormone therapy, including, all medications were executed and prescribed with proper consent from the patient, under appropriate physician supervision consistent with the standard of care, and within Synergen X treatment protocols. The RN adds that all providers at the practice are following company practice guidelines regarding pellet insertion and testosterone dosing. In addition, the RN states that hypothyroidism is managed using the facility protocols, and that thyroid medications were closely monitored and titrated if necessary, with regular office visits and lab testing, however, the patient did ‘not express any medication symptoms at any time with either the RN or two other clinic providers, and the patient failed to maintain regular office visits as ordered. 

As a result, the Texas Board of Nursing placed her RN license in disciplinary action. It’s too bad that she failed to hire a nurse attorney for assistance, knowing that she had every reason to defend herself in the first place. Her defense would have gotten better if she actually sought legal consultation from a Texas nurse attorney as well.

So if you’re facing a complaint from the Board, it’s best to seek legal advice first. Texas Nurse Attorney Yong J. An is willing to assist every nurse in need of immediate help for nurse licensing cases. To contact him, please dial (832)-428-5679 for a confidential consultation or for more inquiries.