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What a Nurse Should Consider if he or she receives a proposed Board of Nursing disciplinary Agreed Order

Knowing a nurse's options if one receives a proposed Agreed Order in a board complaint

What a Nurse Should Consider if he or she receives a proposed Board of Nursing disciplinary Agreed Order 

What is an Agreed Order

As an attorney practicing in the professional license defense field, I appear before many licensing boards as a professional license defense attorney. One such board is the Texas Board of Nursing. In a complaint and ensuing investigation, when the Board of Nursing Staff believes that violations occurred and believes it can prove the violations, it will propose resolution to the complaint and investigation through a disciplinary order referred to as an Agreed Order.  The Agreed Order will contain the finding(s) of violation.  These are contained in a section known and referenced as “Findings of Fact.”

The proposed Agreed Order will also contain the disciplinary mark imposed on the license.  This mark ranges from the least severe, “Remedial Education,” to most severe, “Revocation.” In between, there are marks of “Warning,” “Reprimand,” or “Suspension.” The proposed Agreed Order may also contain proposed conditions, stipulations, and/or restrictions on the license, especially if the violation involves practice issues that the Board believes should be monitored and/or remediated.

Understanding critical next steps for a Texas nurse

Whether a nurse chooses to accept the proposed Agreed Order, at this stage, will depend on whether the nurse continues to dispute the findings of fact.  In short, does the nurse agree that he or she engaged in misconduct? If a nurse does not dispute the Agreed Order, he or she signs the Agreed Order and it will be entered as discipline against the licensee.

If the nurse disputes the Board’s proposed discipline, he or she may continue to dispute this with the Board Staff.  However, whether the Board Staff is agreeable to any changes to the proposed Agreed Order will depend on how the Staff feels about the case as to whether it can establish its case based on the evidence at hand.  For example, if the Staff believes that violations occurred, it will be disinclined to make any changes or alter its position.

Negotiating with the Staff at this stage generally requires familiarity with one’s case, the evidence in the case (or lack thereof as the case may be), and whether the Board can meet its burden of proof.  It is always advisable, if one has not already done so, to hire an attorney experienced with defending licensees to determine whether continued challenge to the Agreed Order may result in the resolution sought.

For example, the Phan Law Firm, P.C. recently had several cases dismissed even after the Board proposed an Agreed Order during the investigative stage of the complaint.  In one case, the allegation was that the nurse had taken blank COVID-19 cards and had improperly and falsely entered information and provided them to family and friends.  The allegation also involved the licensee self-entering information into the Texas Department of Public Safety database regarding that licensee’s covid vaccination status.  The case was ultimately dismissed despite a recommendation of and insistence upon discipline through an Agreed Order during the investigatory process. 

Knowing what type of evidence to provide the Board (e.g., affidavits), how to challenge the credibility of certain witnesses, and how to urge points and the legal authorities without simply telling the Board that it is wrong often requires the need for an attorney, especially a Texas nurse attorney, that can best analyze the case and defend the licensee.