The Texas Board of Nursing (BON) handles complaints against nurses to protect the public and enforce the Nursing Practice Act (NPA). Complaints can come from patients, colleagues, employers, or other sources. Not all complaints result in an investigation or discipline, but the process can significantly affect a nurse’s career. Knowing the steps of the BON complaint process and how to respond can help you protect your license and professional reputation.

How Complaints Are Handled

Each year, the Texas BON receives more than 16,000 complaints. Some complaints are dismissed without an investigation because they involve minor incidents, insufficient information, issues outside the BON’s jurisdiction, or do not violate the Nursing Practice Act. When a complaint qualifies for investigation, the BON begins gathering evidence to determine if a violation occurred.

Investigators can interview witnesses, collect medical, court, or police records, review employer policies, and even conduct site visits. Most investigations are completed through mail or phone, but on-site investigations are also common. Investigations usually take between five and twelve months. Both the nurse and the complainant are updated periodically on the status, and the final outcome is typically communicated to both parties.

Investigation Process

During the investigation, the BON reviews evidence to determine if a violation of the NPA has occurred. If the evidence shows no violation, the case may be dismissed, and the complaint can be expunged from the nurse’s record. In some cases, the BON may retain the information for a set period in line with record retention policies.

If the BON finds that a violation occurred, it issues an Order of the Board with any necessary sanctions to ensure safe practice. Sanctions can include warnings, fines, education, probation, suspension, or revocation of the nursing license. Most Board Orders are public and become a permanent part of the nurse’s licensure record.

Informal Settlement Process

The BON may offer an informal settlement through a proposed agreed order. This order includes investigative findings, conclusions of law, sanctions, and any requirements the nurse must meet to continue practicing safely. Nurses should review these settlements with a defense attorney to fully understand the implications.

If the nurse agrees, the order is signed before a notary and submitted to the BON. The Board reviews the settlement and usually accepts it, but it can modify or reject the agreement. Accepted settlements become final Board orders and are added to the nurse’s permanent licensing record.

If the nurse disagrees with the proposed order, they can suggest revisions in writing. Discussions may occur during informal settlement conferences (ISC) with Board staff and the nurse’s attorney. The BON may send a revised proposed order after these conferences for consideration.

Formal Settlement Process

When informal settlement cannot be reached or the nurse does not respond to BON communications, formal charges may be filed. Nurses must respond in writing. Failure to respond can result in license revocation by default.

Formal hearings are scheduled before an administrative law judge (ALJ). During the hearing, Board staff presents evidence, and the nurse can provide testimony and other documentation. The ALJ then issues a Proposal for Decision (PFD) containing findings of fact and conclusions of law. The BON reviews the PFD and decides whether to enforce sanctions or close the case with no further action. Possible outcomes include license suspension, revocation, mandatory education, or fines.

Protecting Your License

Experiencing a BON complaint can be stressful, but careful preparation and professional support can make a difference. Respond promptly, keep detailed records, and seek advice from a healthcare lawyer experienced in defending nursing licenses. A lawyer can help you evaluate settlements, prepare for hearings, and communicate with the Board. Taking these steps can help reduce the risk of serious disciplinary action and protect your career.

A BON complaint can have lasting consequences, but with proper defense and support, nurses can maintain their licenses and continue practicing safely. Call (972) 290-1031 to speak with our healthcare lawyer in Dallas today about protecting your license and responding to complaints effectively.