Scope of Practice Question - Texas specific

[LevitateMe, RN]

I have a question for anyone that is operating as a Nurse Coach or Health Coach, or anyone that can answer for sure.

I have been thinking about doing freelance health coaching for clients, not contracting with a company but on my own. I have always been under the impression that an RN could not operate and call herself an RN outside of the direct supervision of a Physician.

However, while looking at the Texas BON website and Nurse Practice Act I come across this Position Statement #15.28 "The registered nurse Scope of practice"... It states:

"The RN takes responsibility and accepts accountability for practicing within the legal scope of practice and is prepared to work in all health care settings, and may engage in independent nursing practice without supervision by another health care provider."

My question is regarding that last statement "... and may engage in independent nursing practice without supervision by another health care provider."

Does this mean like in a practice while a doctor is not physically there or does this mean, on your own without reporting to anyone?

I looked on the BON website and can't find anything else. Anyone know who to ask about this type of thing?

Anyone working as a freelance health coach directly to "clients"?

I'd love to hear from you.

Thanks!

[Flatline, BSN, RN]

I have never heard of a requirement for any non-advanced practice registered nurse to practice under a physician in any state.

Nursing is a separate and unique profession from that of physician.

[LevitateMe, RN]

So a nurse can just work as a totally independent nurse, directly with a patient population?

[Flatline, BSN, RN]

So a nurse can just work as a totally independent nurse, directly with a patient population?

Yes and many do. Private duty nursing is fairly popular and I know many vascular access nurses who have independently contracted themselves to facilities.

[LevitateMe, RN]

hmmm thats interesting. I worked as a Private Duty nurse but that was through an Agency.

Thanks!

[caliotter3]

Put your question, specific, in writing and send it to the Board for a definitive answer.

[Horseshoe, BSN, RN]

So a nurse can just work as a totally independent nurse, directly with a patient population?

I have had very good luck with getting questions answered by email from the Texas BON. I second the recommendation above to email the BON.

[LevitateMe, RN]

Do you happen to know the best email? The one I saw on the site was for the webmaster...

[Horseshoe, BSN, RN]

Do you happen to know the best email? The one I saw on the site was for the webmaster...

I'm pretty sure I sent my queries to that email. I got emails saying "thank you for your question..it has been submitted to the proper person, who will review and get back to you." And then I'd hear from someone at the BON with the answer to my question.

[KelRN215, BSN, RN]

I have always been under the impression that an RN could not operate and call herself an RN outside of the direct supervision of a Physician.

I'm sorry, WHAT? When does an RN EVER, outside of one privately employed by a Physician or an NP, work under the direct supervision of a Physician?

Why would an RN, who is granted a license by the Board of NURSING in the state in which he or she is licensed, not be able to call oneself an RN independent of a physician?

Since I left the hospital, I have worked in exactly 0 places that employed Physicians. And I have certainly never been supervised by one.

[LevitateMe, RN]

I was an lvn before I was an RN so I'm guessing that's where I got that from. Also everywhere I've worked I've worked for doctors or at least had a medical director. So that's WHAT.

[tyvin, BSN, RN]

An RN can hang their sheild and open a busniness if they want. Each state has it's regualtions as to what you might be doing in area of chosen business. There are tons of health coaches out there and half aren't even licensed in anything. Incorporate or whatever yourself, make your business models set by the state regualtions if applicable and bingo.

It's start up costs, etc... Some areas are monitored by the state and some aren't. creditionals from CMS if you're going to bill (not worth it). There are many clientele out there willing to pay out of pocket for services. But remember the IRS...and Liability Insurance.

If you run to the board everytime you have a question you will never go anywhere...network in your area of interest.

Do a search on this site for self employed nurses or nurse consults...I think you will find tons of information useful to you.