Assembly Bill No. 204–Committee on Commerce and Labor

(On Behalf of Board of Nursing)

February 11, 1999

____________

Referred to Committee on Commerce and Labor

 

SUMMARY—Revises provisions relating to nursing. (BDR 54-405)

FISCAL NOTE: Effect on Local Government: No.

Effect on the State or on Industrial Insurance: No.

~

EXPLANATION – Matter in bolded italics is new; matter between brackets [omitted material] is material to be omitted. Green numbers along left margin indicate location on the printed bill (e.g., 5-15 indicates page 5, line 15).

 

AN ACT relating to nursing; eliminating the civil liability of members of the state board of nursing under certain circumstances; revising the definitions of "nursing assistant," "practice of practical nursing" and "practice of professional nursing"; making various changes concerning disciplinary action against a licensee or a holder of a certificate; increasing the permissible fees that may be charged by the board; revising provisions governing the approval of schools of nursing; and providing other matters properly relating thereto.

 

THE PEOPLE OF THE STATE OF NEVADA, REPRESENTED IN SENATE AND ASSEMBLY, DO ENACT AS FOLLOWS:

1-1 Section 1. Chapter 632 of NRS is hereby amended by adding thereto

1-2 the provisions set forth as sections 2, 3 and 4 of this act.

1-3 Sec. 2. "Approved school of nursing" means a school of nursing

1-4 that is approved by the board as meeting the standards for nursing

1-5 education established by the board pursuant to NRS 632.430 to 632.470,

1-6 inclusive.

1-7 Sec. 3. "System for the delivery of health care" means a licensed

1-8 medical facility as defined in NRS 449.0151, or other organization that

1-9 provides organized nursing services.

1-10 Sec. 4. A member of the board or an employee or agent of the board

1-11 is not liable in a civil action for any act performed in good faith and

1-12 within the scope of the duties of the board pursuant to the provisions of

1-13 this chapter.

2-1 Sec. 5. NRS 632.010 is hereby amended to read as follows:

2-2 632.010 As used in this chapter, unless the context otherwise requires,

2-3 the words and terms defined in NRS 632.011 to 632.019, inclusive, and

2-4 sections 2 and 3 of this act have the meanings ascribed to them in those

2-5 sections.

2-6 Sec. 6. NRS 632.011 is hereby amended to read as follows:

2-7 632.011 "Accredited school of nursing" means a school of nursing

2-8 which is accredited by [the board or another body or] a nationally

2-9 recognized association or an agency authorized by law to accredit or

2-10 approve schools of nursing in the state in which the school is located.

2-11 Sec. 7. NRS 632.0166 is hereby amended to read as follows:

2-12 632.0166 1. "Nursing assistant" means a person who, under the

2-13 direction of a licensed nurse , [and for compensation,] performs basic

2-14 restorative services and basic nursing services which are directed at the

2-15 safety, comfort, personal hygiene, basic mental health and protection of

2-16 patients and the protection of [patients’ rights.] the rights of patients.

2-17 2. The term does not include a person who is employed by this state or

2-18 under contract with this state to provide, or assist in the provision of,

2-19 personal care of other persons if he does not primarily perform acts that are

2-20 within the authorized scope of practice of a nursing assistant.

2-21 Sec. 8. (Deleted by amendment.)

2-22 Sec. 9. NRS 632.017 is hereby amended to read as follows:

2-23 632.017 "Practice of practical nursing" means the performance [for

2-24 compensation] of selected acts in the care of the ill, injured or infirm under

2-25 the direction of a registered professional nurse, an advanced practitioner of

2-26 nursing, a licensed physician, a licensed dentist or a licensed podiatric

2-27 physician, not requiring the substantial specialized skill, judgment and

2-28 knowledge required in professional nursing.

2-29 Sec. 10. NRS 632.018 is hereby amended to read as follows:

2-30 632.018 "Practice of professional nursing" means the performance [for

2-31 compensation] of any act in the observation, care and counsel of the ill,

2-32 injured or infirm, in the maintenance of health or prevention of illness of

2-33 others, in the supervision and teaching of other personnel, in the

2-34 administration of medications and treatments as prescribed by an advanced

2-35 practitioner of nursing, a licensed physician, a licensed dentist or a licensed

2-36 podiatric physician, requiring substantial specialized judgment and skill

2-37 based on knowledge and application of the principles of biological,

2-38 physical and social science, but does not include acts of medical diagnosis

2-39 or prescription of therapeutic or corrective measures.

2-40 Sec. 11. NRS 632.080 is hereby amended to read as follows:

2-41 632.080 1. The compensation of the members of the board must be

2-42 fixed by the board, but may not exceed $80 for each day spent by each

2-43 member in the discharge of his official duties.

3-1 2. [The compensation of the members of the advisory council on

3-2 continuing education for nurses must be fixed by the board, but may not

3-3 exceed $60 for each day spent by each member in the discharge of his

3-4 official duties.

3-5 3.] While engaged in the discharge of his official duties, each member

3-6 and employee of the board [and each member of the advisory committee on

3-7 continuing education] is entitled to receive a per diem allowance and travel

3-8 expenses at a rate fixed by the board. The rate must not exceed the rate

3-9 provided for state officers and employees generally.

3-10 [4.] 3. All compensation, per diem allowances and travel expenses of

3-11 the members and employees of the board [and members of the advisory

3-12 council on continuing education] must be paid out of the money of the

3-13 board.

3-14 Sec. 12. NRS 632.100 is hereby amended to read as follows:

3-15 632.100 1. The board shall make and keep a [full and] complete

3-16 record of all its proceedings, including [a] , without limitation:

3-17 (a) A file of all applications for licenses and certificates under this

3-18 chapter, together with the action of the board upon each application [, and

3-19 including a] ;

3-20 (b) A register of all nurses licensed and all nursing assistants certified in

3-21 this state [.] ; and

3-22 (c) Documentation of any disciplinary action taken by the board

3-23 against a licensee or holder of a certificate.

3-24 2. The board shall maintain in its main office a public docket or other

3-25 record in which it shall record, from time to time as made, the rulings or

3-26 decisions upon all complaints filed with it, and all investigations instituted

3-27 by it in the first instance, upon or in connection with which any hearing has

3-28 been had, or in which the licensee or holder of a certificate charged has

3-29 made no defense.

3-30 3. At least semiannually, the board shall publish a list of the names

3-31 [and addresses of persons licensed or certified by it under the provisions of

3-32 this chapter, and] of all applicants [,] whose applications were denied

3-33 within the immediately preceding year and all licensees and holders of

3-34 certificates [whose licenses or certificates have been refused, suspended or

3-35 revoked within 1] who were the subject of disciplinary action within the

3-36 immediately preceding year, together with such other information relative

3-37 to the enforcement of the provisions of this chapter as it may deem of

3-38 interest to the public.

3-39 Sec. 13. NRS 632.120 is hereby amended to read as follows:

3-40 632.120 1. The board shall:

3-41 (a) Adopt regulations establishing reasonable standards:

3-42 (1) For the denial, renewal, suspension and revocation of, and the

3-43 placement of conditions, limitations and restrictions upon, a license to

4-1 practice professional or practical nursing [.] or a certificate to practice as a

4-2 nursing assistant.

4-3 (2) Of professional conduct for the practice of nursing.

4-4 (3) For prescribing and dispensing controlled substances and

4-5 dangerous drugs in accordance with applicable statutes.

4-6 (b) Prepare and administer examinations for the issuance of a license or

4-7 certificate under this chapter.

4-8 (c) Investigate and determine the eligibility of an applicant for a license

4-9 or certificate under this chapter.

4-10 (d) Carry out and enforce the provisions of this chapter and the

4-11 regulations adopted pursuant thereto.

4-12 2. The board may adopt regulations establishing reasonable:

4-13 (a) Qualifications for the issuance of a license or certificate under this

4-14 chapter.

4-15 (b) Standards for the continuing professional competence of licensees [.]

4-16 or holders of a certificate. The board may evaluate licensees or holders of

4-17 a certificate periodically for compliance with those standards.

4-18 3. The board may adopt regulations establishing a schedule of

4-19 reasonable fees and charges, in addition to those set forth in NRS 632.345,

4-20 for:

4-21 (a) Investigating licensees or holders of a certificate and applicants for

4-22 a license or certificate under this chapter;

4-23 (b) Evaluating the professional competence of licensees [;] or holders of

4-24 a certificate;

4-25 (c) Conducting hearings pursuant to this chapter;

4-26 (d) Duplicating and verifying records of the board; and

4-27 (e) Surveying, evaluating and [accrediting] approving schools of

4-28 practical nursing, and schools and courses of professional nursing,

4-29 and collect the fees established pursuant to this subsection.

4-30 4. The board may adopt such other regulations, not inconsistent with

4-31 state or federal law, as may be necessary to carry out the provisions of this

4-32 chapter relating to nursing assistant trainees and nursing assistants.

4-33 5. The board may adopt such other regulations, not inconsistent with

4-34 law, as are necessary to enable it to administer the provisions of this

4-35 chapter.

4-36 Sec. 14. NRS 632.240 is hereby amended to read as follows:

4-37 632.240 1. The provision of nursing services in any system for the

4-38 delivery of health care must be under the direction and supervision of a

4-39 chief administrative nurse who is a registered nurse.

4-40 2. [As used in this section, "system for the delivery of health care"

4-41 means a licensed medical facility as defined in NRS 449.0151, or other

4-42 organization which provides organized nursing services.

5-1 3.] The provisions of this section do not apply to a county school

5-2 district whose enrollment is fewer than 35,000 pupils.

5-3 Sec. 15. NRS 632.285 is hereby amended to read as follows:

5-4 632.285 1. Any person, except a nursing assistant trainee, who [for

5-5 compensation] practices or offers to practice as a nursing assistant in this

5-6 state shall submit evidence that he is qualified so to practice and must be

5-7 certified as provided in this chapter.

5-8 2. It is unlawful for any person:

5-9 (a) To practice or to offer to practice as a nursing assistant in this state

5-10 or to use any title, abbreviation, sign, card or device to indicate that he is

5-11 practicing as a nursing assistant in this state unless he has been certified

5-12 pursuant to the provisions of this chapter.

5-13 (b) Except as otherwise provided in NRS 629.091, who does not hold a

5-14 certificate authorizing him to practice as a nursing assistant issued pursuant

5-15 to the provisions of this chapter to perform or offer to perform basic

5-16 nursing services in this state, unless the person is a nursing assistant trainee.

5-17 (c) To be employed as a nursing assistant trainee for more than 4

5-18 months.

5-19 3. The executive director of the board may, on behalf of the board,

5-20 issue an order to cease and desist to any person who practices or offers to

5-21 practice as a nursing assistant without a certificate issued pursuant to the

5-22 provisions of this chapter.

5-23 4. The executive director of the board shall forward to the appropriate

5-24 law enforcement agency any information submitted to the board concerning

5-25 a person who practices or offers to practice as a nursing assistant without a

5-26 certificate issued pursuant to the provisions of this chapter.

5-27 Sec. 16. NRS 632.315 is hereby amended to read as follows:

5-28 632.315 1. For the purposes of safeguarding life and health and

5-29 maintaining high professional standards among nurses in this state, any

5-30 person who [for compensation] practices or offers to practice nursing in

5-31 this state shall submit evidence that he is qualified to practice and must be

5-32 licensed as provided in this chapter.

5-33 2. Any person who:

5-34 (a) Practices or offers to practice nursing in this state or uses any title,

5-35 abbreviation, sign, card or device to indicate that he is practicing nursing in

5-36 this state unless that person has been licensed pursuant to the provisions of

5-37 this chapter; or

5-38 (b) Does not hold a valid and subsisting license to practice nursing

5-39 issued pursuant to the provisions of this chapter who practices or offers to

5-40 practice in this state as a registered nurse, licensed practical nurse, graduate

5-41 nurse, trained nurse, certified nurse or under any other title or designation

6-1 suggesting that he possesses qualifications and skill in the field of
6-2 nursing,

6-3 is guilty of a misdemeanor.

6-4 3. The executive director of the board may, on behalf of the board,

6-5 issue an order to cease and desist to any person who practices or offers to

6-6 practice nursing without a license issued pursuant to the provisions of this

6-7 chapter.

6-8 4. The executive director of the board shall forward to the appropriate

6-9 law enforcement agency any information submitted to the board concerning

6-10 a person who practices or offers to practice nursing without a license issued

6-11 pursuant to the provisions of this chapter.

6-12 Sec. 17. NRS 632.345 is hereby amended to read as follows:

6-13 632.345 1. The board shall establish and may amend a schedule of

6-14 fees and charges for the following items and within the following ranges:

6-15 Not less Not more

6-16 than than

6-17 Application for license to practice

6-18 professional nursing (registered nurse) $45 $100

6-19 Application for license to practice practical

6-20 nursing 30 90

6-21 Application for temporary license to practice

6-22 professional nursing or practical nursing

6-23 pursuant to NRS 632.300, which fee must

6-24 be credited toward the fee required for a

6-25 regular license, if the applicant applies for a

6-26 license 15 50

6-27 Application for a certificate to practice as a

6-28 nursing assistant [5] 15 [15] 50

6-29 Application for a temporary certificate to

6-30 practice as a nursing assistant pursuant to

6-31 NRS 632.300, which fee must be credited

6-32 toward the fee required for a regular

6-33 certificate, if the applicant applies for a

6-34 certificate 5 40

6-35 Biennial fee for renewal of a license 40 100

6-36 Biennial fee for renewal of a certificate [10] 20 [20] 50

6-37 Fee for reinstatement of a license 10 100

6-38 Application for recognition as an advanced

6-39 practitioner of nursing 50 200

6-40 Application for recognition as a certified

6-41 registered nurse anesthetist 50 200

7-1 Biennial fee for renewal of recognition as

7-2 an advanced practitioner of nursing or

7-3 certified registered nurse anesthetist $50 $200

7-4 Examination fee for license to practice

7-5 professional nursing 20 100

7-6 Examination fee for license to practice

7-7 practical nursing 10 90

7-8 Rewriting examination for license to practice

7-9 professional nursing 20 100

7-10 Rewriting examination for license to practice

7-11 practical nursing 10 90

7-12 Duplicate license 5 30

7-13 Duplicate certificate [3] 5 [5] 30

7-14 Proctoring examination for candidate from

7-15 another state 25 150

7-16 Fee for approving one course of continuing

7-17 education 10 50

7-18 Fee for reviewing one course of continuing

7-19 education which has been changed since

7-20 approval 5 30

7-21 Annual fee for approval of all courses of

7-22 continuing education offered 100 500

7-23 Annual fee for review of training program [25] 60 [60] 100

7-24 Certification examination 10 90

7-25 Approval of instructors of training programs [20] 50 [50] 100

7-26 Approval of proctors for certification

7-27 examinations 20 50

7-28 Approval of training programs [50] 150 [150] 250

7-29 Validation of licensure or certification 5 25

7-30 2. The board may collect the fees and charges established pursuant to

7-31 this section, and those fees or charges [may] must not be refunded.

7-32 Sec. 18. NRS 632.350 is hereby amended to read as follows:

7-33 632.350 1. Before suspending or revoking any license or certificate

7-34 or taking other disciplinary action against a licensee or holder of a

7-35 certificate, the board shall cause an administrative complaint to be filed

7-36 against the licensee or holder of the certificate. The board shall notify the

7-37 licensee or holder of the certificate in writing of the charges against him,

7-38 accompanying the notice with a copy of the [complaint, if any is filed.]

7-39 administrative complaint.

7-40 2. Written notice may be served by delivery of it personally to the

7-41 licensee or holder of the certificate, or by mailing it by registered or

7-42 certified mail to his last known residential address.

8-1 3. If the licensee or holder of the certificate , after receiving a copy of

8-2 the administrative complaint pursuant to subsection 1, submits a written

8-3 request, the board shall furnish the licensee or holder of the certificate with

8-4 copies of any communications, reports and affidavits in possession of the

8-5 board, touching upon or relating to the matter in question.

8-6 4. As soon as practicable after the filing of [a complaint or, if no

8-7 complaint is filed, after notice of the charges is given to a licensee or holder

8-8 of a certificate,] the administrative complaint, the board, or a majority

8-9 thereof, shall hold a hearing on the charges at such time and place as the

8-10 board prescribes. If the board receives a report pursuant to subsection 5 of

8-11 NRS 228.420, the hearing must be held within 30 days after receiving the

8-12 report. The hearing must be held, if the licensee or holder of the certificate

8-13 desires, within the county where he resides.

8-14 Sec. 19. NRS 632.400 is hereby amended to read as follows:

8-15 632.400 1. The board shall render a decision on any administrative

8-16 complaint within 60 days after the final hearing thereon. For the purposes

8-17 of this subsection, the final hearing on a matter delegated to a hearing

8-18 officer pursuant to NRS 632.355 is the final hearing conducted by the

8-19 hearing officer unless the board conducts a hearing with regard to the

8-20 administrative complaint.

8-21 2. The board shall notify the person of its decision in writing by

8-22 certified mail, return receipt requested. The decision of the board becomes

8-23 effective on the date the person receives the notice or on the date the board

8-24 receives a notice from the United States Postal Service stating that the

8-25 person refused to accept delivery or could not be located.

8-26 Sec. 20. NRS 632.430 is hereby amended to read as follows:

8-27 632.430 The board [shall have the power to] may prescribe standards

8-28 and curricula for schools of practical nursing, [to] visit, survey and

8-29 [accredit such] approve those schools, and [to remove such] remove those

8-30 schools from [an accredited] a list of approved schools of nursing for just

8-31 cause.

8-32 Sec. 21. NRS 632.440 is hereby amended to read as follows:

8-33 632.440 The board shall prescribe curricula and standards for schools

8-34 and courses of professional nursing. The board shall provide for surveys of

8-35 such schools and courses at such times as it may deem necessary. It shall

8-36 [accredit] approve such schools and courses as meet the requirements of

8-37 this chapter and of the board. It shall evaluate and approve courses for

8-38 affiliation with [accredited] approved schools of nursing in this state or

8-39 with schools of nursing which have applied for [accreditation.] such

8-40 approval.

8-41 Sec. 22. NRS 632.460 is hereby amended to read as follows:

8-42 632.460 1. [No] The board shall not approve a school of

8-43 professional nursing [shall be accredited by the board] until the board has

9-1 caused a thorough survey of the facilities of [such] the school to be made.

9-2 No such survey shall be deemed complete for the purposes of this section

9-3 until a [full and complete] written report [shall have been] of the survey is

9-4 made to the board and [until such written report shall have] the report has

9-5 received the full consideration of the whole board.

9-6 2. If any school of professional nursing making application for

9-7 [accreditation shall indicate that one or more of the courses] approval

9-8 indicates that any course required by the prescribed curriculum is [or are]

9-9 to be offered by an institution [or institutions] affiliated with [such

9-10 applicant,] the school, the board shall cause a survey of the facilities of

9-11 [such] the affiliated institution [or institutions] to be made, and the written

9-12 report [thereon shall] concerning that institution must receive the full

9-13 consideration of the board before [accreditation.] the board approves the

9-14 school of professional nursing.

9-15 Sec. 23. NRS 632.470 is hereby amended to read as follows:

9-16 632.470 1. [Not less than once every 3 years, the] Except as

9-17 otherwise provided in this subsection, the board shall periodically cause to

9-18 be surveyed all [accredited] approved schools of professional nursing in

9-19 this state. [Full and complete written] Written reports of [such surveys

9-20 shall] those surveys must be submitted to and considered by the full board.

9-21 In lieu of causing the approved schools of professional nursing to be

9-22 surveyed, the board may accept a survey and recommendation completed

9-23 by a nationally recognized association that accredits schools of

9-24 professional nursing, if the association has been approved by the board.

9-25 2. If, after consideration of [such] the reports, the board determines

9-26 that [any such] a school of professional nursing is not maintaining the

9-27 standards required by this chapter and by the board, notice thereof in

9-28 writing specifying the [weaknesses shall immediately] deficiencies must

9-29 forthwith be given to [such] the school.

9-30 3. The board shall revoke the [accreditation of any] approval of a

9-31 school of professional nursing which fails to remedy such [weaknesses]

9-32 deficiencies within a reasonable time after receiving written notice thereof.

~