Camp Mystic and the Texas Board of Nursing: What Licensed Professionals Can Learn

A summer camp, a licensed nurse, and a Texas Board of Nursing case may not seem connected at first glance. But when a licensed professional’s training, judgment or credentials are part of the role they hold, the licensing board may still have a regulatory interest, even outside a traditional hospital or clinic setting. 

In this episode of Know Your Regulator, Cimone Murphree is joined by Bertolino LLP’s Amy Cadwell and Melissa Hooper to examine the Camp Mystic nursing license case as an educational example. We do not break down the tragedy itself or assign any blame. Instead, we look at how this situation at a summer camp can become a matter before the Texas Board of Nursing, and what licensed professionals can learn from it. 

We begin with the connection between professional licensure and non-traditional work environments, including what happens when a licensed professional also holds an operational or leadership role. Amy and Melissa discuss why boards focus on function over setting, how emergency planning and medication systems become regulatory issues, and why informal “we’ve always done it this way” workplace practices can create serious risk. 

We cover practical red flags for licensed professionals in Texas, including unclear authority, lack of written protocols, unsafe delegation, inconsistent documentation, and situations where your professional judgement may be overridden or minimized.

If your license is part of the reason why you serve or supervise others, make safety decisions, oversee care, or respond to emergencies, then your professional responsibilities may follow you farther than you think. 

Subscribe to Know Your Regulator, share this episode with a licensed professional who may need it, and know your responsibilities and protocols before a crisis occurs. 

Watch Here: https://www.bertolinolaw.com/know-your-regulator/camp-mystic-and-the-texas-board-of-nursing-what-licensed-professionals-can-learn/

Get more information, details and resources on Know Your Regulator - https://www.bertolinolaw.com/know-your-regulator/

Transcript

Education Only And Legal Disclaimer

SPEAKER_00 0:00

The purpose of this podcast is to educate and inform. It does not provide legal advice. It does not create an attorney-client relationship. While the host is not a lawyer, the content is overseen by licensed counsel. If you need help with a legal matter, you should always consult with a qualified attorney.

Camp Mystic Case Timeline

SPEAKER_01 0:19

I am your host, Simone Murfrey. We've got kind of a special episode for you today. I am here with the Bertolino law firms Amy Cadwell and Melissa Hooper. And together we are taking a look at the Camp Mystic Nursing License case as an educational example. I want to make this really clear. This is not about breaking down the tragedy itself or assigning any blame. Our focus is solely on how does the situation that happened at Summer Camp become a matter before the Texas Board of Nursing and what can licensed professionals learn from a case like this. So before we get into any legal analysis, we're just going to walk through a basic timeline of what's happened with this nurse's license and then we'll kind of jump into things. Amy and Melissa, thank you both so much for joining me. Great to be here.

SPEAKER_02 1:08

Thank you.

SPEAKER_01 1:09

Thank you for the invite. Absolutely. So let's kind of bring it back to the beginning. Um, this camp mystic co-director was a registered nurse. She was the camp's co-director. Um, she was married to the son-in-law of the owners, and she was also the camp's chief health officer. So she wore lots and lots of hats there. Following the events of July 4th, 2025, the board issued a temporary suspension of her nursing license on May 19th, 2026. The allegations that they included in that temporary suspension order were that she had failed to develop and maintain adequate emergency plans and emergency protocols, improper delegation for administering medications, abandonment, and failure to report deaths in a timely manner. However, just eight days later, on May 27th, her license was reinstated, but she had the restriction. She's not able to give direct patient care. Um, and then I think something that's of note is that in this agreed resolution order that reinstated her license with these restrictions, she neither admits nor denies these allegations against her. So, again, let's kind of look at it from a bird's eye view.

Why The Nursing Board Has Jurisdiction

SPEAKER_01 2:29

When people are thinking about summer camp, they are certainly not immediately thinking about the board of nursing. Amy, what is the first connection in a case like this? How does the Board of Nursing come into play?

SPEAKER_02 2:42

You know, what often surprises people is that the Board of Nursing's involvement doesn't depend on the setting, it depends on whether the licensed nursing functions are being performed. So in a case like this one, the connection usually starts with the individual's role and her responsibilities. If a licensed nurse is serving as, like here, a health officer overseeing medical care, making decisions about treatment, coordinating responses to health-related incidents, that's enough to bring the board into the picture. And even in a non-traditional environment like a summer camp, once someone is using their clinical training or isn't relying on because of their license, their action can fall under the board's jurisdiction. So the very first connection is really more about function over form. If nursing judgment, uh, supervision or medical decision making is involved, then the board of nursing has a regulatory interest. That's regardless of where it occurs.

SPEAKER_01 3:41

Yeah, that makes sense. You're you're still acting in that capacity. So let's dive into that for a second. Without the context of a hospital or a clinic or like home health settings, some sort of direct patient care. When the board of nursing is looking at a case like this, what is the key connection here? And is it that she was acting as a nurse and she was using that nursing judgment? Yes, that that's really the central issue.

SPEAKER_02 4:11

The board's not looking at the setting so much as it's looking at the function. If a licensed nurse is making decisions that involve assessing health risks, overseeing care, directing how medical issues are handled, the board is going to view that as the exercise of nursing judgment. And regardless of whether it's happening in a hospital, a camp, or even somewhere completely different. The key connection, her license wasn't just incidental to her role. Here, it was likely part of why she was trusted to make those decisions in the first place. And since that's true, the Board of Nursing has jurisdiction to evaluate whether that judgment met professional standards. It's not about whether you where you practice, it's about whether you were practicing.

SPEAKER_01 4:59

Yeah, that makes a lot of sense. Like you said, that may have been part of the reason why she was in, um, like I said, she wore a bunch of hats. So it may have been part of the reason why she was in those roles.

When Admin Roles Still Count

SPEAKER_01 5:11

Now, kind of off of that, if someone is an operational leader, like a co-director, and they're also a licensed professional, does the licensing board separate these roles or can they overlap?

SPEAKER_03 5:26

They absolutely can overlap. And that's exactly where the where a lot of risks lives for professionals. Licensing boards typically don't let someone turn off their professional obligations just because they're wearing an administrative or a business hat. If your role involves health, safety, or supervision of care, even if it's indirectly, the board can look at whether you are exercising professional judgment consistent with your license. So even if someone thinks I'm acting as a camp director and not a nurse, if their training and license sure informs their decisions, or if others rely on them because of this license, the board may still evaluate their conduct under that professional standard. In other words, your title may change, but your license follows you.

SPEAKER_01 6:18

Yeah, and I think a key phrase that you said there was if others rely on them because of that license.

Emergency Planning Needs Written Structure

SPEAKER_01 6:26

And one of the major allegations that, you know, was in the temporary suspension order involved emergency preparedness and evacuation planning. And I'm sure a lot of people are wondering how is that, you know, relevant to her nursing license? Can you give us some insight on that, MJ?

SPEAKER_03 6:47

I would like to break it down into terms of three columns or pillars, if you will, structure, clarity, and accountability. The first one is before you before a crisis ever happens, professionals need to have clearly defined systems in place, not just a general idea of what they want to do or how they're gonna do it, but it needs to be specific. And we need written protocols that people can actually follow under pressure. This is going to include evacuation plans, medical response procedures, communication chains, and contingency plans if key personnel are unavailable. Equally important, I feel, is making sure these plans are operational, not just in draft format. Staff needs to understand their roles. They need to be properly trained and know how to execute these responsibilities in real time. A plan that exists on paper but isn't understood or practiced can break down very quickly.

SPEAKER_01 7:48

And for you know, other licensed professionals who may not be nurses, maybe, but in leadership roles, what kind of emergency plans or protocols should they be thinking about before the crisis actually happens?

SPEAKER_03 8:06

There I I believe there also needs to be clarity around delegation and decision-making authority. In a fast-moving situation such as this, there's going to be confusion about who's in charge, who's responsible for that, which can create real risk, as we are seeing. Lastly, there should also be a system in place for documenting both the planning and the response. This is going to help demonstrate the reasonable steps taken and provide transparency if decisions are later reviewed. So at a high level, it's not about predicting every possible emergency. It's about having organized, workable systems that support consistent and defensible decision making when something does happen.

Medication Delegation And Documentation Basics

SPEAKER_01 8:52

Another allegation that was in the order, um, it referenced medication administration, delegation, uh, storage, documentation. And in a camp setting, I'm sure that these practices may feel extremely informal compared to a hospital or a clinic. But from a regulatory perspective, you know, we're seeing that the preparedness matters, the organization matters, the systems you have in place matter. But when it comes to, you know, compared to hospital or clinic setting, what still has to be handled extremely carefully?

SPEAKER_02 9:32

Simone, from a regulatory standpoint, those core principles don't, they don't relax just because the environment is more informal. The board is still going to expect appropriate delegation, safe medication handling, clear and accurate documentation, even in a camp setting. Those elements go directly to patient safety. And the challenge is that informal systems can create gaps, especially around consistency and accountability, which are exactly the kinds of things the regulators are focusing on. So while the setting may feel different, the expectation is still that those foundational safeguards are in place. Regulators don't expect perfection, but they do expect structure.

Inheriting Bad Systems Without Immunity

SPEAKER_01 10:16

When you see a situation where a licensed professional has either inherited a messy system or maybe they've joined an organization that just has some really poor practices that have now become tradition, how can they best protect themselves and their license?

SPEAKER_03 10:34

I feel this is one of the most common and maybe even the most dangerous situations a professional can step into. The key is to recognize that you can inherit a problem, but you're you're not immune to inheriting it. So for a risk perspective, here are a few critical steps. Assessing quickly and document concerns early. Avoid going along to get along, escalating issues in writing to leadership or your governing bodies so there's a clear record, and setting boundaries around what you will and won't supervise or and or sign off on. Because again, at the end of the day, the board isn't going to ask you how long has the system been in place. They're going to ask you, what did you do once you knew?

SPEAKER_01 11:35

Yeah, I think that's that's a really big distinction, is that you may come into this, you know, business setting and there may be some terrible practices, but it is still your responsibility as a license holder to not go along with that. Um, and like you said, just going going along with it for the sake of getting along can really get you in so much trouble.

Red Flags That Require A Pause

SPEAKER_01 12:01

Well, as we come to a close, ladies, you know, what are the biggest lessons or red flags that a professional should pause and get some advice before they continue in their role?

SPEAKER_02 12:15

You know, I'd trade red flags through the lens of loss of control and visibility. Those are the big risk drivers. So some examples would be you don't have clear oversight of how clear care-related tasks are actually being carried out, or there's inconsistency and how different people are handling the same responsibilities. You're relying on verbal processes instead of written protocols, or you can't easily verify whether something is actually done after the fact. And then another major red flag is when a professional finds themselves in a role where they're nominally responsible. They don't actually have the authority to fix the problem. That's the worst because it's a very uncomfortable place from the life standpoint because accountability doesn't go away just because authority is limited. So even though you don't have the authority, you still have the responsibility. If you can't see it, control it, or document it, it's probably a risk.

SPEAKER_03 13:16

Also, I would like to add some additional flags that I came out with that should immediately trigger a pause. The first one I came up with is a lack of written policies or emergency protocols, especially where health and safety are involved. Another one is to pressure to delegate beyond what is safe or permitted. Documentation practices that are inconsistent or worse, discouraged. Being asked to rely on informal or we've always done it this way type systems. And lastly, unclear reporting responsibilities for serious incidents. I'd like to add one more when your professional judgment is being overridden or minimized, that's a significant risk point. That's the moment when you should step back, document your concerns, and in many cases, probably seek legal and or regulatory guidance before moving forward. Waiting until something goes wrong is almost always too late from a licensing perspective.

SPEAKER_01 14:22

Completely agree. I think our last episode we had was you know, don't wait until it's too late. Your options shrink, you know, it's it's not a place that you want to find yourself in. And yeah, absolutely.

Key Takeaways And Subscribe

SPEAKER_01 14:36

Well, thank you both for joining me today to break this down. And professionals, please remember that your professional responsibilities do not fit neatly inside the walls of a hospital, clinic, school, or your office. If your license is part of the reason why you hold a role, why you supervise others, make safety decisions, or respond to emergencies, your board may later look at your contact through that professional lens. Be sure to subscribe to Know Your Regulator so you never miss an episode. And until next week, stay inspired and continue engaging with your regulatory agency. Thank you, ladies.