TNA's Priorities for the 89th Regular Session

By Jack Frazee, J.D.

IT’S THAT TIME AGAIN! We are heading into the 89th Regular Session of the Texas Legislature, and there are several exciting issues on TNA’s list of priorities. This article will highlight the top issues we are asking the Legislature to address and will note some broader issues we are monitoring.

STAFFING

In 2009, the Legislature enacted Chapters 257 and 258 of the Health and Safety Code, which are the nurse staffing statute and the prohibition on mandatory overtime for nurses.

These statutes are meant to work in tandem. By prohibiting mandatory overtime for nurses, the Legislature established a practical limit to how much hospital employers could ask their nurse professionals to work. That requires the hospital to use its nurse staffing committee to create policies and staffing plans to meet the needs of their patient population.

During the COVID-19 pandemic, we observed this system break down. The prohibition on mandatory overtime contains an exception that is triggered by a public health emergency. Typically, that emergency would be brief (such as in response to a hurricane on the Texas coast). However, the pandemic meant we were in a state of public health emergency response for three years. As a result, nurses did not enjoy the labor protections they typically would enjoy for three years.

We have heard from our members that the staffing regulatory system broke down during this period and never got back on the right track after the public health emergency declaration was lifted. We will advocate for the Legislature to fix this broken regulatory system and ensure the laws on the books are properly enforced.

I encourage you to read our research and recommendations here.

TNA will advocate for dedicated scholarships, loan repayment, and grant programs to be funded to continue the effort to grow the nursing workforce, reduce the pressures of the nursing shortage, and ensure adequate access to nursing services for our growing population.

EDUCATION FUNDING

Last session, the Texas Legislature made the largest investment in nursing education in state history.

TNA advocated for significant improvements to nurse education funding programs and the Legislature responded in a big way.

Nurses in Texas now have access to dedicated scholarships, loan repayment to assist with student debt, and grant programs to stimulate innovative nursing education programs as well as prevent workplace violence.

TNA will advocate for dedicated scholarships, loan repayment, and grant programs to be funded to continue the effort to grow the nursing workforce, reduce the pressures of the nursing shortage, and ensure adequate access to nursing services for our growing population.

The legislation that enacted all these new programs and restructured existing programs also created a new set of clinical education programs that were not funded in the state budget. TNA will advocate for these programs to be funded to continue the effort to grow the nursing workforce, reduce the pressures of the nursing shortage, and ensure adequate access to nursing services for our growing population.

Nurses must be empowered to speak up when errors occur or healthcare systems break down. When we empower nurses to speak up, we improve patient outcomes and ensure that errors are prevented for future patients.

You can read more about our education funding research and recommendations here.

Nurses must be empowered to speak up when errors occur or healthcare systems break down. When we empower nurses to speak up, we improve patient outcomes and ensure that errors are prevented for future patients.

PREVENTING THE CRIMINALIZATION OF MEDICAL ERRORS

I suspect you have already heard about the RaDonda Vaught case and understand the concerns nurses are raising about the potential criminalization of practice errors.

For decades the healthcare industry has operated under an informal legal framework: Practice errors are addressed by licensing agencies while intentional harm to patients may be addressed by the criminal justice system.

Every once in a while we see a case like RaDonda Vaught’s where a practice error is treated the same as an intentional, criminal act toward a patient.

It is a dangerous precedent. Nurses must be empowered to speak up when errors occur or healthcare systems break down. When we empower nurses to speak up, we improve patient outcomes and ensure that errors are prevented for future patients.

We are advocating that this informal legal framework be codified in state law.

You can read more about our research and recommendations here.

BROADER TRENDS AND ISSUES

In the past several months, Governor Abbott created a healthcare workforce task force to study opportunities to improve the use of government resources to grow the healthcare workforce in Texas.

The task force recently released its report and it includes a number of issues TNA considers priorities.

If you become aware of legislation in the next session that you think TNA should be monitoring, please do not hesitate to contact our government affairs team and share your concerns.

We expect this report to lead to the introduction of relevant legislation in the next session and will be monitoring and advising members of the Legislature on how to implement these recommendations.

We also continue to monitor a broad range of public health issues, women’s health issues, and access to care initiatives. If you become aware of legislation in the next session that you think TNA should be monitoring, please do not hesitate to contact our government affairs team and share your concerns.

Together, we will work to continue to improve the nursing practice environment and the delivery of healthcare in our state.