texa s nu r s e s .o rg
TEXASNURSING M A G A Z I N E
TNA WORKS FOR YOU 2019 LEGISLATIVE AGENDA
T N A : E m p o w e r i n g Te x a s N u r s e s t o a d v a n c e t h e p r o f e s s i o n | W I N T E R 2 0 1 9
WINTER 2019 Volume 93, Number 1 EDITOR IN CHIEF: Cindy Zolnierek, PhD, RN, CAE MANAGING EDITOR: Kanaka Sathasivan, MPH 4807 Spicewood Springs Rd., Bldg 3, Suite 100, Austin, TX 78759-8444 P: 800.TNA.2022 or 512.452.0645; F: 512.452.0648 tna@texasnurses.org | texasnurses.org
MISSION Empowering Texas Nurses to advance the profession
BOARD OF DIRECTORS OFFICERS: Jeff Watson, DNP, RN-BC, NEA-BC, NE-BC, President Tamara “Tammy” Eades, DNP, MSN, RN, Vice President Kleanthe Caruso, RN, MSN, NEA-BC, Secretary Gayle Dasher, RN, PhD, ANP-BC, Treasurer DIRECTORS: Tina Cuellar, PhD, RN, PMHCNS-BC Melinda Hester, DNP, RN Donna Wallis, MBA, MSN, RN Patricia Freier, MSN, RN-BC, RCIS Shakyryn Napier, DHSc, MSN, RN, CPN
TNA DISTRICT AND PRESIDENT Dist.1:
VISION Nurses transforming health TEXAS NURSING (ISSN 0095-36X) is published quarterly— Winter, Spring, Summer, Fall—by the Texas Nurses Association, 4807 Spicewood Springs Rd., Bldg 3, Suite 100, Austin, TX 78759-8444 Periodical postage is paid in Austin, Texas. One-year subscriptions: $25 (nursing schools, libraries, hospitals, non-nurses, out-of-state nurses), foreign $30; single copy $2.50. Subscription is not available to non-member Texas nurses. Some back issues may be viewed online at texasnurses.org. PUBLISHING PARTNER Monarch Media & Consulting, Inc. P: 512.680.3989 or 512.293.9277; F: 866.328.7199 monarchmediainc.com | chellie@monarchmediainc.com Advertising inquiries: call Chellie Thompson at 512.293.9277. TEXAS NURSING is indexed in The Cumulative Index to Nursing and Allied Health Literature and in the International Nursing Index. 16mm, 35mm microfilm, 105mm microfiche, article copies available from University Microfilms International: 1.800.521.3044 Statements of fact and opinion are made on the responsibility of the authors alone and do not imply an opinion on the part of the officers or the membership of TNA. POSTMASTER Send address changes to TEXAS NURSING, 4807 Spicewood Springs Rd., Bldg 3, Suite 100, Austin, TX 78759-8444
Dist. 3: Margie Dorman-O'Donnell, margie.dormanodonnell@cookchildrens.org, District Staff: Jamie Gilbert, jamiegilbert@texashealth.org Dist. 4: Jackie Michael, michaels@uta.edu, District office: Pat Pollock, P.O. Box 764468, Dallas, TX 75376; 972.435.2216; d4tna@flash.net; tnad4.org Dist. 5: David Burzynski, president.tnad5@gmail.com Dist. 7: Crissie Richardson, crissag98@gmail.com, District office: P.O. Box 1482, Belton, TX 76513, tnadistrict7@gmail.com Dist. 8: Linda Juenke, 830.739.7028, ljsoaringeagle3@gmail.com Dist. 9: Tina Cuellar, tinaatutmb@aol.com, District office: Melanie Truong, 7324 Southwest Freeway, Suite 2-1453, Houston, TX 77074; 713.523.3619; tna9@tnadistrict9.com; tnadistrict9.com Dist. 11: Linda Treitler, linda.treitler@mwsu.edu Dist. 17: Cindy Keese, 361.332.1643, cakeese@aol.com Dist. 18: Darla Smith, darla.smith3@stjoe.org Dist. 19: Colleen Marzilli, cmarzilli@uttyler.edu Dist. 21: Jessica Tully, 432.254.1949, jessica.tully@midland-memorial.com Dist. 35: Chrystal Brown, 903.434.8302, cbrown@ntcc.edu At-large: Contact TNA, 800.862.2022, ext. 129, brichey@texasnurses.org
ARE YOU MOVING? Need to change your address? If so, provide it quickly and easily in the Members Only section of the TNA website, texasnurses.org. Or mail your new address—at least six weeks prior to your move—to Texas Nurses Association headquarters. We’ll make sure your TEXAS NURSING makes the move with you. FEEDBACK EMAIL OR LETTER GUIDELINES TEXAS NURSING will select emails/letters on the basis of readership interest and relevance to current nursing/health care events. TEXAS NURSING reserves the right to edit all letters. Guide: Limit to 200 words; focus on single issue; include writer’s name, mailing address, and daytime phone. Send to: editor@texasnurses.org. Copyright 2019 © Texas Nurses Association
T E X A S N U R S I N G M AGA Z I N E | W I N T E R 2 019
Clarissa Silva, clarissa2277@att.net, Terry Acosta, shadowmon@sbcglobal.net
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WORKING TIRELESSLY
FOR NURSES AT THE STATE CAPITOL
MALPRACTICE PROTECTING YOUR LICENSE
12
24
TPAPN'S NEW ONLINE PRESENCE
REMEMBERING A NEVER EVENT
18
20
WINKLER CO. — TEN YEARS LATER
Contents IN EVERY ISSUE
FEATURES
5
8
9
11
14
PRESIDENT’S NOTES
2019 TNA POLICY SUMMIT AND HOUSE OF DELEGATES
NEW YEAR, NEW MEMBER BENEFITS
PRESENTING TNA'S POLICY PODCAST
REMEMBERING JOHN LEVIS BROWN
Learn About Policy Issues During the Legislative Session
Members, Friends, and Colleagues Share Their Memories of Brown's Time at TNA
Avoiding Snow Ruts
6
Join Us in Georgetown
Announcing Four New Member Benefits
TNA MEMBER NEWS Kudos, Obituary
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W I N T E R 2 019 | T E X A S N U R S I N G M AGA Z I N E
FOOD
IS
MEDICINE
April 13, 2019 • Midland, TX
CME & CNE Credits Available
Dr. Michael Greger
Dr. Scott Stoll Hosted by: Drs. Dean and Ayesha Sherzai
Dr. Scott Stoll, author of Alive! and co-founder of the Plantrician Project and the International Plant Based Nutrition Healthcare Conference, will discuss the seven pillars of plant-based nutrition. Dr. Michael Greger, author of How Not to Die and founder of Nutritionfacts.org, will discuss the role of diet in preventing, arresting, and reversing the top 15 causes of death in America. Drs. Dean and Ayesha Sherzai, the husband and wife duo known as Team Sherzai and authors of The Alzheimer’s Solution, will discuss the profound effect of lifestyle in optimizing brain health and avoiding Alzheimer’s.
For tickets: www.ourhealthycity.com
President’s Notes Jeff Watson, DNP, RN-BC, NEA-BC, NE-BC
AVOIDING SNOW RUTS Creating Change Together
SNOW RUTS. Those big chunky pieces of ice made by automobiles as they pass over a snowy road or parking lot. Years ago, during the winter holiday break, a heavy snow had fallen, leaving the parking lot of the grocery store where I worked with snow ruts. I made my way to work, almost slipping numerous times just trying to get inside the store. There were very few cars in the parking lot, and it looked like the day was going to be dedicated to cleaning and organizing, as often happened when customer turnout was low. The lull was short-lived. Within a few hours, the store was alive with people stocking up on the essentials: bread, milk, eggs, etc…. My job that day was to carry groceries out for the customers. I slipped and fell more times than I can remember. However, the clearest memory I have is of a grocery cart that got stuck in the snow ruts. I pushed. I pulled. I lifted. I twisted. I raised my voice. but to no avail. I was so frustrated!
school. Once I had a real job in nursing, I thought, I would never have to experience frustration like this again. I know, I know. Insert laughter here. Frustration has been a close companion to me throughout my nursing career. Frustration, as I’ve learned, is the emotional burden experienced when passionate and caring individuals are unable to meet the needs around them. The key to frustration is in how we choose to tackle it. We can push, pull, twist, and even shout, but those efforts will rarely create the desired change. Wise, articulate Bishop Desmond Tutu once said, “Don’t raise your voice, improve your argument.” For a while nurses have been raising their voices in workplaces on issues like staffing, electronic health record documentation burden, workplace violence, nursing peer review, and end-of-life care. At the same time, for more than 100 years, the Texas Nurses Association has been working
Support your nurse colleagues by reminding them that only one nursing association in Texas stands ready to move them from frustration to action, from raising their voice, to improving their case for change. Remind them, too, that building a strong argument requires collaboration, and we need each other’s expertise to do so. With the help of two other employees, we were eventually able to release the cart from the ruts. I remember thinking on my way back into the store that I couldn’t wait to graduate from nursing
alongside nurses to strengthen positions and generate change. When we created the Policy Council in 2015, it was to improve our collective arguments on these and other prevailing nursing and
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The key to frustration is in how we choose to tackle it. health care-related issues. Listen carefully to the nurses around you. What are they saying? Is what you are hearing the equivalent of snow ruts? Frustration and raised voices? If so, support your nurse colleagues by reminding them that only one nursing association in Texas stands ready to move them from frustration to action, from raising their voice to improving their case for change. Remind them, too, that building a strong argument requires collaboration, and we need each other’s expertise to do so. Every TNA member has an obligation, and it begins with this question: how can I help? I am calling on each one of you to link Texas registered nurses to the mission of the Texas Nurses Association: Empowering Texas Nurses to Advance the Profession. If we miss this opportunity, we risk slipping and falling, a fate far too risky for our profession and those for whom we care. Peace, Jeff i
W I N T E R 2 019 | T E X A S N U R S I N G M AGA Z I N E
TNA MEMBER NEWS SPOTLIGHT ON YOU KUDOS Congratulations to Susan D. Ruppert, PhD, RN, FNP-C, ANP-BC, FCCM, FNAP, FAANP, FAAN, one of four distinguished University of Texas Health Science Center at Houston (UT Health) faculty members elected this year to The University of Texas Kenneth I. Shine, M.D., Academy of Health Science Education (Shine Academy). The title of “Distinguished Teaching Professor” will be awarded to members of the Shine Academy during the 15th annual “Innovations in Health Science Education” conference. In addition, Ruppert received a 2018 University of Texas System Regents’ Outstanding Teaching Award and the 2018 Hall of Fame Award from the University of Texas Medical Branch at Galveston School of Nursing, her alma mater. Ruppert holds the PARTNERS Endowed Professorship in Nursing and directs the Adult/Gerontology Primary Care Nurse Practitioner track at UT Health. Erin Perez, MSN, APRN, ANP-C, AGNP-C, ACHPN, was elected vice chair of the Texas Palliative Care Interdisciplinary Advisory Council. A passionate advocate, Perez has developed educational content for the Texas Health and Human Services palliative care council, including for the palliative care patient and provider websites. A board-certified adult and geriatric nurse practitioner, she has drafted, developed, and supported palliative care
legislation. Perez is a palliative and hospice nurse practitioner at the University Health System in San Antonio, palliative care team, and a valued member of the TNA End-of-Life taskforce. Cathi Burkham, MSN, RN, is the recipient of the IBM Watson Health – Health Hero Award, which recognizes 27 employees from across the globe for making significant innovation, improvement, or cultural contributions that result in a meaningful impact on the people, business, and clients at IBM. Burkham is a graduate of the inaugural class of the Nursing Informatics Master’s Program at the Texas Tech University Health Sciences Center. She works in informatics, serving as the program manager of the Patient-Centered Medical Home for IBM Watson Health. Kudos and welldeserved thanks to Texas Nurses Association (TNA) Member Services Director Belinda Richey and TNA Chief Executive Officer Cindy Zolnierek, PhD, RN, CAE, who are celebrating 40 years and five years, respectively, of service with TNA (pictured with TNA President Jeff Watson). Richey has worked in our membership department since the beginning of her tenure in 1978, moving through the department first as secretary, then as the
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membership coordinator and finally as member services director. She filled two stints as interim editor of Texas Nursing from October 1998 to December 1999 and again from October 2017 to May 2018. Additionally, Richey has served as TNA's event planner since 1996, ensuring each TNA function runs smoothly. Zolnierek joined as TNA’s leader in 2013, first as executive director and then chief executive officer when the title was modified in summer 2018. She previously served as TNA’s practice director, and her nursing career has spanned advanced practice, chief nurse executive, and academic roles. Zolnierek is active in policy development, negotiating legislative approaches to address nursing’s agenda, and providing testimony to many committees and task forces.
OBITUARY Longtime Texas Nurses Association staff member John Levis "J.L." Brown passed away on Dec. 22, 2018. Read more about his work and legacy on page 14. To donate to his memorial fund, visit texasnurses.org /AboutTNF. i
If you are a Texas Nurses Association member and you’ve changed employers, been promoted, received an award, or been elected or appointed to a board or community organization, we’d like to hear from you. Please send submissions to editor@ texasnurses.org.
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Georgetown, TX
convene the House of Delegates (HOD), the association’s annual business meeting, comprised of delegates from TNA’s 25 districts plus the four officers and five directors of TNA’s Board of Directors. TNA is excited to welcome Ernest Grant, PhD, RN, FAAN, president of the American Nurses Association (ANA), who will address the HOD and share his vision for ANA under his leadership, highlight ANA’s ongoing work, and report on ANA's future direction. Delegates will elect a new secretary, treasurer, and two members to the Leadership Succession Committee. Candidates will be available to speak with delegates about their vision for TNA as well as present their formal platforms to the HOD prior to the opening of the voting period.
Empowered Nurses advancing the profession
Member attendees will explore the evolution of TNA's organizational and governance structure and consider possibilities for TNA's future in a facilitated co-creation session. Come imagine with us!
JOIN US IN GEORGETOWN IN 2019 2019 POLICY SUMMIT Be the first to learn the outcomes of the 86th Texas Legislature.
JUNE 7
. – 4:00 p.m. 7:30 a.m - 4:00 p.m. ($150 TNA Members/$200 Non-Members – includes breakfast and lunch) On June 7, 2019, just days after the final gavel of the 86th Texas Legislature hits, Texas Nurses Association (TNA) will kickoff the second annual Policy Summit with a panel of presenters from the Texas Board of Nursing, Texas Hospital Association and the Texas Center for Nursing Workforce Studies to provide an overview of the outcomes of the legislative session. Every nurse needs knowledge to lead. Nurses informed about new legislation, new amendments to the Nursing Practice Act, state fund appropriations for the nursing workforce, and new regulations affecting employers can empower themselves and advocate for their patients. With additional insight into health care trends, workforce demographics, and nursing issues, nurses can influence care delivery and the practice environment. Following the legislative update, Amy Anderson, DNP, RN, CNE, national health
policy consultant, will offer a look at Texas nursing’s future. Participants will then spend the afternoon putting her insights to work by brainstorming potential policy issues and needs for TNA’s Policy Council. Using this information, TNA's committees will spend the interim session developing policies, positions, and statements that are reflective of your needs and benefit all Texas nurses. This action-packed day will also feature time with exhibitors and sponsors during breaks as well as poster presentations by some of Texas’ outstanding DNP students and Policy Council Committee members. All of this will take place at the beautiful Sheraton Austin Georgetown Hotel & Conference Center on the San Gabriel River in Georgetown, TX. Visit texasnurses.org for more information and to register.
After lunch, TNA will hold its annual business meeting. Following the president's address, delegates will hear updates from the treasurer, chief executive officer, and governmental affairs director. Members will consider and vote on resolutions and proposed bylaws changes. District delegates should register by contacting their district president or leadership. Non-delegate members can register at texasnurses.org and must pay an observer fee. i
Texas Nurses Association
Policy Summit
2019 HOUSE OF DELEGATES
JUNE 7-8, 2019
GEORGETOWN
Color the future of your association.
1101 Woodlawn Avenue, Georgetown, TX 78628
JUNE 8
REGISTER TODAY
7:30 a.m. – 3:00 p.m. (No charge for official delegates/$100 for observers – includes breakfast and lunch) On Saturday, June 8, 2019, President Jeff Watson, DNP, RN-BC, NEA-BC, NE-BC, will
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June 8, 2019
Sheraton Austin Georgetown Georgetown, TX Hotel & Conference Center
Visit TEXASNURSES.ORG See the full schedule and register for events.
NEW YEAR, NEW MEMBER BENEFITS Announcing Four New Member Benefits NSO LIABILITY INSURANCE Things can go wrong, and whether or not anyone is at fault, often someone is blamed. Protect yourself and your practice. TNA recommends all nurses carry their own professional liability insurance as an investment to protect your license and livelihood. NSO has safeguarded nursing professionals from malpractice lawsuits and state board license defense for 35 years. Can you afford to practice without it?
CHIPPER Many nurses have outstanding education loans and this unique service will help you chip away at your debt by rounding up change from everyday transactions and applying the funds to your loan. The app service is free for all TNA members for 12 months.
Read about all your benefits in the online Member Handbook in the Member Zone at texasnurses.org.
RX PRESCRIPTION SAVINGS CARD TNA members and their families can immediately start saving on prescription medications. You’ll have access to pricing and pharmacies any time you need them on the TNA website, and you can get the card the way you prefer: print, text, email, or download and save.
AAA
Gerontology Online Master’s Degree & Graduate Certificate
Many are familiar with the benefits of AAA’s roadside services. However, by signing up through TNA, you’ll also receive other benefits such as shopping discounts and a full-service leisure travel agency.
MASTER'S DEGREE 24 credit hours core 12 credit hours electives
Don’t wait. Start benefiting from these new programs immediately.
GRADUATE CERTIFICATE 15 credit hours
Members can access these new benefits as well as existing membership perks on TNA’s website: texasnurses.org. Click on the Member Benefits, Information and Discounts link under the Member Zone menu at the top of the page. i
CONTACT gpidea@ttu.edu (806) 742.3031
hdfsonline.hs.ttu.edu www.gpidea.org
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W I N T E R 2 019 | T E X A S N U R S I N G M AGA Z I N E
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PRESENTING TNA’S POLICY PODCAST By Sola Ahmed Oyewuwo, BSN, RN IT’S THE MOST WONDERFUL TIME OF…every other year! The Texas Legislature convenes biennially in Austin, TX, and during each session, Texas Nurses Association (TNA) advocates on key policy issues affecting nurses across the state. This current session began on the second Tuesday of 2019, and TNA is prepared with our 2019 Legislative Agenda (presented on page 12). This year, we are focused on five issues that concern Texas nurses and our patients:
APRN full practice authority
Workplace violence prevention
Full funding of the Nursing Shortage Reduction Program
Restructuring of the Nursing Faculty Loan Repayment Program
Reauthorization of the Nursing and Allied Health Tobacco Settlement Funds Rider for the innovative education grant
Nurse Day at the Capitol is a great opportunity to become familiar with these legislative agenda points, advocate on the issues by speaking with your representative or senator, and get more involved in the overall nurse advocacy process. However, the impact and importance of our agenda items continues past Nurse Day at the Capitol. Let’s continue the conversation! As part of my fellowship with the American Nurses Advocacy Institute through the American Nurses Association, I will be developing a podcast series to keep the discussion on TNA’s legislative agenda for this session ongoing. I will speak with nurses from across Texas that are experts on the issues in an effort to learn
more about how these topics affect the profession and our patients and how legislation can help. We hope to feature rural nurses, advanced practice registered nurses, nursing professors, and many more in this project. Join us throughout this 2019 legislative session! I am excited about this project because it gives a new and different opportunity to highlight the reality of the policy issues faced in this session. By interacting with nurses from across the state and recording their knowledge to share, I hope everyone can benefit from their experiences. Be sure to check the TNA website for more information. i Oyewuwo works as a clinical bedside nurse in Houston, TX, at the University of Texas MD Anderson Cancer Center and is a graduate student at The University of Texas at Tyler. He received his Bachelor of Science in Nursing from Angelo State University in 2013 and has been a member of TNA since 2015.
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WORKING TIRELESSLY
FOR NURSES AT THE STATE CAPITOL By Andrew Cates, TNA General Council and Director of Government Affairs
The 2019 legislative session is now underway, and things are already heating up in Austin! The capitol is now much more evenly split between the Republican and Democratic parties after the 2018 election cycle, and we are already seeing the effects. The divisive social issues of last session seem to be giving way to more fundamental issues like property taxes and school finance overhaul plans.
TNA’S LEGISLATIVE AGENDA
Since the capitol will be intently focused on these issues, it will be more important than ever for nursing to work hard and capture the legislature’s attention on items of importance to our field.
APRN FULL PRACTICE AUTHORITY – HB 1792 BY REP. STEPHANIE KLICK
This year, Texas Nurses Association (TNA) has been working on multiple issues that impact the nursing workforce across the state. For some issues, TNA engages the legislature through large coalitions of stakeholders and for others, TNA is the only voice at the table, so we have to manage our time and workload carefully to achieve our goals.
TNA supports full practice authority for all advanced practice registered nurses
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(APRNs). APRNs have advanced levels of education and yet are only able to prescribe to patients if they have a prescriptive authority agreement (PAA) with a delegating physician. These types of restrictive practice environments are a waning trend across the country. To date, 22 states, the Veterans Administration, and the Department of Defense have all moved away from restricted APRN practice and into some form of APRN full practice authority— and none have ever gone back. That’s because they know what we all know: APRN practice is just as safe for patients as care provided by physicians,
HOW CAN I SUPPORT TNA
TNA and Texans for Health Care Access are working night and day at the capitol to advance a bill that will provide a pathway in Texas for APRNs to have full practice authority. with equal or higher levels of patient satisfaction. In Texas, only 7% of medical students go into family practice—in contrast to around 75% of APRNs—and yet some medical associations fight vehemently to keep APRNs under a restricted model. This session, TNA is working with a broad coalition, Texans for Health Care Access, comprised of consumer groups like AARP, liberal and conservative think tanks, business groups like the Texas Association of Business, and hospital groups like Methodist Healthcare Ministries and the Texas Organization of Rural Community Hospitals. This coalition is working night and day at the capitol to advance HB 1792 by Rep. Stephanie Klick, which will provide a pathway in Texas for APRNs to have full practice authority. In addition, we are supporting HB 278 by Rep. Tom Oliverson and SB 311 by Sen. Charles Perry, which allow for PAA supervision meetings by video conference. We are hopeful that, with the recent shift in leadership at the capitol, we will succeed this year after fighting for so many years on this issue!
NURSING SHORTAGE REDUCTION PROGRAM It should come as no surprise that Texas has a nursing shortage. In fact, the Texas Center for Nursing Workforce Studies projects that Texas will be 60,000 nurses short of demand by 2030. Causes of this shortage include the impending wave of retirements and increased health system usage by baby boomers, high staff turnover, and lack of faculty and clinical sites to educate new nurses. This program provides millions of dollars to the Texas Higher Education Coordinating Board to be used for awards to high-performing nursing schools which increase enrollments and graduates over time. Schools have expressed confusion and concern over the program’s restrictive requirements and many nursing programs do not take advantage of the
& THE NURSING AGENDA?
available money as a result. So we are working to make the program more flexible and attractive to participating schools. Last legislative session we had a small budget crisis in Texas and the program was cut by 40% down to $20 million. TNA will work with the budget committees this session to replenish the funding up to pre-2017 levels of $33 million or more.
NURSING FACULTY LOAN REPAYMENT PROGRAM – SB 358 BY SEN. JUAN HINOJOSA Last session, TNA successfully fought to create a $3 million line item in the state budget to fund the Nursing Faculty Loan Repayment Program. This program, which was previously unfunded, provides loan repayment assistance to nurses who choose to leave the care setting and go into faculty positions at nursing schools. This session, TNA will work to increase funding for this program as well as open the program up to more nurses by allowing part-time faculty to apply for loan repayment awards for the first time. We believe this is a necessary step to take in Texas because we’ve seen a trend in full-time vs. part-time nursing faculty positions converging over time. TNA believes this is a common-sense solution to a growing nursing shortage problem, and we will work to ensure that this bill passes this session.
WORKPLACE VIOLENCE – HB 1146 BY REP. DONNA HOWARD In 2015, TNA worked with Rep. Donna Howard to pass a study bill on workplace violence against nurses. The study polled health care practice sites as well as nurses themselves, and it showed that 1 in 2 nurses reported an incident of violence in the workplace at some point in their career. Freestanding emergency centers and long-term care sites were the most prevalent settings of workplace violence in the study and the least likely to have protections in place for nurses. continued on page 16
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DONATE TO THE PAC TEXASNURSES.ORG/PAC The Texas Nurse PAC supports legislators who support nurses. We provide campaign contributions to legislators from both parties, and we reach out to nurses to let them know that certain candidates are nurse-friendly. But we can only do that if we have the money to support them. An investment in our PAC is an investment in elected officials that support the nursing industry, so please consider investing today!
TWEET TWITTER.COM/TXNURSESLEGE Every legislator in Texas has a Twitter account and almost every one manages their Twitter feed themselves. This is the only guaranteed way to get our message directly in front of a legislator’s eyes 24/7, so we need to use it! Find your legislator on Twitter and help us spread the message about #TexasNurses. Follow TNA’s Nurse Watch and retweet.
RESPOND TO ACTION ALERTS TNA will be using action alert software this session to keep you informed of action on bills and rules at the capitol. We may ask you to email, tweet, or call to voice nursing’s support or opposition to a proposal. We will use it sparingly, so you will know that when we do send it out, that means it’s important! Make sure to act on the action alerts so we can ensure the capitol hears us.
JOIN CAPITOL CORPS Are you interested in talking to your elected official, but couldn’t make it to Nurse Day at the Capitol in Austin? We’re mobilizing volunteers into the Capitol Corps who want to visit with their legislators in their hometowns during session and during the campaign season. We will give you all the talking points and training you need. Join the Capitol Corps by sending an email to governmentalaffairs@texasnurses.org.
W I N T E R 2 019 | T E X A S N U R S I N G M AGA Z I N E
Remembering John Levis Brown u r se s xa s N e T e n . n g- t i m way o w n, lo , passed a h dementia o r B r ” t . i e L b w . J m e l “ e 1972 r b at t aff m Lev is Joh n ociation st a four-yea tion in a s ia c o s s er As 9 96 s As 8, a f t d in 1 Nurse retire , 201 e xa s yea rs 2 d T 2 n 4 t 2 . a a c ion ing ose De 1973 wo r k nicat ing th
an mu s ing in a lso r. Dur n b e g o r of c o m s Nur irecto a x d t B row e . He T e c ine m e nt e dire e executiv d agaz retire a s th m t es a n is l e h ia t ia il c c s so mm it r u nt s, ’s offi o o e A it c u d N the a s A T d y TN ce Is the e unde o be r ma n n Workpla nd the h e fo ued t o n fo o is in ,a il t a e c li n co oun staff m it te a nd the C Co m s the it tee. g a g m in d in t d ina Co m s e r ve inclu m e r s o a e N lf c , e or l We m it te ta s k f nera s Co m s a n d Ge Bylaw om ic Ec o n
COMMITTED TO THE SUCCESS OF TEXAS NURSES ASSOCIATION Many terms can be used to describe J.L. Brown: gentleman, astute, organized, skilled, compassionate, respectful, and committed to the success of Texas Nurses Association, both the organization and members. With so many opportunities for members to work with J.L. for local arrangements of TNA conventions, his project “check list” kept everyone on the same page. For the 1994 ANA Convention in San Antonio, thanks to him, we had walkie-talkies and cell phones for communicating the many schedule changes to accommodate First Lady Hillary Clinton and Governor Ann Richards! I have many happy memories of time spent with J.L., the organizer!
— Jennifer Cook A VALUABLE RESOURCE OF INFORMATION AND A DEDICATED PROFESSIONAL I was president of TNA before J.L. Brown was employed there, but I worked with him when I held appointed positions for
the association. He was not a nurse, but soon after taking the position with TNA he learned about the field and could discuss with anyone the needs of nurses and their contribution to society. I knew him to always be a valuable resource of information and a dedicated professional. J.L. Brown was a good friend of nursing, and I was proud to call him my friend.
— Billye Brown THE MOST PLEASANT, HELPFUL, AND FRIENDLY EDITOR IN THE WORLD As TNA president in the 80s, not being a gifted author and not liking deadlines, I had the dreaded job of writing a monthly column for J.L. to include in Texas Nursing. With the most pleasant, helpful, and friendly editor in the world, I completed my task without undue pain and suffering. I loved working with J.L., and I still have copies of Texas Nursing from my presidential years. When I finally sit down to reread them, I will remember J.L. fondly. He will certainly be missed.
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— Betty J. Skaggs PAGE 14
Long-time Members, Past Board Members, and TNA Employees Share Their Memories of Brown's Time at TNA.
HE HELPED ME BECOME A LEADER A short twenty years ago, I had the honor of serving as TNA president. I had the privilege of being mentored and taught by great visionary leaders who worked daily on behalf of our profession, including J.L. Brown. Although it has been years since I have seen him, he helped me become a leader who has learned, and who continues to learn. J.L. modeled integrity with his honesty, strong moral principles, and moral uprightness. I always trusted his guidance and it never proved wrong. He also seemed to possess a special calmness or inner peace; he was always serene, always in command of himself. May he rest in peace!
— Alexia Green A GENTLEMAN EXTRAORDINAIRE Dr. Ana Valadez and I joined the TNA Board of Directors at the same time. Somehow, we became the “designated shoppers.” However, every time we went somewhere, we would get
To honor Brown's service, the Texas Nurses Foundation has established a memorial fund. We invite members to donate at texasnurses.org/AboutTNF. One of Brown's noted accomplishments was compiling the history of TNA for our 100th anniversary and writing TNA’s history for the Texas Almanac. As a fitting tribute, the funds will go towards developing a history wall at TNA’s new office. A group of past Presidents and board members have pledged to match up to $2,500 in donations. If the goal of $5,000 in donations is achieved, the funds will also sponsor a past presidents wall to recognize the leaders of our organization.
an English degree and journalism background, we shared many conversations about the publication’s new look and focus. J.L. was meticulous, from his personal appearance, to the way he worked, to the outcomes of his leadership. He left a lasting mark on TNA and warm memories for this grateful board member. I think of him every time I receive TN in the mail, and I always will!
A TRUE CHAMPION OF OUR PROFESSION J.L. Brown was a consummate journalist and superb staff representative for TNA. As editor of Texas Nursing, he applied keen editorial talent, creativity, and dedication to communicating to and for Texas Nurses. Personally and professionally, J.L. was a treasure. Exhibiting a quiet wit, humble demeanor, graciousness, and compassion in his interactions. J.L. believed in nurses and nursing, and he was a true champion of our profession. His memory will live on in his authorship of the History of TNA’s 75 Years.
lost. J.L. would always volunteer to help direct us. Then, the next day he would ask how it went and sigh heavily as we told him how lost we had been. He was a gentleman extraordinaire. He lives on through Texas Nursing. Thank you J.L. for your legacy!
— Patricia S. Yoder-Wise
— Michael L. Evans
— Ferne Kyba
HE LEFT A LASTING MARK ON TNA I was first elected to the TNA Board of Directors in 1987 in the office of treasurer and then in 1989 in the office of president. J.L. was warm and welcoming to me from the first time we met. Creating and continuously improving Texas Nursing was one of his overarching goals. As I have
PAGE 15
HE TAUGHT ME THE IMPORTANCE OF KEEPING THINGS REAL At the dawn of a new century, I had the privilege of serving the nurses of Texas. A special joy was the friendship of J.L. Brown. He always found something to laugh about, even if it was himself. He taught me the importance of keeping things real, and I believe that any time was a great time to be a friend of J.L. Brown. I am honored to have shared a small part of the many great things he did for nurses.
— K. Lynn Wieck
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WORKING TIRELESSLY FOR NURSES AT THE STATE CAPITOL continued from page 13 As a result, TNA will work with Rep. Donna Howard to file landmark workplace violence legislation that includes involving nurses in developing workplace violence prevention plans. This bill will include additional reporting requirements and audits for practice sites, training requirements for workplace staff, and mental health services for nurses who experience violence in the workplace. We expect hefty opposition to the bill from myriad stakeholders, but TNA is committed to protecting nurses in the workplace, and we will work to find ways forward for this important bill.
It is more important than ever for nursing to work hard and capture the legislature’s attention on items of importance to our field. SAFE HARBOR – HB 2410 BY REP. STEPHANIE KLICK Currently, in order to call safe harbor, a nurse must stop what they are doing and fill out a form to document the issue and their objection to it. Based on calls received by nurses at TNA, we understand that this is sometimes not a viable option due to the expediency of a given situation, such as being in the middle of a procedure. TNA is exploring options to allow nurses to temporarily call for safe harbor verbally if circumstances do not allow the nurse to stop and fill out a form, as long as the form is filled out before the end of the nurse’s shift. This bill is not yet final, but we anticipate working with our champions in the House and Senate to file this bill soon.
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FREESTANDING EMERGENCY CENTERS Finally, TNA will attempt to mandate that freestanding emergency centers adhere to the same nursing workplace protections that currently apply to hospitals. These include the prohibition on mandatory overtime, safe patient handling and mobility requirements, workplace safety regulations, and nurse staffing requirements. While TNA does not anticipate filing a standalone bill regarding freestanding emergency centers, we plan to amend existing bill drafts to include language on nursing issues. This is a common-sense approach to protecting nurses no matter where they work. i
If you have received: Letter of Investigation from the Texas Board of Nursing Notice of Peer Review
Call today, delay is not an option!
Joyce Stamp Lilly RN JD Registered Nurse and Attorney
713.759.6430 jslilly@me.com www.nurse-lawyer.com If you cannot hire an attorney, please visit
www.nursingcomplaint.com for suggestions, sample documents and information about the Investigation Process.
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FRESH PROGRAM DESIGN, NEW ONLINE PRESENCE: TPAPN IN 2019 As the New Program Rolls Out, TPAPN Aims to Increase Its Visibility MORE THAN A MONTH after its program restructure, the new Texas Peer Assistance Program for Nurses (TPAPN) model is receiving positive feedback from program participants, evaluators and the Texas Board of Nursing (BON). “I had one case manager come into my office, throw her hands up and say, ‘I love the matrix’,” says Jonathan Wolfarth, MS, RN-BC, TPAPN program director. The redesign now gives case managers better guidance that leads to less ambiguous evaluations. “When a nurse participant asks, ‘Well, what’s that based on?’ TPAPN has an answer,” says Wolfarth. To make this all possible, TPAPN worked with two consultants. John Lehman, PhD, who was hired by the BON, worked as an intermediary, helping design a participant “flowchart,” which would eventually become the TPAPN Matrix, a flexible framework that helps evaluators place participants in more individualized program tracks.
RECOGNIZING SIGNS OF SUBSTANCE USE DISORDER IN A PEER
I
t can be difficult to recognize when a nurse has a substance use disorder, especially distinguishing between impairment and on-the-job stress.
ing medication errors, isolation, inappropriate verbal or emotional responses, diminished alertness, confusion, or memory lapses.1
If you suspect substance use, watch for these four things: behavior changes, physical changes, social changes, and diversion of drugs.
Physical changes might include changes in appearance that escalate over time, wearing long sleeves in warm weather, weight loss or gain, or red eyes.1,2
Behavioral changes can include absences from a unit for longer than the expected time, changes in job performance, frequent trips to the bathroom, arriving late or leaving early, and an excessive number of mistakes, includ-
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Social changes can be hard to see in workplaces, but include sudden changes in friends, hangouts, or hobbies; legal problems; or an unexplained need for money or financial problems.
The increased positive visibility of the TPAPN brand in Texas; the demystification of the participant experience, evaluation process and severity identifiers; and more resources for peer support volunteers will hopefully lead to greater participation rates and outcomes. TPAPN also sought the help of Courtney Hulbert, LCSW, former program director of The Professional Recovery Network, a program similar to TPAPN for Texas-licensed pharmacists, dentists, veterinarians, and optometrists. Hulbert helped rewrite TPAPN policies and the participant manual. Because Hulbert came from a peer-support background, Wolfarth says she was able to understand the need, aligning wording and procedures to match best practice examples from other peer-assistance programs across the country. She also obtained the most currently available evidence to inform TPAPN’s policies and procedures.
NEW ONLINE PRESENCE In addition to a program restructure that individualized participation guidelines, TPAPN’s online presence also underwent an aesthetic transformation, with the launch of redesigned webpages and a new Twitter account. TPAPN staff hope these changes will elevate and
widen the recognition of TPAPN across Texas to reach and help more nurses with substance use and mental health conditions. Visitors to the refreshed TPAPN website may notice its content is now divided into four tabs, designed to ensure applications, forms and other resources are easier to find for our four main stakeholders: participants, employers, advocates, and professionals/providers. Wolfarth says just having some of TPAPN’s organizational documents, like the overview presentation, forefront on the website is helpful to those unfamiliar with the program. The increased positive visibility of the TPAPN brand in Texas; the demystification of the participant experience, evaluation process and severity identifiers; and more resources for peer support volunteers will hopefully lead to greater participation rates and outcomes, says Wolfarth.
Signs of drug diversion might include incorrect medications counts, increased wastage, frequent corrections of records, offers to medicate co-worker’s patients for pain, abnormal reporting of ineffective pain relief from patients, altered verbal or phone medication orders, and variations in controlled substance dispensation among shifts or days of the week.1
Reporting can seem harsh, but it ultimately facilitates nurses getting help sooner than they might have otherwise. Reporting also helps protect the public.
If you see these signs, refer your peer to TPAPN and make a report to the BON. Reporting can seem harsh, but it ultimately facilitates nurses getting help sooner than they might have otherwise. Reporting also helps protect the public.
The Texas Nursing Practice Act requires employers and peers to report nurses who are impaired, or suspected of being impaired, by chemical dependency or diminished mental capacity. TPAPN encourages self-reporting and
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WHAT’S AHEAD In addition to increasing efficiency, improving program completion rates, and reaching more nurses who need help, TPAPN aims to further its status as an academic hub of resources for those seeking help with substance use disorders and mental health. Whether nurses are searching for wellness resources and support groups on the website or looking at mental health crisis infographics on the Twitter account, TPAPN wants to be a source of help for nurses across Texas and beyond. i
#
CONNECT WITH US!
TNA posts and tweets about health resources, policy, legislation, events, and more! Share to spread the word about the great work of TNA and TPAPN, and extend our message. TNA @TexasNursesAssn TPAPN @TPAPN_Support
Nurse Watch @TXNursesLege
TNA also has a Facebook page and a LinkedIn page. Don’t forget to follow us!
concurrent reporting to both TPAPN and the BON. Recovery and return to safe nursing practice are possible!
FOOTNOTES 1. National Council of State Boards of Nursing [NCSBNInteract]. (2013, November 11). Substance Use Disorder in Nursing [Video file] Retrieved from https:// www.youtube.com/watch?v=p8Rhs5h6QIc&feature =youtu.be 2. Mayo Clinic. Drug Addiction (Substance Use Disorder). Retrieved from https://www.mayoclinic. org/diseases-conditions/drug-addiction/symptomscauses/syc-20365112
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REMEMBERING A NEVER EVENT WINKLER CO.— TEN YEARS LATER By Cindy Zolnierek, PhD, RN, CAE THIS YEAR MARKS THE 10TH ANNIVERSARY of a “never event”—an event of such grave significance it should never occur. In 2009, two nurses faced felony charges for reporting a physician to the Texas Medical Board (TMB). In a saga meant for the big screen, not real life, the Winkler County sheriff, prosecuting attorney, and hospital administrator conspired with physician Rolando Arafiles to shut down concerns about the doctor’s practice—at any cost. Winkler County Memorial Hospital is a 25-bed rural, critical access hospital located in Kermit, TX. Anne Mitchell, RN, served as compliance officer and Vicki Galle, RN, was over quality improvement and utilization review. Both nurses became alarmed by Arafiles’ irregular medical practices and exhausted internal mechanisms to have their concerns addressed. Honoring their professional duty to patient safety, the nurses determined they had an obligation to report their concerns externally to the Texas Medical Board. What followed was a convoluted saga of a small Texas town with a thick good-ol’-boy culture more concerned with protecting the status quo than serving its citizens. Notified by the TMB of a complaint against his practice, Arafiles complained to his golfing buddy and business partner (distributors of a nutritional supplement) Sheriff Robert Roberts that he was being harassed. Roberts obtained confidential information from TMB through fraudulent means, traced the report to Mitchell and Galle, and got county attorney Scott Tidwell to issue arrest warrants. The charge: misuse of official information, a third-degree felony. The nurses turned themselves in and hospital administrator Stan Wiley promptly fired them. Ultimately, the case went to trial. Charges against Galle were dropped one week before the trial date, and
In a saga meant for the big screen, not real life, the Winkler County sheriff, prosecuting attorney, and hospital administrator conspired with physician Rolando Arafiles to shut down concerns about the doctor’s practice—at any cost.
PART 1: UNPACKING A LANDMARK CASE Winkler County Courthouse in Kermit, TX
Mitchell turned down a plea agreement the morning of the trial. After four days of testimony, the jury reached a not guilty verdict in less than an hour. Galle and Mitchell relied on whistleblower protections to successfully sue the goodol’-boys: Arafiles, Wiley, Roberts, and Tidwell. The Texas Attorney General later filed felony charges against the goodol’-boys, and all paid fines and served time. Arafiles lost his license to practice medicine and Tidwell, his license to practice law.
Hospital, Galle retired and Mitchell had to look outside her community for employment opportunities. TNA successfully pursued legislation to strengthen existing nurse advocacy protections with Galle’s and Mitchell’s support and testimony.
However, nurses Mitchell and Galle are not celebrating a victory.
In the next three 2019 issues of Texas Nursing, we will look at the full trial and experience of the Winkler County nurses, and what impact the event continues to have on nursing practice ten years later. i
The experience was traumatic, personally and professionally. Unable to return to their long-term employer Winkler County
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There are no winners when organizational culture squelches expressions of concern about patient safety. Only when organizations intentionally adopt a culture of safety and welcome the expression of concerns can we expect improvement in patient safety goals.
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NURSES PUT YOUR NURSING SKILLS IN OFFICE
NURSES IN OFFICE
The to TO WORK INRoad OFFICE
a wide variety of roles, working with Texas sing, and other health organizations.
Representation
The Nurses in Office initiative aims to encourage and support registered
politics, such as getting people out to vote running for elected offices, starting locally—school boards, city ter testifying for and nurses against legislative nne Mitchell, the RN in Winkler County councils, and justice of the peace—and growing eventually to the state er for reporting an incompetent physician and national “not guilty,” vindicated for doing the right levels. Reaching this goal will require local and statewide leadership, teamwork, and individual engagement. I HAVE BEEN IN NURSING for 60 years in a wide variety of roles, working with Texas law and the Code of Ethics for Nurses.
Nurses in Office is the Nurses Association (TNA), the Board of Nursing, and other health organizations. brainchild of Lolly members of the legislature. We want her footsteps andschool perhaps 2040 we will a nurse governor! Lockhart, PhD,more RN. nurses to forfollow hospital bonds during high and by later testifying forhave and against legislative bills. In 2010 I was the expert witness for Anne Mitchell, the RN in Winkler County Here she recounts ave nurses in To get nurses in officewho across Texas, webrought need yourherhelp: had criminal charges against for reporting an incompetent physician how she was inspired When I saw Dr. Billye to the Texas Medical Board. She was found “not guilty,” vindicated for doing the right t Brenda Cleary: Women to build Consider running for office or encourage a colleague to run. this initiative. thing for patient safety, consistent with the law and the Code of Ethics for Nurses.
Rep.engaged Donna g Practice Act. I was actively in Howard inspired this initiative. She first ran for school board, then was elected to the state House. She built on tate run and win. In addition, while on the running a campaign and serving in an elected office to become one of the most influential and valuable her experience Even at a young age I was engaged in local politics, such as getting people out to vote violence.
hool board, I realized es. In a few years, they . Getting more nurses evin Stewart, Texas ctor of practice.
Volunteer to do research for candidates.
As TNA staff for several years in the 1960s, I helped amend the Nursing Practice Act. I was actively engaged in
campaigns Get voters registered andincluding to the Rep. polls. for several candidates, Lloyd Doggett’s first state run and win. In addition, while on the ANA Task Force, I helped develop the current statement on workplace violence. Serve on a campaign team. Nursing Canvass for or otherwise promote a candidate that you believe in. Representatives Needed
Looking at our landscape, I am concerned we do notcould have nurses in an interest group of nurses Tell TNA if you (or a peer) are running forcurrent office.political If you don’t have anyone to run, you create leadership roles such as elected and appointed positions of authority. When I saw Billye in 2019 and 2020. to find a strong nurse candidate. This is the time to check if there will be openDr. positions Brown for her 103rd birthday, she insisted I read a book by her student Brenda Cleary: Women In Politics. I could not put it down. Visit texasnurses.org/nursesinoffice for more information.
“As a registered nurse and a your community member of thein Texas House of Representatives, I use the nursing process daily to analyze complex public policy issues. The nursing process is a great framework for solving complex problems. Nurses are experts in solving problems. We need more problem solvers running for office.” — Representative Stephanie Klick
Thinking of how Representative Donna Howard started on the local school board, I realized that was the key. Get early and mid-career nurses to run for local offices. In a few years, they would be ready for the Legislature, and then for Governor or Congress. Getting more nurses ready to run needs a concerted campaign. I started strategizing with Kevin Stewart, Texas School Nurses Association general counsel, and Ellen Martin, TNA director of practice.
INVEST
Resources to Run
men in Politics: Putting Yourself Out There by iatric nurse Brenda Cleary, PhD, is a great ource on running for office and strategy.
We know nurses underestimate what we can do, in spite of how much we are respected. Our goal became to offer encouragement and support. Not many nurses are familiar with running for office and may lack time or resources.
“As a registered nurse and a member of the Texas House of Representatives, I use the nursing process daily to analyze complex public policy issues. The nursing process is a great framework for solving complex problems. Nurses are experts in solving problems. We need more problem solvers running for office.”
IN THE FUTURE OF NURSING
To help nurses get started, TNA is providing resources for nurses who are interested in running or finding a nurse to run for local office. Nurses will have many opportunities to share experiences and access continuing education on running for office and the SESSION IS HERE. We need your processes involved in local offices.
THE LEGISLATIVE help to support our elected representatives.
We invite you to think about how you can improve your community
TEXAS NURSE PAC is the officially-sponsored political action by serving on a school board or other local office. Help make nurse — Representative Stephanie Klick voices heard and use your expertise to create a healthier Texas. committee (PAC) of the Texas Nurses Association. We donate to people on both sides of the aisle and last year, 12 out of 14 campaigns we supported were successful. Women in Politics: Putting Yourself Out There by texasnurses.org/ geriatric nurse Brenda Cleary, PhD, is a great nursesinoffice resource on running for office and strategy.
TEXAS
One of the easiest ways to give to the TNA PAC is with an automatic monthly contribution. Automatic donations enable the TNA PAC to have a continual influx of funds and be ready to respond to requests from legislators. One-time donations are also greatly appreciated! With your help, TNA can make a difference in our nursing profession through the legislative process!
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[ CAREGIVER ] CARE FOR THE
In disaster situations, nurses must care for others while caring for themselves and their family. Texas Nurses Association and Texas Organization of Nurse Executives, with support from Johnson & Johnson, developed Care for the Caregiver to help nurses before, during and after disasters.
HAVE YOU BEEN GETTING YOUR CHECK UP?
Watch videos, download free resources, and get more information on preparedness, resiliency, and self-care.
The Check Up e-newsletter provides members with a weekly update on TNA activities, events, conferences, learning opportunities, grant, and scholarship opportunities, and much more. If you don’t see the Check Up in your mailbox each Tuesday, make sure to check your spam folder, especially if you’re registered with TNA using your work email address. If you still don’t see it, please contact tna@texasnurses.org and let us know!
RN-BSN PROGRAM The RN-BSN program is for registered nurses who want to earn a baccalaureate degree in an environment that will promote personal satisfaction and lifelong learning through challenging experiences. All courses are offered online to meet the needs of the working RN. Students may be eligible to take NMSU graduate courses while earning their BSN degree.
DOCTOR OF NURSING PRACTICE Advance your nursing career with a Doctor of Nursing Practice (DNP) degree from NMSU! NMSU offers the DNP degree in two specialty tracks: Family Nurse Practitioner and Psychiatric Mental Health Nurse Practitioner, as well as the Post MSN to DN track for licensed nurse practitioners DNP and clinical specialists. The DNP curriculum is taught in a distance education format so students don’t need to relocate to earn their DNP degree.
Please contact us to help you get started. Visit us online at https://schoolofnursing.nmsu.edu. Email us at nursing@nmsu.edu or call 575-646-3812 to speak with an academic advisor.
PAGE 23
W I N T E R 2 019 | T E X A S N U R S I N G M AGA Z I N E
PROTECTING YOUR PRACTICE, PROTECTING YOUR LICENSE By Ellen Martin, PhD, RN, CPHQ , TNA Director of Practice MANY NURSES ARE AWARE that health care organizations carry malpractice and general liability insurance policies. Historically, nurses were rarely named in malpractice suits. The legal principle of “respondeat superior” holds that the employer is liable for the actions of employees. This makes it seem as though it would be in the hospital’s best interest to defend nurses if a patient or family files a lawsuit. While this may be true in some cases, there are many reasons why practicing nurses should purchase their own professional liability insurance.
payments and certain adverse events for health care practitioners including nurses. Data is not available to the public, but hospitals can query the database for information on licensed health care professionals.
Recent studies indicate that claims against all levels of nursing are on the rise. The National Practitioner Data Bank (NPDB) is a confidential information clearinghouse created by federal law and requires reporting of malpractice
Further, nurses cannot rely on an employer’s policy to cover them. Hospital insurance may have gaps. For example, if the incident involved a breach in policy or procedure, the hospital may
Some nurses think that having a professional liability insurance policy makes them more likely to be sued in a case against a hospital or physician. This is a myth because neither the patient, family, nor the attorneys have any way of knowing who has insurance and who doesn’t before a lawsuit is filed.
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decline to cover the nurse. Some policies only cover current employees and a lawsuit could be filed after a nurse has left the organization. Finally, nurses covered by a hospital’s policy have no choice in who represents them and no say in the proceedings. If the hospital decides to settle the case, all the nurses named in the lawsuit will be reported to the NPDB even if the nurses did not do anything wrong. Once reported, there is no way for nurses to “clear their name” from the NPDB. The primary reason that a nurse should purchase a professional liability insurance policy is that this type of insurance often includes license defense coverage. Employers do not provide legal representation if the matter involves licens-
MYTHS AND FACTS ABOUT PROFESSIONAL LIABILITY INSURANCE
ing or disciplinary action against the nurse. The consequences of licensing or disciplinary action can seriously affect a nurse’s career. License defense coverage ensures nurses can retain a highly qualified, experienced health care attorney, one familiar with nursing law, and receive reimbursement for legal fees. The coverage also reimburses the nurse for outof-pocket expenses such as travel, postage, and even lost wages for missed work time for hearings and depositions, up to the coverage limits. It is important to review policy coverage carefully. Most nursing liability insurance includes license defense coverage in a comprehensive policy but other policies may offer license defense coverage separately for an additional premium.
MYTH: I’m a good nurse. Why would I need insurance? TRUTH: Even good nurses can make mistakes or be involved in a situation where someone else made a mistake. False claims are also a risk.
MYTH: My employer is watching out for me. TRUTH: The hospital attorney will look out for your employer’s best interests,
not yours. The policy may not cover all possible situations. Also, you can be sued after leaving a position.
MYTH: I need a lot of coverage. TRUTH: Coverage needs vary depending on practice setting and your
professional license. Different licenses hold different exposure. And nurses should not have too much coverage, particularly not more than doctors they work with. Visit texasnurses.org/memberbenefits for information on Nurses Service Organization (NSO)
It is important to remember that a very low percentage of the 322,199 licensed registered nurses are reported to the Texas Board of Nursing each year. According to BON statistics, 8,481 complaints were received in 2018 and only 942 licensees were sanctioned. According to Nurses Service Organization
statistics, the average claim for license defense was approximately $4,000. The purpose of insurance is protection and peace of mind for unlikely events.
Professional liability insurance protects nurses and their practice. i
TAKE THE
YOUR NURSING CAREER.
OUR ONLINE GRADUATE PROGRAMS: Master of Science in Nursing Nursing Education / Nursing Administration & Leadership Clinical Nurse Leader / Clinical Nurse Specialist
Doctor of Nursing Practice Family Nurse Practitioner / Adult-Gerontology
Acute Care Nurse Practitioner / Clinical Nurse Specialist Post master’s DNP APRNs and Nurse Administrators
APPLY ONLINE harriscollege.tcu.edu/nursing graduatenursing@tcu.edu 817-257-6726
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W I N T E R 2 019 | T E X A S N U R S I N G M AGA Z I N E
TE XAS PEER ASSISTANCE
PROGRAM FOR NURSES
GET SUPPORT AND SAFEGUARD PATIENTS
Nurses Helping Nurses If you, a coworker, or a family member need help with a substance use or mental health issue, call the Texas Peer Assistance Program for Nurses. TPAPN case managers provide guidance, support, and monitoring to help nurses recover and maintain their licenses. And TPAPN peer advocates provide an empathetic listening ear. You and those you care about are not alone!
www.tpapn.org
Rewarding Careers Join a team that is making a difference!
NURSING POLICY RESEARCH GRANT
W
e offer predictable work schedules, set caseloads and an excellent benefits package, including: n New higher starting salaries for RNs n Health and retirement benefits n Paid vacation leave and up to 15 paid holidays a year n Shift differential pay
Find an exciting and challenging career in one of 23 health and specialty care locations across Texas.
TNF is now accepting applications for its next grant award in Spring 2019. For more information and to apply, visit: texasnurses.org/AboutTNF. DEADLINE: MAY 17, 2019 TNA CEO Cindy Zolnierek established the Nursing Policy Research Grant program in 2016 with a pledge of $10,000 over five years. Zolnierek believes in the importance of research-level policy inquiry that can inform policy initiatives to improve nursing education and practice and contribute to safe, quality patient care.
Contact:
Apply online: hhs.texas.gov/about-hhs/jobs-hhs
T E X A S N U R S I N G M AGA Z I N E | W I N T E R 2 019
18D0738
Laura Hunter atof Aging Texas Department and Disability Services laura.hunter@hhsc.state.tx.us
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If not now, when?
The faculty team at Cizik School of Nursing are nurse educators, practitioners, scholars, and internationally recognized researchers committed to educating tomorrow's nurse leaders. Trained in many of the nation's leading hospitals, our students receive one of the finest nursing educations and experiences available in the world.
Academic Offerings
RN-BSN RN-MSN MSN Post-Master's
BSN-DNP DNP PhD
Learn more and apply online tody at nursing.uth.edu
4807 Spicewood Springs Rd. Bldg 3, Suite 100 Austin, TX 78759
REYNOLDS & FRANKE, PC CERTIFIED PUBLIC ACCOUNTANTS REPORT OF INDEPENDENT AUDITORS OPINION: In our opinion, the financial statements referred to in the audit present fairly, in all material respects, the financial position of the Texas Nurses Association General Fund as of June 30, 2018, and the changes in its net assets and its cash flows for the fiscal year then ended in accordance with accounting principles generally accepted in the United States of America.
Current members can log in to view the aduit at texasnurses.org/aboutus.
Needing Your Disability Benefits?
We can help. Marc Whitehead has helped nurses apply for, appeal and win their disability benefits for over 25 years. Download our free e-book today to learn more about how to successfully win your disability benefits.
281.843.9900 Board Certified – Social Security Disability Law, Texas Board of Legal Specialization Board Certified – Personal Injury Trial Law, Texas Board of Legal Specialization
DisabilityDenials.com/nurses-download-e-book
YE A R S