THE GREAT STATE OF
TEXAS
TEXAS NURSING ROUNDUP
By Joe Flores RN,MSN,CCRN,JD
Letter from Joe: It’s my first go at it so I beat the bushes and got some interesting editorials and a couple of articles to give the nation a flavor of Texas Nursing. Besides my law practice my wife and have a Home Health and am still in a physicians group and take call 20 hours a month to keep up my NP status. If any one has any questions you can email me at or call the office at . I also through in my health care fraud campaign commercial. As nurses we need to stop all these corporations and unscrupulous providers from putting profits ahead of patients by false billing and fraudulent schemes. Remember, we all pay for Medicare and Medicaid fraud.
NURSING SHORTAGE?
California, hospitals in Houston, Texas are also short of nurses. The only difference, so far, is that the Texas federal government has yet to regulate the implementation of the 1:4 ratio (meaning 1 nurse for four patients) like in California.
The nurse staffing trend here in Houston hospitals depend on patient traffic. For summer, the first shift (7 a.m to 3 p.m.) has a ratio of 1:6, followed by the second shift of nurses (3 p.m. to 11 p.m.) with a ratio of 1:8, and the third (11 p.m. to 7 a.m.) with a ratio of 1:10.
Healthcare administrators have to face the nurse shortage problem to remain responsive to patient care needs. With the possible governmental regulation of the 1:4 ratio, demand for nurses will definitely rise.
Understaffing in the healthcare industry has serious implications, including stress, medical errors and staff dissatisfaction, which all translate to poor quality patient care.
Organizations like Texas Nurse Practitioners and TNA are advocating for this, but it takes time and Texas is not exactly Union friendly. You only have to see Wubya’s plan to understand: It’s called Texanomics: You are on your own and we loooooooooooove big business.
WHAT TNA IS DOING IN AUSTIN. HERE’S A SNAPSHOT OF TNA trying to get us some relief down here. I know politics. You have to really play hardball to get what you need. We all just need to form Political Action Committees and fund them a bit and believe me, politicians start listening.-Joe
Resolution on Limit on Hours Nurses and Nursing Students Work
Adopted by Texas Nurses Association House of Delegates, April 22, 2006
WHEREAS, Texas Nurses Association and its members are concerned with patient safety;
WHEREAS, The Institute of Medicine (IOM) in its 2004 report, Keeping Patients Safe: Transforming the Nursing Work Environment cited research by Ann E. Rogers, PhD, RN, FAAN, correlating excessive hours worked by nurses with an increase in patient care errors;
WHEREAS, the 2004 TNA House of Delegates directed TNA to initiate a process by which to evaluate the IOM recommendation and determine whether TNA should take steps to implement the IOM recommendations in Texas;
WHEREAS, Subsequent nursing research has further documented this problem,
WHEREAS, The research shows that a statistically significant increase in patient care errors occurs when the nurse works in excess of 12 hours in direct patient care or other care that requires clinical judgment.
WHEREAS, It is a nurse's professional responsibility not to put patients at risk;
WHEREAS, The Board of Nurse Examiners for the State of Texas Standards of Nursing Practice require nurses to make and accept assignments commensurate with the nurse's physical and emotional ability, but do not set any specific limits on the hours a nurse can provide patient care;
WHEREAS, The Texas Department of State Health Services rules for nurse staffing in hospitals prohibit staffing based on mandatory overtime;
WHEREAS, Research on workers in various occupations documents that excessive hours of work have a negative impact on a worker's health;
WHEREAS, Educating nurses and nursing students about the dangers of fatigue and working excessive hours is a critical component of setting limits on hours worked and should be given a high priority;
WHEREAS, The IOM in its 2004 report, Keeping Patients Safe: Transforming the Nursing Work Environment, recommended that regulatory limits be placed on the number of hours that a nurse may work in both a 24-hour and 7-day period; and
WHEREAS, While TNA supports nurses having the right to negotiate the number of hours they work, that right cannot override the right of patients to receive safe care; therefore be it
RESOLVED, That TNA take steps to implement a regulatory model that sets limits on the number of hours beyond which nurses and nursing students cannot provide direct patient care or care requiring clinical judgment affecting direct patient care;
RESOLVED, That any regulatory model that sets such limits reflect the following guidelines:
• Sets limits on both the number of hours worked in a 24-hour period and in a 7-day period;
• Applies limits regardless of whether the nurse or nursing student is mandated to work the excess hours (mandatory overtime) or voluntarily elects to do so (voluntary overtime);
• Recognizes appropriate exceptions such as emergency and call-back situations in the setting of limits; and
• Permits nurses and nursing students to work beyond the limits so long as any excess hours do not involve direct patient care or the exercise of clinical judgment affecting direct patient care;
RESOLVED, That TNA support initially setting 16 hours in a 24-hour period and 60 hours in a seven-day period as the limit beyond which nurses and nursing students cannot be involved in providing direct patient care or the exercise of clinical judgment affecting direct patient care;
RESOLVED, That TNA recognize 12 hours as the preferred maximum number of hours nurses and nursing students work in a 24-hour period and take steps to achieve that limit; and
RESOLVED, That TNA advocate for nurses and nursing students being educated about the dangers of fatigue and working excessive hours as a critical component of setting limits on hours worked.
Texas Board of Nursing: SOME COMMENTS FROM NURSES IN TEXAS
“Just wondering if anyone has a suggestion that perhaps we can do to "improve channels of communication between the Texas Board and outside world?" What a nightmare! Current license in other states and in process of getting my license via endorsement here. Interviewed and accepted a position in mid-april....my start date was/is set for May 17th. The problem: Could not send in my application, etc until the fingerprint cards arrived from the Board. Reqested this packet in April and as of Monday still was NOT here.
I was to the point of TOTAL FRUSTRATION DUE TO NOT BEING ABLE TO EVER GET THRU TO BOARD VIA THE PHONE NO. THEY LIST. No e-mail links are given to access anybody there....So what's a person to do? I DECIDED TO GO TO THE BOARD...(only 6 hours from here) Was able to get fingerprint cards and in the end handed them in everything with my application. Here's the good part----I told the receptionist I'd like to speak to supervisor or person in charge....He looks at me like --Why....Told him I had some concerns and would just like to speak with supervisor about them. He told me if it was about the Phone system...EVERYBODY ALREADY KNOWS THIS....Ends up the supervisor was in a meeting...So I ask to speak to a person who processed the claims....You'd have thought I ask to move the Capitol! We went back and fourth and He was determined I was not speaking to anyone....and I was determined that i was! Luckily for me a lady (one of the processor's) happened to walk out of her office --- so i was able to speak with her briefly. Personally, do not think i was asking to much to actually speak to someone who worked on the applications after driving a total of 12 hours---and over 700 miles! Oh, I did find out the person who mails the fingerprint packets was out on vacation some last week and was out this week.....It will be interesting to see When or IF that darn packet ever comes.
Now they say it can take up to 10 working days to process and mail out my temporary permit. Wish I felt more optimistic about receiving it sometime in the near future....but nothing would surprise me at this point. What an adventure this is turning out to be!” NAME WITHHELD
Re: Starting Texas Union
I am new in here and all , But I think that there needs to be a Nurses Union for Nurses and the Nurses Aides as well .
The reasons that I say the Nurses Aides too , is because without us the Nurses wouldn't know what is happening with the Patiences or the residents in the Nursing Centers or in the Hospitals ...... We the Nurses Aides or the eyes and the ears behind the Nurses all across the world and we should get the same respect as the R.N.'s and L.V.N's and L.P.N.'s do not the pay but at least a better pay than what they are paying us now .....
You just can't make it on $6.20 an hour and especially hen I drive 33 miles to go to work in Texas as an Certified Nurses Aide .
I hope that I don't make anyone mad but this is how I feel about it and if I was asked to join a UNION I sure would in a heart beat.
That my opinion and I hope that there is someone else out there that feels the sameway I do too.
Thats all I have to say on it ......
We have the right to equal or better pay as the others do because we do alot more than some of them do .
Thanks. Name Withheld Per Request. (I don’t blame her in this environment where they blackball you at a drop of a hat even with the nursing shortage).
Reporting from your state
