Nursing Legislative Agenda for Texas 83rd Legislative Session, 2013

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1 Page 1 Page 13 Page 12 Quarterly circulation approximately 293,000 to all RNs, LVNs, and Student Nurses in Texas. Nursing Legislative Agenda for Texas 83rd Legislative Session, 2013 by James H. Willmann, J.D., Guest Contributor The 2013 Texas Legislative Session will again see a full agenda of nursing initiatives designed to improve care for patients, improve the practice environment for nurses and enhance the regulation of nursing. For the session, Texas nursing organizations will initiate legislation that includes extending patient advocacy protections for nurses employed in public hospitals, expanding APRN prescriptive authority, and preventing violence against nurses in the workplace. Workplace Advocacy Texas Nurses Association (TNA) will join with other statewide nursing organizations to initiate several bills that were filed in 2011 but did not pass. 1. Equal protection from retaliation for nurses employed in public hospitals who engage in protected patient advocacy activities. The Texas Nurses Association will again pursue legislation to give nurses employed by public hospitals the same remedy that privately-employed nurses have to recover lost wages and other economic damages suffered as a result of being illegally retaliated against for engaging in protected patient advocacy activities. Why: Currently, publicly-employed nurses are not protected from retaliation for engaging in protected patient advocacy activities to the same extent enjoyed by privately-employed nurses. While it is illegal for both public and private entities to retaliate against a nurse for engaging in protected patient advocacy activities, a publicly-employed nurse does not have the same right to recover lost wages and other economic harm caused by the retaliation as does a privately-employed nurse. Publicly-employed nurses may recover damages only if it is permitted by the Public Employee Whistleblower Act. That law permits a public employee to recover damages only when the retaliation is for a report made either to a law enforcement or regulatory agency. Privatelyemployed nurses, however, may also recover damages for harm resulting from retaliation for raising patient care concerns within the facility. The legislation to be initiated would amend the Texas Nursing Practice Act to give nurses employed by public hospitals the same right to recover damages as privately-employed nurses, but the damages would be capped at the same limit as the Public Employee Whistleblower Law. That law does not allow punitive damages Nursing Legislative Agenda continued on page 3 Join the Texas Nurses Association Today! current resident or Presort Standard US Postage PAID Permit #14 Princeton, MN Application on page 14 Inside this Issue Meet Your Health Care Professionals in the 83rd Texas Legislature Understanding Legislative Process is Key to Legislative Success Self-Directed, Semi-Independent Status for the Texas Board of Nursing Nursing Legislative Agenda Coalition... 9 Telling Nursing s Story to Legislators Don t Miss Nurse Day at the Capitol Nurses Taking Action in Texas Membership Application....14

2 Page 2 Texas Nursing Voice January, February, March 2013 Texas Nurses Association Districts and Presidents Presidents of the 28 statewide Districts of Texas Nurses Association, as well as some District offices, are listed below. They invite you to contact them with questions or comments about TNA District membership and involvement in your local areas. For specific District locations, please refer to the TNA Tri-Level Membership District map on page 14. District 1: Laura Sarmiento Phone: District 2: Helen Reyes Phone: District 3: Dennis Cheek Phone: District Address: Palli Stubbs P.O. Box Ft. Worth, TX Office: Website: District 4: Frances (Frankie) Phillips Phone: District Address: Pat Pollock P.O. Box Dallas, TX Office: Website: District 5: Jen Collins Phone: Website: District 6: Paula Stangeland Phone: Website: District 7: Deborah Daniel Phone: District Address: P.O. Box 1475 Belton, TX District 8: Sarah Williams Phone: Website: org/districts/08/ District 9: Terry Throckmorton Phone: District Office: Melanie Truong 2370 Rice Blvd., #109 Houston, TX Office: Website: District 10: Helen Woodson Phone: District 11: Marcy Beck Phone: District 12: Gerald Bryant Phone: District 13: Vacant LICENSING BOARD, PEER REVIEW, EMPLOYMENT PROBLEMS? DO NOT WAIT!!! Call before you respond to a letter or notice. Toll Free: Initial Consultation is Free Friend & Associates Nurse Health Care Attorneys Practice Throughout Texas District 14: Joe Lacher Phone: District 15: Andrea Kerley Phone: Website: org/districts/15/ District 16: Mimi Baugh Phone: District 17: Eve Layman Phone: Web site: org/districts/17/ District 18: Mary Anne Hanley Phone: District 19: Tara Patton Phone: Website: org/districts/19/ District 20: Debbie Pena Phone: District 21: Rebekah Powers Phone: District 22: Toni McDonald District 25: Inger Zerucha Phone: District 26: Esmerelda Garza Phone: District 28: Jenny Wilder Phone: District 29: Tina Cuellar Phone: District 35: Kim Gatlin Phone: District 40: Contact TNA Phone ext Published by: Arthur L. Davis Publishing Agency, Inc. TEXAS NURSING Voice A publication of Texas Nurses Association January, February, March 2013 Volume 7, Number 1 Editor-in-Chief Ellarene Duis Sanders, PhD, RN, NEA-BC Managing Editor Joyce Cunningham Creative Communications Deborah Taylor Circulation Manager Belinda Richey Editorial Contributors Carol Cannon, BSN, RN, OCN; Joyce Cunningham; Fran Martin, MSN, RN; Deborah Taylor; Catherine White; and Jim Willmann, JD Editorial Advisory Board Stephanie Woods, PhD, RN, Dallas Jose Alejandro, MSN, RN, MBA, CCM, Dallas Patricia Allen, EdD, RN, CNE, ANEF, Lubbock Sandra Kay Cesario, PhD, RN, C, Pearland Jennifer D.M. Cook, PhD, MSN, RN, San Antonio Anita J. Coyle, PhD, RN, CHES, Sanger Thelma L. Davis, LVN, Giddings Anita T. Farrish, RN, MHSM, NE-BC, Waco Patricia Goodpastor, RN, The Woodlands Patricia Holden-Huchton, RN, DSN, Denton Tara A. Patton, BSN, RN, Palestine Dianna Lipp Rivers, RN, CNAA, BC, Beaumont Executive Officers Margie Dorman-O Donnell, MSN, RN, President Karen Lyon, PhD, APRN, ACNS, NEA, Vice President Claudia Turner, MSN, RN, Secretary-Treasurer Regional Directors of Texas Nurses Association June Marshall, DNP, RN, NEA-BC North Region Eve Layman, PhD, RN, NEA-BC South Region Kim Belcik, BSN, RN-BC Central Region Viola Hebert, MA, BSN, RN East Region Jo Rake, MSN, RN, CNAA West Region Executive Director Ellarene Duis Sanders, PhD, RN, NEA-BC TEXAS NURSING Voice is published quarterly January, February, March; April, May, June; July, August, September; and October, November, December by Texas Nurses Association, 7600 Burnet Road, Suite 440, Austin, TX Editorial Office TEXAS NURSING Voice, 7600 Burnet Road, Suite 440, Austin, TX , Address Changes Send address changes to Texas Nurses Association, 7600 Burnet Road, Suite 440, Austin, TX , Advertising Arthur L. Davis Publishing Agency, Inc., 517 Washington St. P.O. Box 216, Cedar Falls, Iowa , Texas Nurses Association and the Arthur L. Davis Publishing Agency, Inc. reserve the right to reject any advertisement. Responsibility for errors in advertising is limited to corrections in the next issue or refund of price of advertisement. Acceptance of advertising does not imply endorsement or approval by Texas Nurses Association (TNA) of products advertised, the advertisers, or the claims made. Rejection of an advertisement does not imply a product offered for advertising is without merit, or that the manufacturer lacks integrity, or that this association disapproves of the product or its use. TNA and the Arthur L. Davis Publishing Agency, Inc. shall not be held liable for any consequences resulting from purchase or use of an advertiser s product. Articles appearing in this publication express the opinions of the authors; they do not necessarily reflect the views of the staff, board, or membership of TNA or those of the national or local associations. Copyright 2013 by Texas Nurses Association, a constituent member of the American Nurses Association.

3 January, February, March 2013 Texas Nursing Voice Page 3 Nursing Legislative Agenda continued from page 1 and sets limits on actual damages of $50,000 to $250,000, depending on the size of the county. The legislation would permit publicly-employed nurses to, at least, a remedy to recover lost wages and other economic harm suffered as a result of illegal retaliation. 2. Preventing Violence Against Nurses in the Workplace. The Texas Nurses Association will join with the Texas Emergency Nurses Association on a legislative initiative that addresses the prevention of violence against nurses in the workplace. The details of the legislation are still being worked out but approaches being discussed are enhanced penalties for assaulting a nurse and required training in de-escalation. Why: Violence against nurses continues to increase not only in the hospital emergency department but also in other areas of the hospital and in other practice settings. Current law does not provide the same penalties for assaulting a nurse as it does a police officer or first responder. Enhanced penalties are intended to discourage individuals from assaulting a nurse in the workplace. The goal of more training in de-escalation is to give the nurse better skills in defusing a situation before violence occurs. APRN Prescriptive Authority The Texas Nurses Association, Coalition for Nurses in Advanced Practice, Texas Nurse Practitioners, Texas Association of Nurse Anesthetists, Texas Clinical Nurse Specialists and Consortium for Texas Certified Nurse Midwives will jointly initiate legislation addressing APRN prescriptive authority. The legislation will replace the current complex and cumbersome site-based model with a collaborative prescriptive authority model. Under this new model, the Advanced Practice Registered Nurse (APRN) would execute a prescriptive authority agreement with a physician or physician group as a condition of prescribing. Physician involvement is still required but the APRN and physician or physician group would address how that involvement or collaboration should occur through the prescriptive authority agreement. Why: The need for greater access to primary care is going to significantly increase as health care reform is implemented. APRNs can make a significant contribution to addressing Texas shortage of primary care providers. However, current law with its requirements that a physician be on-site a specific amount of time and review a specific number of charts means the physician and APRN are spending time on unnecessary oversight that would be better spent seeing patients. The physician and APRN are in the best position to determine how best to collaborate to promote patient care. These changes would allow APRNs to practice more closely to the full extent of their education, experience and competency, and give the public better access to qualified health care providers. Nursing Education / Shortage The goal this legislative session is to maintain funding for the Nursing Shortage Reduction Fund at the same level received in 2011 ($30 million). In 2009 and 2011, the Texas Nursing Workforce Shortage Coalition (made up of over 100 member organizations including nursing, education and hospital members as well as business groups) was successful in educating legislators of the continued need for funding. The Coalition will be working again in 2013 to maintain the same level of special funding for nursing education. Why: A shortage still exists in nursing. Despite an apparent reduction in the severity (due to the economic recession) of the shortage, the need to continue to increase the number of nurses will continue to be a critical issue in Texas. The current reduction in severity of the shortage is expected to be temporary and as the economy recovers, the nurses who delayed retirement or chose not to go to part time will, in fact, retire and go to part time. Adding to the demand will be the aging Baby Boomers, as well as the expansion in care as a result of health care reform. Failure to continue funding nursing education could undo the gains that have been made over the past decade. Self-Directed, Semi-Independent Status for BON Nursing organizations will join with professional associations representing pharmacy and medicine in asking the legislature to grant the Board of Nursing, State Board of Pharmacy and Medical Board what is called self-directed, semi-independent status. This status will give these boards more flexibility in making budget decisions and the ability to function more like a business while maintaining Nursing Legislative Agenda continued on page 4 A road less traveled often leads to discovery. 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4 Page 4 Texas Nursing Voice January, February, March 2013 Nursing Legislative Agenda continued from page 3 the boards as state agencies subject to legislative oversight of their regulatory role. Why: These three boards are currently subject to the appropriations process which means not only that their budgets are set two years in advance but also that the number of FTE employees they can hire is set two years in advance. This makes it very difficult for the boards to effectively respond to changing needs of their constituencies. For example, if there is an increased demand for the Board of Nursing to process applications for new nursing education programs, it is not able to simply hire additional staff even if it has the funds available to do so. No business could operate very long with such lack of flexibility to respond to the changing needs of its customers. Nursing Practice Act Amendments The Texas Nurses Association (TNA) is initiating legislation to address several needed changes to the Texas Nursing Practice Act (NPA) that TNA or the Texas Board of Nursing (BON) have identified. The NPA amendments which have been identified include the following. 1. Deferred Disciplinary Action. Give BON permanent authority to take deferred disciplinary action against a nurse s license for certain violations of the NPA or board rules. Why: In 2009, the BON was given authority to pilot the concept of deferred disciplinary action which permits the BON to delay final disciplinary action for a relatively minor violation, place the nurse on probation, and dismiss that action if the nurse successfully completes the probation. That pilot has proved to be successful. The BON s authority to conduct the pilot will end after this legislative session so if the BON is to continue to be able to have authority to take deferred disciplinary action, the NPA will need to be amended to give it that authority. 2. Student Criminal Background Checks. Require that nursing students submit to a criminal background check. Why: Students have to submit to a criminal background check before they are licensed with the check conducted at the start of their education preparation rather than at the end would be better public policy. A positive background check would trigger the declaratory order for eligibility process to determine if the offense will result in the student not being eligible for licensure, eligible with stipulations or eligible without stipulations. The BON currently does criminal background checks on students on a voluntary basis for schools that request it. Approximately 75 percent of the schools representing about 50 percent of the nursing students who enroll each year undergo a background check by the BON. 3. Confidentiality of TPAPN Orders. Make BON orders confidential that order a nurse to participate in the Texas Peer Assistance Program for Nurses (TPAPN) to address a problem they are experiencing with chemical dependency or mental illness. Why: If in investigating a nurse, the BON determines the nurse s conduct was the result of a problem the nurse was experiencing with chemical dependency or mental illness, it has the authority to order a nurse (nurse must agree) to TPAPN. That order, however, is a public record and will normally include specifics about the problem that the nurse is experiencing with chemical dependency or mental illness. This does not seem appropriate. 4. Others changes. The legislation will make several other technical or corrective-type amendments that primarily relate to the disciplinary process. Other Nursing Initiatives Other nursing initiatives may still be identified. For example, the Texas School Nurses Organization may again initiate legislation requiring school districts to notify parents if a school nurse is not assigned to their child s campus. Such notification will permit parents to make arrangements (such as leaving work on short notice) if their children have special health care needs or experience temporary acute illnesses while at school. Public Health Initiatives Each legislative session, nursing supports initiatives to improve the health of Texas citizens. This session will be no different. An example is supporting the initiatives of the Texas Public Health Coalition which is a broad-based coalition consisting of provider and consumer groups that include the Texas Nurses Association, Texas Medical Association, Texas Hospital Association, Cancer Society, and American Heart Association. In 2013 the coalition will address priorities in four areas: promoting healthy eating and reducing obesity, cancer prevention, promoting a smoke-free environment, and promoting immunizations. Initiatives By Others Every session, legislation is filed by others that directly affects nurses and nursing some positively and some negatively. The Texas Nurses Association and other nursing organizations will monitor the bills expected to be filed in 2013, identify those most directly affecting nurses and nursing, and provide input on those bills as appropriate. Summary Nursing success in achieving its 2013 legislative agenda will depend on a variety of factors. One will be grassroots support from nurses through their contact with legislators and their offices. See Telling Nursing s Story to Legislators on page 9. Another will be understanding the legislative process and avoiding procedural pitfalls that prevent a bill from moving forward. The diagram, Understanding the Legislative Process is Key to Success, on page 7 provides an overview of the legislative hurdles that bills must clear in order to be passed and become law. It emphasizes how fast paced the Texas Legislative session is and how difficult it can be to pass legislation. During the session, nurses can follow the legislation on TNA s website ( under Advocacy for the Profession. Nurses can also be part of the process by attending Nurse Day at the Capitol (see page 12) on Monday and Tuesday, February 25 and 26. Registration and complete details for attending Nurse Day at the Capitol 2013 can be found at > Events. About the Author: James Willmann, J.D., director of governmental affairs for Texas Nurses Association, has advocated legislatively for nursing practice and quality health care in Texas for over 25 years. A recognized expert on the Texas Nursing Practice Act, Willmann is the well regarded annotator of Texas Nurses Association s Annotated Guide (for RNs) to the Texas Nursing Practice Act (now in its 10th edition) and the Annotated Guide (for LVNs) to the Texas Nursing Practice Act (now in its 6th edition). Simplify your nursing research... Nursing Newsletters Online Read Your State Newsletter Online! of Access to over 10 years of nursing publications at your fingertips. Contact us to advertise in this publication or online!

5 January, February, March 2013 Texas Nursing Voice Page 5 Meet Your Health Care Professionals in the 83rd Texas Legislature by Catherine White, TEXAS NURSING VOICE staff The 181 members of the 83rd Texas Legislature who were sworn in on January 8 include three nurses, six physicians, a pharmacist and a paramedic. Nurses: Rep. Donna Howard (D-Austin), Incumbent Rep. Susan King (R-Abilene), Incumbent Rep. Stephanie Klick (R-Fort Worth), New member Physicians: Sen. Deuell (R-Greenville), Incumbent Sen. Donna Campbell (R-New Braunfels), New member Sen. Charles Schwertner (R-Georgetown), Former representative newly elected to Senate Rep. John Zerwas (R-Simonton), Incumbent Rep. Greg Bonnen (R-Friendswood), New member Rep. J.D. Sheffield (R-Gatesville), New member Pharmacist: Sen. Letica Van de Putte (D-San Antonio), Incumbent Paramedic: Rep. Armando Mando Martinez (D-Weslaco), Incumbent Below is a profile of the 11 members of the 83rd Texas Legislature who are also health care professionals. Additional information can be found on Texas Legislature Online (www.legis. under Senate Member and House Member tabs. The Nurses Representative Donna Howard (D-Austin). Although not currently practicing, Rep. Howard holds a BSN and a master s in health education both from The University of Texas. She practiced as a critical care nurse at Brackenridge and Seton hospitals in Austin. She was the first hospital-based patient education coordinator in Austin and also served as a health education instructor at UT. Rep. Howard has also served as president of the Texas Nurses Association District 5, the local Austin-area district association. A recognized expert on public education, Howard was elected to the Eanes ISD board in West Austin, where she served from 1996 to 1999, and was certified as a Master School Trustee by the Texas Association of School Boards. Rep. Howard was first elected to the Texas House of Representatives in She sits on the House Higher Education, Technology, Public School Finance System and General Revenue Dedicated Accounts Committees, and she is vice-chair of the House Administration Committee. Rep. Howard has authored numerous nursing-initiated bills and has been a strong advocate on behalf of nursing at the Texas Legislature. Representative Susan King (R-Abilene). Rep. King earned a bachelor s degree in nursing at The University of Texas at Austin. She has served as co-director of surgery at the Texas Heart Institute, St. Luke s Episcopal, and Texas Children s Hospitals in the Texas Medical Center. Currently, she is co-owner and codirector of Elm Place Ambulatory Surgical Center in Abilene, where she is a practicing surgical nurse. Rep. King was first elected to the Texas House in She sits on several House committees including the Appropriations Committee, Appropriations Sub-Committee on Education, and the Public Health Committee. Previously, she served as vice chairwoman of both the Human Services Committee and the National Conference of State Legislatures Health Committee. Like Rep. Howard, she has authored numerous nursing-initiated bills and been a strong advocate on behalf of nursing at the Texas Legislature. Representative Stephanie Klick (R-Fort Worth). Rep. Klick received her BSN from Texas Christian University. She has served as a hospital nursing supervisor at Glenview Health Care Professionals continued on page 6 Commit to making a greater impact. Fast-track your career with one of Chamberlain s CCNE accredited* advanced nursing degrees. RNs, you can complete your BSN in as few as three semesters, with no on-site clinical requirements. Or go further by completing the Master of Science in Nursing Degree Program in just two years. These flexible, online programs are supported with faculty focused on student success. Make a greater impact with an advanced degree from Chamberlain. Be a Chamberlain Nurse. 3-year Bachelor of Science in Nursing Degree Program** RN to BSN RN-BSN to MSN MSN Graduate Certificates Chamberlain College of Nursing National Management Offices 3005 Highland Parkway Downers Grove, IL CCN (8226) Comprehensive program-specific consumer information: *The Bachelor of Science in Nursing degree program and the Master of Science in Nursing degree program are accredited by the Commission on Collegiate Nursing Education (CCNE, One Dupont Circle, NW, Suite 530, Washington, DC 20036, ). **The on-site Bachelor of Science in Nursing (BSN) degree program can be completed in three years of year-round study instead of the typical four years with summers off Chamberlain College of Nursing, LLC. All rights reserved.

6 Page 6 Texas Nursing Voice January, February, March 2013 Health Care Professionals continued from page 5 Hospital, now known as North Hills Medical Center. Recently, she has worked as a nurse consultant case manager to coordinate care for severely injured patients, and as a compliance consultant for long-term care facilities for the developmentally disabled. In 2005, Rep. Klick was elected chairman of the Tarrant County Republican Party. She has strong ties to District 91, having lived in the Fort Worth area for over a decade. According to her website, Rep.-elect Klick feels her experience in the health care field brings a unique perspective on issues involving wasteful spending in health care. The Physicians Senator Robert Deuell (R-Greenville). Sen. Deuell earned his M.D. from the Medical College of Virginia. He has practiced as a board-certified family physician for 25 years. Sen. Deuell was elected to the Texas Senate in He has passed legislation covering a wide range of issues, including bills related to student athletes and better safety measures to detect and treat concussions; ensuring senior citizens have access to quality, affordable health care services that allow them to remain independent, and aiding the detection and education of students with dyslexia. Currently, Sen. Deuell serves as chair of the Senate Economic Development Committee and vicechair of the Senate committees on Health & Human Services and State Affairs. Additionally, he serves on the Finance, Natural Resources, and Medicaid Reform Committees, as well as several subcommittees. Senator Donna Campbell (R-New Braunfels). Sen. Campbell earned her MSN from Texas Woman s University, specializing in cardiovascular clinical nursing and nursing administration. She received her M.D. from Texas Tech University and completed her residency at The University of Texas Medical Center in Houston. Her primary specialty is emergency medicine and she has a secondary specialty in ophthalmology. She practices in the emergency department of Columbus Community Hospital in Columbus, Tex. Sen. Campbell also volunteers with Christian Eye Ministry performing eye surgeries for patients in West Africa. Senator Charles Schwertner (R-Georgetown). Sen. Schwertner received his bachelor s degree in pharmacy at The University of Texas at Austin, working his way through medical school as a pharmacist. He is an orthopedic surgeon and managing partner of Georgetown Orthopedics. Newly elected to the Texas Senate, Sen. Schwertner previously served one term (2011) in the Texas House where he served on the Appropriations and Public Health Committees. While a House representative, he co-authored bills on the abortion sonogram bill, voter Photo ID legislation, and strengthening gun owner protections. Representative John Zerwas (R-Simonton). Rep. Zerwas is an anesthesiologist with Greater Houston Anesthesiologists. He has also been chief medical officer of Memorial Hermann Healthcare System in Houston. Rep. Zerwas was elected to the Texas House of Representatives in He has worked to increase transparency for health consumers and improve Texas organ donation laws. In the 2011 legislative session, he authored legislation designed to expand Medicaid managed care while making it more cost effective. As a member of the House Appropriations Committee, Rep. Zerwas serves as chair of the Subcommittee on Health and Human Services. He also serves on the Public Health and Calendar Committees. In 2009 and 2011, Texas Monthly named Rep. Zerwas to its Ten Best Legislators list. Representative Greg Bonnen (R-Friendswood). Rep. Bonnen received his M.D. from The University of Texas Medical Branch. His specialty is neurosurgery. He founded the Texas Brain and Spine Center, and co-founded the Houston Physicians Hospital. Rep. Bonnen has volunteered for a variety of charitable endeavors that include providing medical care, and assisting with building schools and homes in Mexico and Panama. His priorities include increasing local control of education, keeping taxes low and working on pro-life legislation. Representative J.D. Sheffield (R-Gatesville). Rep. Sheffield received his D.O. from Texas College of Osteopathic Medicine having completed an internship in family medicine at The University of Texas Medical Branch at Galveston and his residency at Southern Colorado Family Medicine. He is medical director at Coryell Medical Clinic and has served as senior staff physician at Scott & White Clinic, and chief of staff at Coryell Memorial Hospital. He currently is a member of the hospital s board of directors. The Pharmacist Senator Leticia Van de Putte (D-San Antonio). Sen. Van de Putte has been a pharmacist for over 30 years. She received her bachelor s degree from The University of Texas at Austin, College of Pharmacy and was a Kellogg Fellow at Harvard University s John F. Kennedy School of Government. Sen. Van de Putte was elected to the Senate in 1999, and prior to that, served in the Texas House from 1990 to Nationally, Sen. Van de Putte served as co-chair of the 2008 Democratic National Convention and from 2003 to 2011, she was chair of the Texas Senate Democratic Caucus. She is chair of the Veterans Affairs and Military Installations Committees and co-chair of the Human Trafficking, Interim Committee, in addition to serving on committees for Business and Commerce, and State Affairs. The Paramedic Representative Armando Mando Martinez, (D-Weslaco). Rep. Martinez received his B.S. from the University of Texas-Pan American and his paramedic education through the Texas State Technical College. Rep. Martinez was first elected to the Texas House in He currently sits on the Appropriations and Transportation Committees. Online RN-to-B.S.N. We recognize the special challenges you face as a working nurse. Our web-based RN-to-B.S.N. program allows working nurses to balance career, education and family. Apply today!

7 January, February, March 2013 Texas Nursing Voice Page 7 Understanding Legislative Process is Key to Legislative Success Understanding the legislative process that each bill follows is one of the keys to passing legislation in Texas. One might think of passing bills as running a two-lap, timed hurdles race where runners must be sure they cleanly clear each hurdle while focusing on a clock ticking down to zero. Similarly, if a bill fails to complete any step in the legislative process or fails to complete all the steps in the allotted time, it will have lost the legislative race and will not pass. Earliest around 2/8/2013 (30 days) LEGISLATIVE PROCESS BEGINS Getting Majority Vote in 2nd Chamber 140 DAY LEGISLATIVE HURDLES RACE 2013 SESSION Begins 2nd Tuesday in January and Ends Monday Following Last Weekend in May 2nd Tuesday in January January 8, 2013 APPROXIMATELY 100 DAYS TO GET A BILL PASSED Can be less (almost always is) depending on when have committee hearing Getting on Floor of 2nd Chamber for a Vote Getting Committee Hearing in 1st Chamber Governor Signs, Vetoes or takes No Action 1st CHAMBER 2nd CHAMBER Getting Out of Committee LEGISLATIVE PROCESS ENDS Getting Out of Committee 140th Day May 27, 2013 Getting on Floor of 1st Chamber for a Vote Getting Committee Hearing in 2nd Chamber Latest 5/20/2013 Getting Majority Vote in 1st Chamber Copyright 2012 Texas Nurses Association NCSBN Launches e-notification System Now, employers of nurses can automatically receive licensure and publicly-available discipline data on their employees in near real time and without having to launch a search. All it takes is a subscription to Nursys e-notify, a new national, nurse licensure notification system of the National Council of State Boards of Nursing (NCSBN). When changes are made to a nurse s record within Nursys, the e-notify system alerts subscribers. No matter whether the changes are license status, license expirations, pending license renewals or public disciplinary action/ resolutions, the e-notify systems sends notice. Subscribers can customize how often they receive the notifications and when they want to run reports. And employers also have the option to send license renewal reminders directly from the e-notify system to their employees. For little or no charge, nurse employers can subscribe to the e-notify system. The price is dependent upon the number of nurses in a facility who are enrolled in the system. For instance, according to NCSBN, the first 100 nurses in a facility registered with Nursys e-notify are free of charge. After that, each nurse is cost $1 per year. So, if an employer has 99 nurses for which the facility needs to track licensure or discipline information, they pay nothing. If they have 200 nurses, the cost per year is $200. Employers can learn more and subscribe to Nursys e-notify by visiting Spring into New Adventure Enjoy going to work each day without the hassle of heavy traffic. Have an uncomplicated drive in the country and come to a facility that cares enough to make a difference in the lives of our residents. Cypress Woods Care Center 135 ½ Hospital Dr. Angleton, TX RNs, LVNs SAN marcos treatment center, in continuous operation for more than half a century, is recruiting Texas Licensed Registered Nurses to become part of an experienced and effective treatment team. Our highly specialized residential programs provide 24 hour care to a broad spectrum of adolescent boys and girls ages 8-17 with psychiatric, neuropsychiatric, and developmental disturbances. Please visit our website at san marcos treatment center 120 Bert Brown Road San Marcos, TX Pre-employment Drug Screen, Health Assessment & Criminal History Check required An Equal Opportunity Employer Renew your sense of adventure while fulfilling your spirit of compassion. At Samuel Simmonds Memorial Hospital, you ll have the unique opportunity to provide healthcare to the vibrant communities of the North Slope and an Inupiat people ready to share their culture and heritage. Samuel Simmonds Memorial Hospital is looking for adventurous and compassionate nurses in the following capacities: Nurses ER, Clinic, Inpatient, Labor and Delivery, Case Management. In addition to our competitive salaries, we also offer medical/ dental/vision coverage, retirement plans, subsidized housing, a relocation allowance, and much more. For more information go to or to apply contact Human Resources at or call Arctic Slope Native Association Embracing the past. Looking towards the future. Together we can heal. Designed specifically for the Licensed Practical/Vocational Nurse No on-campus classes to attend! Clinical Component May Be Completed Where You Live Graduate from a Highly Acclaimed, Fully Accredited Program More information can be obtained by visiting

8 Page 8 Texas Nursing Voice January, February, March 2013 Self-Directed, Semi-Independent Status for the Texas Board of Nursing The Texas Nurses Association (TNA) will join with other nursing organizations in asking the Texas Legislature to grant self-directed, semiindependent agency status (SDSI Status) to the Texas Board of Nursing (BON). Having such status will permit the BON to operate more like a business by giving it greater flexibility in how its finances are managed. It will permit the BON to fulfill more efficiently its purpose of regulating nursing for the public s benefit. Achieving SDSI Status for the BON will be part of a broader joint initiative of the nursing, medicine and pharmacy professions to achieve the status not only for the BON but also for the Texas State Board of Pharmacy and the Texas Medical Board. The Texas Pharmacy Association and Texas Medical Association will be joining with nursing organizations in this broader initiative. The rapid changes occurring in nursing practice and the changing demands and pressures on the BON s resources have prompted concern by the BON that it may not have the financial resources and the flexibility to efficiently and effectively meet its responsibilities. Self-directed, semi-independent status will give the BON the flexibility to adapt quickly to nursing practice and education changes, nurse license compact issues, and enforcement and licensing challenges, said Kathy Thomas, MN, RN, FAAN, BON executive director. This flexibility would have been advantageous to the BON following the 81st biennium when we saw that the number of schools participating in the student background checks rise from 57 to 115. We requested four additional staff and then had to wait for approval from the Governor s office and Legislative Budget Board before filling those positions. Following the 82nd Texas Legislative Session, the BON gained approval to hire 11 additional staff, primarily investigators needed by the Enforcement Department, but then had to wait an additional six months for budget certification before the positions could be filled. If the BON had self-directed, semi-independent status, Thomas said, I, as executive director, could have requested the Board to approve the additional staff immediately. According to Mark Majek, director of operations for the BON, self-directed, semiindependent status would mean the Legislature would not have to approve the BON s budget as is currently required. As part of the appropriations process, Majek explained, the Legislature not only sets the total appropriation for the BON but also appropriates specific amounts for specific purposes. The BON must spend its funds for these purposes and cannot spend more for a given purpose than was appropriated. And he added, As part of the appropriations process, the Legislature also sets a cap on the number of employees the BON can hire. Because the Legislature meets only every two years, these decisions are being made up to two years in advance. All of this limits our flexibility to respond effectively to any unanticipated demands, he summarized. Implications of New Status If granted self-directed, semi-independent status, the Texas Board of Nursing would be removed from the legislative budgeting process, and its budget would be adopted and approved by the board members appointed by the Governor. On the first day of each regular legislative session, the BON would be required to submit a report to the Legislature and the Governor describing all of the agency s activities in the previous biennium. Additionally, the BON would be required to report its two year expenses and revenue collections to the Legislature, the Legislative Budget Board and the governor by November 1 of each year. The BON would remain a state agency and the BON employees would remain members of the Employees Retirement System of Texas. The state auditor would conduct financial and performance audits. Self-directed, semiindependent status is probably a misnomer, noted Majek. The BON s new authority is well balanced by accountability through reporting and significant auditing processes, he said. Advantages of Self-direction, Semi-independence Status The notion of having self-directed and semiindependent status in order to function more flexibly and not be anchored to legislatively set biennial budget constraints is not a new concept. Currently, seven licensing agencies have the status on a pilot or permanent basis, and it has proven to be successful and effective. The agencies are Board of Public Accountancy, Board of Professional Engineers, Board of Architectural Examiners, Texas Finance Commission, Texas Department of Banking, Department of Savings and Mortgage Lending, and Office of Consumer Credit Commissioner and Credit Union Department. When asked about the advantages to the BON if granted self-directed, semi-independent status, Thomas responded that, The advantages are many and besides the obvious one of the BON s having greater control over its budget, they include greater Board direction over agency programs, more flexibility in compensating employees based on market salaries, and fewer reports to oversight agencies. Thomas went on to say, The BON would continue to be held to a high accountability to its constituents, and the agency budget would continue to be subject to scrutiny by licensees and constituent associations. Nursing organizations themselves are very supportive of the BON having the new status. We think that will be important to legislators, she concluded. The BON and Pharmacy Board sought selfdirected and semi-independent status during the 82nd (2011) Session of the Texas Legislature. That legislation (House Bill 2092 by Rep. Susan King) was voted favorably from the House Public Health Committee but ultimately did not pass. Faculty Opportunities EXCELLENCE on the island Nurse Practitioner Faculty Positions The University of Texas Medical Branch (UTMB Health) School of Nursing on historic Galveston Island invites applicants for faculty positions in our Family Nurse Practitioner Program. These are full-time positions at the rank of Assistant or Associate Professor. The successful candidate will engage in online and face-to-face teaching experiences. The School of Nursing Graduate Program enrolls over 300 students in its master s and Doctor of Nursing Practice Programs. Our students obtain their practice experience in over 600 specialty appropriate clinical sites. QUALIFICATIONS AND EXPERIENCE Candidates should have an earned Doctorate in Nursing or related field or be enrolled in a doctoral program. Applicants should have significant clinical experience in their specialty area, teaching experience, and demonstrated leadership skills. The applicant must be eligible for licensure as a registered nurse in the state of Texas and certified or eligible for certification in their area of practice. Salary and benefits are commensurate with rank and experience. Interested candidates should send a letter detailing their interest and qualifications to: Pamela G. Watson, ScD, RN, Dean, The University of Texas Medical Branch Health School of Nursing, 301 University Blvd., Galveston, TX, , or Include a curriculum vitae, supporting information (e.g., reprints), and the names and contact information for three references. UTMB is an equal opportunity, affirmative action institution that proudly values diversity. Candidates of all backgrounds are encouraged to apply. GROW AS WE GROW CONTINUUM OF CARE IS COMING We will be opening our new state-of-the-art 96 unit Extended Care facility in early 2013 and are anxious to find RNs and LVNs to join our community. Experience in long-term care. Current Texas license. To learn more and apply for these opportunities with a dynamic and growth oriented company please visit our website at Eagle s Trace Eagle Vista Dr. Houston, TX ELM-JOBS Seeking RNs Med/Surg, ICU, ED, L&D, OR Active Texas license or ability to obtain Equal Opportunity Employer To learn more visit

9 January, February, March 2013 Texas Nursing Voice Page 9 Nursing Legislative Agenda Coalition First convened by the Texas Nurses Association in 1989, the Nursing Legislative Agenda Coalition (NLAC) serves as a mechanism for Texas-based nursing organizations to come together before each legislative session to set nursing s legislative priorities for that session its agenda for the session. Even though an individual organization may have its own priorities among the initiatives on the agenda, the agenda represents the initiatives that nursing as a whole supports. The member organizations of NLAC meet three times during each biennium to develop the agenda. During the session, the representatives of the organizations participate in weekly conference calls to keep up-todate on what is happening at the Capitol, so they can in turn inform the members of their organizations. NLAC is representative of both LVNs and RNs, all practice settings and all levels of nursing education. NLAC enables nursing to speak with a stronger, more unified voice than is possible as individual organizations. NLAC members from 2011 that have helped shape the 2013 Nursing Legislative Coalition Agenda are: Association of perioperative Registered Nurses of Greater Houston Association of Women s Health, Obstetrics & Neonatal Nurses Houston Oncology Nursing Society Houston Organization of Nurse Executives Licensed Vocational Nurses Association of Texas Society of Otorhinolaryngology & Head & Neck Nurses Texas Association of Deans & Directors of Professional Nursing Programs Texas Association of Nurse Anesthetists Texas Council of perioperative Registered Nurses Texas Nurses Association Texas Nurse Practitioners Texas Nursing Students Association Texas Organization for Associate Degree Nursing Texas Organization of Baccalaureate & Graduate Nurse Educators Texas Organization of Nurse Executives Texas School Nurses Organization Texas Emergency Nurses Association Texas RN First Assistants Network Texas Association of Vocational Nurse Educators All Nurses Invited: 2013 Annual Conference of Texas Council of perioperative Registered Nurses, February 9 in Austin, Texas. Great speakers. Interesting topics. Beautiful setting. Find out more and register at Telling Nursing s Story to Legislators by Fran Martin, MSN, RN, Grassroots Liaison All nurses need to be involved in grassroots political issues. Why? We are responsible for improving the environment in which we provide care to our patients. To make these improvements, we must monitor the legislation filed that affects our practice and the care we give. We must also be proactive in bringing forward legislation to create the changes we need to increase the safety and quality of the care we provide. Where do we start? We must tell our stories to our own legislators. They must hear our concerns about the health care issues we see daily. The stories help paint them a picture of an arena most legislators know very little to nothing about. How? First, if you are not sure who represents you in Austin and Washington, D.C., you can find out by accessing and filling in your home address. And remember, it is the Texas Legislature that passes the laws that make up our Texas Nursing Practice Act and that govern the Texas Board of Nursing. So starting at the state level makes sense. Your legislators like to hear from you about the issues you are concerned about. You represent the people who elected them, so taking time to hear your stories is important. And, as nurses, you are considered the expert on health care because there is not another group of health care professionals that provide care to as many people in as many different settings as nurses! Plus with over 7,000 bills being filed every legislative session in Austin, the legislators depend on the experts to fill in the information they lack to make decisions. If you feel uncomfortable about visiting with a legislator because you have never before visited with a legislator or a legislator s office staff, you can join with other nurses who have. You find these nurses in nursing organizations and in hospital groups. In the home districts, groups frequently meet with the legislator. These meetings rarely take more than 30 minutes. In the Capitol office, the meetings are frequently with the staff that handles the issues you want to talk about. The importance of informed staff cannot be underestimated. These are the people who keep the legislators organized by flagging the importance issues within all the information that arrives in their offices. It is crucial to have them understand your concerns and to develop a relationship with them. This only happens by meeting them or talking with them on the phone. Leave a card or paper with your issue and contact information when you go to visit. Denton State Supported Living Center Looking for LVNs & RNs to serve individuals with Developmental Disabilities Paid Time Off Paid Health Insurance After 90 Days Excellent Retirement Plan Job Stability Denton State Supported Living Center 3980 State School Rd., Denton, TX EEO/ADA Employer Apply Online Today Texas Department of Aging and Disability Services Nurse Day at the Capitol 2013 you have the opportunity to meet with your peers to visit your legislator s office during Nurse Day at the Capitol, an event presented by Texas Nurses Association and its Governmental Affairs Committee. The dates are February 25 and 26. Registration is available at > Events. All nurses are welcome, both TNA members and nonmembers. Don t miss this event. It is powerful! Part of why it is so powerful is that you can personally advocate for nursing. Legislators know you took time to travel, negotiate parking, and the halls of the Capitol to share the issues you are passionate about. TNA Members If you are a TNA member, you probably are also aware that through the Texas Legislative Session you receive updates on legislation that affects your practice and your patients. These come to you with background on the bill as well as dates, times, and how to give the feedback you want your legislator to hear. The crucial times to give feedback are when a public hearing is coming up on an issue and when the issue is voted on in either the Senate or House. The best place to get your message across is before the public hearings because this is where most of the work is done to iron out any major changes that need to be made to a bill before it can be passed out of committee to be voted on in the Senate or House. A large percentage of bills die in committee. TNA members need to be on the lookout for these s during the Texas Legislative session of January 8 to May 27, Make sure your voice is heard by those who govern us! Wellness Pointe, a $15 million dollar progressive multi-site integrated Federally-Qualified health system is looking for high-energy, resultsoriented, compassionate bi-lingual Registered Nurses Certified Nursing Assistants Certified Medical Assistants If you want to be a part of a clinical team committed to making a positive difference in the lives of the patients we serve, please call Hope Echols, Director, Human Resources at or send resume to Hope. for immediate consideration Wellness Pointe a health system on the move Join us at the newest medical center, in Alaska s fastest growing economy. We are highly ranked in patient satisfaction and core measure scores. FT Operating Room RNs FT Labor and Delivery RN FT Endo RN FT Experienced Med/Surg RN FT ED RN FT ICU RN FT Sterile Processing Tech Competitive wages with exceptional benefits package including Medical/Dental/Vision/Life, 401k with Employer match, Paid Time Off, relocation and sign on bonus.

10 Page 10 Texas Nursing Voice January, February, March 2013 Cervical Cancer in Texas: Saving Lives through Prevention and Early Detection by Carol Cannon, BSN, RN, OCN January is Cervical Cancer Awareness Month, and as we enter into 2013, it is important to acknowledge the ongoing cancer research that has led us to the current screening recommendations. Cervical cancer is caused by oncogenic strains of human papillomavirus (HPV), a common sexually transmitted infection. Only a small amount of women with HPV will develop cancer; however, screening and early detection are extremely important as cervical cancers detected at the earliest stage have a 10-year survival rate of 99 percent. Most cervical cancers and the resulting mortalities in the U.S. are the result of no screening or inadequate screening. The good news is that widespread Pap screening has decreased the incidence of cervical cancer by more than 50 percent in the last 30 years. In October 2012, the American College of Obstetricians and Gynecologists issued new guidelines stating that cervical screening for most women should only be performed once every three to five years. Their recommendation extends the interval between Pap tests, which had previously been one year. The College also suggests co-testing with the HPV test, although this should be limited to women over 30 and once every five years. These guidelines are now in alignment with those previously put forth in 2012 by the American Cancer Society, the U.S. Preventative Services Task Force, and the American Society for Colposcopy and Cervical Pathology. There are also two FDA-approved HPV vaccines available that could potentially prevent approximately 70 percent of cervical cancers caused by HPV infection. However, these vaccines don t protect against all cancer-causing strains of HPV, so continued screening with regular Pap tests is recommended. Together, vaccination and screening can save more lives. The Texas Cancer Registry estimates 1,255 new cases of invasive cervical cancer will be diagnosed this year in Texas, with about 392 deaths that are largely preventable. In Texas, the incidence and mortality rates of cervical cancer are currently one of the highest in the nation. Due to the burden of cervical cancer in the state, programs such as the Cancer Prevention and Research Institute of Texas (CPRIT), an initiative passed by the voters of Texas in 2007 to fund cancer research and prevention programs, are taking an active role in prevention and early detection. To date, CPRIT s Prevention program has awarded 92 grants to academic institutions and community organizations, for a total dollar award of over $82 million. Projects cover the spectrum of cancer prevention and control, including prevention vaccine, tobacco cessation, screening and diagnostics, and survivorship programs. Results from projects focusing on cervical cancer show that 478 precursors and 59 cancers have been detected thus far. These projects are saving lives, reaching many people who have never before been screened for cancer, said Dr. Rebecca Garcia, CPRIT chief prevention officer. CPRIT is fulfilling the promise made to Texans in 2007 and we will continue this important work to lessen the burden of cancer on families throughout the state. There are cervical cancer screening initiatives all over Texas, but women need to be educated and encouraged to get their screenings. Nurses can positively impact patients decisions to get screened, by initiating the conversation and providing the necessary education and resources for appropriate screening guidelines. So make a difference inquire and educate about cervical cancer screening. To learn more about cervical cancer prevention and earn free CNE, check out Cervical Cancer: What the Nurse Needs to Know at org. To learn more about CPRIT, visit References American Cancer Society (2012). Cancer Prevention & Early Detection Facts & Figures, Atlanta: American Cancer Society. American College of Obstetricians and Gynecologists. (2012). Ob-Gyns Recommend Women Wait 3 to 5 Years Between Pap Tests (News Release). Retrieved from About_ ACOG/News_Room/News_Releases/2012/Ob-Gyns_ Recommend_Women_Wait_3_to_5_Years_Between_Pap_Tests Cancer Prevention & Research Institute of Texas. (April 2012). Texas Cancer Plan 2012: A Statewide Call to Action for Cancer Research, Prevention and Control. Retrieved from Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Disease Promotion. (2012). National Cancer Institute: State Cancer Profile. Retrieved from pl?48&057#rt_foracancer Risser, D.R., Mokry, B., Bowcock, C., Miller, E.A., Williams, M.A., Magid, R., Garcia, R. Cervical Cancer in Texas, Austin, TX: Texas Cancer Registry, Texas Department of State Health Services; Cancer Prevention Research Institute of Texas, November, Texas Cancer Registry. Expected New Cancer Cases and Deaths by Primary Site, Texas Cancer Epidemiology and Surveillance Branch, Texas Department of State Health Services, November, About the Author: Carol Cannon is an Oncology Certified Nurse who is new to Austin, Texas. She worked previously as a clinical research nurse on the Oncology/Hematology/Stem Cell Transplant Unit at the National Institutes of Health in Bethesda, Md. She started her nursing career in the cardiac ICU, and feels she has found her passion since working in oncology. Competence in Cancer Care: What the Nurse Needs to Know lncludes OCN test taking strategies and review of OCN test blueprint Earn 7.75 Contact Hours: Scientific basis for practice, treatment modalities, protective mechanisms, disease process, alterations in lifestyle, health promotion, oncologic emergencies Choose a Location: February 2, 2013 in Fort Worth February 16, 2013 in Dallas September 21, 2013 in Corpus Christi October 2013 in Harlingen Reserve your seat now at Are You a Nursing Professional with a Passion for Education? Teach for the DCCCD! Dallas County Community College District, the largest undergraduate institution in the state of Texas, is a leading educator for Nursing and Allied Health! DCCCD offers excellent benefits, a great work environment and state-of-the-art educational facilities! We are currently seeking a Perioperative Nursing Faculty/Program Coordinator, El Centro College (downtown Dallas), Nursing Faculty and Adjunct Nursing Faculty, Mountain View College (Dallas), and Nursing Faculty, Brookhaven College (Farmers Branch). May qualify for market disparity stipend amount may vary depending on discipline. Visit our web site at for more information! Texas Nurses Association/Foundation Provider Unit is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center s Commission on Accreditation. The Nurse Oncology Education Program is part of Texas Nurses Association/Foundation Provider Unit. This CNE activity is grant funded by the Cancer Prevention and Research Institute of Texas, PP and made possible by Texas Oncology and LIVESTRONG.

11 January, February, March 2013 Texas Nursing Voice Page 11 CONTINUE THE CARE IT S ABOUT TIME. Kindred understands that when a patient is discharged from a traditional hospital they often need more time to fully recover. But time doesn t heal things alone, it takes a dedicated team of people. Nurses, doctors, case managers, social workers and family members don t stop caring simply because their loved one or patient has changed location. Neither do we. In Texas Kindred offers services including aggressive, medically complex care, intensive care and short-term rehabilitation in: 25 Transitional Care For more information: Dedicated to Hope, Healing and Recovery

12 Page 12 Texas Nursing Voice January, February, March 2013 COMING SOON: NEW Health Information Technology CNE Webinar Series for 2013 Provided by Texas Nurses Association and Texas Organization of Nurse Executives Updated and advanced webinar topics: Optimizing communications with information technology Transforming digital data into useful information Creating nursing solutions for common IT problems 1.0 contact hours will be awarded for successful completion. Still FREE to pre-registrants. SAVE THE DATES NOW: February 28 March 28 April 25 FIND DETAILED INFORMATION and REGISTER at Texas Nurses Association/Foundation Provider Unit is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center s Commission on Accreditation. Don t Miss Nurse Day at the Capitol 2013 by Fran Martin, MSN, RN, TNA Grassroots Liaison February 25 and 26 will be Texas Nurses Association s Ninth Nurse Day at the Capitol. It has become an empowering event for nurses from across the state. Each legislative session, Texas nursing organizations develop a nursing legislative agenda to improve the quality of health care for patients and the practice environment for nurses in Texas. And each session, nurses gather in Austin on Nurse Day at the Capitol to share their passion for nursing, quality patient care and what needs to be changed in Texas law to improve their ability to provide the care patients deserve. On Nurse Day, TNA lobbyists try to schedule a public hearing on a bill that is part of the Nursing Legislative Agenda. This gives nurses a chance to see the power we have in numbers as we crowd into hearing rooms to listen to our own experts testify on legislation. We visit in legislator s offices throughout the day to share our stories on why we personally see a need for change and what a difference it will make to the health care of the people of Texas. During previous Nurse Days, nursing s power has been shown time and time again by helping legislators understand why a particular bill should be passed because it promotes patient care and why another bill should not be passed because it would harm the quality of care and/ or nursing as a profession. Just one example is when a bill would have required mandatory CNE on Hepatitis C every time nurses renewed their nursing licenses. The bill had a public hearing the day after Nurse Day and the buzz around the Capitol was that my constituent nurses believe that not all nurses deal with Hepatitis C and that the research doesn t change that much in two years. They don t want it. The bill was defeated in committee. Don t miss out on this amazing opportunity to have your voice heard by your own legislator or their staff. Meet with peers from your area and across the state. Online registration is available at Texas Nurses Association District 18 invites all nurses to a unique CNE activity in Lubbock on Saturday, Feb. 16: Achieving Competency in Nursing Practice by Understanding Psychiatric and Substance Use Disorders within Nursing No matter whether it's on a managerial, clinical or personal level, nurses will sometime during their careers deal with certain substance use and psychiatric disorders. In this CNE activity hosted by TNA District 18 and presented by the Texas Peer Assistance Program for Nurses (TPAPN), every nurse can improve nursing outcomes by learning to recognize the relationship between certain behavioral disorders and best practices in nursing. You ll learn how to: Relate risk factors that may increase a nurse s risk for substance use/psychiatric disorders. Recognize signs that may indicate a nurse needs a referral to TPAPN. Identify measures that may contribute to a successful intervention. Develop risk-reduction strategies for the workplace. Recognize barriers to effective management of psychiatric and substance use disorders. Consider the benefits of TPAPN advocacy. Featured Presenters: Michael Van Doren, MSN, RN, CARN, program director, Texas Peer Assistance Program for Nurses Bob Howell, MEd, LCDC, director of Trauma Services, The Ranch at Dove Tree Edwin Stow, RN and Mona Caswell, RN, TPAPN volunteer nurse advocates Registration at 7:45 a.m. CNE ends 1:00 p.m. Refreshments and brunch are included. 3.6 contact hours will be awarded for successful completion. Registration fee: $10. TNA-18 members; $15. Non-members; free to nursing students. Registration fee is accepted ONLY at the door cash or money order (made payable to D-18 TNA ). Reservations are required. Seating is limited. Please register online at Sponsored by: Texas Peer Assistance Program for Nurses is a program of the Texas Nurses Foundation Texas Nurses Association/Foundation Provider Unit is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center s Commission on Accreditation.

13 January, February, March 2013 Texas Nursing Voice Page 13 Nurses Taking Action in Texas: A Series CNO Accepts Health Care Leadership Role as Texas Hospital Association Board Member Caryn Iverson, PhD, MBA, HCM, assumed a first-of-its kind leadership position in January by becoming the first chief nursing officer to be named to the Texas Hospital Association Board of Trustees. In the 83 years since THA s founding, it has had a number of nurses named to its board but until this year, none has been a CNO. Iverson, who is chief nursing officer of Las Palmas Medical Center in El Paso, joins 29 others on the THA board for a three-year term of service. Besides a board chairman, four officers and Dr. Iverson, the board includes 20 hospital and health care system executives, and two physicians. Historically across the U.S., when it comes to representation on hospital boards, physicians have outnumbered nurses. A 2011 survey of more than 1,000 hospital boards by the American Hospital Association found that nurses filled just six percent of board seats; physicians filled more than 20 percent. Yet findings from an earlier 2009 Gallup poll of opinion leaders confirmed nurses are underutilized and don t have the influence in health care reform that they should. The poll conducted on behalf of Robert Wood Johnson Foundation revealed that opportunities to learn from nurses are being squandered and that expanding the leadership of nurses is vital to health care reform. In the Institute of Medicine s 2010 report, The Future of Nursing: Leading Change, Advancing Health, one of the key messages is that nurses should be full partners, with physicians and other health professionals, in redesigning health care in the U.S. Recommendations of the report call on nurses to be involved in decision making for improving the delivery of care. As a chief nursing officer for a hospital with responsibilities for the strategic, operational and financial performance of nursing, Dr. Iverson is taking action in Texas by accepting the THA board seat. As a nurse, she can offer an intimate knowledge of patient care. As a CNO, she is familiar with reducing errors and costs, improving efficiency, and increasing quality of care. Dan Stultz, MD, FACHE, president and chief executive officer of Texas Hospital Association said of Dr. Iverson s appointment, Understanding what it takes to be a key leader in health care requires an embrace of the measures that will move our industry forward. Caryn understands those needs not only from the executive level, but also as a key clinical leader. Her clinical expertise and knowledge of what it takes to lead a team in a health care environment provides a crucial perspective our board can depend on to make decisions. He added, Like Caryn, successful health care leaders must also possess a desire to engage on meaningful measures that will result in change and move the industry forward. Interestingly, Dr. Iverson began her health care career as a paramedic. She earned an associate degree in nursing, a nursing license, and starting practicing in the hospital emergency department. She has been with Las Palmas since An ever present goal for Dr. Iverson was to grow within her own organization. She has. Eight years after getting an ADN she returned to school. She accomplished a master s in nursing and in the fall of 2012, completed her dissertation to earn a Ph.D. She says she now understands how increasing education actually prepares a nurse to deliver better care. When asked what key interest she ll take to her board seat, Iverson said, Health care needs to focus on generational issues the younger workforce. They communicate differently. While Millennials seem to prefer Twitter over s as a way to communicate, she pointed out, they provide us with an opportunity to examine how we work, how we deliver care. It s about efficiencies and there s a lot of quality care issues the younger generations can help solve. They can push us toward questioning how we could deliver better, higher quality care that s also efficient. Dr. Iverson s belief is that a CNO can add a business model to care delivery: Nurse executives can combine the personal, intimate direct patient care perspective and the business aspects of a do more with less focus of quality care, employee satisfaction, and cost and revenue concerns. About Texas Hospital Association: THA is the leadership organization and principal advocate for the state s hospitals and health care systems, and represents more than 85 percent of Texas acute-care hospitals and health care systems. It is one of the largest hospital associations nationally. Board Issues? Medicare and Medicaid Questions? Healthcare Fraud? Joe Flores is a fellow RN, FNP and an Attorney! Joe is a nationwide lecturer on nursing and the law. He represents registered nurses and other healthcare providers in matters concerning various legal aspects. Call Today and Program His Number in Your Cell Phone As a Nurse, You Won t Want to Miss Nurse Day at the Capitol 2013 February 25-26/Austin, Tex. February 26, 2013 at the Texas Capitol is nursing s day to champion a legislative agenda that can further improve nursing practice and quality health care for all Texans. By attending Nurse Day at the Capitol you can: Get energized by the power of a statewide voice for professional nursing. Visit your legislator s office to personally advocate for issues important to nursing. Sit in on potential public hearings to see nurse experts testify on nursing legislation. Network with nursing colleagues from across the state. Plus, attend a pre-session with Joe Gagen, legislative grass roots trainer, and a special orientation from TNA s governmental affairs experts. REGISTER NOW and find out more at Nurse Day at the Capitol is presented by Texas Nurses Association and the TNA Governmental Affairs Committee. TEXAS LUTHERAN UNIVERSITY SEEKS Director of Nursing KEY DUTIES INCLUDE: Finalize the BSN program proposal to the Texas Board of Nursing Move proposal through approval process Provide visionary leadership upon program approval REQUIREMENTS INCLUDE: Masters degree in Nursing, Doctoral degree in a relevant field Hold or promptly obtain Texas RN licensure Demonstrated leadership role within a nursing program Five years teaching experience in nursing; three at the BSN level For more information or to apply, please visit The Harris County Sheriff s Office is currently recruiting for health care staff to provide efficient, effective and compassionate health care to a unique population. The HCSO is the largest jail in the country to be accredited by the National Commission on Correctional Health Care. We offer challenging and rewarding clinical opportunities with competitive salary, retirement, paid holidays and other benefits. The HCSO is currently recruiting for the following positions: RNs, LVNs, & Nurse Practitioner/P.A. Dentist & Psych Tech Please contact Bobby D. Davis, Medical Administrator 1200 Baker Street, Houston, TX at Apply online at

14 Page 14 Texas Nursing Voice January, February, March 2013

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16 Page 16 Texas Nursing Voice January, February, March 2013 Education is a journey. Discover yours... Online. Take care of your patients AND your career with a CCNE-accredited nursing degree from WGU Texas! Relevant and Accredited CCNE-accredited degree programs designed to produce highly qualified, caring nurses, educators, and administrators. Flexible Log in and learn anytime, anywhere you can find the time before, during, and after rigorous nursing shifts. Affordable One of the best values in higher education, WGU Texas tuition is among the most affordable in the entire country. Competency-based Challenging programs that measure your learning rather than your time spent in class. Programs begin the first of every month. Your future can start right now! *RN Prelicensure programs available in select areas! WE DEFEND NURSES AGAINST BOARD OF NURSING COMPLAINTS HIRE AN AFFORDABLE, EXPERIENCED FORMER MEDICAL BOARD PROSECUTOR TO AGGRESSIVELY DEFEND YOU! TPAPN CHEMICAL DEPENDENCY STANDARD OF CARE PEER REVIEW Attorney Oscar San Miguel is a former P.A., O.R. Technician and Medical Board Prosecutor. He has handled hundreds of cases before licensing boards and commissions. Oscar San Miguel s office is in Austin where all board of nursing hearings are held. You don t have to pay travel expenses when you hire Oscar San Miguel. Reasonable rates. Payment plans available on all cases. The Nursing Board wanted me to give up my license for at least a year. I hired a Houston lawyer who quoted me as much as $15, After a phone call with her cost me $200.00, I found Mr. San Miguel in the Texas Nursing Magazine. His fees were reasonable and affordable and ended up being less than ONE THIRD of the first lawyer. Most importantly, Mr. San Miguel saved my license and I am practicing what I love doing today thanks to him. I say to any nurse in Texas with a Board matter, hire Oscar NOW! ~G.S., RN, San Antonio, TX OSCAR SAN MIGUEL 811 W. Slaughter Lane #2601, Austin, TX

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