RN Update, Volume 33, Number 3, July 2002 Page: 1
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July 2002 A Quarterly Publication of the Board of Nurse Examiners for the State of Texas Volume 33,
\ RN UPDATE
The mission of the Board of Nurse Examiners forthe State of Texas is to protect and promote the welfare of the people
of Texas by ensuring that each person holding a license as a registered professional nurse in the State of Texas is
competentto practice safely. The Board fulfills its mission through the regulation ofthe practice of professional nursing
and the accreditationofschoolsofnursing. Thismission, derived from the Nursing Practice Act, supersedes the interest I A
of any individual, the nursing profession, or any special interest group.No. 3
)CEditor's Note: On March 24, 2002, the Texas Departmentof Health (TDH) adopted newRule 133.41(o)[25 TAC, Chapter1.
on ajointrecommendation bythe TexasNursesAssociation and the TexasHospitalAssociation. Thisrule willaffect th
of Texas RNs working in hospital settings. The article below has been prepared by guest contributors who were memb
joint task force that made recommendations to TDH.
TEXAS AMONG FIRST STATES TO AFFECT NURSE STAFF
By K. Lynn Wieck, PhD, RN*, and Teresa Oehler, BSN, RN**
WK. Lynn Wieck, PhD, RN, ispresidentofthe Texas NursesAssociation (TNA). She is also CEO of Man
Solutions for Healthcare, a workforce research company. *Teresa Qehier, BSN, RN, is co-chair c
Governmental Affairs Committee. She is a staff nurse in a cardiology unit at St. Luke's Episcopal Ho
Houston. Both servedon the Joint TNA and Texas HospitalAssociation TaskForce thatdevelopedthep
fornurse staffing on which the new Texas Department ofHealth (TDH) hospitalnurse staffing rules are
On March 24th, theTexas Board ofHealthtookan actionthatwill affectthe practice environment of th
RNs who work in Texas hospitals. The action was adoption of significant revisions to its hospital nurse staffs
[Rule 133.41(o)]. This articlewill reviewthe background that led to the Board ofHealth's adoption ofthe n
and the key provisions of those rules that make them so important to all nurses who practice in Texas.
Background on Adoption of Staffing Rules
Like almost everything else occurring in professional nursing today, the new hospital nurse staffing
rooted in the nursing shortage. A recent report on the nursing shortage by the Robert Wood Johnson FOtl
included an analysis of 16 national studies of the nursing workforce. That analysis identified both the causE
the solutionstothe shortage. Those causes and solutionsfell into two general categories. One category i
the primary cause of the shortage as the lack of adequate numbers of RNs and the solution as increasing th
ofRNs. The othercategory identified the cause ofthe shortage as an unsatisfactory work environment for
that failed to attract and retain RNs and the solution as improving the work environment to attract and retc
registered nurses.
The Texas Nurses Association (TNA) concluded that a "Texas" solution to the shortage would
address both categories. TNA based its conclusion on these facts: 1) the aging of the nursing profession (,
average age of RNs) means the long-term supply of RNs is likely to be inadequate unless the capacity of the
education system is increased; 2) the demand for RNs is only going
to increase with the aging of the baby boomer generation; and 3)___________________
unless the working environment is improved, the production of InietiIsu
more RNs will at best be a short-term fix because new RNs (alonghi Isu
with more and more of the current workforce) will simply leave the Pg. 1 Texas Among First States
profession. AffectStaffing
Because the shortage is most acute in hospitals (60% of Pg. 2 Strategic Plan
Texas RNs practice in hospitals), TNA approached the Texas Pg. 3 Proposed and Adopted Rul
Hospital Association (THA) in late 1999 to propose a joint initiative Pg. 4 Board Adopts Peer Review
to address the "emerging" nursing shortage in Texas. This meeting Pg. 5 Legal Issues: Role of theE
spawned three, more specific initiatives - a series of studies of the Pgs. 8-9 Education Report
shortage in partnership with the Center for Health Economics and Pg. 10 ImposterWarningPolicy (CHEP), a legislative initiative in 2001 to secure more Pgs. 10-12 Notice of Disciplinary Actio
funding for nursing schools to increase enrollments, and creation Pgs. 12-13 Voluntary Surrenders
ofajointtaskforcetoaddressthehospitalworkplaceenvironment. Pg. 13 If A Tree Falls in the Fores
The latterwas the result ofTNA's conviction that any real solution Pg. 14 InsufficientFunds
tothe nursing shortage had to address improving the nursingwork ChangeofAddress
environment. This conviction was validated by the CHEP study, Pg. 15 WorkshopUpdate
Pg. 16 Board Meeting Schedule331based
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Texas. Board of Nurse Examiners. RN Update, Volume 33, Number 3, July 2002, periodical, July 2002; Austin, Texas. (https://texashistory.unt.edu/ark:/67531/metapth1679365/m1/1/: accessed July 17, 2024), University of North Texas Libraries, The Portal to Texas History, https://texashistory.unt.edu.; crediting UNT Libraries Government Documents Department.