Senator Eliot Shapleigh - El Paso, Texas

AUSTIN — In her first major legislative push of the new session, Sen. Jane Nelson, R-Flower Mound, filed a bill Wednesday focused on stemming a nursing shortage in Texas hospitals.

Nelson’s bill would prohibit mandatory overtime policies for nurses and extend whistle-blower protection to publicly employed nurses who report patient-care concerns involving public hospitals, state schools or prisons.

The bill would also elevate the clout of nursing commissions at every hospital, requiring them to report directly to hospital boards and giving them a say in the working environment of nurses in that hospital, including helping establish nurse-patient staffing ratios.

"No Texan wants their loved one receiving care from someone who’s tired from working back-to-back overnight shifts," Nelson said.

The bill is the product of negotiations between the Texas Nurses Association and the Texas Hospital Association, Nelson said.

Texas hospitals have a nurse vacancy rate of 11 percent, according to Rep. Donna Howard, D-Austin, a co-sponsor of the bill in the House.

Nelson has made healthcare her defining issue in the Senate. She has filed nearly 50 bills this session, most related to healthcare. She also helped lead the charge with bicyclist Lance Armstrong on the multibillion-dollar cancer initiative in the last session.

Rosemary Luquire, who is corporate chief nursing officer at Baylor Health Care System, said the proposed legislation would have little effect on that nonprofit company’s hospitals.

Dallas-based Baylor, which operates hospitals in Fort Worth and Grapevine, doesn’t typically rely on mandatory overtime to fill its schedule. And its nurses already contribute to staffing decisions, Luquire said.

They consider how many nurses should work on a unit, as well as each nurse’s skills, in allocating responsibilities, she said.

"We believe that nurses at the bedside should make that decision, not some mandated ratio," Luquire said. "We want nurses to assess their patients on their unit and understand who’s the sickest of those patients, who’s the most stable, and then make their assignments accordingly."

A representative of the Tarrant County Hospital District declined to comment on the bill Wednesday.

At a morning news conference, Nelson said she wasn’t sure how much the bill would cost. It was unclear whether the money would come from the state or from the hospitals. Nelson suggested that the changes might ultimately lower hospital costs if they reduce nurse turnover.