Hospitals Have New Hope to Regain Needed Personnel Power


The old saying about “strength in numbers” applies to hospitals about as well as it applies anywhere. And anytime it’s applicable, you can usually say the opposite is true as well.

John Hawkins, President/CEO, Texas Hospital Association

For years, hospitals here in Texas have been experiencing that opposite: We’ve been hurting as our personnel numbers have waned. But now – after a legislative session in which the Texas Hospital Association stressed workforce again and again – we’ve got the barbells, bands and machinery to regain much of our lost strength.

Lawmakers at the Texas Capitol listened to our stories and gave us much of that equipment we needed to rebuild hospital personnel rosters depleted by the COVID-19 pandemic and other factors. Optimism has been in short supply in hospital circles in recent years, but when it comes to staffing our facilities, several new laws and funding avenues have us bullish about the future.

Keeping our hospital workers safe was one major piece of the puzzle. Recent THA member survey results reflected what we knew going into session: During the pandemic, workplace violence severity increased at a majority of Texas hospitals, and nearly every hospital reported workplace violence had either stayed the same or gotten worse. Undoubtedly, the uptick is linked to attrition we’ve seen in our workforce.

Through multiple new laws, we’ve made major inroads on that score. THA supported Senate Bill 240, authored by Sen. Donna Campbell, MD (R-New Braunfels) and sponsored in the House by Rep. Donna Howard (D-Austin), to put workplace violence prevention policies in place at every health care facility in our state. Hospitals will be required to maintain a workplace violence committee and prevention plan, and provide training on the subject a minimum of once a year. The new law also explicitly prohibits retaliation or discipline against someone who makes a good-faith report of a violent incident.

When violence against a hospital worker does occur, the offender needs to face appropriate accountability. That can happen now thanks to the passage of Senate Bill 840 by Sen. Royce West (D-Dallas), which enhances the penalty for assaulting an on-duty hospital worker anywhere on hospital property. Doing so will now be punishable by a third-degree felony.

Those measures will help keep our existing health care workers in place. But what about the next wave? In 2021 alone, Texas nursing schools turned away more than 15,700 qualified applicants. Difficulties related to faculty staffing, clinical space and finances have created a bottleneck in recent years when it comes to getting students of nursing and other health care disciplines to the educational finish line, and on to their careers as life-savers.

Lawmakers gave us new tools to address those weak points as well. Senate Bill 25 by Sen. Lois Kolkhorst (R-Brenham) revived a dormant nursing scholarship fund, established a clinical site nurse preceptor program to reward teaching nurses and removed an annual cap on loan repayment dollars nurses can receive if they work as faculty in a nursing degree program. And in the state’s 2024-25 budget, workforce-infusing funding allocations abounded. Just a few examples: The Professional Nursing Shortage Reduction Program, a key source of grants, will receive nearly $47 million over the next two years, an increase of $19 million from the current two-year budget. The Nurse Faculty Loan Repayment Program will receive $7 million over the next two years after an allocation of less than $3 million for 2022-23. And once again, budget writers provided full funding for the all-important graduate medical education residency program, making sure we have more residency slots than Texas medical school graduates. (You can read about these and many other hospital successes from this year’s regular session in THA’s end-of-session report.)

Once upon a time, hospital careers were indisputably sought-after professional choices – ones that weren’t as daunting as they have become in recent years. If hospitals are to make a comeback from their widespread workforce struggles, restoring their personnel power is paramount. THA believes that with the help the Legislature provided this winter and spring, achieving the numbers to recapture strength is once again possible, and better days are ahead.

Originally published in the Houston Medical Journal.
July 19, 2023

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