The Story

District 9 of the Texas Nurses Association

About the Broadcast Film

The story of Texas Nurses Association District 9 Nurses highlights the history of healthcare throughout the Houston area and Galveston. Celebrating over 100 years of professional, compassionate and often heroic service, the unique story of the Gulf Coast Region will be told in a one-hour primetime special and broadcast in 10 Texas counties.

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Community Health and Homecare

Committee members:

Shirley Morrison PhD, RN

Sarah Hibbs


Committee Suggestions: Notes and outline for potential storyline and interviews to best represent this topic: May 23, 2018

Private Duty Nursing - a precursor to home health care of 21st  century; District 9 maintenance of Private Duty registry and rules. History of TNA District 9 housing a Private Duty Registry. Included ethical rules of behavior, payment & fees; the role of private duty nurse with patient, family, & physician

Here is a brief overview of the topics for our part: Community Health Nursing;

Private Duty Nursing - precursor to home health care of 21st century; District 9 maintenance of Private Duty registry and rules. History of TNA District 9 housing a Private Duty Registry. Included ethical rules of behavior, payment & fees; role of private duty nurse with patient, family, & physician
Interview: Rosemary Pine, PhD, RN Historical review of history of private duty nursing & TNA District 9 role

Sabina Fritsch – founder of the Visiting Nurse Association in Houston; her estate contributed funding for TNA D9 Scholarships. Acclaimed nurse leader in Houston & active TNA D9  member in the 1940’s 1950’s. Her retirement highlighted in Houston newspaper Houston Post. Copies of newspaper write-ups outlining Ms. Fritsch’s career in public health.

Interview: Karee Carter, 2017 winner of the Sabina Fritsch D9 Scholarship, who will give a brief summary of Sabina Fitsch, founder of the Visiting Nurse Association in Houston

Community and public health services led and provided by nurses in Houston & Galveston.
Interview expert in the field, such as Bets Anderson, faculty  of UTMB.

ACP Home Health – example of home health care provider founded by nurse entrepreneur, Description of current services provided to patients & clients in their homes; services provided by registered nurses.

United Health Care organized and provide home visits and telephone contacts for patients with chronic diseases to minimize emergency room visits & hospitalizations; Nurses play the primary role in this healthcare delivery.

Proposed interview with Sarah Hibbs RN,& her RN manager, Julie Garcia, describing the current role of nurses in home care services, by insurance providers. We are awaiting approval from United Health Care.

TNA D9  purchase of a group of cemetery plots at Forest Park Wayside Dr. in late 1920’s for nurses in need of a final resting place. Located on South Wayside Dr..; among the first plots sold at this cemetery and actively maintained. TNA D9 Nurse leaders buried there, including Sabina Fritsch.

Video tour of Forest Park Lawndale cemetery area where 9 nurse leaders are buried.   

Catastrophes/Disasters

Committee members:

Jacqueline Stout-Aguilar,
PhD, RN-BC, CNE Clinical Educator II
UTMB

Susan Ogunnowo,
PhD, MPH, RN Clinical Instructor
Bell Tech Career Institute

Amanda Chappell,
MSN, RN Manager, Clinical Projects
Memorial Hermann Health System


Committee Suggestions: Notes and outline for potential storyline and interviews to best represent this topic: May 23, 2018


Working with all institutions/alumni associations to obtain nurse names that went through the disasters below:

       1900 Storm/Hurricane
       Hurricane Carla (1961)
       Tropical Storm Allison (2001)
       Hurricane Ike (2008)
       Memorial Day Flood (2015)
       Hurricane Harvey (2017)
       UTMB Disaster Day

Potential Interviews: David Marshall-CNO UTMB, Pamela Watson-Previous UTMB Dean,  David Callender- UTMB President, UTMB Deans of all four schools, Disaster Team leads in Galveston/Houston TMC

Diversity

Committee Memebers:

E. Tina Cuellar
PhD, RN, PMHCNS, BC


Committee Suggestions: Notes and outline for potential storyline and interviews to best represent this topic: May 23, 2018


Interviews:
       Nurses with diverse backgrounds
       Chris Edwards, Dissertation “Men in Nursing” (also former Marine)
       Bruce Leonard-male Navy nurse, nursing faculty
       Betty Gounah-among first Filipino nurses immigrating to the USPam Windle- 2nd/3rd           generation Filipino nurse
       Vivianee Watts- Black Nurses Association of  Galveston; among first to integrate UTMB; has         collected history associated with UTMB minority
       Sandra Chaveleh- Hispanic nurse immigrant
       Funke Omo-Osagie – Nigerian  immigrant to Great Britain, Canada, and US


Progression
Historical overview of the opportunities and challenges encountered by a diverse nursing population. Initial encounters in nursing related to diversity.

Current status related to diversity
Education: politics, policy, the evolution of degrees Karen E. Alexander and Shatoi King


Education

Committee members:

Karen E. Alexander
PhD, RN, CNORDirector of Nursing, RN-BSN
The University of Houston Clear Lake

Shatoi King


Committee Suggestions: Notes and outline for potential storyline and interviews to best represent this topic: May 23, 2018


Gather relevant background:

Will conduct a literature review about the politics, policy, and the evolution of degrees programs of nursing education

Interviews:
Nurses who have worked with or influenced policies in nursing education
Nurses (Retired, Practicing and Students)
- Diploma
- Associate Degree
- Generic BSN
- Accelerated Programs

Progression:
Historical overview of the development and ever-changing pathway of education programs of nursing.
- First nursing programs of education
- First formal college based nursing program

Historical overview of the progression of politics and policies, influences on the nursing schools, colleges and curriculum.
- Discussion of the delivery of nursing education and the benefits to improved patient care.
- Discussion of external agencies governing nursing education (T-BON, ANA, Accreditation)

Military

Committee Members:

Marylois Lacey
PhD, RN, PMHCNS-BC

Lucindra Campbell-Law
PhD, APRN, ANP, PMHNP-BC

Lourie R. Moore, DNP, RN, NEA-BC


Committee Suggestions: Notes and outline for potential storyline and interviews to best represent this topic: May 23, 2018


Theme: “Military Nurses: Remembering their legacy while forging ahead serving others”

Background
       History of Military Nursing
       Experiences in wars (e.g., Vietnam, WW II)
       Explanations of different services in the Department of Defense
       Explanations of rank
       Military bases and VAMCs in Texas
       Different roles/positions
       Active duty
       Reserve
       Civilian

Contributions of Military Nurses
       Clinical practice
       Politics/policy
       Research
       Education
       Entrepreneur

Potential Interviews:
Active Duty Nurse
Ellington FieldLT Ike Akanu

Retired Nurse
Michael E. DeBakey VA
Major Christopher J. Mazza CRNA, MSN
Assistant Chief CRNA Ellington Field
LT. Fiona Sullivan (24 years as an RN- this is her 2nd year in the reserves)

Entrepreneur: Women Veterans Business Development
Marylyn Harris, RN, MSN, MBA (served in Desert Shield and Desert Strom)
President and CEO
Harrland Healthcare Consulting, LLC

Military Recruiter to address benefits of military nursing and commissioning process
Ellington Field
LT. Nathan Vick

Politics/Governmental
Affairs

Committe Members:

Terry Throckmorton, PhD, RN
Principal Researcher ELSEVIER Education


Committee Suggestions: Notes and outline for potential storyline and interviews to best represent this topic: May 23, 2018


Interviews
       Jim Willman
       Andy Cates
       Dorothy Otto
       Claire Jordan
       Shirley Morrison
       Nurses who attended Nurses Day at the Capitol as a student

Content 
       Accomplishments of TNA from the past recruitment flyer
       Selection of a few to emphasize
       TNA Governmental Affairs Committee
       Summary of the interview of candidates at the TNA office and other activities
       Nurses’ Day at the Capitol/photos
       TNA support of the Winkler County nurses and collaboration with the attorneys
       NLAC
       ANA House of Delegates
       TNA’s role in the development of the Workplace Advocacy arm
       Student mentoring in political negotiation
       The inclusion of political advocacy in nursing curricula

Research Contributions

Committee members:

Melissa McFarland

Terry Throckmorton, PhD, R
Principal Researcher ELSEVIER Education


Committee Suggestions: Notes and outline for potential storyline and interviews to best represent this topic: May 23, 2018


Research Interviews:
Nurse Researchers
Will survey institutions regarding nursing research studies and select a few key studies
A  CNO regarding the contribution
A few staff members inspired to conduct research
One or more collaborators in nursing research

Progression:
Historical overview of the development of nursing research in the Medical Center                        First hired nurse researchers 
First hired directors of nursing research  
Development of Behavioral review Committees and Behavioral Research

Departments:  
Influence of Magnet and the proliferation of nursing research 
Note about the influence of funding  
Historical overview of the progression of nursing research in nursing schools and colleges
Discussion of the collaboration and the benefits to patient care   

Technology

Committee members:

Juliana J Brixey PhD, MPH, MSN, RN Associate Professor


Committee Suggestions: Notes and outline for potential storyline and interviews to best represent this topic: May 23, 2018

1. When technologies/devices were introduced for inpatient use 
a. Infusion pumps
b. Bedside EKG monitoring 
c. Electronic vital sign machines
d. Glucose monitoring
e. Dialysis 
f. Ventilators
g. Ventricular assist devices 
h. Artifical heart
i. Telemedicine/telehealth
j. Introduction of helicopters and fixed wing to transport patients
k. EMS services
l. 911

2. Technologies used by patients 
a. Wearables such as fitbits
b. Wearable insulin pumps
c. Use of apps 
d. The mobile phone
e. Home monitoring  (glucose, weight, etc)
f. Social media
g. Personal health records (PHRs)

3. Technology Introduction (Software)
a. EHRs, documentation in an electronic format
b. Implementation of EHRs in hospitals
c. HIEs
d. ARRA and HITECH 

4. Who were the leaders in the Houston/Galveston area
a. Poldi Tschirch
b. Trish Richards
c. James Turley
d. Pamela Salyer 
e. Linda Harrington
f. Constance Johnson

5. How technology has changed nursing education 
a. Online education 
b. Internet
c. Social media
d. Web conferencing 

6. The emergency of nursing informatics/health informatics
a. Courses in Informatics
b. School of Biomedical informatics

7. Surviving Disasters/Downtime Equipment

Texas Medical Center

Committee members:

Lisa Boss, PhD, RN, CNS, CEN
Cizik School of Nursing at UTHealth |The University of Texas Health Science Center at Houston

Chelsea Baker, RN, MSN
Houston Methodist Willowbrook Advanced Wound Center & Hyperbaric's

Maureen Sain, BSN, RN, PCCN
Nursing Clinical Manager
Harris Health System LBJ Hospital


Committee Suggestions: Notes and outline for potential storyline and interviews to best represent this topic: May 23, 2018

UTMB: 1890
St. Joes (affiliated with UST): 1904
Hermann Nsg School (affiliated with HBU?)
All of the nursing schools segwayed into what would become TMCMaribel knows some people who could be interviewed

Bubble Boy: TCH
Pat Schwartz was one of his nurses during his years at TCH/home. TNA D9  member living in The Woodlands. Pat could talk about the multidisciplinary approach to caring for this patient (MD, NASA, RN, etc…), and particularly about the nurses' role it the overall picture.

Jeanette Kernige 
Pioneered  nurses role in cardiothoracic surgery with DR. Cooley at THI/SLEH. She could tell her story about nursing in the 1980s, during the time of innovation r/t work of Cooley and the nurses' role.

The Birth of LifeFlight
Interview one of the first RNs who was involved in this innovation

The Birth of Shared LeadershipKarlene Kerfoot, CNO @ SLEH in the 1990s. Her efforts led to SLEH being the first Magnet hospital in the SW region of US in 2000. Would like to interview her, but if we cannot, then someone who worked with her during  that time at SLEHA

A turning point for operations of the TMC was TS Allison in 2001

     Lab animals drowned
      Wake up call for how to care for patients in emergency
      Opened eyes to what goes on in TMC

Dean Starck/Dean Frazier at UTHealth
Dean Starck was the longest running Dean in TMC.
Dean Frazier, current Dean Starck to talk about her 35 years in the TMC and how the role of the nurse had changed over the years. Frazier to talk about the future generation of nursing and where we are going in the profession as it.

Karen Myers; CNO Memorial Hermann TMC. She has 30 years as a nursing leader in TMC. Her perspective on the role of the nurses now and in future.

Chuck Stokes: CEO Memorial Hermann System
He has been in TMC 30 years and would have a valuable perspective as a leader.

Featuring Interviews With:

Technology Category

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Jacqueline Stout-Aguilar

,
Project Volunteer

Catastrophes/Disasters Category

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Jon Lindgren

,
Executive Producer

Documentary Coordination

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Diversity Research Team

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TMC Research Team

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Shirley M. Morrison PhD, RN

,
Project Volunteer

Community Research Team

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Military Research Team

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Military Research Team

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Sarah Hibbs, MSN, RN

,
Project Volunteer

Community Health Research Team

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Military Research Team

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Education Research Team

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TMC Research Team

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Political Research Team

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Renae R Schumann, PhD

,
Project Volunteer

TMC Research Team

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Education Research Team

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TMC Research Team

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Chelsea Baker, RN, MSN

,
Project Volunteer

TMC Research Team

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Maureen Sain, BSN, RN

,
Project Volunteer

TMC Research Team

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History of TNA/Nursing Initiated Legislation

TNA is the only nursing organization that lobbies legislation affecting all areas of nursing. It has been active legislatively since its inception in 1907. TNA works closely with specialty nursing organizations on legislation of common interest. The nursing specialty organization members of the Nursing Legislation Agenda Coalition provide significant grassroots lobbying for nursing related legislation. The following is a listing of some of the significant accomplishments of this effort. Probably only a few - certainly not all - of these accomplishments would have occurred if TNA and nursing had not been involved.

Advocacy and Whistleblower Protections

There would be fewer pro- tections for nurses when advocating for patients: no right to request safe harbor peer review; no protection when refuse to engage in conduct believed to violate nurses’ duty to their patients; no whistleblower pro- tections when reporting concerns about patient care within the facility or to accrediting agencies, or when reporting other professionals for unsafe care; and no protections from getting a bad employment reference (“nurse does not follow instructions”) when refuse to engage in conduct believed not to be in the patient’s best interest. (1987, 1995,1997, 1999, 2003, 2005, 2007 NPA.)

Nurse Staffing

Nurses would not have the benefit of hospital licensing rules that require 1) nurse staffing levels be set with input from a nursing committee consisting of one half direct care nurses, 2) a written staffing plan evaluated annually on outcomes, and 3) policies on mandatory overtime and floating. (2001: TNA negotiated rule request with hospital association; 2007: committee change)

Safe Patient Handling and Workplace Safety

Texas would not have been the first state in the nation to pass safe patient handling legislation requiring both hospitals and nursing homes to adopt policies minimizing manual lifting. Hospitals would not be required to have policies addressing violence and workplace safety for nurses. (2003: Hospital Licensing Law; 2005: SB 1525.)

Nursing Shortage

Nursing schools would not have received $55+ million dollars to increase enrollments and graduations; there would be no Center for Nursing Workforce Studies to research nursing supply and demand. There would be no $500 tuition exemption for preceptors and their children and nursing faculty would not be included in the Texas Affordable Home Loan Program. (2001-2007: Appropriations Bill; 2001:SB 575. 2003: HB 3126. 2005: SB 132;2007: SB 992.)

Unified Regulation of Nursing

There would not be a single board of nursing and single practice act for RNs and LVNs; no potential for a single agency to regulate the entire continuum of nursing care; and RNs and LVNs would not have same advocacy and whistleblower protections. (2003: NPA.)

Licensure Mobility

Texas would not belong to the Nurse Licensure Compact that permits nurses to move and practice in participating states with minimal hassle and expense. (1999: Occupations Code Ch. 303.)

Regulation of Nursing Education

The Board of Nursing would likely have less regulatory authority over nursing education. (1981 and 2007: Defeated attempts to strip or reduce the authority of BON.)

Nurse Title Protection

se of title “nurse” would not be limited to RNs and LVNs Personnel in veterinarian offices would also be calling themselves “nurses,” “Registered Veterinary Nurses,” and “RVNs.” (2003: Use of title limited to RNs and LVNs. 1999: Nursing efforts defeated HB 2470 authorizing veterinary technicians to call themselves nurses.)

Nursing Peer Review

There would be no nursing peer review; no due process for nurses being reviewed. No communication between the Patient Safety Committees and Peer Review to focus on System Errors and emphasis would still be on individual blame rather than correcting system issues that caused errors. (1987, 1993, 2007: NPA.)

Peer Assistance

There would be no peer assistance program for nurses experiencing problems with chemical dependency or mental illness so they can return to safe nursing practice. (1987: Nursing initiated special statute.)

Practice Protection

There would not be exemptions for RNs in the Speech Pathology Audiologist Law, Respiratory Therapy Law, Social Worker Act, or the numerous other allied healthcare professional licensing acts that have been enacted. (1981-2003: Allied health groups engaging new licensing laws frequently want to exclude RNs from performing acts overlapping with nursing.)

Declaring Death

RNs would not have the authority to determine death. (1991: Health & Safety Code.)

Diabetic Management

RNs would not be able to do the nutritional and pharmaceutical components of diabetes self-management training. (1999: Clarifying amendments to HB 982).

Specific Subject CNE and Curricula

Nurses would be required to take CNE in specific subjects such as Hep C every two years. Nursing schools would be required to teach courses like forensic evidence collection to all students. (Attempts are made every session to mandate all nurses take certain CNE or all schools teach a certain subject.)

Personal Protection

Nurses would not have a right to obtain the test results of a patient tested for Hepatitis C or HIV after an accidental exposure. (1999: Amendment to SB 99 to address a nurse’s access to test results.)occupational Tax. Nurses would not be exempted from paying an annual occupational tax of $200.00 like most other professions. (1989: Tax imposed on physicians, dentists, chiropractors, attorneys, etc. but not nurses.)

Apparel Choice

Nurses would not be able to wear scrubs in the hospital cafeteria or grocery store. (1999: Nursing’s grassroots lobbying helped defeat HB 1530 that would have prohibited wearing scrubs in food establishments.)

APN Reimbursement

APNs would not have Medicaid reimbursement and they would not be included among those providers against whom insurance companies cannot discriminate. (1992: Obtained amendment to Medicaid Plan. 1999: Insurance Code)

APN Clinical Privileges and Scope of Practice

APNs would not be guaranteed due process in seeking clinical privileges; would not be included among those providers against whom insurance companies cannot discriminate; would not be assured of their right to be able to document services that they legally provided; and would not be able to perform physicals for cosmetologists and school bus drivers. (1999: SB 1131, HB 1409. 2003: HB 1095.)

RN first Assistants and Circulating Nurse

RN First Assistants would not be listed among the providers against whom insurance companies cannot discriminate. The circulating nurse would not have to be an RN (2001: HB 803; 2005: HB 1716.)

School Nurses

School nurses would not have the same contractual rights as their teacher, librarian and counselor colleagues and would not be on the same minimum salary scale. (1995, 1999: Education Code.)

Nursing Home Supervision

The Director of Nursing in Nursing Homes would not be required to be an RN. (1997: Defeated Amendment to Nursing Home Reform Bill that would have permitted a waiver.)

Unlicensed Personnel

There would be no prohibition against physicians bypassing the RN and delegating the administration of medications directly to unlicensed personnel in home health. (1997: Amendment to home health legislation.)

And the Top Accomplishment!

100 years (a Century 1909-2007) of Advocacy for Nurses.