By Maxey H.B. No. 1433
75R6367 T
A BILL TO BE ENTITLED
1-1 AN ACT
1-2 relating to peer review protections for registered nurses when
1-3 advocating for patients or refusing to engage in unsafe care and
1-4 when employer reports inappropriate patient care.
1-5 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-6 SECTION 1. Amend Article 4525d, Revised Statutes, to read as
1-7 follows:
1-8 Art. 4525d. Protection for Refusal To Engage in Certain Conduct.
1-9 Sec. 1. (a) A person may not suspend, terminate, or
1-10 otherwise discipline or discriminate against a registered nurse
1-11 [who] because the nurse:
1-12 (1) refuses to engage in an act or omission relating
1-13 to patient care that would constitute grounds for reporting the
1-14 nurse to the board under Article 4525a, Revised Statutes, if the
1-15 nurse notifies the person at the time of the refusal that the
1-16 reason for refusing is that the act or omission constitutes grounds
1-17 for reporting the nurse to the board or is a violation of this
1-18 chapter or a rule of the board or is an act or omission that a
1-19 reasonable, prudent nurse would not commit.
1-20 (2) provides patient care-related information to a
1-21 patient or a patient's representative unless a reasonable prudent
1-22 registered nurse would determine that it is not in the patient's
1-23 best interest for the information to be provided or the patient's
1-24 file contains written instruction from the patient's physician that
2-1 it is not in the patient's best interest for information of that
2-2 type to be provided.
2-3 (3) advocates for a patient to an employer, health
2-4 maintenance organization, preferred provider organization,
2-5 insurance carrier, third party payer, health care professional, or
2-6 health care facility or agency unless a reasonable, prudent RN
2-7 would determine the advocacy is inappropriate or not in the
2-8 patient's best interest.
2-9 (4) identifies herself or himself to the patient or
2-10 patient's representative as a registered nurse verbally, by
2-11 nametag, or otherwise, or identifies other personnel either by
2-12 their authorized title if licensed or certified by the state or as
2-13 unlicensed aides if not licensed or certified by the state.
2-14 (5) discusses with the patient or the patient's
2-15 representative the type of personnel providing nursing care to the
2-16 patient, the amount of time care will be provided by a registered
2-17 nurse, under whose supervision unlicensed personnel will be
2-18 providing nursing care, and whether a registered nurse has overall
2-19 charge of the patient's nursing care.
2-20 (b) An act by a person under Subsection (a) does not
2-21 constitute a violation of this article if:
2-22 (1) a nursing peer review committee under Article
2-23 4525b, Revised Statutes, finds that the act or omission [the nurse
2-24 refused to commit] was not conduct that is reportable to the board
2-25 under Section 1A, Article 4525a, Revised Statutes or an act or
2-26 omission that a reasonable, prudent RN would not have refused to
2-27 commit; or
3-1 (2) a nursing peer review committee under Article
3-2 4525b, Revised Statutes, finds that the act or omission [the nurse
3-3 refused to commit] was conduct that is reportable to the board or
3-4 was an act or omission that a reasonable prudent RN would have not
3-5 have committed and the person rescinds any disciplinary or
3-6 discriminatory action taken against the nurse, compensates the
3-7 nurse for lost wages, and restores to the nurse any lost benefits.
3-8 Sec. 2. (a) An employer, employment agency, employment
3-9 clearinghouse or other person may not provide information to an
3-10 employer, prospective employer, an employment agency, employment
3-11 clearinghouse or other person about a registered nurse that states
3-12 or implies the reason a registered nurse was terminated, suspended,
3-13 requested to resign or otherwise disciplined was because of an act
3-14 or omission relating to patient care that constitutes conduct
3-15 reportable to the under Section 1, Article 4525a, Revised Statutes,
3-16 except as provided in subsection (b). This subsection shall apply
3-17 regardless of whether the person states the conduct is reportable
3-18 as long as the act or omission described is conduct reportable
3-19 under Section 1, Article 4525a.
3-20 (b) Subsection (a) shall not apply if a nursing peer review
3-21 committee has found the act or omission of the registered nurse
3-22 constitutes conduct reportable to to the Board under Section 1,
3-23 Article 4525a.
3-24 Sec. 3. An appropriate licensing agency may take action
3-25 against a person who violates this article.
3-26 Sec. 4. A registered nurse has a cause of action against a
3-27 person violating this article. The person may recover:
4-1 (1) actual damages, including damages for mental
4-2 anguish even though no other injury is shown, or $1,000, whichever
4-3 amount is greater;
4-4 (2) exemplary damages;
4-5 (3) costs of court; and
4-6 (4) reasonable attorney's fees.
4-7 (b) In addition to amounts recovered under Subsection (a) of
4-8 this section, a person whose employment is suspended or terminated
4-9 in violation of this section is entitled to:
4-10 (1) reinstatement in the employee's former position or
4-11 severance pay in an amount equal to three months of the employee's
4-12 most current salary; and
4-13 (2) compensation for wages lost during the period of
4-14 suspension or termination.
4-15 (d) An action under this article may be brought in the
4-16 district court of the county:
4-17 (1) in which the plaintiff resides;
4-18 (2) in which the plaintiff was employed by the
4-19 defendant; or
4-20 (3) in which the defendant conducts business.
4-21 Sec. 5. In this article, "person" includes an individual,
4-22 organization, agency, facility, or other entity.
4-23 SECTION 2. This Act takes effect September 1, 1997.
4-24 SECTION 3. The importance of this legislation and the
4-25 crowded condition of the calendars in both houses create an
4-26 emergency and an imperative public necessity that the
4-27 constitutional rule requiring bills to be read on three several
5-1 days in each house be suspended, and this rule is hereby suspended.