By:  Barrientos                                       S.B. No. 1081

                                A BILL TO BE ENTITLED

                                       AN ACT

 1-1     relating to the regulation of the conduct of certain nurses.

 1-2           BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:

 1-3           SECTION 1.  Article 4525d, Revised Statutes, is amended by

 1-4     amending Subsections (c) and (d) and by adding Subsection (e) to

 1-5     read as follows:

 1-6           (c)  If a person who regularly employs, hires, or otherwise

 1-7     contracts for the services of at least 10 registered nurses

 1-8     requests one of those registered nurses to engage in conduct that

 1-9     the nurse believes violates a registered nurse's duty to a patient,

1-10     the nurse may request a finding by a nursing peer review committee

1-11     under Article 4525b, Revised Statutes, of whether the conduct

1-12     violates a registered nurse's duty to a patient.  A nurse who in

1-13     good faith requests, on a form produced by the board, a peer review

1-14     determination under this subsection may engage in the requested

1-15     conduct pending the peer review, is not subject to the reporting

1-16     requirement under Article 4525a, Revised Statutes, and may not be

1-17     disciplined by the board for engaging in that conduct while the

1-18     peer review is pending.  The findings of the peer review committee

1-19     shall be considered in a decision to discipline the nurse, but

1-20     those findings are not binding if a registered nurse administrator

1-21     believes in good faith that the peer review committee has

1-22     incorrectly determined a registered nurse's duty.  A nurse who in

1-23     good faith requests a peer review under this subsection may not be

1-24     disciplined or discriminated against for making the request.  If

 2-1     the conduct for which the peer review is requested under this

 2-2     subsection involves the medical reasonableness of a physician's

 2-3     order, the medical staff or medical director shall be requested to

 2-4     make a determination as to the medical reasonableness of the

 2-5     physician's order, which shall be determinative of that issue.  A

 2-6     registered nurse's rights under this article may not be nullified

 2-7     by a contract.

 2-8           (d)  An appropriate licensing agency may take action against

 2-9     a person who violates this article.

2-10           (e) [(d)]  In this article:

2-11                 (1)  "Duty to a patient" means conduct, including

2-12     administrative decisions directly affecting a registered nurse's

2-13     ability to comply with that duty, required by standards of practice

2-14     or professional conduct adopted by the board.

2-15                 (2)  "Person"[, "person"] includes an individual,

2-16     organization, agency, facility, or other entity.

2-17           SECTION 2.  Subsection (a), Section 241.026, Health and

2-18     Safety Code, is amended to read as follows:

2-19           (a)  The board, with the advice of the council, shall adopt

2-20     and enforce rules to further the purposes of this chapter.  The

2-21     rules at a minimum shall address:

2-22                 (1)  minimum requirements for staffing by physicians

2-23     and nurses;

2-24                 (2)  hospital services relating to patient care;

2-25                 (3)  fire prevention, safety, and sanitation

2-26     requirements in hospitals;

2-27                 (4)  patient care and a patient bill of rights; [and]

 3-1                 (5)  compliance with other state and federal laws

 3-2     affecting the health, safety, and rights of hospital patients; and

 3-3                 (6)  compliance with nursing peer review under Articles

 3-4     4525a and 4525b, Revised Statutes, and the rules of the Board of

 3-5     Nurse Examiners relating to peer review.

 3-6           SECTION 3.  This Act takes effect September 1, 1997.

 3-7           SECTION 4.  The importance of this legislation and the

 3-8     crowded condition of the calendars in both houses create an

 3-9     emergency and an imperative public necessity that the

3-10     constitutional rule requiring bills to be read on three several

3-11     days in each house be suspended, and this rule is hereby suspended.