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members, sent letters to Texas nurses inviting them to meet. The committee hosted two information meetings in March 2006, one in Austin and another in San Antonio. The 85 attendees had thousands of pent-up grievances, Leonard recalls, ranging from rising corporate profits to their own shrinking ranks. “Can you believe that most nurses, who’ve spent their lives taking care of sick people, have no pensions for their old age?” asks DeMoro. Her union had already begun securing contracts in California that included pensions and health care for retirees, and that appealed to the Texas nurses, too. But it’s hard to prod nurses into public stands, says Julie Byers from Austin. “Nurses can be kind of wimpy. That’s because we’re one of the more beaten-down sectors of the labor market:’ she says. Even in the best of times, it’s difficult to organize female professionals, adds Medlin. “We don’t know how to go out and fight for ourselves;’ she says. After years of accepting downgrades from employers, RN’s joked that they’d become industry “enablers,” allowing hospitals to pump profits and cut services. Many nurses were afraid to speak out, fearing they’d lose their jobs. In Texas, a nurse who sees a patient being mistreated in some way can file a “safe harbor” complaint with her employer. But a spokeswoman at the Texas Hospital Association admits that the “onerous, ninegives nurses and their supervisors two weeks to solve problems, after which the nurse’s job is no longer safe, according to several RN’s. “It’s a sure way to get written up and run off;’ says a nurse who didn’t want to be identified. A core group of nurses was willing to risk it all for a little control. In August 2006, the national committee hosted its first leadership conference, drawing 25 nurses to the Alamo in blistering, 104-degree heat. When it came time for the nurses to publicly demonstrate under the committee banner, only a handful marched. “It was very discouraging:’ says NNOC member Betty Bennett. Over the next few months, she and others continued talking to co-workers about patient ratios and gathering signatures to support the Coleman bill. “What’s remarkable is that Texas has a tremendous number of topquality nurses who are ready to lead the charge,” says Ed Bruno, a national committee organizer. Medlin, Magana, McElreath, Leonard, Bennett, and others began holding strategy meetings in their homes. By November 2006, they not only had a draft of HB 1707, but some sponsors: El Paso Republican Pat Haggerty and Houston’s Coleman. To mark the event, 100 nurses marched on the Capitol wielding union signs. Modeled on California’s law, the bill would establish minimum, safe nurse-to-patient ratios ranging from 1-4 in medical units to 1-1 in emergency rooms. It would also give nurses the legal obligation to advocate for patients, meaning they would have to stand up to executives and insurers if they believed it was in the patient’s best interest. The bill would also give nurses whistleblower protection. The bill’s biggest opponent is industry lobbyist THA. “We have a severe nursing shortage, and we feel this ratio law does not address that,” association spokeswoman Elizabeth Sjoberg says. Texas already has a slew of federal, state, and local laws that guard whistleblowing nurses from retaliation, she explains. “It’s unfortunate,” she says, “that nurses do not know they already have these protections.” To drive home that point, THA is working on two other bills that would “clarify those professional protections,” Sjoberg says. THA recently proposed increasing fines for hospitals that violate rules from $1,000 to $10,000 \(DeMoro’s national committee advocates the birth of the ratio bill, THA has unleashed a flurry of other plans, including simplifying the nurses’ complaint process and educating them about their rights. To hear THA explain it, the main problem is ignorant nurses. As Sjoberg says, “Nurses need more guidance and assistance in understanding the laws.” That attitude dismisses valid arguments for ratios. Even Schwarzenegger’s office has acknowledged that California’s law has produced some benefits. For one thing, it’s lured thousands of nurses back to work, easing that state’s shortage. But don’t count on that message getting through in Texas, as the nurses’ bill faces tremendous odds. “It’s a long shot,” admits Medlin. But Texas nurses know that DeMoro’s California nurses spent 10 years pushing their bill uphill. “If our bill doesn’t pass,” says veteran nurse Evelyn Posas from Dallas, “it will not diminish my faith and desire to keep going, no matter what.” 0 n that overcast day in March, the surprisingly large crowd of 250 nurses advanced up Congress, drawing stares and bemused smiles from passersby. The chants grew louder as they approached the Capitol, where they added a little rhythm: “The nurses, united, will never be defeated?’ DeMoro and her staff were already on the Capitol steps unfurling banners, plugging in microphones, and setting up a photogenic backdrop for the protesters. The hands-on leader was facing several other battles besides the one in Texas as national committee nurses were drafting similar ratio bills for Illinois, Ohio, Maine, and Missouri. When the Texas marchers reached the Capitol steps, TV cameras started rolling tape for the evening news. San Antonio nurse Magana took the microphone and, in a voice trembling from stage fright, said: “We know the reality and truth of what’s happening in our hospitals, regardless of what the corporations and other organizations are telling you.” While she asked lawmakers to pass the ratio bill, other nurses arranged themselves on the steps and held up sheets of white paper that rippled like gauze. Each sheet contained a dozen nurses’ signatures supporting HB 1707. The women had managed to collect some 3,000 nurse signatures, an amazing number that shocked even this congregation. “Dang!” shouted one Dallasbased nurse. DeMoro beamed, knowing the Texas battle is well under way. Kathleen Sharp is an award-winning journalist and filmmaker based in Santa Barbara, California, who covers the health care industry. 10 THE TEXAS OBSERVER MAY 18, 2007