Supporting Texas’ Healthcare Workforce

THOT’s members are the largest employers of hospital-based nurses and serve as clinical training sites for nursing and other healthcare professional students.

Our work focuses on ensuring a strong nursing pipeline and a strong and resilient nursing workforce as well as supporting clinical residencies and training for other healthcare professionals, including respiratory therapists, pharmacists, lab technicians, surgical technologists, and medical assistants.

THOT’s members train students in all clinical professions, ensuring a strong workforce pipeline.

2023 Legislative Outcome
Senate Bill 25 – Passed

THOT-supported Senate Bill 25, by Sen. Lois Kolkhorst (R-Brenham), which incorporated provisions from earlier nurse workforce bills (SB 2059 and HB 3930) to augment clinical training capacity at hospitals and other care sites for nurses was signed by Governor Abbott and is effective immediately. It includes THOT’s proposal for nursing education clinical site grants, including for clinical site nurse preceptors, nursing innovation and coordination to increase the nurse workforce and improve retention, pilot programs for graduate readiness, and clinicians and faculty taking on part-time roles. Read more.

The Nursing Shortage

Texas’ nursing shortage precedes the COVID-19 pandemic, but the pandemic made the shortage even more acute. For more than a decade, analysts have forecast a growing gap between available licensed registered nurses and need. The ongoing pandemic and the unrelenting need for inpatient care widened that gap even further. In addition, the increased reliance on temporary and contract nurses drove up staffing costs, causing more nurses to leave full-time hospital employment for more lucrative temporary positions.

Amid the significant staffing challenges, Texas’ teaching hospitals are staying true to their patient care and educational missions.

In October 2021, THOT interviewed nursing leaders with three of our member institutions to better understand the operational shifts and investments taken to manage the nurse staffing shortage.

Among the findings:

  • The nursing shortage is likely to continue.

  • A cooling down of the rates for contract labor is essential.

  • Hospitals cannot assume that every temporary nurse has the necessary skills and competencies to deliver care at the level expected and required and must invest in real-time education and integration.

  • The effectiveness of financial incentives and soft incentives on nurse retention and employment varies by market.

  • A sustained focus on addressing burnout and bolstering resiliency is required.

Workforce Solutions

As part of its advocacy on behalf of Texas teaching hospitals, THOT engages with legislative and regulatory leaders on long-term health care workforce solutions.

Download the brief to learn more about how our members navigated nursing challenged during the pandemic.

Investments in clinical sites for training, retention, transition to practice, workplace safety and workforce innovation are needed to meet the demands of today’s nurse workforce.

See the work our members are doing to strengthen Texas’ nurse workforce.

Based on a review of the published literature and real-world experience, the executive nurse leaders of the member hospitals that comprise the Teaching Hospitals of Texas developed specific recommendations and identified possible funding vehicles to target and address challenges driving the state’s nurse workforce shortage.

THOT’s recommendations include:

  • Fund preceptor pay differentials at clinical sites to increase the number of preceptors needed to expand clinical site capacity.

  • Create and fund nursing innovation and coordination grants for clinical sites, including hospitals and health systems, and increase funding for workplace violence prevention.

  • Create and fund clinical nurse faculty grant programs

  • Create a Clinical Workforce Consortium advisory group within the Texas Center for Nursing Workforce Studies (or increase clinical nurse executive representation on the Center’s Steering Committee).

Read/download the full report here.


See School of Nursing Faculty Trends from DSHS Texas Center for Nursing Workforce Studies Here

Evaluation of THECB’s Nurse Shortage Reduction Program here.

Board of Nursing and Texas Organization for Nursing Leadership Summit Report: The Future of Nursing in Texas: Stakeholders Moving Toward Alignment here.

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