COVID-19 is the disease caused by the novel coronavirus (SARS-CoV-2), which spread in late 2019 and early 2020. Since then, the disease has been classified a pandemic and cases have appeared in all states of the United States. In Texas, many cities
and counties are now under a shelter-in-place order, including parts of Dallas, Austin, San Antonio,
Houston, and many others. We will update this page twice a week, as necessary and possible.
Watch our Facebook Live Q&A every Friday at noon.
Please note: There will be no Facebook live on May 8.
Nurses can contact us at email@example.com, through the Practice Hotline 1.800.862.2022, ext.132 or the TNA Member Helpline.
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From Texas Nurses Association
- Live Q&As with CEO Cindy Zolnierek, PhD, RN, CAE, Director of Practice Serena Bumpus, DNP, RN, and Director of Communications Kanaka Sathasivan, MPH
- April 16 | APRN Practice During COVID-19
- April 15 | Conversation with United States Senator John Cornyn
- April 9 | Nursing Peer Review (paid or free with Learning Curve Subscription)
with Nancy Mastronardi, MSN, RN, CPHQ, and Leah Koen May MSN, RN, NE-BC
- April 2 | Crisis Standards of Care with Jeanie L. Sauerland MA, BSN, RN, Catherine Robichaux PhD, RN, Alumna CCRN, Cindy Zolnierek, PhD, RN, CAE
News and Tips
Messages from TNA President and CEO
Crisis Response and Planning
Personal Protective Equipment
Guidance by Practice Area
Help for Nurses
- Weekly Texas Health Care Industry COVID-19 Strike Force: invitational meeting of 14 organizations including Texas Medical Association, Texas Hospital Association, the Texas Department of State Health Services, and the Office of
- Enhance statewide cross-sectorial COVID-19 healthcare response collaboration
- Identify critical vulnerabilities that need to be urgently addressed
- Identify State Regulations that need to be modified
- Leading weekly Nursing Legislative Agenda Coalition calls
- Receiving daily or weekly DSHS updates; THA updates; ANA innovation learning updates
- Communicating with the Board of Nursing on licensure waivers, nurses’ questions, peer review, resources, etc.
- Working with THA and TMA to advocate for nurses, particularly for workplace safety and PPE, and to develop a coordinated approach
- Conducting End of Life coalition discussions on standards of care
- May 8 | Health Care Advocates Ask Gov. Abbott to Extend COVID-19 Waivers
- May 1 | Broad Coalition Thanks Governor, Asks to Waive Additional Regulations for APRNs
- April 16 | Conference call with the Texas Association of Business regarding full practice authority and nursing education
- April 14 | Letter, from Texas Public Health Coalition, to Gov. Abbott
supporting a slow approach to reopening the state
- April 13 | Conversation with THA CEO and others about planning surge nurse staffing and use of volunteers
- April 12 | Update and roundtable with Nursing Legislative Agenda Coalition
- April 6 | Letter, signed by TNA, TONL, BON, to express appreciation to nurses
- March 31 | Letter, from THA and TNA, to Gov. Abbott encouraging a statewide stay-at-home order
- March 29 | Texas Health Care Industry COVID-19 Strike Force Recommendation letter delivered to Gov. Abbott to use of
mass critical care guidelines
- March 27 | Letter, signed by THA, TNA, THCA, TMA,
to Gov. Abbott to advocate for information about PPE distribution
- March 26 | Letter, signed by TNA and over 50 organizations, to
Gov. Abbott and other state leaders to ensure more Texans have adequate health insurance
- March 20 | Letter, from Texas Public Health Coalition, to the Gov. about protecting front-line health care workers
- March 20 | Memo, from Texas Public Health Coalition, to state legislators about preventing
the spread of COVID-19
- March 20 | TNA signed on to the Texas Women's Health Coalition letter asking HHS for a special enrollment period for people to get insurance.
TNA in the Press
- May 11 | State leaders respond as COVID-19 crisis takes a toll on jobs (Nexstar Media Group)
- May 9 | 1 in 5 coronavirus patients in Bexar County work in health care (San Antonio Express News)
- May 8 | Reopening? Ways Businesses Can Protect Employees’ Health (RA News)
- May 6 | They were once trash, now treasured. Fort Worth regional hub for mask decontamination (Fort Worth Star-Telegram)
- May 6 | Checklist: Gyms can reopen in Texas, but must follow these guidelines (KVUE
- May 6 | National Nurses Day: Austin Nurses Find Ways to Relieve Stress During COVID-19 Pandemic (KVUE ABC)
- May 6 | People in Austin say 'Thank You' during National Nurses Day (CBS Austin)
- May 1 | Houston nurses working through coronavirus pandemic (Houston
- April 29 | GUEST VIEW: Healthcare workers shouldn’t have to decide between their own health and that of patients. Period. (OA online)
- April 28 | Cornyn: Health care workers shouldn’t have to decide between their own health and that of patients. Period. (Houston Chronicle)
- April 27 | Medical professionals, politicians react to Gov. Abbott's plan to gradually reopen Texas businesses (KVUE Austin)
- April 27 | UTSW Nurses Question Mask Cleaning, Recycling When Hospital Is Not Overwhelmed (5
- April 23 | As Texas Businesses Reopen, Nurses Urge Leaders to Rely on Data (5 NBCDFW)
- April 23 | Emergency room facilities struggling to stay open during COVID-19 (KXAN Austin)
- April 20 | Demand For Oil Has Plummeted, But Industry Keeps Building New Infrastructure Anyway (Huffington
- April 16 | Combating COVID-19: Nurses inside the coronavirus ICU tell all (Click2houston.com)
- April 14 | Medical professionals, Austin Chamber of Commerce react to Gov. Abbott's gradual approach to reopen Texas economy (KVUE
- April 9 | 5 Things Texas: Gov. Abbott, Building capacity (State of Reform)
- April 8 | Austin nurse grateful for job as some in other cities don't fare as well (KVUE Austin)
- April 8 | Texas provider leadership tout new flexibility for COVID-19 fight (State of Reform)
- April 6 | Health care workers on the front lines of coronavirus don't get expanded paid leave protections (Texas Tribune)
- April 6 | Nurses facing threats, judgement for being out in public (KXAN
- April 3 | Texas Nurses Preparing for Coronavirus Surge (Spectrum Local News)
- April 2 | Expecting a rush of COVID-19 patients, Texas hospitals prepare their most important resource: health care workers (Texas Tribune)
- April 2 | Le Texas attend un <<tsunami>> (in French, La Presse)
- April 1 | Dallas 'Curve Rising' With 100 New COVID-19 Cases; Two More Deaths Wednesday (5
- March 31 | Are Texas Hospitals Ready For A Surge Of Coronavirus Cases? (Texas Public Radio)
- March 31 | 'The time has come' | Texas health care organizations urge Gov. Abbott to issue statewide stay-at-home order (KVUE Austin)
- March 31 | 'We stay here for you, please stay home for us' | Medical professionals start social media campaign (KVUE Austin)
- March 31 | Gov. Abbott closes Texas schools until May 4, issues list of essential services (Fox 4 Dallas)
- March 29 | State leaders respond as COVID-19 crisis takes a toll on jobs (KXAN Austin)
- March 27 | COVID-19 pandemic highlights shortage of nurses and respiratory therapists looming over Texas (Dallas
- March 26 | Here’s how graduating and retired nurses can help fight COVID-19 in Texas (KXAN Austin)
- March 26 | A nurse answers COVID-19 questions (KXAN Austin)
- March 23 | Abbott Waives Regulations to Get More Nurses Into Workforce (NBC5 DFW)
- March 23 | Gov. Abbott waives several regulations to allow more nurses to go to work (KEYE Austin)
- March 23 | Abbott Waives Regulations to Get More Nurses Into Workforce (NBC5 DFW)
- March 23 | Texas Nurses Association hosting job fair while battling the coronavirus pandemic head-on (NEWS4
- March 22 | Gov. Abbott issues orders to postpone non-essential surgeries, expand Texas hospital capacity amid warning about lack of beds (Texas Tribune)
- March 19 | Texas hospitals don’t have enough beds for coronavirus patients (KXAN
- March 19 | Coronavirus panel information in Spanish (Univision)
- March 18 | Hospitals packed as health care workers hope for more masks (WFAA
- March 18 | Risk getting sick or don’t see patients (KXAN Austin)
- March 17 | Texas hospitals don't have enough beds if too many people get sick at once with COVID-19 (CBS
- March 12 | Watch: Your Questions On Coronavirus Answered By Health Experts (KUT Austin)
- March 4 | Dallas is ready for coronavirus, health experts say (Dallas Morning News)
General Info for COVID-19
What can I do, as an individual?
- Read Community Help Tips from our board and staff
- Contact your elected officials to emphasize the need for PPE and more health care funding
- Find PPE stockpiles: call your local contacts and ask them to donate
- High school chemistry labs – goggles, gloves, aprons
- Oil fields and construction workers – N95 masks, gloves, goggles
- Nail salons - N95 masks, gloves
- Sew headbands with buttons for health care workers so they can continuously wear masks without ear strain
- Show your thanks to nurses:
- Write thank you cards and send them to your local hospital (great activity for kids).
- Donate to your local hospital or clinic (many facilities are having to raise funds for additional PPE).
- Order food for a shift at the hospital (call the hospital first to coordinate).
- Tie a white ribbon to trees in your neighborhood to show support for health care workers.
- Texas Disaster Volunteer Registry
- Can we refuse to care for a patient, if we are scared, feel undertrained, worried about our families? Can I call Safe Harbor if my organization is not supplying us with appropriate amount of PPE?
to our information about a nurse's ethical duty in times of crisis.
- How do we keep our children safe at home when we as healthcare professionals return from hospitals?
We know this is a scary and challenging time for healthcare professionals with children. We have provided tips on how to transition from work to home.
- I am pregnant. Is it safe for me to care for patients with COVID-19?
Pregnant healthcare personnel (HCP) should follow risk assessment and infection control guidelines for HCP exposed to patients with suspected
or confirmed COVID-19. Adherence to recommended infection prevention and control practices is an important part of protecting all HCP in healthcare settings. Information on COVID-19 in pregnancy is very limited; facilities
may want to consider limiting exposure of pregnant HCP to patients with confirmed or suspected COVID-19, especially during higher risk procedures (e.g., aerosol-generating procedures) if feasible based on staffing availability.
- I am in the high-risk category and believe it is too risky for me to care for patients with COVID-19. Can I refuse to work in the COVID unit?
If you believe caring for a patient diagnosed with COVID-19 is not
safe for your personal health, you will need to discuss this with your Primary Care Physician and ask that they provide you with documentation disclosing your high risk status. You will then need to discuss and disclose your
health risks with your employer so they can provide you with reasonable accommodations during this time. You will likely be asked to complete an ADA form along with this to support your request.
- Why am I being asked to cross train into other areas of the hospital? What if I am not comfortable working in other areas?
Hospitals are working hard to ensure staff are prepared to care for a potential surge
in COVID-19 related cases in the coming weeks. Since elective surgeries have been cancelled and hospital volumes are down, they are taking advantage of this time to prepare these staff members to work in other areas of the
hospital. Each facility is required to have a contingency staffing plan to address crisis situations. Contingency plans include exploring and implementing different models of care.
- Are organizations required to follow and adhere to my TPAPN restrictions during the COVID-19 pandemic?
Yes, except for overtime. Because there is a federal and state declaration of “disaster” or “emergency,”
overtime for nurses is mandatory, TPAPN cannot interfere with mandatory overtime during a national disaster. TPAPN requires that the participant’s employer submit in writing to the participant’s case manager that they are requiring
overtime due to the declaration.
Are sewn cloth masks okay to wear?
- What is considered appropriate PPE? Can surgical masks help protect inpatient units? How long can we use the same mask? What is the appropriate way to store these masks?
Surgical masks with eye protection
or face shields are sufficient for entering rooms and for some nursing tasks. Droplet precautions can be used in most cases. For tasks performed in close proximity to the patient or when aerosols are generated, nurses should
wear N95 (or higher) respirators or positive air pressure respirators and use airborne precautions. Get the latest guidance from the CDC.
- How safe is it to reuse masks? How are masks disinfected?
There are various approaches to mask disinfection happening across the country. Some are using UV light, some vaporized hydrogen peroxide, and others
are using ozone therapy. The most widely used approach is UV light. Read CDC guidelines and studies with different decontamination procedures.
Sewn cloth masks are acceptable for the general public to wear. Cloth masks are meant to protect other people in case you are infected. They are also recommended for healthcare
providers to wear over their surgical masks or respirators to preserve the life of the mask. Healthcare providers should only wear cloth masks when all PPE has been exhausted and is the only thing available to wear. Read more from the CDC.
Doesn’t our employer have a duty to provide us with appropriate PPE to protect us?
Healthcare organizations across the country are struggling to obtain the appropriate amount of PPE. As a country, we have implemented
Crisis Standards of Care to preserve the amount of PPE available. Unfortunately, if we used our current supply of PPE for single patient use, we would run out and have nothing available to care for our patients. This is not
an ideal situation. Our healthcare organizations want nothing more than to provide their associates with the appropriate amount of PPE. TNA, along with other professional organizations and healthcare organizations, continues
to advocate at the state and federal level for the procurement and availability of additional PPE supplies.
Unemployed, Inactive, Retired
- I am a retired nurse. How can I reactivate my license?
Please visit our step by step guide here.
- I have been out of the healthcare setting for several years. How can I temporarily enter the workforce to help with COVID-19?
If your license is no longer active you will need to reactivate your license using this process. If you have an active and unencumbered license, you have several options.
- Register to volunteer through the state of Texas.
- Reach out to local health care organizations in your area.
- Reach out to local temporary nurse staffing agencies in your area.
- My license has restrictions due to prior disciplinary action. Is there a way to have those restrictions lifted so I can help during the pandemic?
The Board of Nursing has received several inquiries from nurses
with licensure restrictions. Please contact the Texas Board of Nursing regarding your specific case. They are reviewing these on a case by case basis.
- What can nurses do if they were laid off or furloughed from their employer?
- Use the TNA Career Center to find other positions.
- Register to volunteer through the state of Texas.
- Reach out to local health care organizations in your area for employment opportunities.
- Reach out to local temporary nurse staffing agencies in your area for temporary assignments.
- What does governor Abbot’s waiver mean for nursing students?
Gov. Abbott has waived several regulations to help meet Texas’ growing need for nurses as the state responds to the COVID-19 virus. The Governor’s
actions will expand Texas’ active nursing workforce by:
- Allowing temporary permit extensions to practice for graduate nurses and graduate vocational nurses who have yet to take the licensing exam.
- Allowing students in their final year of nursing school to meet their clinical objectives by exceeding the 50% limit on simulated experiences.
- Has there been any progress with graduate nurses progressing to finish clinicals?
We are encouraging schools of nursing and health care organizations to partner together and come up with the best solutions
to accommodate student nurses. Some organizations have opted not to allow students in their facilities leaving SONs to provide simulation for clinical experiences. Read about clinical rotations during a pandemic.
- Is TNA working to help facilitate telehealth for graduate nurse clinicals?
Not at this time.
- Any guidelines or changes for student nurses being asked to start residencies early, before graduation?
Prior to graduation, student nurses still would not be able to perform licensed functions. Some organizations
are employing nursing students in nurse extern or nurse tech positions. This allows students to work in a limited capacity while attending RN residency didactic classes. Students are not allowed to practice as a GN or GVN until
they have graduated from their accredited program and received their authorization to test from the BON.
- Where does it originate and how was it transmitted to humans? Did it come from a bat?
COVID-19 is caused by SARS-CoV-2, which is part of the coronavirus family. Other coronaviruses include SARS, MERS and some
that cause the common cold. The virus that causes COVID-19 is highly related to a virus isolated from bats. Read more from the CDC.
- How is it spread? Is it airborne or droplet?
SARS-CoV-2 spreads primarily through droplets that are expelled through coughs and sneezes. Droplet precautions can be used in most cases. The virus can also be spread
in aerosolized form through breathing and during medical procedures such as manual ventilation, intubation, bronchoscopy, nebulizer therapy, and non-invasive positive pressure ventilation (BIPAP, CPAP). In those situations,
use airborne precautions.
Read more on infection control from the CDC.
- How long are people contagious?
There is an estimated time period of 2-14 days during which pre-symptomatic patients can spread the virus. The illness itself lasts from 7-25 days. After the illness has subsided,
patients may be contagious for up to 3 days after fever subsides. Read more on discharging patients from the CDC. Read criteria for health care professionals returning to work after COVID-19.
- Are cats and dogs at risk of contracting the virus?
A very small number of infections in cats have been noted. Even if pets do not get sick or show symptoms, they can still pass the virus on through physical
contact. Avoid letting your pet interact with anyone outside your household. If anyone inside the household becomes sick, keep them isolated and away from the pets.
- What are the symptoms?
Dry cough, fever and fatigue (extreme tiredness) are common symptoms, along with shortness of breath. Less common symptoms include runny nose and sore throat. Other possible but uncommon
symptoms include headaches, body aches, loss of smell or taste, and diarrhea. Read more from the WHO.
- Why does COVID 19 attack the lungs so severely?
The SARS-CoV-2 virus binds to receptors in the lungs, and eventually leads to pneumonia, inability to breathe, and respiratory failure (acute respiratory distress
syndrome). Many patients are also developing heart problems and dying of cardiac arrest. Cytokine storms caused by the immune system can also be fatal in some cases.
- Do people with COVID-19 gain immunity to the virus or can they be reinfected?
It is still unknown whether those who have recovered from COVID-19 can be reinfected or if the virus can reactivate in the body.
(Last updated April 13, 2020.)
- Should the public wear facemasks?
Yes. CDC has changed their guidance on this. People who
are unaccustomed to wearing masks tend to touch their face more, meaning that wearing masks could increase spread of the virus. However, when wearing masks, pre-symptomatic or asymptomatic people infected with SARS-CoV-2 will
spread less virus when out in public. People should still practice social distancing even while wearing masks.
- Does heat kill the virus? Will the pandemic slow in the summertime like influenza?
While heat can kill the virus (such as when cooking or microwaving food), there is not yet enough data to know if the
virus will be slowed by summer heat. Countries in the southern hemisphere were also reporting cases during their summer, so we cannot count on the weather to limit the spread of the virus.
- How close are we to making a vaccine?
Due to the well-known structure of SARS-CoV-2, the preliminary creation of a vaccine happened fairly quickly. There are several vaccine candidates entering human trials
in April. Any potential vaccines would also need to go through a regulatory review and approval before they can establish a manufacturing process and quality control. It will likely be 9-15 months before a vaccine is widely
available. (Last updated April 13, 2020.)
- Why were experts telling people to get flu vaccines when that vaccine cannot prevent COVID-19?
COVID-19 can often present with someone of the same symptoms as the flu (coughs, body aches, fever, etc.). The flu
also hospitalizes and kills upwards of 1 million Americans each year. By encouraging more people to get the flu shot, public health experts hope to reduce the number of cases with similar symptoms and reduce the burden on the
health care system. A bad flu season in 2019-2020 has already led to PPE shortages nationwide.
- Is all this fuss worth it? Do we need to close schools and businesses?
Yes. One of the largest concerns nationwide is reducing the burden on the health care system, which is experiencing shortages of PPE, nurses,
ventilators and dialysis machines. By asking Texans to stay at home, wear masks when they have to go outside and to practice social distancing, public health experts hope to slow the spread of the virus and prevent a situation
where people are unable to get care. Read how COVID-19 compares to other outbreaks.