The Texas Nurses Association, a professional association of registered nurses and a constituent of the American Nurses Association, was originally founded as the Graduate Nurses' Association of Texas when nineteen Texas nurses met in Fort Worth on February 22, 1907. Bylaws were adopted in Houston on June 3, 1907. A year later the organization, renamed Texas Graduate Nurses Association, petitioned for admission to American Associated Alumnae, a twelve-year-old national organization and the forerunner of the American Nurses Association. Early leaders of the TGNA were A. Louise Dietrich, Ellen Louise Brient, and Jennie Cottle, the first president. One of the first objectives of the Texas Graduate Nurses Association was legislation for the registration of nurses in Texas. The organization influenced the state legislature to pass a nurse-licensing law in March 1909. Since the law had no provision for inspecting or accrediting nursing schools, the association initiated a study of how standards in Texas nursing schools could be improved. Not until 1923 did an amendment provide for an educational secretary to visit nursing schools at least once a year and write yearly evaluations of the schools. Through the years, leaders, members, and lobbyists of the Texas Nurses Association have attended legislative sessions to influence legislation on nurse licensing and education and on issues regarding health care. Accountability within the profession and the professional growth of individual nurses have remained constant concerns of the association. Educational conferences address problems of patient care, administrative and managerial roles and techniques, communicable diseases, employment rights and responsibilities, education, and standards of practice.
Public-health, hospital, and private-duty nurses were the force of the association from the 1920s through the middle 1950s. Throughout this period the association was also the center for planning and decisions when nurses were needed during wars, natural catastrophes, and epidemics. After World War II nurses with experience from military nursing were reluctant to return to the tight constraints of the hospital, and hospital nursing-school enrollments also declined. The result was a shortage of nurses. Problems in nursing, including the shortage, were attributed to conditions in nursing education. Studies, both national and Texan, proliferated. In the late 1940s more baccalaureate nursing programs were established in the state, in addition to the two already developed by Incarnate Word College and the University of Texas. Not until 1959 did junior-college education in nursing begin in Texas, although junior colleges had been growing across the state since the late 1940s. In the late 1940s the employment conditions of nurses became a major concern of the organization. In 1947 the TNA adopted a code of personnel practices that set down minimum recommendations for employment conditions for hospital nurses. TNA's Economic and General Welfare Program, as it was called, grew through the ensuing years. In 1968 TNA won exclusive entitlement to represent registered nurses in collective bargaining at the Veterans Administration Hospital, Temple (now Olin E. Teague Veterans Center). Subsequently, TNA represented nurses at the Waco and Dallas Veterans Administration hospitals (now Veterans Affairs Medical Center, Dallas, and Veterans Administration Medical Center, Waco. When the Taft-Hartley Act was amended in 1974 to extend collective bargaining rights to employees of private, nonprofit health-care facilities, TNA offered its representative services to nurses in those settings. Over the following five years, a dispute over the appropriateness of TNA's acting as a union divided the membership of the organization. The debate culminated in 1979, when members directed the association to cease representing nurses under collective bargaining contracts.
In the 1970s and 1980s three major social and economic movements affected the direction of the association: the women's movement, the growth of health care as a major United States industry, and recognition of higher education as a measure of professional value. Responding to the impetus, TNA followed the national trend and focused on setting educational requirements for beginning nurses. Six resolutions defining entry level into nursing practice for two-year and four-year nurse graduates were adopted by TNA in March 1984. The plan, which may take up to twenty years to implement, will require future legislation to revise requirements for credentials and increase resources for higher education. In 1975, to influence state and federal legislation that affects nurses and health care, TNA established a political action committee, Texans in Nursing Coalition for Action in Politics. When career alternatives for women increased in the 1970s and the shortage of nurses was intensified, the pressures of supply and demand changed employment practices for nurses. In Texas much of the change was based on information compiled by a TNA-sponsored blue-ribbon committee. The committee produced a study showing that nurses left their jobs because of poor administrative support and tension due to lack of autonomy, inflexible work schedules, indifferent and inadequate personnel, and noncompetitive salaries and benefits. In 1993 TNA had 5,600 members in thirty-two active local districts. State headquarters were in Austin.