Last month, Susan King, RN, co-owner of the Elm Place Ambulatory Surgical Center in Abilene, Texas, began her second term as a Republican in the Texas House of Representatives. One of her first orders of business was to joint-author a bill that would give nurses a greater voice in patient-care decisions made in Texas hospitals.

Being a nurse and being a politician have similarities, she says. Both require you to have thick skin because you're working in a hostile situation. "Anyone who enters as a patient is unhappy that they are there," she says. When you're a nurse, you can't please everyone, and not everyone is going to say "thank-you." The same goes for politics, especially in Texas, with its colorful but ruthless political culture. "People are always struggling for power," she says.

Rep. King is a reluctant joint-author of the proposed legislation that would empower Texas nurses. She supports nurses and is behind hospitals having nursing committees that give them a voice, but she would rather not have nurses' clout created by government mandate. "I hate that government is involved in any of that," she says.

Since 2007, Rep. King has represented Taylor and Nolan counties in central Texas. She's a gun owner, political dealmaker and ENT surgical nurse who used to work with Denton Cooley, MD, one of the pioneers of heart transplant operations. A blonde woman who is recognizable in the Capitol chambers for her bright red coat and high heels, Rep. King is one of about 10 state legislators from the healthcare field.

A mother of three grown children, Rep. King began in politics in 1998, when she started attending local school board meetings. She didn't like the way the board disregarded public opinion. One of her daughters, who was in high school at the time, suggested that she run for the school board. She was elected and eventually became board president.

When the Abilene district's longtime state representative announced he was retiring, Ms. King decided to run for the seat. She was elected in 2006 and re-elected in 2007. Becoming a state representative is no guarantee of riches. The job pays $700 a month, plus expenses for lodging in Austin, travel and food.

The Texas legislature is one of the few governing bodies in the nation to meet every other year. During the current 140-day session, Rep. King says her priorities are education, water use, developing wind power and stiffer sentencing for drive-by shooters.

Rep. King and her husband, otolaryngologist Austin King, MD, opened their one-OR surgery center in 1987. The center has three full-time employees and two part-timers. Although Rep. King is the center's director of nursing, she can do nearly every job in the center. Each week she spends one day in the OR with her husband, working five or six ENT cases.

Patients don't always realize that their scrub-clad nurse is also their state representative until they see her name tag and ask. Then it's democracy in action, she says. "Sometimes it takes me twice as long to admit patients because they want to talk about government."