Frequently, I get inquires from nurses that have been referred to TPAPN (Texas Peer Assistance Program for Nurses) and the nurse was wondering if they should go to TPAPN. If a nurse has substance abuse/addiction issue or mental health issues, TPAPN can be a beneficial rung on the ladder to recovery or health and the nurse should definitely consider entering the program. TPAPN offers not only recovery support, but also the ability to avoid a disciplinary action by the Board.
But, if a nurse is thinking of going to TPAPN solely to avoid being reported to the Board, the nurse should know this is risky and frequently backfires. Several steps in the TPAPN process require a nurse to admit to being an addict or alcoholic and to continue to do this when a nurse is not; it begins to wear on the nurse (especially with the emphasis on truth and accountability in the recovery process). Also, once a nurse admits to a problem it is very difficult to back track and declare there is now no problem. I have heard from nurses that have come close to completion of the TPAPN contract and then decided they can’t “live the lie” anymore and they announce they are not an addict and don’t belong in TPAPN. If this nurse was a third-party referral, TPAPN must report the nurse to the Board, which puts the nurse right back where they started.
Monday, September 24, 2007
Can TPAPN Help?
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26 comments:
Do you have any advice for me? I have been an RN for 17 years now. I was referred to TPAPN because someone reported that I smoked marijuana. When asked, I admitted that I used it recreationally although never before or during work, etc., do not drink at all and so on.
The Board referred me to TPAPN or face an investigation by the Board. I chose to comply with TPAPN. I attended AA meetings as mandated faithfully. I passed every random urine test for 16 months. Then in November, 2008, unbeknownst to me one day my test came up "dirty" (21 ng/ml). I was called up less than 48 hours to repeat the test although I didn't know at that TIME the reason was that the first one has shown up as positive. The second one was completely clean.
Two months later (January, 2009), I got a call out of the blue saying that I was being suspended from TPAPN. The representative told me that my case was being referred back to the Board for determination. I was shocked beyond belief, and I protested adamently (in fact I BEGGED) that I would do ANYTHING that TPAPN wanted me to do because my sobriety date is July 7, 2007, and remains so to this very day. She told me that because I was ordered to choose instead of self-reporting intially that the ordinary rules did not apply to me as outlined in the TPAPN manual of being given a second chance.
I called the lab, and talked to the technician who had been taking my blood each time I went. She said absolutely there can be mistakes in the testing procedure occasionally.
The Board refuses to return my calls, my letters, etc. My colleagues and former supervisors wrote letters of recommendation for me which I sent to the Board, finally, but still no response.
My employer laid me off immediately after the TPAPN representative called them pending the determination by the Board as to what disciplinary action they decide. They admitted to me that they would rehire me back immediately as they are short-handed, I am a good RN, and I have worked there for years without any sort of problem; however the "corporation" refuses to let them.
That was two months ago NOW. I finally got unemployment because my employer did not protest it, but I really feel completely robbed at this point. I am now a pariah.
I go for an interview tomorrow, will of course take a drug test that will come up clean, but I'm concerned when they find out that my license is being reviewed, they will not hire me anyway.
Thanks,
Mick
You need to get an attorney to help you before the Board (either me or one of the other attorneys that FREQUENTLY represent nurses before the Board). You should not have been sent to TPAPN unless you had been diagnosed as having addiction. TPAPN is only for nurses with chemical Dependency or mental health issues, not recreational use of drugs. In other words, I have seen your situation before.
At the risk of sounding whiny, how much does this cost???? I have NO money. Seriously. I think I may have to get a job doing something else if possible to raise money to hire a lawyer to save my license.m
Each attorney charges various rates (hourly, flat or both) based on such things as experience, location, area of law, whether the attorney is Board Certified, etc. Most attorneys will give a free initial consultation which will also include their fees for accepting your case.
For Texas Board of Nursing cases, I have seen the following range of fees:
Hourly $150-$500 an hour
Flat $3000-$5000
Be sure to read my posts in May 2007 among others regarding how to chose the best attorney for your case.
I have been an RN for 30 yrs. Just got reported to TPAPN by a little 2yr exp. RN who has no clue what Nursing is all about. I am floored, broke and dismayed. TPAPN is a joke. First of all, at the worst time of your life, you are required to pay for random drug tests you cannot afford. My "on site" drug test was negative, yet MY LICENSE was reported to TPAPN by an inexperienced "small-town" nurse who had "climbed the corporate ladder." I have given up on Nursing,.... and what a shame. I am an excellent nurse and was set up by a jealous "smalltown" LVN who was my ADON. I have lost my car, house, credibility, and faith in humanity. Good luck guys!
If a nurse is reported to TPAPN without cause, there are steps that can be taken so do not give up hope. Peer Assistance programs are for impaired nurses and if you do not fit that definition then you should not go to TPAPN, nor should you be able to get into the program. Please contact an attorney to help you sort this out.
I have a question if you are an RN and work in a rehab unit and have to care 9-10 highy acuity patients and have medication incidences, no errors that would harm a pt. and repeatly told the nurse manager and don there is problem on the floor acuity is to high, pt to nurse ratios are to large to adeqautly care for pts safely. i have minimum med/sug experience. i am a OB nurse but live in mostly retired area. ti filled out a nnonymous online survey blasting them for being abusive and uncaring. they fired me. stating to unemployment that i have had multiple acts of negligence. the nurse manager told me they were inceidences. this is slander i never was insubordinate, never abandoned my pts, and never left a shift. what do i do against this large hospital rehhab system?
One way of potentially protecting yourself against Board action is by filing safe harbor when you believe that you are being asked to perform duties that you believe violate your duty to your patient.
I think nurses also need to step back and evaluate when they may be in a bad system or situation. Too often nurses will stay somewhere that is not supportive or healthy and then they have Board issues afterwards and the reasoning can be attributed to the bad working conditions. Do not continue to work for a bad system hoping that it will change, because in the majority of cases it will not.
Whenever a nurse believes that he/she has been wrongfully terminated, they should immediately contact an employment attorney to determine if there is any action that can be taken.
In my long searches regarding this topic, I have come across your website and would like to inquire about my situation. I am a nurse practitioner working in another state. I was convicted of DUI 1st offense on 2 separate occasions in 2007. The circumstances surrounding these episodes are that I had just gone through extensive treatment for breast cancer followed by a difficult divorce. I am not making excuses but was in a difficult place emotionally and made some really stupid decisions. I have since gone through intensive outpatient substance abuse treatment, served a 21 day jail sentence and have completely turned my life back around. I have gotten re-married and had a baby 1 year ago. I have had no disciplinary action taken on my current license as a result of these charges. My husband and I would like to relocate to Texas and I have received a fabulous offer working in Texas. I sent in my application to the Texas BON for licensure, along with all legal documents and several letters of recommendation and support. The enforcement office just called me yesterday to inform me they would approve a provisional license with the stipulation that I enter the peer assistance program. I am willing to jump through whatever hoops they ask to be able to accept this job….however with the work restrictions, I do not know if the potential employer will be able to bring me on board. Abstaining from drugs and alcohol are not a concern or issue whatsoever. Going to daily AA meetings seems excessive in that I have already satisfactorily completed treatment here over 1 year ago. Not being allowed to take call and write prescriptions seems very ridiculous to me….as I have been doing all of this without restriction here for the past 2 years with NO issue or concern whatsoever. Neither incident occurred while I was working, there has never been ANY concern regarding my ability to provide safe and effective nursing care to my patients, I have NO issue with narcotics, and have tried to put the alcohol issue behind me.
So my questions are:
Are you aware of anyone with 2 charges being allowed to do the EEP in place of the complete TPAPN program?
If I need to do the complete TPAPN program, is there any flexibility on the work restrictions?
Is this something I should try to fight?
I appreciate any assistance or advice you can provide.
You have several issues in your case that make a simple answer difficult. Typically, TPAPN limits work as a NP the first year in their program and the program is for three years instead of two.
The Board will not allow a nurse to do the EEP unless the nurse is assessed and no chemical dependency issues are found. You also have the added problem of the criminal issue.
TPAPN is not very flexible but you can always ask. Only you know if you want to fight the recommendations or not, it is a personal decision and not every solution works for every nurse. I always tell my clients to look to their heart and decide what can they live with and that will make the decision for them.
I have been an RN in the ICU and then dabbled as a case manager, all in 2 different states for over 11yrs. While in the other state I have had medical/pain care for a back injury I had before I became an RN. In my last state I was put on Methadone(60mg a day) and Oxycontin(40mg a day) for flare ups. I also got Xanax(100mg a month) mostly for flying and night, I was living in NYC on 9/11 and it affected me, especially flying. We just moved to Texas for my spouses job, while I was in my 120 day temp license for reciprocity, I went to 4 dift md's to get on the same regiman. During which I got a couple months of 2 RX's that I filled. Then 1 time only I realized I would be out of Xanax, and I forged an RX. That was in October. My 120 day license has lapsed waiting on 1 verification till they issue perm't. I was called to the police, in a couple weeks I am being charged with 1 count of RX fraud and sent to "divert" court. I will have to stay off the Xanax while in this process, my lawyer and the police don't know about the Oxycontin and Methadone given by a pain MD. The police said they are not involving the BON. I may do an o/p program for the xanax. Do I self report? Go toTPAPN which is extreme, I messed up. What options do I have? I don't think TPAPN will look good when my license does come through and I go job searching.
This is a very detailed and complicated case which is beyond a quick general answer. You need legal advice. You need to contact an attorney that represents Texas nurses before the Texas Board. All of the attorneys in my firm represent nurses before the Texas Board (www.nursingattorney.com)and there are other nurse attorneys available to speak to as well (you can do a search for Texas Board of Nursing attorney). Just be sure that whichever attorney you hire is experienced before the Board of Nursing.
Whatever happened to "INNOCENT" until "PROVEN GUILTY?" I have a question and will be needing an Attorney soon because I do NOT entend to go along with the TPAPN B/S I have worked to hard to get my RN License, my mistake was trusting a friend and DON with a question that is still bothering me. MY QUESTION?? Do I have to say that I have an addiction or have been treated for an addiction if I asked to be put on suboxone after surgery??? I was diagnosised with cancer in 2006 radical hysterectomy, radiation and chemotherapy, Graduated in 2008 LVN to RN, & have had 5 FIVE abdominal surgeries to relieve bowel obstructions and remove part of my intestines scarred by radiation. I have been on many drugs during these last 4 years, but never abused drugs, never stole drugs or wrote or fordge prescriptions, my only problem was that I asked for suboxone. I asked my friend if I should self report to the BON or if that even counts, since I did it to prevent dependency. She reported me to BON & MY employer I was suspended and terminated. She was aware of all of the surgeries and pain, and I have held an office position, I don't see how it can be fair that I should have to pay ALOT OF MONEY to prove I am "INNOCENT!"" But I refused TPAPN and I need to get an attorney!!! Shouldn't there be something that can be done to someone that ruins your reputation when they know you are not an addict and report you anyway!!ANNY
I cannot give legal advice on this blog since it is for educational purposes only. If you have case specific questions, please contact an attorney who practices before the Texas Board of Nursing. Thanks.
I relocated from Utah to Texas several months ago. I have two DUI convictions, 11 and 8 years ago. The Texas board of nursing sent my endorsement application to the enforcement division, and now I am just waiting. I do not have a substance abuse problem, and these misdemeanor infractions are becoming quite remote. My Utah RN license is spotless, and there has never been a problem. I am a great and safe practicing nurse, these were truly youthful immature indiscretions. What may happen as far as obtaining my Texas RN license? If they refer me to TPAPN, will that restrict my license? Please some opinion or input would be appreciated because nursing is my life. I'm quite frustrated because these occurrences are so long ago.
If you need specific advice, please contact an experienced administrative attorney who practices before the Texas BON. I cannot give advice on this blog and most situations are specific enough to require evaluation by a lawyer.
I am a nursing student who had to report to the Texas BON that I was diagnosed with Bipolar Disorder in 2007. They told me I have to participate in the TPAPN program after I receive my licensure. I read through the TPAPN handbook, did research online and talked to the my school…all which left me very concerned. Is the TPAPN program the same for people with substance abuse as it is for mental illness? Also, I'm concerned that I will have difficulty finding a job. Is this something I should worry about? I'm wondering if I should even continue trying to be an RN.
I am a nursing student who had to report to the Texas BON that I was diagnosed with Bipolar Disorder in 2007. They told me I have to participate in the TPAPN program after I receive my licensure. I read through the TPAPN handbook, did research online and talked to the my school…all which left me very concerned. Is the TPAPN program the same for people with substance abuse as it is for mental illness? Also, I'm concerned that I will have difficulty finding a job. Is this something I should worry about? I'm wondering if I should even continue trying to be an RN.
TPAPN is for mental illness as well as substance abuse. The Board will require monitoring either by TPAPN or the Board for certain psychiatric diagnoses (listed on the applications/renewals).
In today's job market having stipulations on your license or being in TPAPN can cause employment issues since the available jobs have decreased.
I have received an invitation to join tpapn because I self reported bipolar on my renewal in 2011. I feel this is ridiculous since i've been under the care of the same doctor for years with no issues. My question is what is the difference between EEP and TPAPN and do I qualify? I have no other problems, no substance abuse diagnosis. I am totally confused about why this has happened. I am a prudent, fit nurse. Honestly, I feel like I have no choice but to accept it and participate, but feel this is a witch-hunt.
EEP is the extended evaluation program and according to the January 2011 Texas Board of Nursing newsletter: "The EEP is a voluntary monitoring program designed to help nurses avoid possible disciplinary action by the Texas Board of Nursing (BON) against their nursing licenses by
demonstrating that they do not have a drug or alcohol problem.
Participants are required to demonstrate one year of
abstinence confirmed by random drug testing. EEP is recognized and approved by the BON and is administered by the Texas Nurses Foundation’s Texas Peer Assistance
Program for Nurses (TPAPN)."
EEP is not mental health issues. Currently the only program which provides for some confidentiality for mental health issues is TPAPN. Whether the Board is within the Nurse Practice Act and the Board's rules and regulations will depend on how long you have been stable with your diagnosis. You should discuss your case with an attorney experienced before the Board of Nursing. Most administrative lawyers who represent nurses before the Board offer free initial consultations.
From reading your blog I've noticed that you fray from legal advice so my question is about what you have seen happen in general in the past with a dwi 2nd offence. The first offense was 26 years ago and the 2nd was on 9/1/13. Just asking in general worst case scenario vs best case. BTW I've had a clean record with the same employer for almost 21 years. Thanks
In response to the question about two DWIs with many years in-between: the reason I only give general answers is every case can be different. The scenario you describe will depend on many factors which will be taken into consideration. For example there is a difference if the nurse obtained treatment the first time and then maintained sobriety compared to a nurse who was not treated but just stopped drinking--here the nurse may have had actual sobriety and then relapsed, but the other option of the nurse being what is referred to as a "dry drunk" meaning the addiction disease was never addressed, it just went dormant. Other factors are AA meeting attendance, work performance, counseling and others. The 2013 may be considered a second DWI or it could also be considered a first time since so much time has passed.
There have also been some significant changes with TPAPN which make it a better option than before; the biggest is that TPAPN Orders are now confidential. There is also more changes coming soon.
I think im going to get reported to bne. Diverted about 80 vials of dilaudid over a 4 month period. What is the next step, wait until the bne contacts me?
If you have a problem with substance abuse and diverting drugs would qualify, you should consider contacting TPAPN and entering the program since that is the likely outcome of a Board investigation into diversion and substance abuse.
I am a APRN that has been reported by 3rd party for obtaining too many prescriptions for a drug to help me sleep. I got caught up in life with work and sleep. Rotating shifts and got off track. I have never been in any trouble before. I never took this med during work or before or called in my own scripts. However I feel like TPAPN is my only option. I have not signed yet but this is all so scary due to losing my prescriptive authority and probably my job due to that. I realize I am fine without the drug. I don't need it. I have no fear of relapsing bc this has all scared the fire out of me. One long mistake and I have lost what I worked so hard for in life. It seems extreme to be in for 5 years and lose my prescriptive authority.
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