Thursday, June 12, 2008

What is TPAPN?

I spoke with a nurse that agreed to TPAPN, yet she did not understand what the Texas Peer Assistance Program was all about. When she asked a clerk at the BON, she was given very vague information and she agree to what she thought was a short term monitoring of her practice consisting of providing drug screens and being supervised at work. TPAPN is much more. I have discussed this issue before in a previous blog.

TPAPN is an approved peer assistance program. As a peer assistance program, TPAPN assists the nurse to practice nursing while in recovery for chemical dependency or while returning to competent practice for nurses with mental health issues.
A nurse can self-report to TPAPN, be referred by an employer or be ordered to participate by the BON. If a nurse recognizes impairment within their life, it is better for the nurse to self-report rather than to receive a third party referral or to be ordered to participate by the BON. Sometimes employers report nurses to TPAPN when there are no impairment issues. Some nurses agree to participate in TPAPN even when there are no impairment issues in order to avoid investigation by the BON; however, this is a dangerous path because in order to participate in TPAPN, a nurse must admit to being impaired and once a nurse starts this process it is very difficult to later discount the admissions.

The TPAPN program lasts for 2 years (3 years for APNs). The program is very intensive. For substance abuse issues, some of the requirements are: the nurse must complete 90 meetings in 90 days and then continue to go to very frequent meetings; the nurse is subjected to random drug screens, which for more frequent initially and then taper off; the nurse is limited to certain hours and specialties when working; and the nurse cannot administer or handle narcotics. The restrictions common for nurses with mental health issues involve counseling requirements.

TPAPN is not an absolute solution to an investigation by the Board and a nurse should discuss the case with an attorney prior to agreeing to go to TPAPN. There have been cases where the BON sent a nurse with years of sobriety to TPAPN and there have been nurses that have agreed to go to TPAPN just because the BON sent them a TPAPN Order and not because the facts of their case warrant a peer assistance program. It is not the BON's responsibility to educate a nurse about their case or to suggest the best resolution, so be sure to get proper advice.

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