Please don't regard this post as complaining about tpapn. I am eternally grateful that TPAPN is an option. Yes it's got it's positives and negatives, but overall I'm thankful to keep my license. The following is an issue that initially a negative influence on my recovery.
Irregardless of your DOC, length of addiction, severity of addiction, self reported, caught red handed...whatever... here you are. The fact that you are participating in a nurse recovery program indicates that you have a desire to keep you license active.
Courtesy of my duel diagnosis, I am required to maintain ongoing sessions with a licensed therapist. I am also required be under the care of a psychiatrist. (I believe minimum every 3 months but I go monthly) In order to maintain compliance, I had to sign a waiver of confidentiality between all my providers and tpapn. In addition, both of these professionals must submit periodic reports on my behalf or I am deemed non-compliant.
I personally hand picked my MD and therapist. They were not assigned. These are the professionals that I chose to pay a fee to in exchange for their services. I pay them to provide me the benefit of there education, knowledge, and experience.
One of the questions on this required report is: Is this nurse safe to practice?
So here's the conflict. If I do so happen to relapse it would obviously be in my best interest (as far as my recovery) to tell my health care providers. Don't we all love the patients that lie to their doctors and the entire healthcare team?? But because I know this person is going to report weather or not they believe I am safe to practice, if I want to maintain employment, hell no I'm not going to tell them.
Ignore the issues related to mandatory reporting laws...harm to self/others. That's not what I'm referring to. I'm concerned about the issues that arise while in early and stable recovery that SHOULD absolutely be reported to your care providers. However, reporting these issues could cause them to believe you are not safe to practice.
What if I'm having cravings. What if I say I've been fantasizing about using. What if I tell them I started diverting again. If I want to keep my job, I'm keeping my mouth shut!! And in not seeking help I continue to put my recovery at risk even further. It's a catch 22. I understand why the program is designed like it is. And I have absolutely no idea how to make it better.
Furthermore, what is the liability to a doctor if you did report a relapse, they don't tell the board and continue to report that you are safe to practice....and something catastrophic happens because you were high at work?
When signing up to become a nurse, we waive certain rights and privileges by accepting the license. We accept that we are not always going to get our legally protected break times. People in other professions have a federally protected law that states they can take 12 weeks off of work to seek drug and alcohol treatment and there jobs are protected. Yeah FMLA. Nurses who seek treatment for addiction are not protected by this law, and are subject to discipline. Every 2 years we are expected to fully disclose our federally protected right to privacy as it relates to medical care. We understand the rules are different for nurses.
I just have a hard time embracing that when seeking medical treatment for a significantly life threatening disease. We nurses waive our fundamental right to doctor/patient confidentiality.
Last edit by JustBeachyNurse on Dec 6, '12
: Reason: correct formatting
Dec 6, '12
Lisa, my stipulations are identical to yours. I had them change the psychiatrist thing because I am not on medication and I see an actual therapist vs going to him for therapy. I told them that my psychiatrist was literally scheduling appts just because I had to fill out the form. So, I wasn't paying for treatment; I was paying to have the form filled out, which the form was to monitor my treatment for the BPD. It was pointless to go to him. I had it changed. Now, the plan is to go PRN (like if I ever needed medication or something, I schedule an appt).
But, anyway, they are there to report whether you are safe from a behavioral perspective. They can tell if you have relapsed (at TPAPN) by UDS.
Oh, and I also had to sign something disclosing my records and everything to HPMP.
Dec 6, '12
I completely understand what your saying Lisa. I too have had the same thoughts. I know there main goal is patient safety but it's simply not far we are not protected by the same law. We are ppl too. Good luck with your recovery. I wish you all the best.
Dec 6, '12
Lisa: i agree that we are caught up in some kind of catch-22 - r/t protecting patient/client rights & maintaining their safety; but our own rights & needs get lost in the shuffle. very much not fair or to our benefit, but one of those "it is what it is" deals- & i, too, don't know of any way around it that is feasible.
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