Anyone allowed to stay on pain management on TPAPN?

NurseJackie69 · Apr 15

Overwhelmingly likely you WILL be allowed Neurontin and almost a given. Overwhelming likely and almost a given that you will NOT be allowed Hydrocodone.

As for work, overwhelmingly likely you will NOT be allowed home health for the first year. Almost unheard of as a matter of fact. They want an RN in the same building with you and preferably on the same unit.

Do NOT surrender your license. You will not be a nurse again if you do. If you decide you don't want to do the program, then do NOTHING. Sounds crazy, right? It's not. By doing nothing and telling them you are NOT doing the program, there is at least a chance they Suspend your license and do not Revoke your license. There is still a decent chance at them Revoking it which is the same as you Surrendering which means pretty much the odds of you being a nurse again are extremely low. But, a Suspended license leaves the door open for you in the future if you decide you want to come back and do monitoring and re enter nursing. So, if you are dead set on not doing monitoring, the worst that can happen from a license standpoint is Revocation or Surrender. The best is Suspension. Therefore, don't surrender. Make them take it and you will find that about 50 percent of the time, they Suspend instead of Revoking.

The BON is sneaky and they lie by withholding info. For example, they told you they are more open to people being on prescription medication. That's true, but also a lie. It's true that drugs like Lyrica and Neurontin are allowed eith prescription, but not all prescriptions are the same. The lie comes in by what they did NOT tell you and that is.....no opioid prescriptions.

I think the chances of you being allowed to stay in home health for the first year is also "true" regarding Possible. If I have a 1 in 100 chance of surviving a 38 foot fall, then it's "possible" I live. It's also likely that I die 99 out of 100 times. So, again, they told you the truth, but they also lied by how they withhold ALL of the truth. It's overwhelmingly likely you aren't getting anywhere near home health for the first year.

Healer555 · Apr 15

Is Gabapentin a controlled substance in your state? They may allow opiates initially and expect you to stop over time. It all depends. We can take anything approved but it buys us a longer monitoring agreement and more frequent testing.

NurseJackie69 · Apr 16

Gabapentin is not federally controlled, but some states do control it. In Texas, it's a controlled schedule 5. That does NOT matter regarding whether you can take it. Texas DOES allow Gabapentin and Lyrica which is (also a controlled schedule V in TX). I have 4 contacts in Texas. Like I wrote, you can forget about Hydrocodone. You aren't going to be allowed to take it regarding your 5 year monitoring window. For opiates like Hydrocodone, Texas will mandate pain management and your official 5 year monitoring time (the time your monitoring ends) will NOT start until you are off of Hydrocodone. So, if you tske1 year yo get off of Hydrocodone, you will have 5 years left to go in monitoring.

As for Neurontin, you WILL be allowed to take it, but there's a catch. They will mandate pain management and require the pain specialist to send a monthly report directly to the BON, and you will undergo increased drug testing while on Neurontin, but you can be on Neurontin for the 5 years of monitoring and finish the program.

As for Hydrocodone, I'm just bring honest and giving you a fair warning. It's not going to happen. You will be required to stop taking it, OR....you time in monitoring (the 5 year clock) will not start until you get off of it.

April Thompson · Apr 16

this is really helpful. I wish you could get answers like this from TPAPN. I'm scared to tell my pain management Dr because I know substance use disorder will be in my medical chart forever.
I've been a nurse 21 years. I have grown to hate it over the last 2 years. So it's really hard to imagine going through all of this for a job that I want to leave so badly. But I just go back and forth every 10 minutes.
I always wanted to be a teacher. And I was thinking , I could go back for my bachelors and find a rewarding career teaching social studies or something and never look back ... HOWEVER... now that I am looking into that it seems like a background check would show disciplinary action from the BON and if that's true I wouldn't want to spend 1.5 years finishing a bachelors just to be denied a teaching certification.
or not be able to find a teaching job because they can see it.
I haven't stopped crying for days . I've never been more terrified and panicked. It feels like I'm drowning

NurseJackie69 · Apr 16

April Thompson said:

this is really helpful. I wish you could get answers like this from TPAPN. I'm scared to tell my pain management Dr because I know substance use disorder will be in my medical chart forever.
I've been a nurse 21 years. I have grown to hate it over the last 2 years. So it's really hard to imagine going through all of this for a job that I want to leave so badly. But I just go back and forth every 10 minutes.
I always wanted to be a teacher. And I was thinking , I could go back for my bachelors and find a rewarding career teaching social studies or something and never look back ... HOWEVER... now that I am looking into that it seems like a background check would show disciplinary action from the BON and if that's true I wouldn't want to spend 1.5 years finishing a bachelors just to be denied a teaching certification.
or not be able to find a teaching job because they can see it.
I haven't stopped crying for days . I've never been more terrified and panicked. It feels like I'm drowning

Yep, as it relates to teaching and getting certification, the state will not give you a license without you being in some kind of monitoring program IF....IF....your nursing license was suspended, Surrendered, or revoked. So, for people who change professions, don't wait until your education in the new profession is completed to start some kind of monitoring program for PA,s Dr's, Teachers, Lawyers, etc. For example, if going to be a teacher and you have 2 years left to finish an education degree, start some kind of monitoring/check in/ testing program from the first day you start school, not at the end of school when you are about to apply for your license.

In your situation, the Board of Education is going to look at any and all licenses you have had or have and it's an easy 1 minute internet check and they can see, nursing license, suspended or revoked, etc. They are thinking like any other organization. "We aren't giving this person certification until we are sure she is clean and sober." So their first question when they receive the application from you is.........have you been In a drug testing program? They will want proof and if you have it and are compliant, you will get a license. "Talking to a therapist" or your "word" that you have been "sober for this long" will not cut it regarding proof. They want check ins where you get randomly tested just like the BON would.

NurseJackie69 · Apr 16

So, you can be a teacher. How to become one and I am NOT telling you what to do. I am telling you what I would do IF I wanted to be a teacher.

1. I would do nothing with the BON other than asking my lawyer to ask them to Suspend my license, but NOT Revoke it. You said you had a lawyer. I would ask my lawyer to get the BON to Suspend, but not Revoke and certainly I would NOT surrender my license. If you license is suspended, you are exempt from the BONs monitoring program UNLESS you want to come back to nursing in the future.

2. Go back and finish my 18 months to become a teacher, but again, enter a monitoring program the very same day I start my education so that when it comes time to get my teachers certification and my credentials from the State, I would easily be granted them because I would have been in recovery/Monitoring Program for over 1.5 years.

3. Now you are a teacher.

Lastly......be certain and have a deep thought about whether Hydrocodone is now Hurting you more than Helping you at this point in your life. You need to have that deep conversation with yourself. Opioidsare not designed to be 10 years in length of duration. Is surgery an option, injections, other pain modalities, etc? I am not saying Hydrocodone is causing you more bad than good. I am saying......you need to reevaluate internally and have that conversation with yourself

April Thompson · Apr 16

What you're saying is definitely helpful. I've already had a few surgeries and lots of epidural steroid injections that never help and are really expensive, in fact, I had one a few months ago that gave me a wet tap and ended me up in the ER.What you're saying is definitely helpful. I've already had a few surgeries and lots of epidural steroid injections that never help and are really expensive, in fact, I had one a few months ago that gave me a wet tap and ended me up in the ER needing a blood patch. I could definitely try to get off of it . But that seems so scary.
mom so let's say I did that and they suspend my license and I do my own drug monitoring program, then what about gabapentin? Like if I did a drug monitoring program, but I show them I have a prescription for that is it less strict than TPAPN ? of course I also take ambien:/. That would be really hard to come off of two because same thing. I've probably been on it for 10 years

I could have another spinal fusion because I need it but the last fusion only helped for like 6 months to a year and I did get off norco but then I ended up right back when the pain started to get unmanageable again

I do think it causes more harm than good.

but I also feel like I will not be able to work without it. And I am going to have to leave my job in like 2 weeks when I give the board a response which means I won't have insurance. And I have no idea what to do for a job. I've sent out a bunch of applications and not heard back from anyone

this is really helpful. I wish you could get answers like this from TPAPN. I'm scared to tell my pain management Dr because I know substance use disorder will be in my medical chart forever.
I've been a nurse 21 years. I have grown to hate it over the last 2 years. So it's really hard to imagine going through all of this for a job that I want to leave so badly. But I just go back and forth every 10 minutes.
I always wanted to be a teacher. And I was thinking , I could go back for my bachelors and find a rewarding career teaching social studies or something and never look back ... HOWEVER... now that I am looking into that it seems like a background check would show disciplinary action from the BON and if that's true I wouldn't want to spend 1.5 years finishing a bachelors just to be denied a teaching certification.
or not be able to find a teaching job because they can see it.
I haven't stopped crying for days . I've never been more terrified and panicked. It feels like I'm drowning

April Thompson · Apr 16

Also I thought Texas was 3 years for RN , but people keep saying 5... is it 5?!

NurseJackie69 · Apr 16

April Thompson said:

Also I thought Texas was 3 years for RN , but people keep saying 5... is it 5?!

Depends on the person, and the state and what you did. All 3 matter. For example, in Michigan if you have a DUI or substance abuse issue that in no way effected work or your job and you didn't divert at work or come in high, (but you got a DUI for example) it's still 3 years for most people, but in Michigan, if you diverted at work, it's been moved to 5 years in the last 6 to 8 months and is no longer 3.

In Texas, if you diverted at work, expect 5 years, not 3. Here is where I tell nurses that it's CRITICAL to get into monitoring IF......IF....the evidence is clearly against you such as diverting at work and you admit it or are on camera, etc. In these situations, ENTER monitoring immediately because it's Automatic that the BON will require it and it will require 5 years, bit in the Very Very Rare occasion that the BON only gives you 3 years, it still doesn't matter, get the clock started by entering.monitoring. If you would have entered monitoring 2 years ago, you would only have 3 more to go. Many nurses who have overwhelming evidence against them like I mentioned above for some reason or another...they wait. They wait until the BON gets back to them 3 months, 6 months, or 1 year, or sometimes 2 years later, and then they start monitoring of which they basically let 2 years go by that could have already started working on the clock. So, the entire stress process becomes a 7 year process when it could have been 5 years.

Your consent order from the BON will require 5 years of proven sobriety. Proven sobriety to the BON, means......you're checking in daily and get random drug tests through a monitoring program. Proven sobriety to the BON is Not "I met with a therapist for the last 2 years," or "I've been sober for 2 years." They want monitoring as a proof of sobriety.

The 5 years of monitoring and the whole issue with the BON ends 5 years from the day you enter monitoring. It doesn't start and end from the day you diverted, or from the day the BON gets you your consent order, or from the day you met with a therapist or from tje day you verbally claim sobriety. It starts and ends from the day you Enter monitoring.

For any nurse reading this. If you get into trouble and you know the evidence is obvious such as....you diverted at work or 3 people seen you high at work and/or you admit it, and/or you are on camera, and/or deep down you know you have a problem, if ANY of the above apply, Enter Monitoring Immediately in order to get the clock started so that means, the whole process ends earlier. If you wait until the BON investigates and gets you your consent order before starting monitoring, you are letting sometimes 6 months, 1 year or even 2 years go by Before you starting the 5 year clock when you could have already started that clock and if it takes 2.5 years for the BON to get you your consent order,then whoopty doo and who cares, because you have 2.5 years down and only 2.5 to go.

Now, if you do NOT have a problem and the evidence is weak such as Nurse A claims Nurse B "smelled" like Alcohol yesterday or you have 1 or 2 Pixis discrepancies but you deep down know it was not intentional, then DO NOT enter monitoring. Lawyer up and fight it, but when it's obvious......get into monitoring.

I have a colleague in Nevada who got a DUI in March 2020. She entered the monitoring program immediately, within 3 days. It took the BON 26 months (May 2022) to finalize her consent order and catch up with her. The BON mandated 3 years of proven sobriety (monitoring). 10 months after the nurse received her consent order (only 300 days later) she was Done. She had completed the 3 years. This is the perfect example of how Not Waiting is obviously the better choice when the evidence is overwhelming and clearly against you. Her entire stressful ordeal was 36 months. If she would have waited to enter monitoring after receiving her consent order, her entire stressful ordeal would have lasted 5 years and 2 months or (62 months total). This is the perfect example of why entering monitoring early greatly reduces or shortens overall stress levels.

NurseJackie69 · Apr 16

One more thing. Be careful which lawyers you choose. For nurses reading this, you want a nurse lawyer. Every state has them. Try to get one of these. Why? Here's the perfect example........IF......IF.....you get a lawyer. Not everyone needs or wants a lawyer, but if you go that route, read this post.

Example A. A NON nurse lawyer who says "they have experience working with the BON." The nurse diverts at work and is found passed out by colleagues. She gets the lawyer. The lawyer tells her to "wait" until he or she gives the OK to move forward and not to do anything yet. 14 months goes by and during these 14 months, the lawyer tells the nurse he is working hard and will "save the nurses license." At 14 months, the BON mandates 5 years of monitoring and the nurse "thanks the lawyer," for "saving her license" and enters monitoring which begins the 5 years, and 14 months are waisted and the nurse is down 15 grand for the lawyer.

Example B. The nurse hires a lawyer who is also a nurse (nurse before going to law school). The nurse tells her lawyer the situation and how she was found passed out at work from substances and the lawyer tells the nurse that she needs to enter monitoring immediately because there is absolutely no getting out of this and that the nurse will not lose her license because for first time offenders, licenses are not revoked and if the nurse enters monitoring early on, the license is often not even suspended. The lawyer argues for the nurse to get the monitoring time reduced because the lawyer gives proof that the nurse is active in recovery for the last 14 months and sober and has taken all proper steps, so the BON at 14 months after the nurse diverted gives the nurse 5 years of monitoring, but the nurse-lawyer argued that a stipulation be placed that the nurse can petition to be done with monitorong and consent order at the 4 year mark because of how active and aggressive the nurse was from day one in her recovery.

See the difference in the above 2 lawyers? One took your money and didn't do *** and only made you waist 14 months of your time Before entering monitoring and he didn't save your license because your license wasn't going to be revoked anyway. The nurse-lawyer shortened your time on the front end by having you starting monitoring early and got you a decent chance at being able to be done in 4 years instead of 5.

Careful which lawyer you choose.

Healer555 · Apr 16

April Thompson said:

What you're saying is definitely helpful. I've already had a few surgeries and lots of epidural steroid injections that never help and are really expensive, in fact, I had one a few months ago that gave me a wet tap and ended me up in the ER.What you're saying is definitely helpful. I've already had a few surgeries and lots of epidural steroid injections that never help and are really expensive, in fact, I had one a few months ago that gave me a wet tap and ended me up in the ER needing a blood patch. I could definitely try to get off of it . But that seems so scary.
mom so let's say I did that and they suspend my license and I do my own drug monitoring program, then what about gabapentin? Like if I did a drug monitoring program, but I show them I have a prescription for that is it less strict than TPAPN ? of course I also take ambien:/. That would be really hard to come off of two because same thing. I've probably been on it for 10 years

I could have another spinal fusion because I need it but the last fusion only helped for like 6 months to a year and I did get off norco but then I ended up right back when the pain started to get unmanageable again

I do think it causes more harm than good.

but I also feel like I will not be able to work without it. And I am going to have to leave my job in like 2 weeks when I give the board a response which means I won't have insurance. And I have no idea what to do for a job. I've sent out a bunch of applications and not heard back from anyone

this is really helpful. I wish you could get answers like this from TPAPN. I'm scared to tell my pain management Dr because I know substance use disorder will be in my medical chart forever.
I've been a nurse 21 years. I have grown to hate it over the last 2 years. So it's really hard to imagine going through all of this for a job that I want to leave so badly. But I just go back and forth every 10 minutes.
I always wanted to be a teacher. And I was thinking , I could go back for my bachelors and find a rewarding career teaching social studies or something and never look back ... HOWEVER... now that I am looking into that it seems like a background check would show disciplinary action from the BON and if that's true I wouldn't want to spend 1.5 years finishing a bachelors just to be denied a teaching certification.
or not be able to find a teaching job because they can see it.
I haven't stopped crying for days . I've never been more terrified and panicked. It feels like I'm drowning

There's a lawyer who was on long term Suboxone and he was referred to a monitoring program for lawyers. He represented himself and got to continue Suboxone without a monitoring agreement. I don't know what lead you to this situation. I was too scared to fight it and I'm guessing his situation was unique but it's possible to argue it under the right conditions. He was an addict buy he was protected under ADA. I'd rather have an impaired lawyer than provider but ..