Home Health on TPAPN

jackstem · May 26, 2010

Many boards of nursing and/or alternative to disicpline programs do not allow the nurse to work in home care, specialty areas like ICU and ER, Hospice, etc. They also limit hours and shifts in many instances. Check with the program in your state. Have you checked to see if your program has a web site?

Jack

Ohio's program explains possible requirements as part of an agreement here:

Chapter 4723-6 Alternative Program for Chemically Dependent Nurses

RNRutRO · May 27, 2010

Actually, here in Texas it is very possible to do. I know from experience. There is an extra page in the contract you have to agree to along with employer, but I didn't find it too difficult. One thing was, I had to make a face to face contact, and preferably first thing in the morning. Then a call throughout the day.

I was lucky to work with a really great manager, and a field nurse that would always meet up with me. Plus, if I recall correctly, you can only take call once a month and those days you will have to have a face to face with someone. That was kinda a downer on the weekends when you didn't have to see anyone. But, again, I made the bad decisions, so it wasn't horrible. :nurse:

The BEST part for me, was there was really no temptation. In HH you don't really give narcotics. Of course, if you want to find trouble, you can. Right?

Plus, honestly, the pay was much better than the hospital, and more flexible.

Good luck. If you have any questions, please feel free to PM and I will do my best to help you. FYI, I did complete the program with little problems. So, it can be done. Again, best of luck!!

dkalang · May 27, 2010

I am also in TPAPN in Texas. I was terminated one month after starting TPAPN and that was in November 2009. I am still unemployed. I was told that I couldn't work Home Health unless someone went with me. I'm confused. Do they decide on a case by case basis. I think I will give my case manager a call tomorrow and ask about this again.

RNRutRO · May 27, 2010

please do check with your cm (i truly hope you don't have the ole bat i had, but apparently, she was what i needed at the time)

i did find that sometimes the "rules" would change while in the program. it also depends on where you are at in the program.

i don't remember all the added stipulations i had, but it was very doable for me. and, like i said, i had a don and case manager in the office that didn't make a big deal when i "checked in daily" plus i used a field nurse that i had become comfortable with to explain my situation to, and she became my "back-up, back-up" so, i'd meet her often, have lunch/coffee for the day. seems to me, i kept a calendar and had whoever initial the days i worked when we met up for the day. that way, no one could say i didn't have my "face to face"

also check with your advocate. he/she may also know something about home health. in fact, when i finished, my cm told me that they had had very "good results" with hh and participants.

hope things haven't changed.

keep me posted and best of luck!!!! you will make it!! promise! how far are you in the program, if you don't mind me asking?

dkalang · May 27, 2010

:)Thank you for the info. I will call my cm. I've already talked to my advocate about it and she doesn't know. In fact, she doesn't know a whole lot for an advocate. I'm thinking about requesting a new advocate. The one I have does all of the talking... about herself, and not recovery related. I haven't called her much because she has yet to know the answers to any of my questions. My cm is great. The one I had at first reminded me of nurse managers and supervisors who are very narrow-minded, opinionated, and stiff. She was an RN but the new one I have is an LCDC and she has been great. Takes her time in answering questions and is willing to work with you. She wasn't very good at explaining the home health thing to a potential employer when they talked to her on the phone. And I had a hard time understanding specific stipulations that I would have if I worked home health. I guess she was vague because, being new to the job, she wasn't sure herself but didn't want to admit. I will ask her about it again. Maybe with more experience, she knows more now. Thank you so much. I will post when I find out something.

dkalang · May 27, 2010

Sorry I didn't read your last question. I've been in TPAPN since Nov. 4, 2009. I voluntarily admitted substance abuse to my employer on Oct 19, 2009 and asked for help. (I did this voluntarily because I had been clean since 1987 and relapsed and I knew what was going to happen if I did not act. My first experience was in 1983 when TPAPN did not exist. I was caught diverting, fired from my job, report to and lost my license, and arrested and charged with theft. I did get my license back and luckily had many wonderful years of recovery. Needless to say, I stopped doing what I needed to do (meetings, sponsor, literature, steps) I thought I had overcome addiction. The last 2 weeks before asking for help was a nightmare! This disease progresses despite clean time. It was as if I never stopped using. It was very frightening and surprising to me. (This disease is insidious and deadly) I was in outpatient treatment and attending my 90 in 90 when I was terminated from my job on Nov 23, 2009. That's a long story. I did end up qualifying for unemployment, which is about to run out. And I filed a complaint with the EEOC just days ago for wrongful termination due to discrimination based on disability. Like I said it is a very convoluted, twisting, long story. I've been meaning to post it on this forum, just don't feel like doing that much typing. I need to go to bed. I will post more later.

caliotter3 · May 28, 2010

I've been told that most boards do not allow it, but makes no sense to me. Very simple to keep one off cases where controlled meds are being used by the patient. And easy to incorporate a little more supervision also. But each state has their own rules. Good luck no matter how this all turns out. You will get to the other side eventually.

dkalang · May 29, 2010

I have no sanctions and am not being monitored by the board of nursing. But you are right. I am under no illusions; home health patients do have alot of meds laying around. That's why I am on TPAPN. It makes me accountable. I have 7 months clean and I need accountability. I had 13 years clean previously and I know that I have a disease that is trying to kill me. I have to work the steps, go to meetings, read the literature, call my sponsor, and most importantly, stay in constant contact with my God. I prefer working in case management, utilization management, but at this point, I am getting pretty anxious to get a job. I do have faith that I will get something soon. Thanks for your reply.

Magsulfate, BSN, RN · May 29, 2010

:)Thank you for the info. I will call my cm. I've already talked to my advocate about it and she doesn't know. In fact, she doesn't know a whole lot for an advocate. I'm thinking about requesting a new advocate. The one I have does all of the talking... about herself, and not recovery related. I haven't called her much because she has yet to know the answers to any of my questions. My cm is great. The one I had at first reminded me of nurse managers and supervisors who are very narrow-minded, opinionated, and stiff. She was an RN but the new one I have is an LCDC and she has been great. Takes her time in answering questions and is willing to work with you. She wasn't very good at explaining the home health thing to a potential employer when they talked to her on the phone. And I had a hard time understanding specific stipulations that I would have if I worked home health. I guess she was vague because, being new to the job, she wasn't sure herself but didn't want to admit. I will ask her about it again. Maybe with more experience, she knows more now. Thank you so much. I will post when I find out something.

Call TPAPN and , tell them your concerns about your advocate, I don't know if they will get you a new one, but maybe they can try to figure out what the issues are and resolve them. They may just need to speak with him/her and clarify some things. Also, please remember the advocates are VOLUNTEERS. TPAPN is short on advocates and sometimes it is difficult to even find one that is in your area. Advocates have their own full time jobs to keep up with along with volunteering for TPAPN. This can be very stressful and frustrating at times. Specially when you've got participants who don't want to follow the rules. Your advocate may be very new at this, just be patient. You have to check in with your advocate like your contract says, and your advocate does not need to be your 'friend". Call them, check in, answer their questions. Make sure she knows that you're calling in for drug testing everyday, that you're continuing to go to your meetings as ordered and that there are no other issues.

TPAPN is also very short on money and resources. Remember, they are doing the best with the funds that are given to them. They can close up shop at any time and all the participants would be out of the program, end up face to face with the board. That is not a good thing when you're a nurse with chemical dependency issues. The board is much harsher than TPAPN.

One more thing to remember, the advocate is not your counselor. They are there because your case manager probably has more than 200 other tpapn participants to keep up with and there's no way that a cm alone can manage to give personal attention to all of her participants. The advocate should try and answer your questions and if it is out of her scope then she must refer you to the case manager. SHe is not responsible for any paperwork, communication or stipulation issues that you have with TPAPN. The advocate can stand in for the case manager in the return to work meeting and she can be there to help potential employers understand TPAPN rules, etc. Your advocate will not be making decisions regarding your stipulations, other than how often you will call in and check with him/her.

And please remember, the best advice I can give you, is to just follow TPAPN's rules to the letter. Don't call them unnesseccarily and definitely don't call them when you're upset. As a matter of fact, keep the calls to Austin as limited as possible. Follow the rules, fill in all blanks, and do exactly what you're suppose to do. Then you'll be fine. :)

Magsulfate, BSN, RN · May 29, 2010

To answer your questions about home health, yes tpapn will allow it. However, you must be doing very well in your recovery. If they have any reason to suspect that you may not be able to handle home health and stay sober at the same time, then they will not let you do it. Same thing goes with working nights.

Like Rnrutro was saying, there has to be face to face contact with your manager everyday before you go out to the home. Someone has to make sure that you're not impaired. right? lol Well, relapse is very common and you must work hard to not have it. . . . TPAPN will also allow nurses to work night shift if there is good support at work and you have a manager on site at night.

Home health goes along with the tpapn rules that you can't be autonomous. You certainly wouldn't be able to work somewhere that YOU are the manager and there is no other person above you to make sure that you're doing okay.

All of these stipulations are put into place because they want the recovering nurse to have as least amount of stress as possible. It has been proven somewhere that more stress equals greater chance for relapse. Go figure.

lance197728 · Jun 2, 2010

Monica,

hey I think I know who you are...pm me you email address, I don't have the upgraded membership.

Lance