Most of the time I am bitter! TPAPN

[Ash2213]

I just wanted to post some thoughts about this journey. I am about 10 months away from being done with this nightmare of TPAPN. I will have a clean license pending any issues prior to finishing. I have been sober over 2 years. My drug was alcohol, nothing else "did it" for me or I am sure I would have been addicted to other things as well. I was at my low in Sept 2015, showing up to my night shift after a bottle of wine or some vodka in my water bottle. I could not get through the day without drinking. I was in my mid 30s with young kids, a husband who loved me, a new house, great car, great job, everything going my way. And yet, I was a drunk. Why? I really don't know.

I believe most of us addicts start out struggling with mental health issues and find our poison when we are trying to manager our anxiety or depression. I have been working in psych since my fall from grace in 2015 (entering TPAPN) and I see it SO much. I took the first job offered to me in TPAPN, which was actually the first I applied for. It was a nightmare psych job with so many safety issues. But I gritted my teeth and did over a year there. If not for the wonderful people I worked with I would not have made it. Most did not know I was in monitoring. It is good to have people like that around when you are working in such a labile environment. I believe the lack of jobs offered to us TPAPNer's is a big factor in why so many don't make it. It is slim pickens. Those who hire us cannot find anyone that is willing to work in the conditions we do. (I know this is not the case all the time, but I believe it to be true for the majority of the time). I have been at another facility for almost a year now, but it is the same really. Just fancier on the outside!

I will be honest. I am SO SO SO sick of working in psych. I am so sad because I believe I will have a hard time moving back to critical care nursing when I am out of TPAPN. How do I explain 3 years in psych... I really don't know.

I know, I need to be grateful and thank the gods above for even having a job. I still don't deserve one after what I did, right? That's what I am still led to believe. Will we ever actually be deserving to care for patients again? How long do we need to prove ourselves? Are we done when we are out of monitoring? How do I help others in my shoes in the future? I feel like we care for so many, and yet we are often hung out to dry by our profession. My greatest fear is a false positive. I know I am sober, but who will believe me if I pop positive? It is so scary. Do our case managers know how scared we are? Does it even matter? What is the solution?

Anyway, thanks for listening to anyone who reads this. I just needed to vent. There is hope for those starting out. Hang in there. It does get easier but it is still a constant battle. I am tired of the battle. I hope 10 months fly by. Then I don't know what I will do, other than put my sobriety first.

If anyone is new to TPAPN or has questions, I welcome you to PM me. I was so scared when I started and am happy to answer some questions or give you some encouragement.

[SpankedInPittsburgh, DNP, RN]

I'm Bitter all the Time about this stuff. The pure hatred of this program helps insure my continued compliance as there is no way I will let the rip-off artists and the 12 step born-again's win. Honestly, even if I thought I was an alcoholic I drink the minute I was able out of pure spite. Please note I don't advise this to anybody but that's me. I feel the same about the false positive. I live in constant fear of eating something that and ingredient that will kick a false positive unwittingly.

As far as being "deserving" to see patients? You are deserving and are in fact seeing patients now. So long as you are sober and competent you should be allowed to practice your profession. This garbage where nurses make other nurses feel "less than" for years or even life because they suffer from a disease or made a mistake is putrid and symbolic of all the very worst nursing has to offer.

[catsmeow1972, BSN, RN]

Vent all you need to. I see so much of myself in your words. From the taking of a nightmare job because it was the only one I could get because the existence of IPN slammed so many doors in my face to being forced into an area that I would have otherwise never have done and am not well suited for. That first job hired many contract people because anyone with any other option would run the other direction, fast. I would not send my worst enemy there. It is almost as if we are set up for failure.

We puke up money on a nonstop basis. We spend multiple years being frightened that this nightmare will never end and when it ‘officially' it never really does because we are then left to explain away our absence from the areas we have the most experience in.

This experience that I never really belonged in, in the first place but got caught up in the tidal wave of fraud and carelessness, has hurt me in ways that I cannot even explain. Even after this ends I think I will forever feel like damaged goods. Thanks to my fellow nurses who have chewed me up and spit me out......

[Randomnurse3]

It's sad to see nurses spend their career helping others get better and when those same nurses need help they are discarded and made to feel ashamed. It goes against everything Florence Nightingale stood for.

[Recovering_RN]

I fear the false positive too. I think I'm starting to fear that more and more as my completion date gets closer. I have just under 6 months left in TPAPN.

As far as explaining your 3 years in psych, I think that would be easy if you worked ER before TPAPN. You'd say that you saw so many psych patients come through the ER, and nobody wanted those patients, we just wanted to do whatever we needed to and get them the heck out of there! Truly psych patients are among the most dreaded in the ER! We're not really equipped to deal with them, yeah we get training and yeah we have the special rooms...but we don't really have the time needed to care for them, that's what you say in an interview. You wanted to explore that aspect more, the psych evaluators maybe did or said something that you found meaningful, something like that. You can def spin it in a positive fashion!

[SpankedInPittsburgh, DNP, RN]

Yep, Recovering is right. I've actually seen more than a few ER Nurses do to psych over the years because of that very reason because it rings true. She's completely correct about Nursing's interactions with mental health patients in the ER. The ER is a completely unsuitable place for these poor souls in my opinion. They are brought to a loud and busy environment often with some patients trying as hard as they can to die around them. Often their behaviors escalate and they wind up drugged and tied up. In my experience the best thing you can do for a psych patient is get them out of the ER quickly and to some place that can help them because in most cases the ER ain't it. Many nurses feel bad about this and actually will transfer to one of our behavioral health units to try to help these folks. I'd rather eat glass but different strokes for different folks so the story rings true. As a plus you can take what you have learned in mental health and apply it to helping patients wherever you go. We also have nurses that used to work in psych and came to the ER. The unjaded among them are sometimes an asset in helping with these patients.

As far as popping positive falsely you are right nobody will believe you. I popped positive on my first pee test out of rehab. My PNAP counselor called and tried to get me to confess to drug use (she wouldn't specify what). I told her she was crazy and that I had nothing more intoxicating than coffee and nicotine from smokes in my system. Apparently I was going to suffer some kind of punishment for this. This went on for a couple days and she started dropping hints as to what I tested positive for. Finally she asked me if I was on any meds & I said no with the exception of the Vivitrol shot I agreed to take three months before at the inpatient counselor's & PNAPs request. It turns out that was the explanation. However, we didn't get to that fact until I was faced with the accusation of using drugs (never did that booze is my thing) and I steadfastly told them they were nuts. I pray this doesn't happen to you because the presumption of guilt is palpable even when it makes no sense. All you can do is watch what you ingest and hope for the best

[catsmeow1972, BSN, RN]

I'm still scratching my head at why they were pushing Vivitrol on you? Didn't we discuss that it was probably some kind of marketing ploy. Sick, sick sick......

[Eris Discordia BSN, RN]

I'm still scratching my head at why they were pushing Vivitrol on you? Didn't we discuss that it was probably some kind of marketing ploy. Sick, sick sick......

I'm in monitoring and alcohol was never, ever my DOC (I was/am afraid of the calories in liquids). I was not abusing opiates at the time either (I did in the past, but the BON didn't know about that and I was years clean from that when I was reported). I am in it for abusing something unusual and generally not known to be abusable.

But as cookie cutter programs go, if I want my narc restriction lifted, I either have to get Vivitrol injections or have daily witnessed oral doses of naltrexone. No alternative option. It's a requirement for me to have my restriction lifted...in psych. It's not even like I will have access to anything other than benzos or phenobarbitol. Doesn't matter.

4 years to go....

[Ash2213]

Oh my gosh. I just cannot fathom how any of that is even legal! It is ridiculous. Forcing you to take a medication. I am all worked up now! That is such a rights violation.

[SpankedInPittsburgh, DNP, RN]

Yeah I've heard of mandatory Vivitrol in some programs. Kind of takes intrusiveness to new heights. I agreed to the shot in the hopes of getting out of inpatient rehab (a fully loathsome experience) early. Of course the ploy didn't work & only got out when my insurance carrier cut off the funds upon me telling them of the complete uselessness of my experience. I'm admittedly jaded but Vivitrol was a pretty expensive shot and I can't help but think this is simply another money grab

[catsmeow1972, BSN, RN]

Oh it totally is. I got stuck with the key restriction because they write the contracts (which I'm pretty sure are all the same anyway since they are all in bed together) based on the "recommendations" from the rehab, who of course have to invent junk to justify forcing you to stay (especially if they've already gone to the trouble of getting your credit card info). I asked if I could get around that with Contrave, which is Wellbutrin and naltrexone. Vivitrol is injectibable naltrexone. I already take Wellbutrin. Contrave happens to be a weight loss drug. I happen to be fat. It's also way cheaper than Vivitrol. Nope, not acceptable....whatever. Donkey south-ends.

[Eris Discordia BSN, RN]

"Everyone has to do it" was the response I got from my case manager.