Disclaimer: This surrounds my experience in TPAPN, but it should apply to many state monitoring programs with some exceptions.
Three years and I'm finally finished with a completion letter in my hands.
I thought it would be nice to share some advice for those still pulling their hair out at the idea of starting and those still exhausting their savings trying to keep up with the testing. Here are a few helpful tips I think many could benefit from in no particular order.
1. Stay Under the Radar
I believe I've read a handful of posts on these forums in the last three years from nurses talking about aggressively making phone calls to their advocates, TPAPN, and their case managers. I know the policies and requirements are awful. In fact, they are terrible at times. Unfortunately, most of us have screwed up along the way and TPAPN is our only hope towards a future career in nursing. If you have no chance at escaping TPAPN and you start off like this you're three years in the program will likely be more difficult than the rest of us because you put yourself in the spotlight early on.
Reading all the posts from nurses screaming, fighting, and shouting "I'M GONNA GET A LAWYER" to me has been like watching a wild animal getting pinned into a corner by a group of hunters. While I encourage people truly innocent to use a lawyer, I think getting a lawyer for the purpose of getting out of the mess you honestly made is worse than the three years you'd have to do in TPAPN. Not dealing with your addiction, for many, has greater implications than a measly 36 months of being in a program that forces you to be clean for once.
I already put my disclaimer up that if you're innocent, indeed you should seek legal counsel. For the rest, well... You know who you are.
2. No Excuses for False-Positive Results
False-positive test results is another popular thread you'll find here. While I am aware of specific things that will cause false-positive results, the most common reason these drugs tests come back is because these nurses used drugs.
In three years I was tested about seventy-five times (Just Over $4,000) and had zero problems. Here are some things I did that may have helped avoid some problems:
- I kept a box of gloves in bathroom because it's hard to find chemical components of cologne or perfume for you ladies. Most of them are made with heavily concentrated forms of alcohol. I would always spray cologne onto the gloves and then rub it on my clothes and never my skin.
- Don't be embarrassed to ask friends or family if there was alcohol used in the food they prepared for you. My oldest sister, who happens to also being a raging alcoholic, uses wine in a lot of the Italian food she cooks. This isn't a problem unless you're someone that gets drug tested. I always believed alcohol cooked out of food if it was well heated up; however, there's a great amount of information available online to suggest that for that to be true the cooking conditions have to be very specific. Don't trust everything served to you - ASK!
- Enjoy your bakery items. I ate a pint of vanilla ice cream in two nights leading up to a drug test that tested for alcohol consumption and it was negative. I've consumed my own banana bread the night before and morning of a test and had no issue despite having vanilla extract. Unfortunately, once upon a time some nurse before you couldn't admit to their addictions to alcohol and got busted. They got busted and probably cried on these forums looking for people to say "Ohhh get a lawyer girl! It was the vanilla extract. Fight them girlie #hugs!" when really they probably consumed alcohol and said it was the vanilla extract in their pineapple upside down cake. Sorry, no. Stop drinking alcohol and enjoy your bakery items.
3. Random Testing Isn't So Random
While most of them will be random, don't bet on it for vacations. Make absolutely sure that you schedule your travel/flights to accommodate testing times. If Quest Diagnostics only allows us drug addicts to get tested from 0900-1500, it's probably not a good idea to pick a flight that lands at 1430. Check where testing locations are prior to booking your hotel to make sure there is a location close to where you'll be staying.
There were two vacations we took that were about a year apart where I was selected to test on the days of travel. For the first vacation, I was selected to test both the day of arrival and departure. I thought "Surely they wouldn't test me on the day of travel for a vacation I requested three months in advance?" Surely I was wrong. I didn't leave a lot of wiggle room for testing for the arrival day. I was supposed to land at 1400 and the plane was late and came in at 1420. I had to get our rental car and get to the testing center that was twenty minutes away. I walked into the Quest Diagnostics center at 1455. I was so stressed my hands were shaking. Don't put yourself into that position and plan your flights/travel to accommodate delays.
4. Pay Close Attention To The People At Quest Diagnostics
One thing that really stinks is that even if you go into test, the test can be invalid and considered non-compliance if the people at Quest screw up. Out of $4,000+ of tests, here are some of the most common issues I ran into that you have to be vigilant about:
- The online system at Quest says "USE SPLIT SPECIMEN" and the COC form says "USE SPLIT SPECIMEN". I can't tell you how many times I was handed a single specimen container and told "Nah, you don't need a split." Make sure it's split!
- Pay close attention to testers hands. There was two separate occasions where I had a young lady test me months apart who would soak her hands in ethanol based hand cleaner and then touch all of my testing supplies. If you feel uncomfortable about how your sample is being handled - Speak up!
- Don't believe what people at Quest tell you. In my last few months of testing, I accidentally pulled an old RecoveryTrek COC form that was sitting in my car for over a year and used it to test. As I was walking out I noticed it and I told the staff I needed to test again because it wasn't an Affinity COC form. They told me, "Oh sorry. You can only drug test once a day. Just come back tomorrow." Come back tomorrow? Ya, ok... I traveled to the other side of town to another Quest and tested with no issues. Remember that in this program if someone is uninformed and gives you bad advice it's not their fault. It will fall on you because TPAPN will not care that someone told you something that wasn't true.
- Expect at least once screw up with a COC form. There was one test in my first year where RecoveryTrek sent me an e-mail saying that I put the wrong social security number on a COC form and that if I did that again it would be considered non-compliance with the program. I had a copy of the COC form and the social security was perfect. Some things will be out of your control and be quite frustrating.
5. You Should Never Lie With One Exception
That one exception is in regards to your COC forms. In case you didn't notice, the DONOR COPY on the back page of the COC packet is the only page that blocks out the receivers signature/date/time so you have no evidence to take home that you actually provided a sample. Why? I couldn't tell you. However, what this means is that the DONOR COPY is a piece of worthless paper if anything ever happens to your sample. And who's problem will that be? Yours.
What I would always do is tell the collector "Hey, my boss wants their copy today to prove that I actually came here" even though they could care less. The collector would then hand me the second to the last page labeled EMPLOYER COPY which is the same as the DONOR COPY but the receivers signature/date/time is on it. With this copy, you can actually prove you provided a sample if anything were to happen to your sample in transit.
6. Finding Employment In TPAPN
This is an interesting subject because it varies from city to city. I'll share my story about job finding and perhaps it might be helpful to some.
When I first started TPAPN I dedicated 100% of my time off to job hunting. I have children and my wife was already a hard working stay at home mother. I was the only provider, so I had a lot of passion to look for work. Luckily, we were Dave Ramsey fanatics that had over six months of cash to live on and no debt, but I didn't want to chomp all the way through it. And so job hunting began.
I live in a small town where almost every single facility is owned by HCA or Tenet corporations. HCA would not hire me because it's the facility I was fired from. The CNO's from two other facilities said that I would not be able to work for them for the rest of my life. That sucks. Tenet would be my next best option. I successfully got two jobs from interviews. One was for rehab and another doing scheduling/clinical coordinating of sorts. I waited until after they offered me the job to tell them about TPAPN. Both times they said they would call me back after discussing it, and both times they said they could not hire me simply because of the restrictions. No nights, no overtime, no narcs, quarterly meetings, and sign in sheets from charge nurse or supervisor is an administrative nightmare and I don't blame them for waving goodbye to me.
I finally established a job about a month after joining TPAPN because the substance abuse counselor would network other TPAPN nurses together. Through his networking, I was able to get in contact with a nurse who was in home health that worked for a company who's director had been through TPAPN. What a find huh? What I found out later is that most home health companies will hire anyone with a nursing license and a pulse. It can be really boring, but it keeps you doing some skills and in our case it kept the lights on and put food on the table.
Since we had no debt and a low monthly mortgage, I decided to leave nursing after I satisfied TPAPN's 12 months of "safe and effective nursing practice" to work for a sub-company of Albertson's as a driver and part-time at Wing Stop.
7. Provide Perfect Urine
This might sound strange. However, in the $4,000+ I did of testing, I had a dilute urine twice. I was never warned about it; however, out of worry I decided I would only provide urine that was concentrated from then on. I started to provide TPAPN my first urine of the day. This ended up back firing. I had two urine samples that TPAPN thought were too concentrated and they actually sent me a letter about it. While most people get warned for dilute urine, my letter said that my urine was too concentrated and that if it continued my urine would be considered positive regardless of results and that I would lose my license. My advice is don't over hydrate yourself, and don't give them your first urine of the day either. Both are bad and can cause you to lose your license.
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Hopefully some of you find this information helpful. Please don't hesitate to send me any questions. If you're the type that can't be honest publicly for whatever reason, don't hesitate to just send me a private message. Take this one day at a time and sooner or later it will all be over.
