New grad in TPAPN needs help on next steps after graduation

Dear Nurse Beth Advice Column - The following letter submitted anonymously in search for answers. Join the conversation!

Published  

I'm a new grad (soon-to-be RN) seeking advice from anyone who has been in a similar situation. Before starting my nursing program, I signed an order with the BON to join TPAPN about 45 days after licensure. This decision came after voluntarily admitting myself into treatment a few years back, and I've been sober since.

Now that I've just graduated and am studying for the NCLEX, I'm trying to figure out my next steps regarding the job search. Throughout nursing school and with advice from my attorney, I've been diligent about keeping track of meetings, drug/alcohol tests, and any documentation that might help me file for an exception to the TPAPN order. I even paid for a chemical dependency evaluation on my own (before joining TPAPN), hoping it might strengthen my case.

Here's my dilemma: I know it's tough to find a job with TPAPN. My options seem to be:
1. Wait for the BON's response and risk having nothing lined up for months.
2. Start interviewing now, with the hope of landing a residency or position and deal with the TPAPN status as it unfolds. (As a new grad, I only have one shot at a nursing residency)

My main concern is whether it's a bad idea to interview if my license isn't yet unencumbered. I don't want to make a mistake by jumping the gun, but I also don't want to lose valuable time and opportunities by waiting around.

For those who have been in this situation, what would you do? Any advice on how to approach interviews and potential employers in this context would be greatly appreciated!

Share this post

+ Add A Comment
Specializes in Tele, ICU, Staff Development.

Congratulations on achieving and maintaining sobriety throughout nursing school! Your dedication and resilience are commendable.

The Texas Peer Assistance Program for Nurses (TPAPN) is a program designed to help nurses who have substance use or mental health issues that might impair their ability to practice safely. It is run by the Texas Board of Nursing (BON) and offers support, monitoring, and guidance to nurses in recovery. 

How TPAPN Works

  • Referral to TPAPN. Nurses can be referred to TPAPN if they self-report, are reported by an employer, or are found to have an impairment.
  • Monitoring and Support. Nurses in TPAPN are required to undergo a period of monitoring. This often includes:
    • Random drug and alcohol testing (usually for several years)
    • Regular meetings with a case manager or peer group
    • Counseling or therapy (especially if the impairment is due to a substance use disorder)
    • Education on topics related to recovery and professional practice
    • Reporting and Documentation: Nurses in TPAPN must keep thorough documentation of their meetings, tests, and progress in treatment. These reports are often submitted to the Board of Nursing (BON) or their TPAPN case manager for review.
    • Completion and Graduation: After completing the program the nurse may be allowed to have their license unencumbered (I.e., free of restrictions). This is typically contingent on demonstrating continued sobriety, meeting all program requirements, and receiving positive reports from monitoring.

How TPAPN Affects New Grad Nurses

  • License Encumbrance. When a new grad nurse is placed in TPAPN, their nursing license is typically encumbered. This means their license has certain restrictions, such as limited practice conditions or ongoing monitoring. A new grad nurse with an encumbered license may have difficulty getting hired in certain settings, especially those requiring a clean employment license (e.g., hospitals and clinics).
  • Job Search Challenges. Many healthcare employers, particularly hospitals, require that nurses have an unencumbered license to practice. As a new grad, this can significantly impact your job search because:
    • Some employers may not be willing to hire a nurse who is under TPAPN
    • Even if an employer is open to the idea, the additional monitoring and restrictions may be seen as a burden or a potential risk to patient care.
    • Residency Programs: New grad nurses often aim for competitive nursing residency programs, and most require a clean and unrestricted license. 
    • Additional Burden: Beyond the job search, new grads in TPAPN face the added challenge of complying with the monitoring requirements of the program, which may include:
      • Frequent drug and alcohol tests
      • Therapy or counseling
      • Regular reporting to the Board of Nursing or TPAPN case managers

All of this can be overwhelming, especially in the early stages of a nursing career.

  • Job Options and Flexibility. Some healthcare organizations, particularly those with programs dedicated to supporting nurses in recovery, may be more willing to hire nurses under TPAPN. For example, nurses in recovery may find support from facilities that offer second-chance employment or have specialized programs for nurses with a history of substance use disorder. Dialysis is also known for being more flexible.

Key Points for New Grad Nurses Under TPAPN

  • Challenges: Job search limitations, potential delays in finding employment, and additional monitoring requirements.
  • Opportunities:  Finding a job requires honest communication and extra effort in finding those opportunities.
  • Proactive Steps: You've done well at keeping records and working with an attorney.

Conclusion

For new grad nurses, TPAPN can significantly affect job prospects and career progression, especially in the early years of nursing. However, it's also an opportunity for recovery and growth. The key to navigating this situation successfully is maintaining sobriety, complying with the program's requirements, and being proactive in your job search while being transparent with potential employers.

It may (will) take time, but many nurses have completed TPAPN and gone on to have long, fulfilling careers in nursing. 

There is a helpful Nurses In Recovery forum here on allnurses.

Starting Interviews Now

While you risk facing rejection or awkwardness in interviews, you should not delay interviewing for several reasons. You have nothing to lose. Starting interviews early gives you a sense of what's available in the market. It's also a good opportunity to build connections and have open conversations with potential employers about your situation, especially if you're upfront about the TPAPN. Some employers may have experience with TPAPN candidates and may be more willing to work with you or even help you navigate the process.

The more interviews you have the better. Your skills will improve, and you never know when you will encounter an employer sympathetic towards recovery.

As a new grad, landing a job sooner rather than later is essential.

Things to Consider for Interviews

  • Be Transparent: It's generally advisable to be open and transparent about your situation if it's directly relevant to your application. Explain that you're currently in TPAPN but that you've been sober for years and have shown consistent commitment to your recovery. Employers will appreciate your honesty.
  • Highlight Your Strengths: Your dedication to recovery and the effort you've made in showing proactive responsibility, which is a positive aspect to emphasize. Let them know how this experience has shaped you into a stronger, more empathetic nurse.
  • Know Your Rights and Options: It might be helpful to consult with your attorney on how to navigate potential questions about your TPAPN status in interviews. They might suggest how to frame your answers in the best light.
  • Look for Employers Who Understand TPAPN. Some hospitals or healthcare organizations have specific programs for nurses in recovery or may be familiar with the TPAPN process.  Sometimes, dialysis employers are more willing to work with restrictions.

I do wish things were simpler for you. If you remain persistent, opportunities will present. Don't give up. You have come too far.

Good luck, and take things one step at a time!

Nurse Beth

+ Add a Comment