PNAP no legal charges

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I’m an NP student almost done with my program. I voluntarily entered rehab but have no legal charges on my record. I’m being pressured to do PNAP but am horrified by the stories I’ve read about the program and how it will impact my APN licensure and work. If an attorney is necessary could someone suggest a good one? I in no way risked my license or patient care. Thanks.

Specializes in Emergency Nursing.

I wonder how many nurses have been disciplined for being under the influence while doing patient care? The IPN in Florida is just as bad as what you are describing. AA and NA were SO destructive for me. 

By the way,  the Supreme Court ruled that making a 12-step group mandatory with no secular alternative violated First Amendment rights under the Establishment Clause-  

Also, lawyers took issue with being asked personal questions about mental health on their applications for the Bar Exam. Now that is considered a violation of the ADA and there is a movement against those types of questions called "Ban the Box"

My personal opinion about 12 step groups and "powerlessness" -once an addict always an addict- and all the other things that "the program" teaches- is that it cannot work for everyone. Meanwhile the things that are proving to help depression and anxiety like Ketamine are a big no-no! God forbid that shows up in a hair test that is ordered by the Board. 

To get over addiction, depression, or whatever crap life throws at you, you can't be powerless. You have to be a hero in your own life- pick up your sword- and with your friends and family at your side and slay the dragon.

Just my humble opinion... and soapbox. 

 

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Lust4life said:

What is NP and DEA stand for? Nurse Practitioner? 

I'm sorry you went through all that and I'm glad you are still with us on earth...even though it is not easy here that's for sure. I hope all is well with your son also.

 

NP- Nurse Practitioner 

DEA- Drug Enforcement Agency 

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I researched PNAP a couple of years ago and found many comments here on allnurses. Now that I am in the program, every once in a while, I come back here to look for mention of PNAP. I am always a little shocked by the comments. I try to follow through with the claims about the BON, the PHMP, and PNAP for clarification. I have been able to disprove most of the claims made by my fellow nurses, but have never felt the need to join in the discussion. I believe that people who come here to rant are probably not going to be dissuaded. The amount of misinformation in this post, though, has convinced me to create an account and maybe add a little bit of clarity for some newcomers. Because I have followed up on the wild claims some make about PNAP, PHMP, and the BON, by asking questions sometimes unrelentingly, I think I may have some knowledge to share. Asking unrelenting questions is a habit I've formed over the years so maybe I can shed some light so that you don't have to! 

For starters, PNAP cannot require anyone to enroll in a monitoring program and they have no power to take your license if you do not. PNAP does not set the requirements for monitoring, the BON and PHMP does. Juujuubee mentions a PNAP doctor. PNAP doesn't employ doctors. PNAP cannot prevent a doctor from prescribing you medications. So that whole scenario sounds made up....beyond a misunderstanding. PNAP cannot "take your license". How could they? They are not the BON or Department of State. They are a private non-profit agency. PNAP is only tasked with monitoring you according to the terms of your contract written by the BON and enforced by the PHMP. This contract, if you are enrolled in the program, was signed BY YOU. 

There are also claims that nurses are required "by PNAP" to meet with your sponsor once a month for a $100 fee. Huh? a) PNAP doesn't require you specifically to meet with your sponsor. But, you have a sponsor and they charge you money to meet with them?? You're being hoodwinked. Again, PNAP doesn't employ doctors so I'm not sure what the $50 medication fee claim is about. 

The requirements to get permission from THE PHMP, not PNAP, to return to work are specific and laid out in your monitoring contract, again that YOU signed and returned to the state. When those requirements are met, you will be permitted to work, it is not a matter of the PHMP, PNAP, or the BON state of mind at the time. 

I definitely cannot speak for every nurse's experience with PNAP, for sure, but to read the claim that PNAP was telling a nurse that they are a piece of crap addict that will never get better....I cannot believe. My experience was the exact opposite of that. Support, kindness, willingness to answer all the questions I had so that I could feel in control, absolutely no judgment about being an addict. I saw one comment about Joann Megon being evil. I have spoken with her over and over and have met her face to face on a couple of occasions. Whoever made that comment must not be talking about the same person. She is the absolute picture of patience, kindness, and sincerity. Were there a couple times when I could detect a tinge of frustration from her after asking the same question 10x...yes. But she, like the other PNAP employees, is human! That tinge of frustration never resulted in her refusal to help me, anger, or judgment.

Anyway, scores of nurses have completed the requirements of THE BON and PHMP through monitoring with PNAP. Of course it is not easy and it is a financial burden, but in my opinion, nobody was put into a monitoring program without reason. And PNAP has no control over what the requirements of your contract are with the BON and the PHMP. Even if you don't agee with the process, you have to be able to understand that a licensing board has a responsibility to protect the public. And with that huge liability, must be strict with professionals who MAY possibly be a risk.

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Specializes in Justice ⚖️ Nursing.

Ask PNAP is they allow nurses to take maintenance medication, such as buprenorphine, when it is prescribed by your doctor, and still participate fully without having to quit taking it. 

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Oh, believe me I have. If you had, and had listened to the answer, you would know that PNAP is an abstinence based program. So, no, your compliance with your agreement with the BON and the PHMP cannot be monitored by PNAP if you choose to remain on buprenorphine. PNAP cannot "take your license" if that is the route you decide to take. They would simply not be the agency monitoring you. Your compliance would then be monitored by the PHMP only, not PNAP. That was explained to me from the beginning. My first reaction was defensive as yours seems to be. But then I reflected, read my contract with PNAP and with the BON and PHMP, and asked questions instead of assuming.

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You have a license to pratice nursing, which is a priviledge, not a right so I'm not sure how discrimination fits here. The BON has a mandate to protect the public, wouldn't you agree? Beyond that, the BON held liable for licensing nurses without due diligence in the event of accident with a patient, God forbid. You were in an accident while intoxicated. Driving while intoxicated is against the law. If you were the BON, with that information, would you not at least require an evaluation? 

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Specializes in Justice ⚖️ Nursing.

Read about Illinois monitoring program and how they now must allow those in the program to continue to take their medications. It's a violation of the ADA not to. I'm not defensive about it, just feel strongly about it. 

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I guess that could change for PA, too. Time will tell. My dispute is with the claim that PNAP has the power to make you stop using medications or they'll "take your license." And that PNAP is the only option for monitoring so if PNAP won't do it you'll lose your license. At a point it seems like the people claiming that are purposefully spreading misinformation and trying to scare people.  It is not helpful for people coming here looking for answers. 

This program saved my life and my career. I am forever in debt. And I am not alone. Newbies should know, you'll only hear the worst here. And most of it is patently false. Find the people who know (PNAP), ask questions, listen to the answers even if it is something you don't want to hear. In my experience and after hours of questioning, PNAP can't MAKE you do anything. But, they can tell you what may happen if you don't do what is being asked of you by the BON and the PHMP and they know that better than your lawyer or your colleagues or your friends.

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You have a license to pratice nursing, which is a priviledge, not a right so I'm not sure how discrimination fits here. The BON has a mandate to protect the public, wouldn't you agree? Beyond that, the BON held liable for licensing nurses without due diligence in the event of accident with a patient, God forbid. You were in an accident while intoxicated. Driving while intoxicated is against the law. If you were the BON, with that information, would you not at least require an evaluation? 

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Look, lets approach this from a recovery perspective.  If you are still....notice that word, STILL trying to find legal loopholes and you are trying to "do battle" with what the nursing board must continue to "allow" you to take, you are so SCREWED.  The chances of you remaining sober are near ZERO, so I suggest you just quit the program now and safe yourself time.  Sure....you can get your attorney to argue and get a deal where the Board has to allow you to "get your fix" with Buprenorphine or whatever other addictive FIX such as Adderall that you are STILL not letting go of, that's fine.  But that attitude is a gigantic indicator of whether you use again.  It's like an alcoholic who only drinks "Odouls."  They are STILL holding on that fix, no matter how slight. 

I've been in the monitoring program for 4 years.  1 more to go.  Just do what you are told and keep that mouth shut.  That's 50% of your problem.  That mouth....that attitude.  That's how we got here (including myself).   Sure, you can argue it to where they allow you to take your Buprenorphine or Adderall or whatever fix that you still want to get, but they quickly require a monthly report from your physician Directly to the Board in the form of a report, and the Board can and DOES do that.  They require proof of that script each month.  If your physician NP misses one report, or if he or she is out of town and forgets, or if one stroke of the keyboard is off when he sends the email and that report is late, you are done.  The Board remembers the arguing and pleading and attorney and your actions, and you will not get any slack.

It's a lot less stressful to get past the "Fix."  Stop it with the Subutex and Adderall, get through the stress of letting that go, and you don't have the stress of each month, every month, for 60 months in a row, you better not be off one time with your provider sending the Board the report.  The Board doesn't care about your "technicality" which is the Dr. was sick that day, or "he forgot to do it."  You are DONE if that report misses, and you have to be perfect, 60 months in a row.  What are the odds of anyone, even if you are doing everything correctly, not hitting one stroke of the keyboard wrong when they do it for 60 times?  What are the odds you Doctor isn't on vacation 60 times in a row when that report is due.  You are BEGGING, you are PLEADING for DISASTER if you go this route.   Let the FIX go.  Certainly, take the meds that you actually need like your BP meds, cholesterol, etc.  

As for the Board.  Yes, they are there to protect the public.  They are also there to MAKE MONEY.  Here's an example.  We have the nurse compact thing, so lets say you get in trouble in California and you are licensed also in 2 other states, for example, Nebraska and Colorado.  The correct thing to do for your non-home states like Nebraska and Colorado is to accept the monitoring agreement you have in your home state of California, and have your California Monitoring Program Case Manager simply send your quarterly report to Nebraska and Colorado and that be simplified for you.  But....Most Boards don't do this.  Colorado and Nebraska want you to meet THEIR requirements which usually means, one of those weekly meetings they call Aftercare which basically you have to pay for, even if via Zoom all the way from California.  That is WRONG.  It should actually be legally challenged.  Boards shouldn't be able to get away with this.  After all, it was State Boards who were the one's arguing for the Nurse Licensure Compact many years ago to simplify things, but when it comes to money, things all of a sudden aren't so simple.  Yes, the Boards are there to protect the public and do a good job, but don't kid yourself on their need for income.  

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Specializes in Justice ⚖️ Nursing.

There's that stigma and misinformation. Not everyone is the same. It's not a legal "loophole" and it shouldn't be a battle. It's not a crutch and it doesn't cause impairment. If you don't know because you don't have that experience then I don't think you can give a valid opinion. 

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Nobody wrote that is was a crutch.  Nobody wrote that everyone was the same.  I have a valid opinion because I am a CRNA and work in a pain clinic and do pain management, so I know something or to.  You do NOT need Subutex to survive or be out of pain.  You need it to GET off of drugs because you are NOT completely off of drugs yet MENTALLY.  You do not need Adderall to survive.  There are other ADHD (Non controlled-non amphetamines).  

When you are having an attorney or yourself argue or state your case with the Board on why you need the controlled substance, you can call it what you wish.  If it's not a loophole then fine, it is still AN ARGUMENT.  An ARGUMENT implies....YOU have yet to surrender and submit to addiction.  You are STILL holding on.  That attitude or the back and forth with the Board on why you need the medicines implies in EVER addiction medicine circle, that you are showing signs of not being able to turn it over.  Now, you may not like that, but that's the way it is.  Again, do you want the stress of arguing and the back and forth calls and email with the Board and added to that, the monthly reports required by your Doctor and you being responsible for it if he didn't send the report.  That stress goes on for 5 years.  Do you really want that instead of simply....getting pain injections and steroids with local anesthetics and taking Lyrica and other non opioids that actually removes any OPIOIDS from your life and actually TREATS your pain, and guess what, they are non controlled.  You don't have to worry with the back and forth battles with the Board and the emails and mandatory Physician monthly reports.  

Why on earth some nurses choose this path.  The path of actually adding MORE stress to an already stressful situation is just amazing to me.  It's the ultimate form of ignorance.

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