RecoveringRN

All is good here...I hold no ill will toward you. I have been tough on a few people in the past too. Sometimes it's what a person needs to get something through their head! What is the OIG exclusion?? Well, for starters, here in Tennessee we have no face to face meetings with our case managers from TNPAP on any regular basis. I met my case manager 6 years ago when I signed my contract. Haven't seen her since. We have our nurse support groups but they are not our advocates, per se. They don't have any say in any decisions that TNPAP makes. All I have to compare to is the pharmacist's peer program here. If a pharmacist is caught diverting, working under the influence or self reports their license is suspended by the Board of Pharmacy. They then, after finishing with the recommended treatment, go before the Board and plead their case. They don't need a lawyer because their advocates are right beside them. The advocates for TPRN are other pharmacists in recovery who volunteer for the position. It is a service they perform for their fellow recovering pharmacists. They are present at the caduseus (sp) meetings with the other pharmacists every week. Paperwork is turned in directly to them. Their advocates ARE their peers. Not so with TNPAP. TNPAP on the other hand has five paid case managers and decisions are made by the case manager and the director of TNPAP. I don't KNOW these people and they don't KNOW me. Sorry, but I want someone who knows me to make a judgement call about me and my life. Personally I think TPRN works very well. It seems more of them stay in recovery compared to nurses. If nurses had to plead their case in front of the BON to get their license reinstated they might think twice before making the choice to relapse. I know that if someone is going to relapse they have relapsed in their mind long before they pick up and there is no stopping someone who is determined to use. But there has got to be a better system. A system that makes the recovering nurse feel more a part of than like they are being punished. To me TNPAP is puntative in many ways. It is not set up that way but it IS that way a lot of times. After six years with TNPAP I have seen, heard and experienced a lot. Well, there's a start anyway!...lol!

Your opinion versus medical proof...I think I'll go with the medical proof. I learned a long time ago there is no sense arguing with prejudice or preconception. Have a nice day :)

Thanks so much....I am really excited about this year and the good things I know are going to happen. Yes, it is wonderful to be happy. And that is what God want for us anyway...to be happy and enjoy our lives.

I appreciate your post and will keep you updated. But to go back and forth is not going to get anywhere as several of the questions you asked I explained in previous posts. Things will work out great no matter what I have to do because I am not in control of it anyway. You go by "exnursie"....why are not still a nurse?

Thanks a lot!! I appreciate the note!! I fully believe that everything that has and is happening to me is for a reason. It has made my love for life and recovery stronger but I also believe that had I not gone through what I have and am I wouldn't understand where my daughter is at right now. She is 21 and a beautiful girl but I knew from the time she was a baby that if any of my kids would suffer from addiction it would be her. Strong-willed, needs to be in control...lol...she was ME!! I didn't chose to become an addict but it has brought special blessings. I see the great things that life has to offer me and my family. My husband is a recovering pharmacist and their peer group IS part of their Board. Their license is suspended then once they complete treatment they go before the board of pharmacy and if they have complied their license is reinstated. The board works closely with them. They go to their support group once a week and just like any other 12-step meeting they donate a dollar but then at the end of the year they take the money they have collected and give it to a charity that they all agree on. The nurse support group meetings here in TN are $40 a month and some who aren't working can't even afford that as they struggle to even get gas for their cars to get to the meetings. There definitely needs to be some changes in the nurses system here. I could go on but right now nothing is going to change and I don't have the ability to change it so until I do...lol. If I ever have the opportunity I will embrace it with open arms. I believe in supporting other nurses in recovery and in fact sponsor several that I have known since they came in for treatment. I know having a nurse there from the beginning was a blessing for me so I try to make sure the new nurses know they are not alone and they are not bad. My lawyer and I have briefly talked about ideas for her practice and things that need to change with TNPAP. Once this ordeal is behind me, whichever way it goes, I fully intend on continuing to give back. I would not be here today without the ones who freely gave to me and I will be forever thankful for them. I am so glad I found this site

"Knowing that the CM has a load of 400 nurses, I personally would not place myself in potential danger of noncompliance when I was not." Sorry, I want to touch on this too. First off it is 5 CM for almost 400 nurses. So my CM's load was approximately 75 and I didn't know about these numbers until this past November when I was researching the BON and their actions against other nurses. This information is not readily available unless you are specifically looking for it. They do not tell you about it. Thank goodness all my information IS in writing in a file right here in my home.

Let me first clarify something. Until now the BON here has known nothing about me. TNPAP is basically a buffer between me and the BON. So sending things certified mail makes no sense with this. It is my job to remind my case manager about everything that was going on with me. She wanted communication by phone but after a while of realizing that she forgot things and discussing it with my nurse support group facilitator I was advised to send her emails so I would have record of what was communicated. After a while she started saying she did not get emails, but they were only ones that if she had admitted she had gotten them would have put her job in jeopardy. I only gave a couple instances....there are many, many more. Too many to go into detail. And fortunately for me I am not the only one she has done or is doing this to. There is a long list of people, including my sponsor, that my CM has done an inadequate job for. I take responsibility for my recovery 100%. It is not my CM's job. BUT it is her job to work as my ADVOCATE and that is something she had not been doing. Like I said...too many things to go into on here. My lawyer has a timeline starting from day one of the issues that have gone on and she got a taste of it first hand when my CM told her something that was completely untrue about something I had supposedly done. It was cleared up between her and the person who could verify that it was not true and that is all that mattered. I was compliant for 5 1/2 years...still am compliant as I have set myself up with random drug screens for my own safety...not for anyone else. As for remembering detail of every prescription I have had over the past 18 months, I would not expect anyone to remember every detail. I wish I could but my memory is just not that good plus having to be on pain meds helps deplete the memory also. It has nothing to do with disregard for my recovery. I had it all in writing in my file at home but unfortunately I was 250 miles away. I could have easily cleared it up had I had all my documentation in front of me. Lesson learned but too little too late. It has also been straightened out...AFTER my CM decided to discharge me from TNPAP. A discharge from TNPAP is an automatic report to the BON. I was not working as a nurse when I lost this past job...that's the point of it. Had I been working as a nurse it would have been an entirely different issue but I was not even obligated to tell my CM about the job since I was not using my license. I did it as a courtesy so she would know what was going on with me. Believe me I have many, many emails to and from her. I am responsible for my recovery but SHE is responsible and it is her JOB, again, to work as my advocate and that IS stated in my contract and consent forms. Geez I could go on but unless you could see it in front of you I understand how hard it is to grasp. Being in recovery doesn't mean a person has to suffer. And I have been through H**l over the past 18 months with my back. Anyone who has been there and had what I have had done will tell you. I saw my neurosurgeon just this past Wednesday and he was still amazed that I was off pain meds. I am just blessed that I was able to come out the other side with a strong grip on recovery. That is what my strong recovery network and my HP are all about. There is a difference between need and want when it comes to taking meds. I would have taken an extension on my contract and told them that it would be understandable after being on pain meds. It would have made perfect sense. Unfortunately they insisted on long-term treatment and nothing less. The new 5 year contract would be mandatory if the BON refers me back to TNPAP. That is my understanding anyway. Again, it is in God's hands. I have done everything I can to protect my recovery and that is what matters. I have peace about it. Thank you so much for your post and I will let you know what happens.

NA but sometimes we go to AA also. It doesn't really matter to us but the meetings we hold at the treatment center are NA meetings.

I know this thread is older but I still wanted to comment about this subject. I am a recovering nurse (so THAT's what the name "RecoveringRN" means...lol) with 5 1/2 years clean. I won't go into all the details of my story right now but the main part is my addiction started with surgery and ended in rehab. I am also an advanced practice nurse so I had a 5 year contract with our peer program. It is the Tennessee Professional Assistance Program (TNPAP). My contract started December 31, 2003. I self reported in September '03, went through IOP from home while still working, taking care of kids,etc and relapsed in April '04 leading Inpatient treatment and 3 months of Support living and IOP. So my recovery really started June 14, 2004 and I am so blessed to have gone through everything I did. EXCEPT...and here's the kicker...TNPAP. I am not upset that I signed with them. It is a requirement so you don't get turned over to the BON. I am grateful for the accountability it gave me and for the opportunity it gave me at a new life in recovery. Unfortunately there is a down side to my story. I have lost four jobs as a direct result of my case manager talking to my employers and giving them incorrect information about me, the last one being in September. Before I go on any more about that let me say that as of last report to the BON by TNPAP in March '09 they were monitoring 379 nurses in the state of TN. TNPAP has only FIVE case managers monitoring almost 400 nurses. I have met my case manager one time; the day I signed my contract 6 years ago. Since June of '08 I have had three lumbar surgeries, the last one in June '09 being a fusion. I was told before the fusion that it would be 4-8 months of recovery with most of that time on pain meds. As of October 2 I have been of pain meds; this was 2 months sooner than my surgeon was planning to take me off of them but as I know, I should only take them if I NEED them and at that time I felt that ibuprofen was sufficient. And it was. I weaned down from the the higher dose of percocet to a lower dose and stopped. I still experienced a couple days of withdrawals but was expecting it and got through the minor discomfort. I need to add that my husband is a pharmacist and is also in recovery. (He has 2 weeks on my clean time having been clean since May 27, 2004.) My children are adults and all are supportive. In fact my 21 year old went through treatment this year and is now almost 6 months clean and living with us while she gets back on her feet. My best friends are in recovery and they surrounded me with their love and support during my surgeries. I continued my meetings throughout all this. My sponsor is also a nurse in recovery and was also my roommate in treatment (a total GOD thing there!). Because of my back issues and being off and on pain meds I have not worked using my license since before the first surgery. While still in a back brace and on pain meds I started working in September for a doctor as his medical assistant with the understanding that once I was off the meds and cleared to work under my license again it would change to a NP position. He is also in recovery from ETOH and we made the decision from the start that there would be no narcotics kept in the office. I emailed my case manager about the job just as a courtesy and to keep her updated about what was going on with me. A month later I got a call from my husbands pharmacy manager saying she had a patient that needed to be seen. While we were trying to schedule him in he went into a seizure. I was 30 seconds away by car and not busy (no patients at the time) so I ran down there. He was obviously hypoglycemic so my husband gave him some glucose, he perked up a little and when EMS got there 10 minutes later I went back to the office. I was immediately yet gently chastised by the doctor for "using my license" just by going down there. We discussed it and I explained that I didn't even take his BP but was just there trying to be supportive for the pharmacy personnel were panicking. Later that afternoon he called my case manager would generally is a good thing. They need to keep in touch also. Unfortunately for me, my case manager stated she never got the email about me working and called me threatening to turn me over to the BON. Now, this was not the first time she has claimed to either not remember a phone conversation, not remember the conversation accurately, or not getting an email. One other example so you can understand better. The day of my fusion surgery I emailed her to remind her of it and that I would not be checking in for my UDS for 5-6 days as she had put them on hold for my previous surgeries. Six days later she called me asking if I was "in trouble." She said I hadn't checked in for 6 days...big sigh...so I again reminded her of my surgery and I had also sent the email. Ultimately I was laid off from my job as doc explained, it was 90% financial (he couldn't afford to pay 2 people until business picked up) and 10% concern for his sobriety and my recovery since I had used my license and gone to the store when the man had the seizure. I saw an addictionologist that TNPAP wanted me to see before going back to work. I talked to him for one hour, was honest and thought everything went well. He asked me about a couple of prescriptions from 9 months prior when my 2 discs herniated again and I told him I couldn't remember the specifics about them. I was just so thankful to be off of them finally. His recommendation to TNPAP was I was in active addiction (yes I was off the pain meds when I saw him) and that I needed "long-term residential treatment; ie:3-4 months) and recommended a place in Alabama. Also a 6 month extension on my contract that was due to be up in 2 months. At that point it was either I do what they say or they would turn me over to the BON. After 3 weeks of discussion with my husband, my counselors and friends from the treatment center I had gone to in '04 and still hold meetings at twice a week AND with a lawyer, I decided to take my chances with the BON. I completely understood and had previously told them an extension would be understandable and I would be good with that. What's six more months. I also told them that I would be continuing random drug screens after my contract expired if for nothing but the accountability. Bottom line; TNPAP does not have NEAR enough case managers for the amount of nurses that are being monitored. Because of this they cannot effectively do their jobs, nor can they know their nurses because they are never face to face with any of them after that initial signing. These people hold a nurses license in their hands. I went through six years of putting up with my case managers mistakes, forgetfulness, misquotes, etc etc ad nauseum. I have let things go over and over because I know that resentments are detrimental to my recovery. This last one I could not just roll over and let them kick me yet again while I was down. It was time to take my stand for my life and my recovery. My lawyer used to be director of the TN state related boards so she knows the BON and how it works. She is very frustrated with everything I have been through. I understand that in the end I may end up having to do everything that TNPAP had recommended along with another five year contract but that is the chance I am willing to take and if that happens then I know I did what I felt in my heart was the right thing and I will do whatever God is directing me to do. I am trying to keep my mind open to all the possible outcomes. Bottom line is this. Peer programs are a wonderful asset to any state and I fully support them. BUT, they need to have sufficient staff to handle the amount of nurses that are monitored. They also need to be in face to face contact on a regular basis. You cannot really know someone by their reports and telephone. I have ideas for change and maybe that is where all this is taking me, I don't know. God has his plan and all will eventually be revealed....even if it's that I end up back in treatment in Alabama....lol. I hope this is enough info for you to understand yet succinct enough for it not to be a novel!! I am thrilled that I found this forum.

A close friend of mine is a diabetic and would show positive for alcohol.

Opinions are just that....opinions, and everyone has them. Yes the DSM lists addiction as a disease because there is medical evidence through genetic testing that it is inherited....thus it is an inherited disease. An addict is BORN with this genetic tendency. The first time they use a drug or take a drink that disease process is triggered. If they understand addiction and how it works then yes, it becomes a choice. But for most of us that had NO idea that we carried this genetically inherited disease it was not initially a choice. The disease processed was triggered and like any other disease it has it's own agenda. At some point if the person seeks help they can then put the disease into remission. After that yes, it becomes a choice. I have a choice today to use or not use but before I went through treatment and understood what I had, choice was not an option. It is an all consuming addiction...just like your addiction to tobacco is. Could you just up and quit smoking without withdrawals and WANTING another cigarette?? As for working, not only am I in recovery and have worked around narcotics, my husband is a pharmacist, owns his own pharmacy AND is in recovery from addiction. He works around it every day...temptation??? Of course. Is it worth dying for? NO. Opinions are OK but those based on bias, stigmas and/or prejudice should be kept to that person.