LisaRNsober

I have been told that there are certain periods of time in recovery that are known to be "high risk relapse." And i told me that recovery programs will increase testing around these times. I believe they are the first week out of rehab, 30 days, 3 month, & the 1 year mark.

It's no secret nurses in recovery have a difficult time finding employment. My google research has lead me to believe it's next to impossible and getting harder everyday for Texas TPAPN nurses to find jobs. I am currently just getting started on my "post getting sober and enrolling in TPAPN" job search. As a newbie at this process, one of my biggest fears and concern is the issue of when to mention TPAPN and what specifically to say about it. Or in my case not to say. As I have a history of over-sharing at times when I would have been better off shutting up. I thought it would be helpful (especially to me;) If those of you in who have been at this longer shared your tips and tricks. Examples of what worked and what didn't. All of us here could use all the help we can get. Topics I would be interested in hearing about: Situations where you worded your "confession" in such a way that was well received or perhaps not well received. Has there been anything you've said that afterwards...you wish you could take back. Examples of questions you've been asked after reveling your participation in your state's program. Success stories. Mistakes you've feel you've made during the process. Things you've said or done that worked well. Please share your experience and wisdom!!! I'll go first. After applying for a position at a large hospital they emailed me and scheduled a phone interview. I had already been advised "not mention TPAPN on the first date" and to wait until they liked me and showed interest. So I was caught off guard when she asked if I "had any restrictions on my license." I wasn't anticipation that question and my gut reaction was to of course not lie. So I told her I was in TPAPN and then started babbling about that's all behind me and I'm completely ready to go back to work...blah blah blah I was definitely not prepared for that question. They never called back. I wasn't shocked. Later when telling my advocate about what happened she informs me that my license does NOT in fact have any restrictions on it. I was thoroughly confused. She then explains to me the difference between restrictions on your nursing license and TPAPN required work restrictions. Well I wish someone had told me that sooner!!!

Please don't regard this post as complaining about tpapn. I am eternally grateful that TPAPN is an option. Yes it's got it's positives and negatives, but overall I'm thankful to keep my license. The following is an issue that initially a negative influence on my recovery. Irregardless of your DOC, length of addiction, severity of addiction, self reported, caught red handed...whatever... here you are. The fact that you are participating in a nurse recovery program indicates that you have a desire to keep you license active. Courtesy of my duel diagnosis, I am required to maintain ongoing sessions with a licensed therapist. I am also required be under the care of a psychiatrist. (I believe minimum every 3 months but I go monthly) In order to maintain compliance, I had to sign a waiver of confidentiality between all my providers and tpapn. In addition, both of these professionals must submit periodic reports on my behalf or I am deemed non-compliant. I personally hand picked my MD and therapist. They were not assigned. These are the professionals that I chose to pay a fee to in exchange for their services. I pay them to provide me the benefit of there education, knowledge, and experience. One of the questions on this required report is: Is this nurse safe to practice? So here's the conflict. If I do so happen to relapse it would obviously be in my best interest (as far as my recovery) to tell my health care providers. Don't we all love the patients that lie to their doctors and the entire healthcare team?? But because I know this person is going to report weather or not they believe I am safe to practice, if I want to maintain employment, hell no I'm not going to tell them. Ignore the issues related to mandatory reporting laws...harm to self/others. That's not what I'm referring to. I'm concerned about the issues that arise while in early and stable recovery that SHOULD absolutely be reported to your care providers. However, reporting these issues could cause them to believe you are not safe to practice. What if I'm having cravings. What if I say I've been fantasizing about using. What if I tell them I started diverting again. If I want to keep my job, I'm keeping my mouth shut!! And in not seeking help I continue to put my recovery at risk even further. It's a catch 22. I understand why the program is designed like it is. And I have absolutely no idea how to make it better. Furthermore, what is the liability to a doctor if you did report a relapse, they don't tell the board and continue to report that you are safe to practice....and something catastrophic happens because you were high at work? When signing up to become a nurse, we waive certain rights and privileges by accepting the license. We accept that we are not always going to get our legally protected break times. People in other professions have a federally protected law that states they can take 12 weeks off of work to seek drug and alcohol treatment and there jobs are protected. Yeah FMLA. Nurses who seek treatment for addiction are not protected by this law, and are subject to discipline. Every 2 years we are expected to fully disclose our federally protected right to privacy as it relates to medical care. We understand the rules are different for nurses. I just have a hard time embracing that when seeking medical treatment for a significantly life threatening disease. We nurses waive our fundamental right to doctor/patient confidentiality.

I have a few random questions about TPAPN that I hope ya'll can help with. Yes I know I should call my advocate or case manager. However, typically my advocate doesn't know the answer to my questions. And it typically takes 1-3 days to hear back from CM. Plus, I try not to call her unless absolutely necessary. I check in everyday and understand that I can be tested on any given day. However, all of the quest diagnostic labs within driving range (and there are many) none are open on Sat/Sun. Has anyone ever been called to test on a Sat and had this issue? I understand that I may be asked to give blood, urine, hair, or saliva. I have been tested 6 times thus far and they have all been urine. I was wondering if any one has ever been asked to give hair, blood, or swab....and if there was a difference in cost?? I am not in any way trying to be deceptive, I am really just curious. I know I have to disclose my tpapn participation to my employer. I also now that I sign a consent for my employer and tpapn to communicate. However, does TPAPN ever disclose details to a potential or current employer. For example, what drugs I reported I was abusing? And/or could my employer request my tpapn file? Thank you for reading.

Please don't assume I'm seeking information for selfish reasons. I'm am grateful to be clean and sober since July 2012. These questions came up during a friendly debate with my brother. He's of the opinion that all forms of drug testing should be illegal, I don't want the government in my business types. He's a nut and I love him! Some questions came up that google couldn't answer!! I just want to make clear that this post is curiosity motivated only. Has anyone ever ben asked for an "observed urine collection" pre-employment drug test. I always thought (not sure why) that observed urine collection was illegal by employers in Texas, and only allowed for court ordered, probation related types of situations. He said that's not true and it's at the employers discretion. Any answers out there?? We also debated the legalities of pre-employment screening. Can an employer demand the test be observed as a condition of employment. If you think like a lawyer....you could reasonably argue that "a requirement of employment involves allowing a stranger to see your genitalia." I can't recall ever having a pre-job test that was observed. Has anyone ever experienced that? I have had an observed collection at the hospital when a bunch of us had to test when the narc count was off. It didn't bother me because I understand the rules are different in healthcare...but I can see how it might bother someone. And why is it that hospitals send you to an outside lab for pre-employment testing, use the hospital's own lab for post accident or random testing, and collect the specimen in house and then send to an outside lab for a reasonable suspicion drug test? Recently Baylor announced that all new hires are required to do mouth swabs for tobacco use and they will not hire a smoker. Does that mean down the line they could randomly test employees or become suspicious that someone has started smoking, then terminate? Also, I find it interesting that with TPAPN participants (the Texas peer assistance program for nurses in recovery) randoms are unobserved. The paperwork says that they CAN request hair, blood, urine, and saliva. I'm curious if anyone has ever been asked for hair, blood, or saliva while in a state managed nurse recovery program? It seems to me that hair testing gives more information and is harder to "trick" than urine. I have no idea the cost, but my understanding is hair testing goes back 90 days. If I'm in charge of hiring people, i would rather know if they had used in the last 3 months vs the last 3 days. Have anyone been asked for hair, blood, or saliva during a pre employment or while employed in healthcare?

Thank you all for your kind words. I realize how really lucky I am that I got help before I hurt someone or otherwise caused myself more hardship...I try not to beat myself up to much....but occasionally the feeling so angry at myself gets overwhelming.I asked my advocate about cadeous meetings and she didn't know. I'll call tpapn after the holiday but if any of y'all know of a group in the Dallas area please PM me.

My name is Lisa, and I'm an addict. Good, got that out of the way. I've been in TPAPN since Aug 2012. Sober since July 19, 2012. I'm sure my story is no different, no better, no worse than most so I'll spare the details. I self reported to both my employer and TPAPN. In hindsight, only the latter was a sound decision. I really only self-reported to my employer in that I was requesting medical leave for inpatient treatment. (my hubby and I had already decided I was going inpatient for 30 days before I reported to anyone) Unfortunately, my employer didn't appreciate my honesty (yes that's sarcasm). And like so many other Texas TPAPN nurses, here I sit with no job. Once I knew that I would NOT be returning to work after FMLA leave, I was fortunate enough to be able financially to not work for a little while. So I have spent this time focusing on my recovery, my self, my family, and of course my mental health...the things we nurses never have the time to focus on. And to be able to have this time off of work without the stress of worrying about an income (well not major stress), I am truly grateful. I knew it would be difficult to find employment once on TPAPN. I've accepted this. My thinking was...no one wants to hire a nurse who is 45 days sober. I believed employers would be more receptive if I applied for a job at 5-6 months sober. So in the past 3 weeks I've applied for 7 jobs. I know that's not a lot. But NO ONE has called me back....well 1 did. She asked if I had any restrictions on my license so I felt I had to be upfront. My advocate has since explained to me the difference between restrictions on license and TPAPN. So moving forward I better know how to answer that question. Needless to say, I haven't heard back. This is completely distressing to me. I'm ready to go back to work (part time). I want to go back to work. I was not cut out to be a stay at home mom. I'm just not built that way. I'm afraid the longer I stay unemployed, the more likely I am to get really depressed again. The worst part is I've had such a good reputation in my area. I've worked at 3 local hospitals over the last 11 years, and developed such good relationships with doctors and nurses. In the past, when I was ready to leave a facility I picked up the phone and called in a favor. Going in for the interview was just a formality. I've never had to deal with a situation like this. Although I never "came out" officially to my co-workers, they all know. Towards the end I wasn't kidding anybody. So of course when I email or text asking if I can use them as a referral...I get no response. So what do I do?? I know there are TPAPN nurses out there with jobs. Anyone out there in cyber land want to put in a good word for me?? Referral bonus!! YEAH!! Anyone know of any PT day nurse jobs in the Dallas area where I won't work alone, or nights, or call.... All joking aside, if anyone knows of a nurse support group in the Dallas area please let me know. If not, lets make one. The worst part if feeling so isolated from my peers. Doesn't have to be a 12 step thing...let's just get together and vent, complain, and support each other through this. Maybe even help each other network for jobs. Thanks for listening to me gripe.