Refresher Course and TPAPN?

liandra · Aug 28, 2009

Can you please explain what TPAPN is?

Editorial Team / Admin · Aug 28, 2009

The Texas Peer Assistance Program for Nurses [TPAPN]

phlox · Sep 9, 2009

I sure need help with this.

I have posted several places on this forum but I can't get an answer. First,I need a refresher course because I have been out of nursing for so long. And second, I need to be in TPAPN because I am Bipolar. PLEASE does anyone know the order of events. How do I do this? Do I do this concurrently? Does the time I do clinicals during my refresher course count as part of the TPAPN time?

morte, LPN, LVN · Sep 9, 2009

i am sorry you arent getting any response...esp 'cause i sent you over here!

try reading some of the posts here, and try to pick out a few freq posters and address a post to them directly...if you have enough posts (15) you can pm one of them...good luck

phlox · Sep 9, 2009

Thanks morte.

I was not fired or "let go" or asked to quit because of mental illness. I was diagnosed and put on medication and then thought to myself that I should quit in order to be safe. So there was never an incident of any kind. That is one reason I resent the whole TPAPN thing. I did no wrong. In fact, the way I handled the situation was closer to overkill. My DON did not want me to quit and asked me to stay. I quit so nothing "bad" ever would happen. But now for so long I have been stable and, as always, compliant with my meds. I do not drink or do street drugs.

But even so, I am clumped in with those who have abused drugs and alcohol. I was born with my condition and it makes me who I am. I am an artist and I am gifted in ways many are not. My Bipolar Disorder is not something that I should have to be ashamed of and the very idea of TPAPN makes me and others feel like it is somehow "wrong". Bipolar Disorder is not wrong and it is not some bad choice I made either.

liandra · Sep 10, 2009

I am in another state so I am not sure how things work in your state. I know we had a woman with depression that was in our group, the rest of us had substance abuse problems. (The leader has moved so currently I am looking for a new group) I can explain how it works in my state.

But, first just for your information, actually substance abuse and mood disorders such as bipolar are not that different from each other. You may be mistaken in your opinion of nurses and substance abuse and people with substance abuse period. Many of us didn't hurt any one, although certainly neglect may occur or be very close to occurring, or have occurred in some cases, especially when the disease is progressing and one is going through periods of withdrawl - one is too caught up in their own problems to take care of the patient, but you might be able to imagine, that this is an issue that can occur with those with an active mood disorder as well. Of course there are worse cases when there have been damage to a patient - those cases are treated very severly, you might not even see nurses with that type of history even getting a chance to get their license back. Many substance abusing nurses are actually very high achievers. Some used drugs in an attempt to self medicating a mood disorder. That is true for me, and as well, I found out later that I had hypothyroid, and I simply did not know how to get help for my own problems, or to recognize them, a issue that is not unusual for many caregivers. Anyway, in despiration, also in the middle of a difficult divorce, I took pain pills to give me energy to make it through the shift as they got rid of my low energy and migraines. It seems really dumb looking back, but may have happened as the only way I knew to get help - i knew in the back of my mind that of course eventually, especially if I kept stealing the pills, that someone would notice pills removed without an order in pharmacy. I could have obtained them without taking them out of the pixis, because I was taking things like even tramadol, which one can get online (not recommended - much more addictive than is commonly known) but I was just too weak and my self esteem too damaged to take the step of seeing a doctor and/or arranging therapy for my self. It turned out I was hypothyroid, as well as depressed.

I thought I'd better mention this to you, in order to help you, as you are likely to offend the other nurses in the group if you go in thinking that they were all fired, etc. Really a person with substance abuse is not always very different than a person with a mood disorder. Both are not functioning at their highest level and may not be able to see that. The substance abusing nurse in many cases has taken it one step further, started self medicating, which is a bad thing, but I'm just saying the underlying problem may not be as different from you as you think.

The nursing group, at least the one I was in, is mostly there as a monitoring group, to make sure you are following your consent orders (getting and maintaining support is an important issue - 12 step groups are recommended for the support that they can give, as well as the reality check) . There is a 12 step group called "emotions anonymous" that might be appropriate for you, as there you could find more help than a once of week nursing group can give. The woman with depression in our group, attended this 12 step group. Mostly the nursing group is helpful in that we discuss licensing issues, how to deal with the board, and keep an eye out for each other. They most often don't address the emotional issues, except to recommend getting in closer contact with your home group and sponser when needed.

In our state, it is the state branch of the American Nurses Association, or your state branch, for example if you are in Texas, the Texas Nurses Association that sponsors the impaired nursing program. So you call them, and they can give you a list of groups. You call up the leader of the group closest to you to see if you can join. If that doesn't work, call the state licensing board, and they will direct you where to go for the impaired nurses program. Once you join the group, you will get more directions on what exactly you need to do.

You may first need to speak to the person in charge of the impaired nurses at the licensing board.

I can see where, in order to keep the patient safe, they want you to be monitored for a few years (maybe less than substance abusing nurses - even within this group the consent orders will vary)- the board will write up your consent order based on your individual case - to make sure you are remaining stable, just as they do with substance abusing nurses. If you are doing really well, then you are likely not to have severe restrictions. Just make sure you are looking at yourself correctly, in bipolar disorder there can be periods of grandiosity, where one thinks they are in exception of everyone else, so it may be important for you to be humble about your condition, and not to assume that you are that much different that nurses with substance abuse issues.

I wish you the best. Feel free to respond to me at anytime, I realize I may not be able to help you in more specific ways, being that I am out of state, but I am on your side and want to see you remain well, and want to be supportive of anyone in what can feel like a very lonely position.

sallyrnrrt, ADN, RN · Sep 14, 2009

Thanks morte.
I was not fired or "let go" or asked to quit because of mental illness. I was diagnosed and put on medication and then thought to myself that I should quit in order to be safe. So there was never an incident of any kind. That is one reason I resent the whole TPAPN thing. I did no wrong. In fact, the way I handled the situation was closer to overkill. My DON did not want me to quit and asked me to stay. I quit so nothing "bad" ever would happen. But now for so long I have been stable and, as always, compliant with my meds. I do not drink or do street drugs.
But even so, I am clumped in with those who have abused drugs and alcohol. I was born with my condition and it makes me who I am. I am an artist and I am gifted in ways many are not. My Bipolar Disorder is not something that I should have to be ashamed of and the very idea of TPAPN makes me and others feel like it is somehow "wrong". Bipolar Disorder is not wrong and it is not some bad choice I made either.

OK lets do it in steps..ie what is you TxBON status, did you keep your lis. renewed and appropriate CEU hrs etc?

If not, you will have to first petition the board for reactivation, re-instatement, TxBON usually issues a temporary lis. for the distinct purpose of completing a refresher course( for me PHES.com was very useful, they are out of Houston, but a lot can be done via correspondence, they also hold classes in Dallas, SanAntonio , TPAPN is usually very resourceful, and will help direct you also........ Good Luck, and WELCOME BACK !!! :nurse:

catmom1, BSN, RN · Sep 18, 2009

Thanks morte.
But even so, I am clumped in with those who have abused drugs and alcohol. I was born with my condition and it makes me who I am. I am an artist and I am gifted in ways many are not. My Bipolar Disorder is not something that I should have to be ashamed of and the very idea of TPAPN makes me and others feel like it is somehow "wrong". Bipolar Disorder is not wrong and it is not some bad choice I made either.

There are many who believe that addicts are also born with their addiction. But that is not my main point. It sounds like you are struggling with feeling "less than" others because of your condition. Understanding that bipolar is nothing to be ashamed of is your job to overcome. When you do, you will feel a lot more at peace with yourself, whether you return to nursing or not. Everyone has struggles in life, unfortunately some are more public than others.

To answer your original question regarding refresher courses, etc, you should contact your BON to ask them how it would work. In my own case, I took a course from among those approved by my BON and only after that did my probation time start.

Phlox, keep in mind that your probation is only for two years, and then your license is free and clear, unlike how it works in my state, where no matter what, you have a permanent negative mark on your license if you have been on probation for any reason.

Good luck getting back into nursing,

Catmom :paw:

exnursie · Sep 19, 2009

my bipolar disorder is not something that i should have to be ashamed of and the very idea of tpapn makes me and others feel like it is somehow "wrong".

i agree with catmom on this, and that you are in charge of how you feel, and

it is your job to overcome your feelings about your illness. it is common that people blame the bon and think that the bon is all about punishing, or demeaning , or ostrasizing the nurses they monitor. but please try to see that

it is not the bon's fault that this is how you are feeling, it is yours.

the concept behind any bon monitoring program is based on the idea that the ability to regain a stable life and return to sucessful nursing practice.

phlox · Jan 20, 2010

I have not been here to the forum in a good while and came back and was pleased to find more comments to my post. It is wonderful to have all of yalls ideas and thoughts. I have such a low opinion of myself. I have gained weight, ny feet hurt, I am not the woman I was before. I want to be that vivacious nurse running up and down the halls again and not the sad person I am now. Just knowing that there are people who think I have even a remote chance of being a nurse again makes me smile and feel like a real person again.

I am going to make the changes I need to. I must get a new Texas ID. And I will make the calls I need to. I guess I will need some scrubs and shoes and stuff. I still feel so far away from all of this.

sallyrnrrt, ADN, RN · Jan 20, 2010

come on back girl, I might suggest starting back in LTC, pace a little slower, and believe it or not rewarding, home health another option.... ! :yeah: