TNPAP MONITORING AGREEMENT

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Specializes in LTC.

QUESTION: First, here's my history.. I admitted to self medicating at home and diverting hydrocodone 5/325 mg -- 5 times at work for 3 months. I have not been asked for a drug test or tested positive for one, was never accused by my DON of diverting or taking anything. My DON was knew something was wrong but didn' know what was wrong. I admitted to her what I was doing because I was ashamed and knew it was wrong. Shes an amazing boss!

My DON asked that I enroll in TNPAP to save my license. My DON has created a non nursing position for me while I complete the TNPAP recommened Outpatient therapy(which is 20 sessions) and individual counseling but I have not recieved my monitoring aggreement as of yet. I have tested negative on all drug screens thus far.

My question is - what is the standard monitoring aggreement for something like this? If I am cleared for going back to a floor nursing position, what are the standard stipulations? To be able to perform a floor nursing position, I cant have restrictions such as: narcotics or supervisory restrictions. (Nurses are all supervisors on the floor of the CNA's)

I’m not from your state but think the very minimum would be a 3 year contract, and I believe most states have a maximum of 5 year contract which can get extended if you relapse or have any issues whatsoever.

For diverting you are probably looking at the most severe of monitoring agreements that your state has to offer, which would undoubtedly include the longest contract in your state (that varies), and narcotic passing restrictions for a minimum of 6 months. Other likely contract stipulations would include: no 3rd shift, no overtime, no more than two 12 hour shifts in a row, regular drug and alcohol screenings, possible inpatient or outpatient treatment, possible therapy and psychiatry, possible addiction medication, regular AA and support group meeting attendance, a worksite monitor who will be required to provide quarterly reports.

Lawyer up as quickly as possible so that they can get the very best monitoring contract to protect your livelihood. Once you sign it, that’s it. Better to get a lawyer now than regret signing a contract you are stuck in for the next few years of your life.

These programs don’t offer help, they offer nightmares and extortion while they hold your license in a vice grip and milk you for every cent you have. I don’t mean to scare you but I think it’s necessary to be that blunt and honest with you since these programs tend to be the most exploitive of the people who come in trying to do the right thing and not protecting themselves. I can commend what you did by being honest with you DON but now is the time for self preservation. Let your attorney do the talking (TAANA.org).

It looks like you’ve already had your TnPAP evaluation and gotten the recommendation for IOP? It honestly seems like you’re in a good position as far as your job is concerned if they’re willing to hold you in a non nursing position.

Standard first time TnPap contract is 3 years, two 12-step meetings a week, one online Birchwood meeting per week, and your aftercare/individual therapy requirements will be based on what your IOP recommends at discharge. Mine was meet with a therapist for a minimum of three months, and it was at her discretion on when I could stop. Some aren’t so lucky and are mandated to do aftercare meetings at the IOP’s discretion for a year in addition to the 12 step & Birchwood required ones.

I’m in Tnpap for opiate diversion and I had a six month narc restriction. I was required to work that six months then another six months without one to fulfill my contract, meaning if I wanted to work at McDonalds after that year was up for the remainder of my Tnpap contract I could do so. If you work on the floor during your six month restriction someone else will have to give your narcs for you. You can be in a limited supervisory role, such as charge nurse, but not as a manager and not in a position where you have other TNPAP participants under you. I’m not allowed to work home health, hospice, travel contracts, staffing agencies, be float pool, in a drug treatment center, or in any role where I’m alone/unsupervised. No OT for the first year, then I could apply to do so. Your employer has to fill out quarterly evaluations on you.

It seems overwhelming at first but I promise it’s not that bad. I have applied for four jobs since my contract started and gotten offered all four. I am actually happier and making more money than I was before I resigned and self reported a little over two years ago.

Specializes in LTC.

Do you have any restrictions on your license?

No. Unencumbered. I have to limit my practice to the state of TN but my compact status will be reinstated once I complete the contract.

Specializes in LTC.

Thank you so much you’ve been a huge help to me.

Specializes in LTC.

Could you tell me your whole story so I know what I may be looking at. If you don’t want to share I understand. Very nervous about this whole process. Did you do IOP? When did you get your monitoring agreement ?

Sure. Can you get pm yet?

ANYONE in TPAPN been discharged then let back in or discharged for first positive drug screen for THC?

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