TNPAP Right or Wrong?

[Marie2021, BSN]

My situation is different. To make a long story short, I befriended a new neighbor and her kids. She made T-shirts, hats, etc. She did family reunion T-shirts for me and was I was impressed with her prices and skills. One day she texted me while I was at work and asked could I stop by the post office and pick up her package, so she could finish my order that night. That was no problem. It was on my way home. I stopped by the post office, picked up her package and as I was walking out the door, I was thrown to the ground and a gun put to my head. It was the most humiliating thing I'd ever experienced. I was so scared I peed on myself. My nursing uniform was torn and ripped. Apparently she had been getting drugs through the mail. The package I picked up for her had 500g of marijuana in it. I was given probation for that offense. Fast forward to now. I was given a consent order by the board of nursing to undergo a TNPAP evaluation. I don't drink, I don't smoke and I've never used drugs. Also I've never had any disiplinary action against my nursing license. I have never failed a drug test ever. I have never been suspected of taking or diverting drugs. Even through my court proceedings I was subjected to random drug screens that I gladly took to proove I didn't do drugs.

I went through the TNPAP evaluation ($800, $600, $400, $400, $70 per drug screen. Of course I couldn't work while doing all this. OK the recommendations were 1. that I complete level 1 outpatient counseling for anxiety, depression and PTSD. 2. Consult with the therapist about the appropriateness of Wellbutrin and Lexapro for PTSD, and 3. Consult a pain management specialist for chronic pain management education. My question? What does any of this have to do with nursing and my ability to take care of my patients and perform the job that I've done for over 26 years. The level 1 therapist is $400/month. I am veteran and I am I already being treated for anxiety, depression, and PTSD through the VA for free. I have a great relationship with my therapist of 8 years. Also I've taken Wellbutrin for years and it has been very effective for PTSD. It is a drug that is NOT allowed under the TNPAP monitoring agreement, but it's also a drug that you don't stop abruptly. 

The other issue I have is that I was a nurse in an Army Combat Support Hospital and was injured in the field. Now I have some permanent nerve damage in my right foot and have been diagnosed with neuropathy and lymphedema. My doctor prescribed Gabapentin, but it is also a medication NOT allowed while under TNPAP. If I choose to continue to take these medications, I can't work at all in any form as a nurse. I have worked for years while taking these medications. 

The issue I have is that TNPAP should be specific to each individual. Everyone's situation is different. I was NOT found to be a drug addict. I can go back to work without restrictions as long as I stay under the TNPAP monitoring agreement for 2 years. It makes no sense to me. I don't need a stranger to step in and charge me for something I'm already getting for free. My job is aware of everything and my boss has been so supportive and she has known for years about my military injury as well as the medications I take as I've worked at the same place since 1999. I'm stuck between a rock and a hard place. Any advice for me from anyone?

[AbbeyR, ADN, BSN]

I am so unbelievably sorry this happened to you. Unfortunately with the mental health history you are going to be stuck in the monitoring program if you want to work as a nurse. I would definitely fight to continue to stay on your prescription medication. But I’ve read on this forum it’s difficult. Do you have a criminal conviction as well? If you are able to keep your job by signing the monitoring contract that might be a good thing and 2 years is very short compared to other States, the avg is 5.

[DistressedRN]

Wellbutrin (Bupropron) is absolutely 100% allowed under a TNPap monitoring program.   Buprenorphine is not. 

[Knurse1967, RN]

Unfortunately these monitoring programs are designed as one size fits all. I’m sorry this is happening to you. You should be able to take your Wellbutrin. I would double check. 

[LMRN2003, MSN, RN]

I'm sorry this happened to you. I am very surprised that Wellbutrin and Gaba are not allowed. I am in CA and was taking both of those and was totally allowed to since they were both prescribed by psych/addiction docs. I am also a veteran! Was in the Navy. These programs definitely need reform. They are not very rehabilitative, especially for someone like you who does not have addiction problems. It is unfortunate that you are being treated as such. I don't think addicts should be treated in such a punitive matter either, but it's much worse when someone that truly doesn't have a problem has some bad luck. Hang in there and I would fight to be able to take those meds bc you are absolutely correct that Wellbutrin should not be ceased abruptly.