TnPap (Tennessee)

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I worked in critical care and was hoping someone had some information to help me because I was told I would be turned into TnPap. They said that I had pulled more meds during one month than other nurses in my unit, and I wasted incorrectly on a narcotic because I typed a 3 instead of 2mg in the Pyxis machine. I never gave anything outside of a doctors order, I was simply flagged due to giving more than my peers in one month and typing in an incorrect waste number. I was completely baffled at the way my situation was handled because my clinical manager walked me out in front of my friends/coworkers an hour after coming into work to take on two VERY CRITICAL patients. After some discussion, I agreed to a urine test and asked for some water. Then my clinical manager said I would have to be written up and take off two weeks of work. I asked to pull up patient charts and wanted to know what my rights were, they didn’t want to go over either with me. During our discussion on the matter, the interventions coordinator laughed at me when I said I had three degrees and would not risk that by taking lethal medications that could kill me. At this point they completely disregarded my confidentiality (again) and opened the door to the room for our MRT (rapid response) team to come in and get their keys/backpacks. I was so embarrassed at this point that they could treat me this way as a person, let alone as a nurse, that I walked out. Some Backstory: My situation is simple in the fact that I do not have to work because my husband makes enough money; I work because I love what I do. Critical care was a stepping stone in my career and I was waiting for my boss to come back from vacation to turn in my resignation out of respect. When this situation occurred, my boss was on vacation.

Upon walking out, I explained that I was not going to be treated this way by being mocked and that I was so embarrassed on the way things were being handled. I also said that I felt like it was extremely disrespectful due to the lack of confidentiality. I explained to my clinical manager that I was putting my notice in anyway but I was waiting for my director to get back from vacation out of respect for doing so because I had better offers on the table.

After this, they said they were turning me into TnPap. I consulted a lawyer who suggested I go through the evaluation process to go ahead and get it underway and to have paperwork documented to prove I am not using drugs. So, I self-reported to TnPap at this time and explained my situation. During my TnPap evaluation, I did a urine test ($70), saw an independent evaluator for one hour ($500), then spent $290 for a hair follicle test which was a 14panel. All tests came back NEGATIVE. My evaluator said he did not see anything that would signify me as abusing narcotics in which the drug screens verify that.

Now, TnPap wants me to agree to a “Monitoring Program” for 6 months. I am not sure if I want to accept this since I don’t have an abuse problem, it was documentation errors. I was wondering if anyone else had some helpful information to inform me on the right decision. My issue lies with the facts that TnPap does not guarantee that the BON won’t get involved regardless of doing what they say. I have all documentation showing that I don’t have a drug use problem, so I don’t understand why I would need to be monitored? I asked TnPap why I would need to be monitored when I don’t have a drug use problem, and their response was “for extra assurance”. Can anyone give me some better input as to why it would be beneficial? I feel like this program is not beneficial to individuals like me who have not done anything wrong besides misdocumentation.

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Specializes in Med/Surg, Women's Health, LTC.

GET. AN. ATTORNEY. Yesterday! Have them handle this. Especially if there was no positive tests.

What did the test done at work say?

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Don’t agree to anything!! Get an attorney. Take a job offer that’s on the table if you choose. You can beat this!

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4 hours ago, rn1965 said:

GET. AN. ATTORNEY. Yesterday! Have them handle this. Especially if there was no positive tests.

What did the test done at work say?

I ended up not taking the drug test at work because of the lack of respect I kept receiving, the mocking, and the lack of confidentiality they were giving me so I ended up walking out after agreeing to do the urine test. I did my urine test and a hair follicle test through TnPap in which both were negative. I have consulted a lawyer in Nashville which I spoke with before and he said for me to go ahead and do the evaluation process, so I did. I’ve tried reaching out to him again because even though all my tests were negative, TnPap wants me to agree to a monitoring agreement for 6 months. During this monitoring period I can work, I will be drug tested randomly, have meetings, and required to have to tell my new employer. I don’t see why doing this would be necessary when I didn’t do anything wrong besides messing up my documentation.

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Specializes in Med/Surg, Women's Health, LTC.
3 minutes ago, ams0822 said:

I ended up not taking the drug test at work because of the lack of respect I kept receiving, the mocking, and the lack of confidentiality they were giving me so I ended up walking out after agreeing to do the urine test.

In my experience and from what I have heard, refusing a "for cause" drug screen is considered a positive by most employers and nursing boards. I understand your frustration with them, at the time, but, unfortunately, in their eyes, you had something to hide. Even if you didn't.

6 month monitoring seems like a pretty relaxed "punishment" for what I have read on these forums, so, I may be inclined to take it.

Or, you can reach out to an attorney who has experience in dealing with license defense and see what they can do, especially if you are not getting anywhere with your current attorney.

These are only my opinions, as I am not and cannot offer legal advise.

Good luck and keep us posted!

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1 hour ago, Randomnurse3 said:

Don’t agree to anything!! Get an attorney. Take a job offer that’s on the table if you choose. You can beat this!

I reached back out to my attorney in Nashville to see if he will give me some more free advice. I don’t believe I would need to drop money on a lawyer right now unless the BON gets involved. But TnPap said that if I don’t do the monitoring agreement that they will close my file and it goes to the BON. Even though there is no proof of me “diverting” or “abusing” medications. I simply had pulled more meds than my peers and wasted incorrectly in the Pyxis. In which I did find out from my coworkers that most of them were giving multiple doses from a single vial. I was only giving one dose per vial because each vial is SINGLE USE. So I got red-flagged for it because I pulled more than my peers. Even if I did the monitoring agreement, it still doesn’t guarantee that the BON WONT contact me later. They just “usually” go with what TnPap has put on file (this was straight from my evaluators mouth). But I feel like even if I got investigated by the BON, they will see that I completed the evaluation process, all documentation was shown to be negative for drugs, my physician evaluator describes me not having a drug problem, so would they really try to pursue this with no evidence?

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14 minutes ago, rn1965 said:

In my experience and from what I have heard, refusing a "for cause" drug screen is considered a positive by most employers and nursing boards. I understand your frustration with them, at the time, but, unfortunately, in their eyes, you had something to hide. Even if you didn't.

6 month monitoring seems like a pretty relaxed "punishment" for what I have read on these forums, so, I may be inclined to take it.

Or, you can reach out to an attorney who has experience in dealing with license defense and see what they can do, especially if you are not getting anywhere with your current attorney.

These are only my opinions, as I am not and cannot offer legal advise.

Good luck and keep us posted!

Yes you are exactly right and I wish I would have known that at the time because then I would have peed at work and then put my notice in. Maybe the 6 month monitoring is a light punishment because I was negative. I have long hair down my mid-back, and a hair follicle test shows up to a minimum of 3months of substances. In some cases they will test a whole strand of suspected, which for me would be at least a years worth of any type of abuse. I think I will try to find another attorney if I don’t receive a call-back today to see what advice they have to offer. I appreciate your input!

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3 hours ago, ams0822 said:

I reached back out to my attorney in Nashville to see if he will give me some more free advice. I don’t believe I would need to drop money on a lawyer right now unless the BON gets involved. But TnPap said that if I don’t do the monitoring agreement that they will close my file and it goes to the BON. Even though there is no proof of me “diverting” or “abusing” medications. I simply had pulled more meds than my peers and wasted incorrectly in the Pyxis. In which I did find out from my coworkers that most of them were giving multiple doses from a single vial. I was only giving one dose per vial because each vial is SINGLE USE. So I got red-flagged for it because I pulled more than my peers. Even if I did the monitoring agreement, it still doesn’t guarantee that the BON WONT contact me later. They just “usually” go with what TnPap has put on file (this was straight from my evaluators mouth). But I feel like even if I got investigated by the BON, they will see that I completed the evaluation process, all documentation was shown to be negative for drugs, my physician evaluator describes me not having a drug problem, so would they really try to pursue this with no evidence?

Sending you a PM!!

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I would take the 6 months contract and just go with it. You will spend untold amounts of time and money fighting this and in that time you do that, you could be done with the monitoring. Also, if you don’t accept it, then TNPap WILL get the board involved in the meantime.

Find out if you even have to work while on the contract. Because if you don’t, take the six months off, do the meetings and the screens, then go back to work like nothing happened. I don’t have to work as far as financial reasons either, and you better believe as soon as I meet my requirement of working 6 months with no restrictions I am OUT of nursing til this contract is over.

Don’t worry that the board will still nail you anyway if you take the contract, either. As long as you’re compliant, the board will look at that and accept it and nothing will be noted on your license.

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I’m not from Tennessee but I will tell you this. These programs don’t care if you innocent or not. They want money. I can’t go to much into detail about my case due to not wanting my nursing board to know it’s me but I proved to these people I never took drugs. Urine, hair and a 2k evaluation said I didn’t have any problems but guess who still have to do 2 years of monitoring? Me. I wish they did offer me 6months I would have been done a long time ago. I know it’s not fair that they still want you to do monitoring but at the end of the day they make the rules and you either follow them or lose your license.

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Specializes in LTC.

Does anyone happen to know that when you get your monitoring agreement and it says you have a 6 month narc restriction... Does that restriction start from the day you get your agreement OR the day you signed up for TNPAP? I'm finished with my IOP and individual counseling and about to sign my monitoring agreement. Thanks!

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Specializes in Med/Surg, Women's Health, LTC.
32 minutes ago, sam2brooke said:

Does anyone happen to know that when you get your monitoring agreement and it says you have a 6 month narc restriction... Does that restriction start from the day you get your agreement OR the day you signed up for TNPAP? I'm finished with my IOP and individual counseling and about to sign my monitoring agreement. Thanks!

I was lucky enough NOT to get the narc restriction, but, from everything I have read, at least in TX, the narc restriction is WHILE working. So if you do not get a job until 18 months into your contract, the 6 months starts there.

Not sure how TN works. I have talked to nurses in other states and they say the same as Texas rules, WORKING 6 month restriction.

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