TPAPN friendly employers in Austin?

Tigerlily8 · Aug 16, 2018

I suggest that you apply at the local psychiatric hospitals. Home health is also TPAPN friendly but if you don't have experience there is a steep learning curve and it is a difficult way to earn a living. Once you are assigned an advocate, that person may have suggestions. Are you able to PM me? I do not want to post my employer's name here.

JustBreatheRN · Aug 17, 2018

Unfortunately it won't let me pm you. Can you pm me or is there a way I can navigate this?

Edit: I do have home health experience

caliotter3 · Aug 17, 2018

You need a total of 15 'quality' posts before the PM function is available. By 'quality', they mean you have to actually say something, not just, "yeah", or "I agree".

Recovering_RN · Aug 18, 2018

Home health was my first job after I got into TPAPN. Since you have experience that might be a good fit for you. I don't live in Austin though so I have no agency recommendations.

There's an extra form in the paperwork packet for "distributive nursing settings" or something like that, which just means you are out there without your nurse supervisor watching you all the time (I think school nursing is another example of that). You'll need to check in with your manager every day you work prior to seeing patients, (just a simple "hi, I'm here) and you'll check out with your nurse manager after you finish for the day. One of those check ins/outs can be by phone, the other must be in person. You'll need multiple people at the home health agency (secretary, HR person, whoever) who will also be allowed to accept your "check in" and "check out" because there will be times your manager is unavailable. So those people's names will go in the paperwork too, I think. TPAPN requires that every one of these check ins and outs be recorded with your manager's signature (or other designated person) and you fax those sheets in with your quarterly reports (well, we don't fax quarterly reports anymore, do we? Hmmm, ok, idk how they keep track of that now then, sorry). I consider that signature page (it has to have date, time, and signature for every single day you work) pretty time consuming for your employer to keep up with so I know I was SUPER GRATEFUL mu employer agreed to do it! They'd had a TPAPN nurse already so they knew the drill.

I only lasted 8 months in home health, it just wasn't for me. One of the things I hated was that check in and check out was a constant reminder that I was in TPAPN. If I had to see a patient on a weekend, I had to drive to my manager's house or meet her somewhere first, to "check in", and call afterwards to "check out", and it was like I could never ever forget that I was in TPAPN! In other jobs, once the narc restriction is over, you pretty much just do your job and TPAPN doesn't really come up much, other than the quarterly reports, but that daily check in/out really wore my spirit down! But hey, it's a job!

JustBreatheRN · Aug 25, 2018

Did you apply for a different job when you left? Do you have to start narc restrictions all over again if u leave the job before the year long period? The narc restrictions are what really make it hard to find woek

Recovering_RN · Aug 27, 2018

Did you apply for a different job when you left? Do you have to start narc restrictions all over again if u leave the job before the year long period? The narc restrictions are what really make it hard to find woek

Unless your restrictions are different than mine were, the narc restriction is only 6 months. Once it's done, it's done. After my narc restriction was completed during my home health job , I applied and was hired at a free standing ER/urgent care. There's only one nurse there at any given time, and the nurse manager works office hours (M-F 9-5) so we had to get the physician medical director (and maybe all the other doctors who work there? I'm not sure, I wasn't part of that conversation, it was between my hiring nurse manager and my tpapn case manager) to agree that the doctor who was on staff while I was there would be considered my "supervisor" as far as TPAPN rules go.

But no, the narc restriction does not start over. Once I finished 6 months, while I was at the home health job, my case manager informed me my narc restriction was lifted. Then applying to the free standing ER company was much easier, their only responsibility was that someone be considered as my "nurse supervisor" (I work night shift so my hiring nurse manager had to assign the doctors as "supervisor").

You mentioned a "year long period". If we had the same contract, TPAPN requires that you have one year (12 consecutive months) of work as a nurse in order to complete the TPAPN contract. My case manager told me that my eight months at the home health agency would be added to any additional time that I had at my second job, the freestanding ER,to complete that 12 month requirement as long as there was no space in between my first and second jobs, and also assuming I left the first job in "good standing".

I only mention that 12 month thing because I seriously considered avoiding the shame and humiliation of interviewing, where I had to admit that I was in TPAPN, by taking a three year leave of absence from nursing. I wanted to just stop working for three years, until I was finished with TPAPN , but TPAPN doesn't allow that. You have to work as a nurse for 12 months, in order to complete your tpapn contract.

ATXRN83 · Jul 24, 2019

Hi Just BreatheRN...I am in the Austin area and am just starting my TPAPN journey. I was just curious about what you did for employment up until you were cleared to nurse again. Also, if you had any luck finding a TPAPN friendly employer in our area? Any insight would be appreciated!

Tigerlily8 · Jul 24, 2019

Hi ATXRN83,

I reside in the Austin area and recently completed TPAPN. My first job in TPAPN was in Home Health. It was not really for me, I found it to be a difficult way to earn a living but it did allow me to circumvent the narcotic restriction. Another advantage was some control over my daily schedule and the opportunity to catch an AA meeting during the workday. I worked for 2 different Home Health companies, Jordan Health Services and HealthAtHome, and was offered a position by Encompass. Eventually, I ended up in Psych. Again, it is not an easy way to earn a living. The narcotic restriction should not be a big deal in Psych, I work in Psych now and really do not give that many controlled substances, mostly Haldol, Geodon, Zyprexa but with a sprinkling of Ativan and Xanax.

I would suggest focusing on the smaller agencies and facilities. I must have applied for hundreds of positions @ Seton, Baylor Scott & White, St. Davids and the State of Texas to no avail. Among psych facilities, I have applied to Rock Springs many times without success.

Best of luck to you.

Are you able to PM me?

ATXRN83 · Jul 24, 2019

Thanks so much! I don't have the PM feature yet as I've just recently joined the forum but will gladly give you an ancient unidentifiable email address you could use to send me any info. I was actually thinking about Rock Springs as that's where I did my MH rotation.

[email protected]

rn1965, ADN · Jul 25, 2019

To you TPAPN/TX nurses:

I was originally licensed in AZ, and was revoked for not completing their diversion program. I decided to get back into nursing, but live in TX, so decided to do it here. I have been sober since 2005.

I have done the didactic portion of the refresher, and submitted all my paperwork for endorsement (for the temp permit to do clinicals) and of course (as I expected it would) the app went to the enforcement department. That was over 4 months ago and I cannot get any response from anyone at the Board of Nursing. I have called, emailed, written, to no avail. Do you have any idea how long that process really takes? I know the website and app say 90 days, but we are waaayyy over that now.

I am trying to be patient, as I do not want them to decided I am a pain and not give me a temp permit/license, but, I am afraid I am going to lose my clinical spot. Any suggestions??

ATXRN83 · Jul 30, 2019

Tigerlily8-

I can't get into the old email I posted for you so I'm not getting anything you may or may not have sent. I'll put my direct email at bottom. I have one other question for you. Where did you do your IOP? Would you recommend it? Also, are you an advocate for TPAPN? You should be. You have calmed my frazzled nerves just by sharing your story and by being willing to share your information which really helps since we're in the same area. Anywho I'll put my email so you can send anything you feel would be helpful or encouraging. Thanks a ton!

[email protected]