TPAPN Success Story

[TexTPAPN]

Hi All!

I just wanted to give some support and info and let you guys know that while monitoring totally sucks, it is VERY doable and I have actually completed this process and if I can do it so can you!

I have been on this message board before under another user name, so I won't go into much detail regarding my story and how I ended up in TPAPN....let's just say I was pretty much railroaded into the program (and YES you CAN end up in monitoring if someone petty reports you), NO I didn't divert, and no I didn't get a DUI, no I didn't abuse anything other than alcohol ON MY OWN TIME. No I didn't compromise patient care or show up to work under the influence. And in the words of Forrest Gump "that's all I have to say about that".

But I would like to say that I found the program doable, if not super expensive. I didn't have to do any inpatient treatment and for that I am super grateful and very lucky; however I did have to complete a very pricey evaluation with one of the "approved" evaluators. I also had to complete outpatient substance abuse counseling, which in retrospect I actually found very helpful, along with the AA meetings (UGH). I had two very helpful and supportive case managers, and one who was pretty much no help at all (basically 3 case managers in 2 1/2 years), as well as a super awesome peer monitor.....and for some unknown reason I was actually discharged early! I'm not sure if it was because I probably should have been in the EEP Program (the short duration monitoring), or because I followed ALL of their requirements to the T (well for the most part, I had several dilute drug screens), or if because my last case manager took pity on me (LOL)!!

So after reading all of the horror stories on this message board over the past couple of years, I just wanted to say that these programs, while totally horrible, can be done and you can actually successfully complete them! I think all of the drug testing is not really "random", I think it is geared toward the individual and what caused them to end up in monitoring. I never had a hair, nail or PETH test (even though I was in for alcohol). Also, even though I had a few dilute urine screens, I think my testing frequency may have been bumped up, but I really didn't get selected for some of the super expensive testing. I made sure I went to each and every one of my AA meetings (ugh), I had sponsors, I submitted ALL of my documentation timely, and I made sure that I knew when my employer evals were due and bugged my boss early and often to make sure he submitted his portion on time! I checked in daily on the computer, and also with my peer monitor as required, and I never, and I mean NEVER took any medications or prohibited substances unless I had an RX which was submitted to my case manager prior to taking the medication and made sure that it was approved by her before I took it. Yes it's a SUPER HUGE inconvenience, but I certainly didn't want to risk it. I also made sure that the Talbot Recovery Guide was with me anytime I went to the MD to make sure that possible medications that I might need were not on the "NO-NO" list. I also made sure that all foods and beauty products were as low/no alcohol as possible. Again SUPER inconvenient.

I know this really sounds like "blah, blah, blah" or like I'm a paid spokesperson for the program, but believe me, I found that being super on top of my requirements, making sure I followed the directions and TPAPN manual as best as I could really reduced my stress about being in monitoring. Believe me, it really wasn't easy though. I lived in a relatively small town at the time, and found finding work that would accommodate my restrictions was almost impossible.....so I moved all the way across the state to find a decent paying job (and by the way, Texas is HUGE. we're talking a 14 hour move from my previous home). I lost my home, my car and my health benefits.....so it was a real burden being in the program. But again, if I can do it so can YOU!!!! Keep up the hard work and you will eventually see your way out of this mess!!!

[rn1965, ADN]

Thank you for your honesty. Sorry you were roped into a program with no real proof of wrongdoing. I have heard that a few times in this forum.

I am just finishing up my 80 clinical hours on my temp permit and awaiting my license and TPAPN orders. However, maybe you can answer this for me -- I scheduled the evaluation, because I assumed it WOULD be required. I do not have a case manager yet and when I called TPAPN to ask about it, I was told, "well, we do not even know if we will require you to have one". So, I was taken back a bit. I have been sober almost 15 years (I am a re-entry nurse).

But, will they just take my word for it? Have you or anyone in TPAPN ever heard of NOT being required to do the evaluation? Those appointments are hard to come by and I had to cancel it, so now, I worry that it will take forever to get another.

If you have any insight, please let me know! And congratulations on completing the program!

[TamRN27]

I'm in kind of a unique situation and was wondering if anyone has experienced anything similar.. 

I just started tpapn about one month ago. 

The event that led up to this board ordered happened in 2022, and it took this long for the board to reach this decision. 

In the meantime I had a surprise baby born June 2024 and we decided I was going to be a stay at home mom until she goes to preschool when she's 3 or 4 at which point I absolutely want to return to nursing. 

From what I understand, working is a requirement to complete the program. Or is it ever possible not to have to work as part of the program?

[SheelaDavis]

Answer for Texas is NO in most overwhelming cases. Are there exceptions? Yes. If a human falls 40 feet, over 98 percent die. 2 in 100 might live. The odds of being an exception to Texas work requirement are increased if you are living outside the state of Texas, are also in another monitoring program, and you get an attorney to argue logistically not possible for you to work as a nurse in Texas as you live in another state, and even in these situations, it's 50/50 at best. Chronic Health reasons are also something that helps be the exception. Serious ones like MS, Parkinsons, etc, not depression or anxiety.

I wish you the best. I am also being HONEST with you as well and not blowing smoke emotionally to tell you what you want to hear. In Texas, the Board would approach it is......"OK, you were going to be a stay at home mom for a bit and that's respectable, but based on a choice you made that landed you having issues with the Board, your preference for being a stay at home mom and not working is now Superceded by public safety and the public has to come before your personal wishes. I am not giving you MY reasoning. This is the reasoning from the BON. Texas comes at their monitoring as.........you need to not just be monitored for no drugs, but you need to work (be in a usual everyday nursing job that is stressful for 2 or 3 years) to absolutely ensure you are safe, which then guarantees the public is safe. Again, I don't agree with the Texas BON and their take, but....I'm simply sharing with you their take.

The odds of you living in Texas and being allowed to not work as a nurse while in monitoring to meet their work requirement are overwhelmingly.....overwhelmingly low, even with an attorney, it's a waste of time. You aren't going to win.  Add in Chronic illnesses, or living outside of Texas, and that changes your odds. But having a young child is not even in the ballpark regarding a substantial argument to the Texas BON.

I wish you the best. Hope it works out, and have empathy for you. I have also given you Honesty, which is a form of compassion, and lying to you or telling you what you want to hear is not compassion. It's lying. 

With all if the above written, is their any harm in trying? Of course not. I would ask the Texas BON compliance department, explain your situation and go from there. There is zero harm in asking. I just want you prepare you ahead of time before you get the response and not lie to you. But is there a chance? There's always a chance, but admitting truthfully, very, very, very low.

Someone will respond at some point in this thread and tell you about a "friend, or cousin, or what they heard in the break room" about a nurse who didn't have to meet the requirement with TPAPN. Yhetes ALWAYS one out thetr. When you read that.......go back and read the point I made about the fall from 40 feet and odds. 

[RNigothis]

TamRN27 said:

I'm in kind of a unique situation and was wondering if anyone has experienced anything similar.. 

I just started tpapn about one month ago. 

The event that led up to this board ordered happened in 2022, and it took this long for the board to reach this decision. 

In the meantime I had a surprise baby born June 2024 and we decided I was going to be a stay at home mom until she goes to preschool when she's 3 or 4 at which point I absolutely want to return to nursing. 

From what I understand, working is a requirement to complete the program. Or is it ever possible not to have to work as part of the program?

Hi TamRN27,

Thanks for sharing your story—congrats on your baby! That's a huge life shift, and I can imagine balancing that with TPAPN adds a layer of complexity.

You're right that most monitoring programs like TPAPN typically require active nursing practice to complete the program. The idea is that they want to monitor how you perform in a professional setting while following the program's guidelines (e.g., drug testing, therapy, check-ins, etc.).

That said, it may be possible to put your participation on hold or request a delay in the "work requirement" portion of your contract—especially if you have a documented reason like being a stay-at-home parent. Some programs allow for what's called "inactive monitoring" or a temporary leave of absence until you're ready to return. It might extend your total monitoring time, but it's sometimes allowed.

That said, I'd encourage you not to feel defeated. Some people here seems to reply often with a very "Board of Nursing" perspective, sometimes giving the impression she works for them (though I'm sure she doesn't). Her posts can come off more pessimistic than necessary, and they often frame things in terms of odds and absolutes. 

I'd suggest reaching out to your case manager or liaison and being honest about your situation. Let them know you're committed to returning to nursing later, and you just need guidance on how to stay in good standing with TPAPN while being home with your baby.

Wishing you and your little one all the best! 💛

[SheelaDavis]

Some people reply with a BON perspective because the BON is the one making the decision. A nurses perspective matters, but a nurses perspective does Not matter at all As It Relates to the decision. The BON makes that. It doesnt matter what "perspective" one "replies" with on this forum. The perspective could be from the nurse, from the BON, from Jesus, from the Devil or somewhere in between. It's about TRUTH, honesty and what is most likely. As for delaying the work requirement or delayed monitoring? Of course. That's easy and done commonly in 50 states and not hard to do at all, but.......it doesn't start the clock.  I've seen nurses delay monitoring for 3 years and allowed without a problem, but......the 5 year clock doesn't start until the nurse returns to work, so the entire ordeal basically ends in 8 years, not 5. The BON wants you to be monitored while under stress. This is why they want working in a nursing position while undergoing drug testing.

Getting your monitoring delayed and having the BON place your license in a hold type status is actually easy.  Just ask them, BUT.....your question was......can you get out of the work requirement? It wasn't about whether you could delay the work requirement. As to whether you can delay it? Very easy to do. As for getting out of the work requirement which was the exact and original question asked? Whether it begins now, or in 1 year or in 3 years, there is no getting out of it.

What you can do. Texas requires 3 years of work out of the 5 years. You can ask if you can begin monitoring to get the first 2 years knocked out, but Texas will want you to work starting that 3rd year. They don't like monitoring interruptions that are long. Meaning, 1 or 2 years is Long. A 6 month interruption for pregnancy, delivery, newborn is fine, but not a 1 or 2 year interruption once you have already started.

Understand though.......if you delay starting full monitoring work requirement, plan on taking a nurse re-entry course if you are out too long. States vary. Some states, if you are out for 3 years, you have to take a physical, in person, clinical retraining course that can be 1 month up to 3 months long that you have to pay for and you don't get paid while doing it. Some states allow 4 years, a few allow 5 years. The retraining/re entry programs vary by state, but be aware that if you delay returning to work to long, there are potential consequences and you need to be aware of that so you aren't blindsided when it occurs.

Best wishes to you. There is one poster on here who knows nothing she speaks of. Has zero experience with nurse legal issues of which I had a career doing for over a decade, and that nurse is your typical co-enabler. The addict is Willing to withhold truth in order to tell you what you want to hear in order to actually make Herself feel better. Co-enabling is tricky. Seems nice and so compassionate on the surface. Under the surface, it's a nasty bugger. Addictive in nature and harmful., More damaging in the long term.

As for "acting like she works for the BON." LOL, I can't stand BONs. They are corrupt as hell and I fought them for over a decade when I was a legal nurse consultant. I'm answering questions with facts, honesty, truth. I'm don't answer a question with coenabling babble. For example, you wrote "your monitoring might be extended" by an interruption or delay in monitoring. STOP LYING and coenabling and get treated. You know better. There is no "might be extended." It WILL BE extended and you KNOW that. This is the type of co enabling example and co enabling that can actually harm this person down the road by not telling the truth, but you pass it off and disguise it as "compassion" You are the typical lethal and deceptive coenabler. Why? Because YOU have to make yourself feel better. Your approach is directly out of a recovery 101 playback for co enabling. Come off as vague as if there is always no correct or no answer more likely than most (which allows the door open for you to take your approach) then withholding known or more likely truths in order to "make the person feel better," which is ultimately only to make you feel better (at their expenseand at the risk of withholding truth), and by wrapping the entire co enabling mess into a big ball disguised as "compassion." Co-enabling is tough to identify. It's tricky. It goes first hand with covert narcissism. Ever ask the question about how the morbid obese 800lb person got the food and all the excess calories after being bedridden for 3 years before finally dying? The answer rests in.......there was a coenabler. And......she wrapped it in "compassion" and lashed out to those who recommended, "hey, maybe would should stop giving him all this fast food, it might be killing him." She, the co enabler was the one who keeps feeding, all that wrapped in compassion, living in denial, withholding truth, playing the "vague" and refusing any outcome of certainties or more likelihoods than not. These are the coenablers and just like an untreated Heroin addict, they can be lethal and do damage, but this little Booger, the coenablers are tougher to spot, harder to point out, sneaky fellas, and are notorious for building a coalition to back their "compassion". Don't fall for it. Compassion isn't there motive.

To the original poster who asked the question. Here's the Non Coenabling truthful answer that you asked for your question now that I have deflected the personal, under the surface beautifully disguised, typical covert narcissistic co-enabling attack.

You are highly, highly unlikely to get out of the work requirement. If you delay monitoring, understand monitoring doesn't end until you have completed the full 5 years with 3 of those 5 working as a nurse. It's unfortunate, it's not fair, you planned to stay at home until the little one got a bit older and approaching pre school. It's not likely going to happen. You are tough. You are a nurse. You are an adult. You can overcome. Your little one wants you to be financially in good shape for them when they become a teenager and maybe become a nurse themselves for college, so make the adjustment, share your concerns in recovery, grieve about it, overcome, move on, go back to work and knock the 3 years out and put this behind you and move on with great things for the rest of your life and the little ones long life ahead. You have got this.

See the difference? That's truth. It's tough. It's not easy, but it's truth and the truth matters. No coenabling answer given here. Just truth and facts.