Working with Nurses in TPAPN-

Working with Nurses in TPAPN:What Coworkers Need to KnowTexas Peer Assistance Program for Nurses (TPAPN)A program of the Texas Nurses Foundation

Hello, and thank you for taking the time to view this short presentation about TPAPN, the Texas Peer Assistance Program for Nurses. Well cover what you need to know if one of your coworkers is a nurse participating in the program. So lets get started.1Board of Nursing (BON) approvedAlternative, voluntary program for LVNs, RNsAvailable to eligible nurses who may benefit from peer assistance servicesReturns nurses back to practicePromotes professional accountability and protects the publicWhat is TPAPN?

TPAPN is a Board approved, alternative, voluntary program for LVNs and RNs offering life-renewing opportunities for recovery from substance use and psychiatric disorders. The goal is to return participants back to nursing practice, which promotes professional accountability and thus protects the public.

2Recovery is confidential, but not secretProtected health information regarding TPAPN participants is protected under Texas State law/HIPAA

Confidentiality

An important feature of the program is that participation is confidential, but not secret. TPAPN maintains confidentiality consistent with state and federal laws. However, coworkers need to know if someone they work with is in TPAPN and will be informed of work restrictions.

3No access to abusable medications - e.g. counting narcotics, administering narcotics, witnessing wastage, receipt from pharmacy No on-call duty

Work Restrictions - First 6 Months

TPAPN participants have some restrictions on their practice which prevent them from performing certain nursing duties.Participants wont have access to abusable medications for the first six months after signing the Work Agreement, though nurses who are participating for psychiatric disorders are usually exempt from this restriction. Additionally, there will be no on-call duty.4TPAPN nurses are not approved to work if:In an autonomous or unsupervised positionShifts longer than 12 hoursFor multiple employers or in self-employed practiceIn short-term staffing or work as a travelerOut of predetermined area (Floating)More than 96 hours per two week pay periodAt various practice sites, without BON approval

Work Restrictions

Here are some additional restrictions for TPAPN nurses that will apply during their participation in the program. Supervision is required and shifts are limited to 12 hours or less. It is very important that the nurse only work a pre-determined area, unit, and shift. TPAPN participants may not work more than 96 hours in a two week pay period and are restricted from working at multiple practice sites, without BON approval. These restrictions are enforced to help ensure safe nursing practice. 5Supervisors will designate a coworker to handle abusable medications for the TPAPN nurse

In exchange, the TPAPN nurse provides care and treatment for patient(s) assigned to the coworker

Labor Exchange

Even though some participants may not be able to access controlled substances for a short period of time, this restriction can be eased through a labor exchange where designated coworker(s) handle the TPAPN nurses medication and in exchange the TPAPN nurse provides treatment and/or certain care for patients assigned to the coworker. This is one way to promote a safer and more positive work environment.

6TPAPN nurses may have to leave work for a short time for drug testingParticipants with positive drug screens must immediately discontinue nursing practice Drug Testing

TPAPN nurses may have to leave work for a short period of time if they are selected for drug testing. Additionally, employers may request drug screens for reasonable cause, if it is perceived that a participants job performance or behavior is impaired. A confirmed positive drug screen will result in either a contract renewal or dismissal from TPAPN. 7Now: Voice your concerns with your direct supervisorLater: Educate yourself about TPAPN, substance abuse and psychiatric disorders in the workplace at www.tpapn.org

What if I have a concern about a TPAPN participant?

If you have a concern about a TPAPN participant, its critical that you contact your supervisor as soon as possible. For more information on signs of impairment related to nursing practice, there is a wealth of information on the TPAPN. We must all recognize that nurses are not immune to these chronic, progressive and potentially fatal diseases. 8Teamwork: Nurses Helping NursesEmployer/SupervisorCase ManagerVolunteer Nurse AdvocateSponsor (if in 12-step recovery)

Each TPAPN participant has a team of people for support: A supervisor, a Case Manager based in Austin, a volunteer nurse Advocate, and a sponsor (if in 12-step recovery). Participants supervisors should know who to call at TPAPN if they have questions or need to report issues.

9Ensure your workplace has a TPAPN AdvocateBecome an Advocate: volunteer with TPAPN Be the peer in peer assistance and witness positive transformations of the human spirit! Make a Positive Difference

Volunteer with TPAPN! An Advocate must be an LVN or RN with an active, unencumbered Texas licensure. Advocates provide one-on-one support and information for TPAPN participants and their colleagues. As an Advocate, you will assist participants in coping positively while in the program and help decrease the stigma of substance use and psychiatric disorders.10www.tpapn.org

Thank you!

TPAPN is a positive component to health care facilities quality assurance, risk management and turnover cost-avoidance systems. Together we can help nurses with substance use and psychiatric disorders return to work and advance patient safety. Thank you for your attention!11