McDonald, Mackay and White, LLP

The Texas Peer Assistance Program for Nurses [TPAPN]

TPAPN was created as an alternative to reporting a nurse to the Board of Nursing when the nurse had mental health issues or chemical dependency issues. However due to recent legislative changes, a nurse who commits practice violations must be reported to the Board even if those practice violations are believed to be a result of chemical dependency or diminished mental capacity [Nurse Practice Act section 301.410]. TPAPN operates under the Texas Health and Safety Code as an approved peer assistance program. As a peer assistance program, TPAPN assists the nurse to practice nursing while in recovery for chemical dependency or while returning to competent practice for nurses with mental health issues.

A nurse can self-report to TPAPN, be referred by an employer or be ordered to participate by the BON. If a nurse recognizes impairment within their life, it is better for the nurse to self-report rather than to receive a third party referral or to be ordered to participate by the BON. Sometimes employers report nurses to TPAPN when there are no impairment issues. Some nurses agree to participate in TPAPN even when there are no impairment issues in order to avoid investigation by the BON; however, this is a dangerous path because in order to participate in TPAPN, a nurse must admit to being impaired and once a nurse starts this process it is very difficult to later discount the admissions.

The TPAPN program is designed to slowly reintroduce the nurse into nursing practice, slowly increasing the boundaries of practice and monitoring the nurse along the way. Initially, the nurse is usually restricted as to when and where the nurse is allowed to work and then as the nurse progresses in the program more restrictions are lifted. This can be problematic for nurses who practice in specialty areas or for Advanced Practice Nurses. As part of the TPAPN program, nurses are frequently assigned an advocate to assist them in their return to nursing practice. Sometimes being in the TPAPN program can cause difficulty for a nurse with employment. This is often due to misunderstandings the employer has regarding TPAPN. McDonald, Mackay & Weitz has has been working to address these misconceptions and questions and to hopefully ease the nurse’s reentry into nursing practice by having one of the firm’s partners involved with the TPAPN Employer Liability Task Force.