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Texas Peer Assistance Program for Nurses


TPAPN is a non-profit program and a project of the Texas Nurses Association (TNA); an approved peer assistance program that operates under the Health & Safety Code, Chapter 467. This program is designed to help an impaired professional whose ability to perform a professional service is impaired by chemical dependency on drugs or alcohol or by mental illness. TPAPN maintains confidentiality consistent with State and Federal laws.

About TPAPN:

This program is available to Licensed Vocational Nurses and Registered Nurses of Texas having one or more diagnosis to substance abuse, substance dependency, anxiety disorders, major depression, bipolar disorder, schizophrenia and schizoaffective disorder. The mission of TPAPN is to offer opportunities for recovery from chemical dependency or mental illness and integrate nurses back into the profession, thus protecting the public and promoting professional accountability. TPAPN’s emphasis is one of education, advocacy and opportunity. TPAPN serves as an alternative to a nurse being reported to the licensing board. A nurse may self-report to TPAPN or may be referred by an employer. Every nurse referred to TPAPN has the right not to participate and withdraw from the program at any time. It is completely voluntary. Participants in TPAPN work directly with an assigned case manager who possess educational expertise and clinical expertise in chemical dependency and psychiatric nursing. Advocates also play a role in communicating with the participant when the case manager is not available. Advocates are LVN and RN volunteers solely for the purpose of providing support to the participant. The TPAPN program combines the roles of overseeing appropriate treatment, continuing care, self-help groups, practice restrictions, drug screens and monthly/quarterly reporting to help insure that nurses honor their TPAPN agreements.

How TPAPN Works:

By choosing to participate in TPAPN, a nurse must agree to the following terms:

  • Eligibility; must be determined by the TPAPN staff;
  • Assessment and Treatment; must obtain assessment(s) to determine eligibility and must obtain appropriate treatment and remain in treatment until approved for discharge;
  • Disclosure of Information and Consent Forms; must complete any authorizations, release of information forms, or consent forms needed to permit disclosure;
  • Self-Help Group Attendance; must attend daily self-help meetings such as NA or AA during the first 90 days after treatment and at least four self-help group meetings per week thereafter. Mental health participants must follow the recommendations of a psychiatrist or therapist;
  • Return to Work; must obtain written authorization from the TPAPN case manger to return to work and shall have restrictions on practice
  • Restrictions on Practice; a nurse will not function in an autonomous or unsupervised role, will not have access to controlled medication during the first six months of work, will not work shifts longer than twelve hours, will not work overtime or on-call assignments, will not work night shifts, will only work on regularly assigned units and will not float to other units for the first year of work or unless approved by TPAPN case manager, will not work for multiple employers or be self-employed and will not accept employment with staffing/temporary agencies;
  • Abstain; must abstain completely from any use of abusable substances (drugs and alcohol) abusable medications to include, all illicit substances, controlled medications, other abusable medications.
  • Drug Screens; must provide random urine and/or blood samples for drug screens;
  • Length of the Program; Minimum of TWO YEARS; the nurse must also work in nursing a minimum of 64 hours per month for 12 consecutive months;
  • Costs and fees; the participant is responsible for payment and fees.

Benefits of participation in TPAPN:

This confidential program serves as an alternative to a nurse being reported to the Board and facing possible disciplinary action taken against their license.

TPAPN participants are offered an opportunity for successful recovery and assistance to return to the safe practice of nursing. Both Case Managers and Advocates serve as a support system to the nurse who chooses to participate in TPAPN. Advocates can assist the nurse by serving as a role model and a friend during the recovery process. The Case Managers have the education and clinical expertise to assist the participating nurse as well as serve as the liaison to the nurse’s employer. If an employer refers a nurse to TPAPN, Texas state law provides civil immunity for all reports made in good faith and for all employers who work with TPAPN nurses in good faith.

Non-compliance of/Withdrawal from TPAPN:

TPAPN Staff must report to the nurse’s employer, as well as the Board if the nurse is noncompliant, has a positive drug screen, withdraws from the program, or moves out of State. If the nurse is a self-referral, TPAPN Staff will report the nurse to the Board only if the program determines that the nurse may be an immediate threat to themselves or others. This program is voluntary and unless the nurse can admit to having a problem and commit to the recovery process through TPAPN, then TPAPN may not be the program for them.