Importance Of Participation In TPAPN

* Baby social worker visited. Plan is to initiate care proceedings ASAP reasons; history of substance misuse, concealed pregnancy, poor engagement with treatment and services

Ms. Bynum is a self-referral who agreed to participate in the TPAPN monitoring program. On 11/24/16, Ms. Bynum tested positive for alcohol (ETG - 2510 ng/ml, ETS - 77 ng/ml) and renewed her program with TPAPN. On 2/26/16, Ms. Bynum tested positive for alcohol (ETG - 7980 ng/ml, ETS - 1580 ng/ml). On 4/7/16, Dr. John Lehman conducted an assessment on Ms. Bynum and recommended 90-day inpatient treatment program that Ms. Bynum refused. Additionally, Dr. Lehman stated on assessment that Ms. Bynum is not fit to practice and has a high-risk for relapse.

Plan - Client Objectives until next review: attend monthly group as scheduled, verify sober support meetings, schedule and attend individual sessions, provide UA when asked, and comply with legal mandates to maintain the privilege of deferred prosecution. Client is to work on treatment plan on a timely manner.

The Nurse Practice Act of Illinois State is 225 ILCS 65. IL offers an APN to diagnose, interpret labs and order diagnostic tests. APNs is able to provide counseling and education for prevention of illness and promotion of health. They can provide palliative and end of life care, and can supervise and delegate to task to LPNs and RNs. APNs have prescriptive authority if they have a written collaborative agreement with a physician and are limited to 30 days (IGA, 2014). In order to practice as an APN in IL one must have a current unrestricted RN license, have a masters degree approved by the State Board of Nursing in the specialty of choice and a national certification. State Board of nursing is the regulatory authority of IL APN practice, and they accept certification from ANCC or AANP or certification from specialty agencies. APNs in IL requires 50 hours of continuing education in a 2-year license renewal period. IL is one of the States that offers versatile certification opportunities for APN in addition to advocating for the full practice authority of APNs. A systemic review done by Kuethe (2013) finds it is better for an NP to manage chronic diseases such as asthma and diabetes for their better control and healthcare cost reduction as physicians do not have enough time to provide comprehensive care (p. 5).

The Texas Nurses Association (TNA) District one meeting for the El Paso area, took place on September 20, 2016 at 1845. The President of District one, Paula Meagher was unable to attend the meeting as she was ill. She did however provide us with a list of the current Advanced Practice Registered Nurse (APRN) issues that TNA is engaged in. The issue that really caught my attention was Texas Occupations Code, section 157.011 (b-1) which deals with APRN restrictions on writing prescriptions for Schedule two controlled substances. The TNA website states:

The Full Practice Authority for APRNs (HB 1415/ SB 681) deals with the legislation which will permit Nurse Practitioners (NPs) to practice to the complete magnitude of their education and training. It will also eliminate expensive and difficult regulatory requirements like having contracted delegation arrangements with physicians, and will place NPs under the select supervisory authority of the Texas Board of Nursing (BON). Bill HB 1415 was filed on 02/01/2017 and was “Left pending in committee” as of 04/25/2017. Bill HB 681 was filed on 01/31/2017 and was “Referred to Health and Human Services” as of

The counselor met with the patient for her scheduled Addiction Severity Index assessment. The patient is a 54 year old black male. The patient states he is single with no children. He report currently lives with sister in law of his decease brother. The patient reports having a 14 years of education however no degree. The patient report receiving disability for mental health disorder. The patient reports he is currently not on probation. The patient reports he last use Cannabis 7/17/15 and started using at the age of 13 and smokes 3 to 4 times a week at least 2 joints. He also report using Alcohol 7/20/15 a 40oz beer and usually drank a couple a day. The patient denies any issues with HI/SI. Patient also reports he is taking his medication as prescribed. The patient appear to be in the pre-contemplation stage of change. The patient next scheduled individual session with the counselor is on Monday, July 27, 2015 at 02:30p

Attending the Texas Nurses Association District 8 annual meeting was educational, remarkable, and inspirational. Meeting the new officers for the coming year and the recognition for outgoing officers had a sense of camaraderie, which envelops nursing. The legislative updates and highlights included a significant bill to APRN’s, House Bill 1415. Although left pending in committee, this bill will allow APRN’s full practice authority. TNA has partnered with coalitions to assist in the passing of this bill. While there has been opposition to this bill by physician based associations, the impact of the passage and implementation of this bill is beneficial to the state, medical community and most importantly, our patients.

Xavier then reported, the applicant recovery is up and down and the reason the patient was transferred and admitted to the Norwich location was due to an altercation as the Hartford Dispensary has zero tolerance for physical violence. Since May of of this year, the applicant's UDS results are negative. Last positive result was in April for cocaine, according to the counselor. Please note, during the applicant intake, he was asked about other illicit drugs and only confirmed for use of heroin and THC, not the cocaine. The applicant's current dose at the Hartford Dispensary is 105mgs as he is being detoxed daily. His highest dose was at 145 mgs before his detoxification. The physical altercation was the applicant's first behavioral incident at the clinic. He was also on a 90 Probation for his illicit use and it would have expired in August, but due to the recent incident, he was removed from the clinic, not discharged, but transferred as mentioned before. Counselor Xavier only concern of the applicant is maintaining his

Why is it important to join the national NP association, AANP, and how does it benefit the APN? Discuss items such as CEUs and protection of NP practice.

On 10-1-2016 I was assigned to follow up to CPS Intake # 3471749, which involved

I became a licensed PTA shortly after the start of my employment in October of 2015. Since then my case load has been steadily expanding. DHDPT is a privately owned out-patient clinic. As a PTA at DHDPT, I am exposed to a variety of patient types ranging from all ages. My employment opportunity at DHDPT has allowed me treat a significant number high school and collegiate athletes. A vast majority of my daily case load includes postoperative orthopedic patients. In August of 2016, I began working PRN at Thibodaux Regional Medical Center (TRMC) in acute care and in-patient rehab to further refine my skills as a PTA. This allowed me more exposure to different patient types such as those with neurological

Why it is important: According to Texas Nurse Association, “The Texas Peer Assistance Program for Nurses is a non-punitive, confidential, and voluntary alternative for RNs and LVNs with concerns related to substance use and mental health. TPAPN encourages nurses to seek help with psychiatric or substance use disorders. By recognizing and managing nurses with psychiatric and substance use disorders in the workplace, TPAPN advances patient safety. Guided by an Advisory Committee comprised of representatives from a number of important Texas nursing organizations and other stakeholders, TPAPN offers a minimum 1-to-5 year monitoring program (5-year for APN’s) that is voluntary and abstinence-based” (TNA, n.d.).

After following all recommendations of the treatment program, including attending a minimum of 3 twelve step meetings each week, the nurse is required to attend weekly aftercare meetings for one year. Once the nurse is approved to reenter the nursing practice their license will be monitored for 3 years and all positions must be approved by the AP (Alternative). Their license must also reflect that the nurse remained at the same facility for 2 consecutive months during the first year and for 3 consecutive months after the first year. During the first year of the initial AP completion there are certain guidelines the nurse must follow. These include not working from the hours of 11PM to 7AM, not handling controlled substances, not working in a PACU, OR, Labor and Delivery, ICU, substance abuse facility, or Cardiac Cath unit. They also need to work under the direction of another RN and should not float between units. Additionally, for a minimum of two years the nurse should not work as a traveling nurse, in home health or hospice, or as CRNA. The program and random drug screening lasts for a total of three years, at which time the license will be reviewed and limitations

Pt. has been in the program for over 3 years and she is currently in Phase 0. Pt. has participated in the AMS of De methadone clinic, she has been able to achieve abstinence from illicit drugs but she is failing to comply with the mandatory counseling sessions. Pt. is now eligible to receive phase 1 take home privileges if she maintains satisfactory attendance and scheduled appointments. Pt. identified her children as a motivational factor to change and to reinforce the importance of remaining in recovery. Pt. was advised to obtain a sponsor and attend 12 Step meetings. Pt. has done in achieving her goal of maintaining financial compliance despite the holiday financial stress. Pt. seemed to accumulate a back balance, but normally pays for late account balance in full upon notice of an administrative taper.