Just because it is something to think about

In the July 14, 2008 issue of NurseWeek, there is a article that I can't seem to get out of my mind as I enjoy the summer. In the Germy Truth about public swimming pools, Connie C. Chettle, RN, MS, MPH, CIC, COHN-C writes, "Fecal accidents are not uncommon in pools. Each day, up to 2 to 3 pounds of feces can be found in the water of an average-sized public pool from fecal accidents and from swimmer's bodies from improper cleansing after bowel movements."**

There is much more to the article (regarding illnesses associated with public swimming pools), but it is the part quoted above that I keep thinking about when I am sitting at a pool. Especially when I see kids sucking the water up and spitting it at each other or when someone gets a mouthful of water. Just join me in saying, "Yuck!!"

**you can read the article without having to pay for the CUE

More TPAPN and the Board issues

The BON is meeting July 17-18, 2008. One of the agenda items involves the Board's Legislative Appropriations Request. This is how the Board asks for money from the state to fund their activities. One of the requests in this draft documents involves TPAPN. The Board is requesting more money because there has been an increase in the number of nurses in TPAPN. Perhaps this number could be reduced if the problems that I previously addressed with TPAPN referrals would be resolved.

The document states:

Peer Assistance Program Increase - The current peer assistance funds are capped at $625,000 to fund a total of 550 registered nurses and 225 licensed vocational nurses each fiscal year. The TPAPN program has experienced a twelve (12) percent increase of nurses in the program in fiscal year 2007 over the current cap. The Texas BON is requesting that the cap be raised by an additional $75,000 each fiscal year and be added to the Peer Assistance Strategy. This would place the cap at $700,000 each fiscal year.

TPAPN and the Board of Nursing

I think it is time for a discussion concerning how TPAPN is being used by the Board. I would like to see this be a public meeting so that nurses affected and also, defense counsel are allowed to bring forward the problems they experience or see.

Personally, I am seeing too many cases where nurses that are not appropriate for TPAPN are being referred there by the Board. The nurses frequently will agree to TPAPN because they want to get the issue resolved with the Board or because they do not know what being in TPAPN involves or they do not know that there are other options. These nurses then get into TPAPN and they do not fit.

I have seen nurses referred to TPAPN that have years of sobriety (TPAPN is geared more towards new addicts) or that have no chemical dependency problems or they have mental health issues that are under control and do not require monitoring. It appears that when the Board is overloaded or not sure what to do, they refer to TPAPN; that may not be the case, but that is exactly how it is appearing. Inappropriate referrals are not a good use of TPAPN's time or resources. It is interesting to note that the annual TPAPN audit was performed and is being presented to the Board at the July 17-18, 2008 meeting. Within that audit it is noted that TPAPN staff noted that the BON is sending fewer "nurses with histories that raise questions of current impairment."

The last poll was interesting, so how about another one? This poll is for nurses that are not in TPAPN or that have never been in TPAPN. I want to know if you were offered to go to TPAPN to resolve an allegation of substance abuse or mental illness before the BON, would you understand what would be required of you in the TPAPN program? This is a fair question because the program is not explained to nurses prior to them being offered the TPAPN option.