All About Nursing (45) Dawn Webb

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Welcome to All About Nursing with your host Dr. Joyce Bachelor. Executive nurse advisor Dr. Bachelor will present a significant role in nurses' play in providing healthcare in the multitude of healthcare settings.

Listen to some of today's key nurses who work in practice in academia settings and talk about the challenges they face in today's modern medical world. So please welcome the host of All About Nursing, Dr. Joyce Bachelor. Good evening.

I'm your host Dr. Joyce Bachelor and All About Nursing and we're live on the BBM Global Network in Tuning Radio. I'm delighted to have a very distinguished guest with me on the show this evening and I'd like to tell you a little bit about her. This is Dawn Webb.

She is a nurse who has joined the Texas peer assistance program for nurses as the program director in April of this year. Prior to working at what we call T-PAPN, Dawn worked at Austin Trappis County Intergirl Care as a nursing supervisor for the supported housing and homeless services team. Dawn provided oversight to multiple units including outpatient clinics, community outreach and homeless shelters. Her previous experience includes working at St.

Joel Creek Hospital as a licensed chemical dependency counselor at Austin Drug and Alcohol Abuse Program and the treatment alternative to incarceration program. Dawn has spent her entire career working with individuals affected by substance use of disorders and mental health conditions and is a major advocate for reducing stigma and raising mental health awareness. So Dawn, I'm delighted to have you on the show. Thank you.

So why don't we start with you just telling the audience a little bit about why you decided to become a nurse? I've been a nurse for about seven years now. It was pretty much a natural progression from my role as a substance abuse counselor. I spent many years as a case manager and then became a substance abuse counselor and then just from there I decided to go back to school and become a nurse with the intent of being a psychiatric nurse.

So that's with my specialty and from there I've just worked my way into leadership. So you did like an alternate entry kind of program with a bachelor's and some other science field I guess, right? Yes. Well actually I took the long route.

I did an associate's degree in nursing and then went back and got my bachelor's and then went back again and got my master's in nursing administration. So I just kept going back because I love a nursing. Any more than I thought I would. So especially the leadership role that I have now.

That's wonderful because we've talked about how there's so many different options for nurses in terms of how we can go to school and the different levels and how nurses progress. So that's wonderful that you've been able to share that with us. So you have had some very interesting experiences and I would love to hear from you. What are some highlights of your career that you'd like the audience to know about?

I think the biggest highlight is my position prior to coming to TPAPN, not that TPAPN isn't a big highlight in my career because we have a lot going on here. But prior to coming here I worked at Interval Care here in Austin and I worked at the Community First Homeless Village in East Austin. It's a community of tiny homes and RVs for individuals that are chronically homeless. In there we opened a clinic, an integrated care clinic.

Pretty much in the ground up it was dirt when I arrived there. So in the process of building that clinic I really learned just to end and out of compliance and management and it's pretty much where I decided I wanted to move forward in my leadership role and get my master's degree in nursing administration. I used to think that I wanted to be a site nurse practitioner but doing everything in relation to that clinic and supervising nurses and just kind of all the excitement that goes around a leadership role and just a multitasking was just a really natural fit for me. I also worked with an amazing team where my direct supervisor gave me all the tools I needed to become a strong leader and that's how I ended up at TPAPN.

That's fascinating and I didn't realize because I've heard a little bit about the fact that there's been a community built like this and I was just curious, what kinds of skills did you find yourself needing to have in order to do that kind of work because it's definitely not a normal setting that nurses find themselves and people usually think about hospitals and clinics and it's a pretty unique opportunity. Did you have anything in particular that you thought you really needed to have in terms of skills and experience that made you successful? Well, part of my career was working at psychiatric emergency services. So having a clinic onsite where people live, although it was a psychiatric behavioral health clinic, of course we had people just walk in with anything.

So even though my scope of practice with psychiatric and leadership, we ended up having a primary care team that provided medical that came out. So I really had to learn how to triage a lot, which basically when someone would come in, I mean it would just be anything from a cold to psychiatric symptoms. So I really had to learn how to manage anybody that walked in the door, almost like a walk-in clinic. And in doing that, it was more of like how I hired people.

So I just made sure when I hired staff and I hired nurses that they had the right experience to handle that situation. And again, one of the nurses that I hired was from the emergency department. She had some psychiatric experience, but I also needed someone that could handle emergencies. So there was just a lot of interesting situations, very interesting situations, just because people live there.

And then you have cats and dogs and goats and all kinds of other things going on. So managing chaos, I think was really important and just kind of being comfortable with an environment where knowing that at any minute something could happen. And then also leaving the site, I would have to leave the clinic and maybe go to someone's home to check on them or outside in the parking lot or the city bus, a city bus would come through there. And there was a couple of times where I had to run out to the city bus and hop on and see how somebody was doing.

So just kind of being ready for anything in that environment. And then also making sure that I was able to communicate with people and kind of just where they were at, whether it was psychiatric symptoms or they were brand new. I'm just making sure that I could take the time to sit down with someone and talk to them and figure out what they need. Because sometimes individuals coming in are not even sure what they need in that moment.

So just handling crisis, handling medical emergencies, making sure that we have the staff available to handle different situations, always having a person on call throughout the day. So we had case managers there also. So it was a team of individuals. We had nurses, case managers, team leads that really just kind of sustained that clinic and that setting and provide the support.

I mean, because a huge portion of the folks that live out there also have a mental illness. So you're pretty much handling someone that's transitioning from homelessness, which is very challenging to go into an environment and it's all about community. So you go from living under a bridge to living in a community with all of these people that are surrounding you with love and everything you need, which could be overwhelming. I think it just kind of goes with great things in our life.

They're wonderful, but they can be stressful. So also considering the stressors of transitioning from homelessness to being housed. Now, do you have all age groups that you were taking care of and finding that they were living in this community? Out there, no, just adults.

I have my entire career. I've only worked with adults. So just adults out there. And again, people all from the Austin community, there's a lot going on in Austin right now with homelessness.

So it's one of those places that is really helping transition people into their community. This is very interesting. And right now, this is all about nursing and Dr. Joyce Bachelor.

We're live on the BVM Global Network and it's time for a short break. According to the American Nurses Association, there are approximately three and a half to four million nurses in the United States. So where do all these nurses work? What kind of roles do they have?

What kind of education and training help to prepare them for so many different settings? What kind of impact nurses have on patient outcomes? The World Health Organization has announced that 2020 will be the year of the nurse honoring the 200th Earth anniversary of Florence Nightingale. An international initiative called Nursing Now is underway to raise the profile of nursing.

The National Academy of Medicine has convened a committee to create the future of nursing in 2020 to 2030 that will focus on how the nursing profession can create a culture of health, reduce health disparities, and improve the health and well-being of the U.S. population. Learn more and join Joyce Bachelor on all about nursing, Wednesdays from 7 to 8 p.m. Central Standard Time on the BBM Global Network.

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That's H-U-G-U-E-S, born Abetit and Blessa. Welcome back everyone. You're listening to All About Nursing, live from the BBM Global Network in Tune & Radio. I'm Dr.

Joyce Bachelor, the host of the show. And I have a guest on with me this evening, who is Dawn Weber. She is currently working at the Texas Peer Assistance Program for Nurses as a program director. And she was telling us before the first break about the incredible work that she was leading when she was working in the Austin Trappas County Intergal Care Unit, helping to really support housing and homeless services to people here in Austin.

So very fascinating because we've talked about how nurses work in a variety of roles. This is certainly one that's a little more unusual from what people might normally think about when they think about what nurses do. I think it'd be interesting if you could tell us a little bit about what is this program for the direct role about Texas Peer Assistance Program for Nurses. Maybe you could tell them a little bit about what T-PAPN does, what it stands for.

So T-PAPN is the Texas Peer Assistance Program for Nurses, and we are the Alternative to Discipline Program. So I've been here since April. And since I've come here to T-PAPN, I've implemented quite a few changes, had a huge vision, like when I first started. I just really wanted to focus on T-PAPN becoming a program that was more recovery-focused.

There was a reputation in the past that T-PAPN was punitive, and we were a part of the board. And we do work with the board. We are not the board. And I think that's one misconception that people have about T-PAPN.

Our role is the alternative to discipline. So if we're getting to the point where someone needs disciplinary action, that would be handed back to the board of nursing. So my focus was to really look at making sure we're providing person-centered recovery-focused work. And we've done many things.

We've shifted our language to using more person-centered language. The team has the team of case managers here. We've done training and motivational interviewing, just making sure that when we're communicating the power of communication for one thing, and then also realizing our role, that there is power in our role, and we're making sure when we're talking to people that they do understand we are truly here to help them through their recovery, and that we don't want this program to feel punitive. We want it to feel supportive.

So by doing person-centered language, by training the staff and motivational interviewing, we're able to help participants identify their goals. Obviously, the ultimate goal is for someone to keep their nursing license. But there's reasons why we want to be nurses. There's more to nursing than just, you know, I just want to keep my license.

Recovery around a nursing means taking care of ourselves. And that's one thing I really want to push with this program and with nursing in general is the self-care component of just nurses. We take care of other people, but we find ourselves in positions where we don't take care of ourselves. I'm hoping that T-Papping can really move in that direction of whole health, where nurses are identifying, you know, I'm in a place where I'm stressed out.

I'm in a place where, you know, I'm setting myself up to be vulnerable, because all the different stressors that come with nursing really set us up, and then, you know, with access to drugs, and all of the stressors were at higher risk than the average population, mainly because of that access that also we work long hours, we work night shifts, you know, there's a lot of, we work with families, we work with patients, we work with doctors, we work with other nurses, and, you know, unfortunately not everybody is in the best place when they're in the hospital or when they're sick or when they're under stress, so nurses take the brunt of that. So I'm just really, really hoping that we can just really push that self-care component in early referrals to the program. We've been talking on some other shows about the burnout factor and the whole emphasis of trying to figure out how to put joy back in the workplace, and that it's impacting physicians as well as nurses and other health care professionals, and you've named a lot of the reasons why the pressures seem to be so high, all the regulatory standards and just the demand in terms of the work they're doing. I think that it's reflected, but what's happening in the society as a whole in terms of the drug usage, and I think that my struggle used to always be when I was in my former C&O role, is this program is wonderful when people are willing to admit they've got a problem and get the help, but sometimes people aren't willing to admit that, and that just seemed like it was a whole different course of action that we'd have to take, which was very painful to do.

So I didn't know if you've been trying to work with leaders in terms of helping them understand that maybe there's ways that they could interact with the nurses before they're coming to you or even to try to help them come to you rather than have to have some other disciplinary course when they're denying it. Have you been doing work like that? Yes, so again, I've only been here since April, but I have done some outreach. I actually went to the Rio Grande Valley and met with several nurse leaders, actually leadership at several different organizations and really talked about, well, first of all, self-referral would be amazing if we could get individuals to self-referral.

Yes. But I mean, that's a lot to ask, the self-referral piece. But also, kind of nurse leaders identifying the stigma attached to substance use disorders and mental health conditions and also to keep happening and kind of trying to shift culture, which shifting culture is one of the hardest possible things we can do. But we need to shift culture where it's okay to talk about mental health, it's okay to talk about substance use disorders.

Nurses supporting one another, nurses seeing a referral to T-PAPN is more of an active compassion versus I'm telling on my peer. If we view it in a way of telling our peers, then we're basically allowing our peer to fail, which could be the consequences of substance use disorders basically could be a patient safety issue, it could be the nurse finding themselves in a legal situation, and ultimately it can lead to death. We know that those consequences are heavy, but having those conversations, I don't think a lot of people want to say that out loud. Like the ultimate, the end to a substance use disorder, ultimately, if there's no intervention, it's ultimately it's death and we have to consider that.

We have to think about the individual that's experiencing what they're experiencing, the symptoms of the substance use disorder. Because when someone's in it, there's really no way out until somebody else helps you and helps you identify that there is a problem because we rarely see our own problem. Thank you very much. Now we're going to need to take a break.

So we're coming to you live from the BIM Global Network in TuneIn Radio. This is the All About Nursing Show and I'm Dr. Joyce Bachelor and we'll continue this conversation when we come back. Have you ever felt like no one is listening or you're not getting the honest attention you deserve?

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Relied on the BPM Global Network in Tune and Radio. And before the break, my guest, Dawn, was the program director for the Texas Peer Assistance Program for Nurses, was sharing with us some of the work that she's been leading in terms of trying to have leaders and others understanding the kinds of resources and support that there is for nurses who may in fact by themselves having some difficulties with mental health issues and drug abuse. And so I think you had said something about what you all are trying to do and how that is different from the Board of Nursing and trying to make sure that the distinction of disciplinary action versus support is really understood by our nurses and others. You may want to say a little bit more about what the differences are.

Yes, so T-PAPN, one of our folks is nurses helping nurses. But the main difference between T-PAPN and the Board is that the focus for T-PAPN is we're helping nurses along with safeguarding patients. And so we do have that public safety piece with it, but the primary goal is to support the nurse and their recovery knowing that when we're supporting the nurse through the recovery, that public safety just comes along with that. You know, if a nurse is healthy, if a nurse is doing self-care, if a nurse is working in an environment where they're supported, the public safety piece will naturally be taken care of.

So with T-PAPN, we also have peer support partners. They used to be called advocates, but now we've changed it to more of a social peer support role. So we have nurse volunteers who provide peer support to nurses who are in T-PAPN. And this is someone who the nurse can call on a weekly basis or they can go have coffee and just kind of talk about what's going on, talk about what's happening with T-PAPN.

They're not sponsors, so that role is not like a role where the peer support partner isn't necessarily like a sponsor or a recovery coach or anything like that. They're really just, again, somebody walking side by side with them, another nurse who understands nursing and understands the stressors of nursing and has a clear concept of the things that may have led a nurse to be in T-PAPN. So the peer support is a huge component of T-PAPN. And the board is more focused on the investigations, monitoring and discipline.

And we're more guidance, support and monitoring. Does that make sense? Absolutely. And I was just curious, what other kind of outcomes are you trying to achieve as you're working with the nurses who are willing to admit they have an issue and really want to have the kind of support that your program can give?

Well, I'd really like early intervention. It would be awesome. I'm doing more outreach with the hope that we can do early intervention. I'd love to see an increase in self referrals.

We have already seen an increase in self referrals, but I really want that to continue. And just kind of remind nurses that by self referring to T-PAPN before a practice violation of hers, that they can avoid a report to the board. Again, when someone is abusing substances or their mental health, it's suffering. It's really hard to make that, to take that step.

But my hope is that people will learn more about T-PAPN nurses, nurse leaders. Anyone who's a round of nurse who can provide support and say, hey, you know, T-PAPN is available. You might want to give them a call. And that way we can avoid practice violations, avoid the board being involved.

Also there's board order fees. So if a nurse is referred to the board and then it comes to the board to us and it's not on board order, there's fees involved with that. And self referral, they can avoid those fees. Also if they haven't lost their employment because there's no practice violation, they still have insurance.

So the evaluation, there's an evaluation required. And when someone starts in T-PAPN, that may be covered by their insurance. So that's a plus in self referring. And then we can also look if the individual has possibly been hospitalized for a mental health condition, that may be a prior evaluation or diagnosis could be factored into the T-PAPN assessment.

And so there's just a lot of pros to self referring. You know, as you were talking, I was thinking about some of the cases that we did end up having to refer not just to T-PAPN, but the unfortunate ones is when they weren't willing to admit they had an issue and then the pharmacy board gets involved. And because of the quantity of the substances involved, it was even calling the police, which I would say to you, it's the leaders struggle a lot myself included, especially when you know these people and you just can't even imagine that this is happening to them and you certainly don't want it to be happening to them. And you try to do whatever you can to support them.

But I think your message getting out sooner is awesome because there's a lot of, I think, stressors for the people that have been working with this person that know them, care about them and they see the struggles they're having, especially when they won't admit they have a problem. That's the hardest thing, truthfully, that I experienced. So, I think that's wonderful what you're doing. So how do nurses, employers, and others learn about your program?

So recently, we actually have done, we're working on a marketing campaign. This is something that we've been working on over the past few months. There's a lot of nurses, never received mailers. We sent out thousands of mailers in the middle of the summer just with information about T-PAPN.

I'm just a kind of remind nurses that we're here. And we were really focused on also LVN to get our, because we would like to see more LVN's participating in the program. So we send out these, these mailers to all LVN's in the state of Texas. And then also I'm, I have done some traveling to, like I said, I went to the Rio Grande Valley.

I've done some webinars. And then we also advertise the program in a Texas nursing magazine. I'm the one that TNA puts out the Texas Nurses Association magazine. We're on the Board of Nursing Bulletin.

We have information there. And then we're also on social media. And again, the Texas Nurses Association also, they, they post things for us on their social media, like Facebook and Twitter. So those are kind of ways that we put ourselves out there.

And then we try to stay involved. If we see, you know, maybe an article or stuff that happened in the news that affects nursing, we try to respond to some of those things. You know, even, you know, with things going on, you know, the unfortunate things that are going on, I'm like an El Paso. We reached out to our nurses in El Paso and tried to be there and be a support.

That's wonderful. So we'll talk more about that in a little bit. Right now we're coming to you live from the BVM Global Network and Tune in Radio. This is all about nursing show and I'm Dr.

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I think T-PAPN needs to take an active role in making sure that we are reaching out and we are saying, hey, we want to make sure that we're here. We want you to take care of yourself. Again, that self-care component. T-PAPN has always, not only say, T-PAPN has pretty much just been that alternative to discipline program.

I like to see T-PAPN be bigger than that. I would like to see us more as a mental health advocate, a program that is really looking out for a nurse's well-being and doing things just to be actively involved. We recently, our team here along with the Texas Nurses Association, we did a NAMI walk, the National Alliance for Mental Illness. We did that walk here in Austin just to show that we support mental health.

So, yeah, we had a team of almost 30 people, which we were really small programs, so that's a lot of people. We even raised funds for that. So, just being present, being available, making those phone calls, checking on people, those things are just really important. Nurses experience so much in the workplace.

I mean, I could even discuss workplace bullying, those kinds of things that nurses also experience, and we just need to make sure we're looking out for one another. Yeah, no, I think you, that's great to be able to summarize it like that, because we've had some discussions on prior shows around the, again, need to look at the work environment, but the whole quadruple aim as a result of physician suicides being up and studying nursing suicides and just the impact that all this is having in the work settings. You know, you had shared a little bit about how your goal is that nurses would self-refer to TPAPN, and certainly if someone's working in an organization and they're suspected of having issues with drug abuse, that that's another way they can be referred to TPAPN. Are there other things that you would want us to know in terms of how nurses are referred and the kind of conscientious work that's going on to really help these caregivers?

Yes, so first I'll start with how nurses are referred. So, we received third-party referrals through, or self-referrals are directly through the TPAPN website at TPAPN.org, so that's one way an individual can be referred. We also receive referrals from the Board of Nursing, and those can come in as a third-party referral, or they can come at the Board Order. What the Board of Nursing does is that they receive a referral from the community about a nurse's practice being possibly impaired.

If it appears to be a substance use disorder or a mental health condition, they will route that referral over to us for us to handle. So, that's one way that we would get referrals. So, if an employer or a nurse peer or whoever refers, whether it's a TPAPN or to the Board of Nursing, again, if it's something in relation to a substance use disorder or mental health condition, it's going to end up with us. And we receive, you know, probably we get Board orders too, and those Board orders are basically nurses who have been under investigation and have agreed to specific terms, and then that order is sent over to us, and then we start to work with them.

So, those are the ways that we get referrals. The, I'm sorry, I'm just trying to kind of process all this. So, when we get referrals, I mean, it can be anything from someone to be impaired in the workplace. It can be for diversion of drugs.

It can be for suspicion of a substance use disorder or even a mental health condition. It could be a family member who refers a nurse to our program because they're aware that the nurses, you know, possibly using drugs or experiencing a mental health crisis possibly. So, we can receive referrals from pretty much anyone in the community, but we want the person to, our referrals are confidential, but we do need to know who that person is. It's confidential to the person they referred, but it is not confidential to us.

We need to know who they are because we don't just take anonymous random referrals. We want to make sure that the referral source is someone that we can reach out to to get more information. That's wonderful. I was curious when you were talking about the outreach that you were doing, have you also been reaching out to like the student nurses before they begin to practice that they're aware of the kinds of resources that are available.

If in fact during their career, they either encounter somebody that they think might need a referral or they themselves find themselves in a crisis or a situation that may precipitate some sort of mental strains that they need some assistance with. Yes. So, recently we actually had one of our peer support partners present. I can't remember which city it was in.

Texas is a really big state to remember where everything's happening at. But we did have one of our peer support partners present kind of the T-PAPN overview to a nursing program. And that is an area that we are going to add to our outreach and education. I have a couple of case managers who work here at T-PAPN who want to reach out to some of the schools and just go in and talk to the students and let them know that T-PAPN you know once they become a nurse is available to them.

But right now we don't work with students. It has to be a licensed nurse. Right. So, we'll get there.

Yes, that's wonderful. This is all about nursing. I'm your host, Dr. Joyce Bachelor.

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Welcome back everyone, you're listening to all about nursing live on the BDM Global Network and tuning radio. I'm Dr. Joyce Batcher, the host of the show and I have a guest with me this evening, Dawn Webb, who is the program director for the Texas peer assistance program for nurses and she's located in Austin, Texas. And prior to the break she was telling us a little bit about the challenging work that she's involved in and the kinds of things that are being done proactively to really assist nurses.

I think it might be interesting to the audience for you to share a little bit about some challenges or barriers that nurses do face when they're referred to or they participate in the T-PAP program. Right. I think one of the largest barriers is the cost. A lot of times when nurses are referred to the program, they may have lost employment or maybe they've had to take a different job and they're underemployed.

So initially when someone is referred to us, there is an evaluation that has to take place. That evaluation is what helps us place them in the program that they need to be in and that evaluation can cost anywhere from $500 to $2,000, which when you're, sometimes, nurses are the sole care provider for their homes and it's super expensive and we really don't want nurses to not participate because of cost. And I'll talk a little bit more about that after I explain a couple other things. But drug testing is also a part of participating in T-PAP and that could be anywhere from 18 to 24 drug tests a year.

And those can range anywhere from $55 and up. So kind of being prepared for the expense. Another issue or barrier is the stigma attached to being in the T-PAP and program. So when nurses go out and apply for jobs and they have to say, I'm in T-PAP and I'm going to have workplace restrictions.

Definitely a barrier there. And that's where my outreach comes in and hopefully working with more employers and organizations so that they will hire T-PAP and nurses. And then the workplace restrictions, the nurse may have an narcotics restriction. They also have to have supervision by someone who is either the same licensure or higher than them.

Also, we are concerned with nurses working in an autonomous role like home health care. We, home health care can be pretty risky for nurses participating in T-PAP and then also sometimes, not all the time, the nurse won't be able to work in night shifts kind of just depending on what the evaluation says. If it looks like a night shift might have been contributing to the related incident that got the person referred in the first place, then we may want to look at them not working nights for a while. So that could be another barrier.

And that's going to be another financial barrier too because a lot of nurses will work night shift because of the shift differential. So then again, that's another cost. So the hope is that the nurse is going to be working in a supportive environment and that they're able to kind of identify that these restrictions are in place for them to protect their license. When I was at my last job, I was the chairperson of our peer review committee and I just, every single time a nurse came through peer review, I would just remind them, protect your license.

Whatever you do, whatever's going on, any situation, and the board teaches us to protect your license because when it comes down to it, it's about you and your license and that's your likelihood. So with autonomous roles, we're pretty leery about those roles, especially in home health care because if something happens in a home, say someone's medication goes missing and it's a narcotic and it could have been anybody, not necessarily the nurse, but if the nurse is accused of that and a nurse, he's having participants, doesn't look very good. So that's one of the reasons why we like to kind of avoid the home health situation or like hospice situations. And I think sometimes it's really hard for nurses to understand that we truly are wanting them to protect their license and really, we want them to have jobs that are supportive.

And when we get employers or situations where the nurse is already feeling like that negativity is on them, they're offering them the job, but they're not really supportive. Sometimes we have to ask the nurse, like, I know you really want this job, is this an environment that is going to be helpful to you? Is this an environment that could support your recovery? So in those challenges, it's just really trying to figure out what's best for the nurse and their success.

It may be a challenge, but at the same time, there's that protective factor that we look at. I used to find that if people had self-referred or they were willing to get help, the staff that they were working with tended to want to be supportive of them, I think the challenge becomes harder when someone has tried to deny it and then it makes people not necessarily trust to have you back and that there's not the same level of support. So I think there's a lot of education that needs to be done all the way around all of that. I was listening and saying, wow, this is just, you have a whole lot of different challenges that are out there.

So do you have other people or how are you overcoming some of these challenges because they're very real? Yeah. So the T-PAP and case managers, they work closely with participants. They provide support and guidance throughout the entire process.

One of the things that our case managers do is help the nurse have that conversation with an employer or with their peers. One thing that I've said in different kind of webinars that I've done and training and things is the nurse, again, I go back to stigma. Nurses won't say they're in T-PAP and are they're afraid to tell their peers what's going on because the stigma attached. How many nurses have that conversation with peers, with their supervisor?

And one thing also about a barrier is when a nurse has to have another nurse give medications for them, then it's like, oh, they're in T-PAP and they can't give meds. But the nurse who's in T-PAP and saying thank you, thank you for helping me with that and just kind of learning that they can communicate. But they have to have a safe environment to do that. So we're trying to teach our participants how to communicate with employers, how to communicate with peers about T-PAP and about what's going on and finding kind of a comfortable place where they're not stigmatizing themselves.

Because unfortunately, people do stigmatize themselves and I think nurses are really hard on themselves. So I think it's kind of this higher level of stigma when we kind of are kind of looking at ourselves. So we have to really look at that. Yeah, that's really very important.

Thank you for sharing that. This is all about nursing. I'm your host, Dr. Joyce Bachelore, live on the BBM Global Network and Tune in Radio and we'll continue this conversation when we come back.

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My guest this evening is Dawn Weber, the program director for the TPAPN program here in Austin, Texas. She was telling us about a lot of the challenges and different ways that her group works to really overcome obstacles and concerns that the nurses and others may have. All of this is really very important, I think, because we maybe haven't said enough yet about doing this is a lot better than having the alternative be disciplined. And maybe you could share a little bit about what are the benefits of alternative to discipline programs?

Well, for TPAPN, one of our main flow-in is nursing nurses helping nurses. So I feel that with an alternative to discipline program, we empower nurses by connecting them to resources. We connect them to peer support. We want them to continue to practice nursing safely and live a self-directed life and reach their full potential.

So we're looking at all aspects of the person. It's not just about going to work. It's about what do you do every day to take care of yourself to be the best that you can be when you go to work. So it's more than just making sure that someone's going to work and being safe.

We're making sure that someone is taking care of themselves so that when they go to work, it's just kind of a natural consequence of being a healthy person that you're safe at work. And I think we just got to lose focus on that. It's like, oh, we have the safeguarding patient's piece. But again, if a nurse is healthy and nurses taking care of themselves, they can focus on their work.

They don't have a lot of kind of things going on. We talked about bullying. We talked about secondary trauma. Those all of those things, if an employer is supportive in identifying those things and making sure that they have a healthy work team, then you, these natural consequence is going to be a safe environment for the nurses and for the public.

And I know that we did talk about referral a little bit earlier in self-referral. It'd be really great if we did get more self-referrals. But also we do take referrals, again, from family members, loved ones, friends. You may have a best friend who's a nurse.

You may have a sister or a brother or someone that you know that's a nurse who's struggling right now. And you don't know what to do. So T-Pappen, again, our website is tpappen.org. That referral can be made.

Even suspicion of substance use disorder can be, you know, we can look into that and see what's going on. And at least get that initial evaluation done to find out what's going on with the nurse and give them the help that they need. And I think it's awesome. And you've been saying this during the course of our radio show this evening that it's important for the public to know this because we're very conscientious about making sure that when nurses are working that they are very safe and they're able to give good care because we are the most trusted professional.

And so I really applaud the kind of work that you and your team are doing. Is there anything else as a final takeaway that you would really like to say to the audiences we're getting ready to wrap up our show this evening? Yeah, mostly I would like for the world to know that, you know, T-Pappen really is here to support a nurse through the recovery journey. We, you know, disconnecting to case management.

We really are working to make sure nurses feel supported and to not, and for this program to not be a punitive program, for this program to truly be the alternative discipline. You know, and we really, really want nurses to feel like that they can reach out to us. And we want to build trust. T-Pappen, you know, I really want to see us build trust in the nursing community.

And I know that that takes time, but I want nurses to see us as a resource. If we can get there, we're nurses, even if they just call us to ask us questions, just start building that relationship with the nursing community. That's wonderful. And I really thank you for being on our show this evening.

It's been very informative. And again, congratulations on the great work you're leading. You are listening to all about nursing live from the BVM Global Network in Tune & Radio. Dr.

Joyce Batchelor, the host of the show. And hopefully you'll tune in again next week. Thank you. You've been listening to all about nursing with your host, Dr.

Joyce Batchelor. Tune in each week and get a daily dose of nursing and the healthcare services they provide. And how nurses are finding innovative ways to address the key healthcare issues they're facing today. Here on Dr.

Joyce Batchelor's All About Nursing. You've been listening to the BVM Global Network. The ideas, views and opinions of this broadcast are those of the participants of the program and are not necessarily the ideas, views and opinions of the BVM Global Network Company.