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TPAPN Employers
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Employers working with TPAPN are usually trying to find information on reporting a nurse or hiring a TPAPN participant. 

Reporting facilitates nurses getting help sooner than they might have otherwise. Reporting also helps protect the public. The Texas Nursing Practice Act requires employers (and peers) to report nurses who are impaired, or suspected of being impaired, by chemical dependency or diminished mental capacity.

  1. If the impaired nurse is believed to have committed a Nursing Practice Act violation, the nurse must be reported to the BON.
  2. If no Nursing Practice Act violation occurred, the nurse must be reported to either TPAPN, to a nursing peer review committee (if available), or to the BON.

We encourage self-reporting and concurrent reporting to both TPAPN and the BON.

Nurses who participate in TPAPN are highly motivated to return to safe nursing practice. In some situations, their recovery plan includes workplace monitoring. Employers who would like to support a nurse being monitored in the program should contact TPAPN. Below is a summary of the requirements for employment. For a full agreement, contact TPAPN

General Requirements for Employment

  1. Approval from TPAPN case manager prior to returning to practice and before accepting a new position or returning to previous employment.
  2. TPAPN participants must inform prospective employer prior to accepting position. The participant may be required to submit a job description to TPAPN. An employer consent must be submitted to TPAPN. After submitting, employer must call TPAPN Case Manager to discuss and “approve” the position. The TPAPN Case Manager will speak with the prospective employer and orient employers regarding TPAPN work requirements and restrictions prior to participant beginning employment.
  3. TPAPN participants must provide employers with a copy of the TPAPN Work Agreement to be completed and submitted to TPAPN before starting work.
  4. Participant's supervisor must complete Quarterly Work Evaluations to document the participant’s job performance and behavior in the workplace.
  5. Approved position(s) must include direct supervision (see Supervision Requirements tab). Supervisors must be aware of TPAPN participation and readily accessible. If the supervisor does not work the same shift, additional contacts must be identified. Requirements to be a workplace contact are described on page 1 of the TPAPN Work Agreement. TPAPN participants cannot work in a unit without another informed employee on the same unit. 

Supervision Requirements

If practice monitoring is required, a TPAPN participant must be supervised by another licensed healthcare professional, as outlined below, working the same shift, who must see the participant periodically throughout the shift, and must be aware of the participant’s TPAPN participation.

  • CRNA – must be an Anesthesiologist or CRNA
  • NP – must have a protocol with a supervising physician
  • RN/LVN – supervisor must be an RN or above

Practice supervision can be direct or indirect. 

  • Direct requires supervision by a nurse with the same or higher level of licensure who is on the same unit and is immediately available to provide assistance and supervision to the nurse.
  • Indirect requires supervision by a nurse with the same or higher level of licensure who is on the premises but does not have to be on the same unit as the nurse.

Potential Practice Restrictions

TPAPN practice restrictions may include:

  • Controlled substance/narcotic restriction (typically 6-months)
  • No on-call assignments
  • No shifts longer than 12 hours
  • Work will be on a regularly assigned, predetermined unit. Floating is restricted.
  • Nurse will be employed in nursing by only one employer.
  • No self-employed nursing practice
  • No staffing or temporary agencies, traveling or registries, or hospice or home health.
  • No more than 96-hour of work per 2-week period
  • Single work site nursing practice only. Exceptions, on a case by case basis, require TPAPN and Board of Nursing approval.




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Texas Peer Assistance Program for Nurses
Phone: 800-288-5528
Fax: 512-467-2620
Office Hours: 8 a.m. to 5 p.m. M-F

Texas Nurses Association

Texas Affiliate of ANA | 4807 Spicewood Springs Rd., Bldg 3, Suite 100, Austin TX 78759

800.862.2022 | 512.452.0645 |