Methadone: A Flicker Of Light In The Dark

Methadone: A Flicker Of Light In The Dark

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 Resolutions and outcomes from grievance filings

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Finallyachance

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Number of posts : 68
Location : Over the rainbow
Registration date : 2011-10-11

PostSubject: Resolutions and outcomes from grievance filings   Sat Dec 03, 2011 7:32 am

I will never forget the day I left my clinic and drove around for hours fighting off the desire to get high, quit MMT and/or find another clinic as the treatment by the nurses at my clinic had reached an all time offensive that had totally floored me and sent me into a panic that it took days even weeks of posting, crying, and in the end filing the grievance that I thought would never be resolved. I am sure a few of you on here remember the story but I will recap it a bit because I would like to re-present an old issue that I think we all need to re-address and I am in hopes you can re-direct me in finding the best reaction on my behalf as I think my "old clinic" may deserve the credit for at long last resolving the grievance I filed.

I had been attending this clinic for two years and was going to said clinic once a week for my takehomes and once a month with my counselor etc...but, there were these two nurses who had become a tag team in offending the clients even to a bullying degree. I had out of no where been told I needed to have a Peak and Trough, EKG, Physical before I could dose one wednesday when I showed up for my weekly visit. Everyone was acting wierd to me even my counselor so my imagination started in high gear thinking the worse. Because number one I had been asking for a peak and trough for over a year and a half but after several attempts of sticking me nine to eleven times each try they gave up trying therefore I was stuck at dose 160 but never feeling stable as I still suffered withdrawals and cravings. Number two was my admission EKG had showed a 540 QTC's and my admit nurse had told me they would have to redo one in 90 days and methadone might not be an option for me if I continued to run a high QTC which left me in a pure panic for a year and a half I was able to dodge the followup and now they were going to make me do one so I was convinced with those two issues and some weird behaviours from clinical staff they were trying to get rid of me etc...So that Wednesday I took the EKG which was 450 instead of 540 which was better only boderline QTC but I was still afraid and I got the physical and lastly I scheduled the P&T for the next monday as we have to go in for three days in a row dose same time each day on third day have P&T staying at the clinic in front of staff for four hours that last day. On Monday when I went to the window to dose I had my box with my last three takehomes still in my box and the nurse whisked my hands to the side and grabbed my takehomes and said I'll be taking these real smart ass like. I ask why in a fearful reaction and she said because I can and nothing says I can't does it? so that was it. I was now convinced something was totally gone wrong at the clinic with me. I was either a high maintenance client because of my QTC's and hard to stick for P&T's and/or someone or something was said that made them mad at me etc...
I immediatley went to my counselor and ask her what the hell was up and I told her what had happened and she said I was over imagining the issues of the clinic sabatoging me but those nurses had been totally out of control doing as they had done and said and there had been many other incidents of abusive remarks to me and other clients for a long time with these two nurses. So she told the admin director and the next day, (the second day in a row) they both confronted me in a plea to write a grievance as they can not do anything without people writing grievances and everyone wanted to complain about these nurses but no one would ever file the grievance that was needed so in effecting an investigation. So I did file the grievance on the last day of the P&T which btw they were able to get this time with only six sticks which pissed me off as they never got it at all before when I requested the P&T's. Well I got my takehomes and that whole next week reached out to my online forums and before the next week I transferred to another clinic. The new clinic got my P&T the day they adnitted me from my old clinic and the doc agreed I was in need of increases etc... as my peak was 881 and my trough was 226. So he increased me 5 mg and told me to talk to my counselor every few days and ask for more up until I felt more stabilized. Hooray finally I was heard. All is well. This clinic is gonna be a lot better. etc... welll.....NOT. I have been there 7 weeks now and have gotten increased twice at 5 mg each and they are more unorganized and less client oriented than my old clinic. I was also trying to still follow up on the grievance at the old clinic and after several attempts I get a phone call from the same admin director (the only one) that talked me into filing it and he told me he could not follow thru on the grievance unless I came back that once I left he had no authority to discipline those nurses.
Once again I reached out to you all and my other forums I like where I received the same reaction by all "THIS IS BS". So I just gave up. Then while I was getting the run around totally the opposite of how the doctor at the new clinic had been at admission about my increases I got mad and called the old admin director again and told him that I felt it was BS that he could not follow up on my grievance unless I came back and...even tho I wanted to believe him cause I hate my new clinic worse I was scared. He told me the information of how to follow up on the grievance by using a grievance with CARF, his home office clinic and the State Methadone Authority etc...(which gave me a bit more respect for him) but once again he offered me to come back and reiterated exactly what I wanted to hear that he told me in first conversation as the doc there had gotten my P&T and had written up orders to increase me 10 mg a week up until 250 mg then readdress it if I was still unstable and it was in writing for me to see etc...He said he had spoke to the doctor too about the nurses and my grievance and he could not go into any further detail but he could assure me that it was being addressed without me having to be there but he could promise there would be some determinations made in the next few weeks and once again he invited me back. I found out last week the worst one of the nurses was fired and the other one was put on administrative probation so I called him again. He was hesitant to discuss exactly why the one was fired and so on but assured me that my grievance was taken into consideration. I made an appointment to see him my old counselor and the doctor this wednesday and now I am considering that fact of going back. I can take it and I want the honesty you all have never denied me in response back on this post please. I am hopeful, but scared.
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lilgirllost
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Number of posts : 863
Age : 44
Location : live in Louisiana but attend MMT clinic in Tx
Job/hobbies : COUPONING & GEOCACHING are my favorite past times but I also love reading and spending time with my husband and kids
Humor : I don't have a sense of humor.............
Registration date : 2009-05-25

PostSubject: Re: Resolutions and outcomes from grievance filings   Sun Dec 04, 2011 2:22 am

I am sorry your are still conflicted about what is going on w/your former and current clinic. I know it must be hard for you and I can't even imagine the turmoil you are going through.

You are going to be the one that has to decides what is best for you. We can't tell you what to do. I can only tell you what I would do and that is what I was telling you before: File the complaint, continue on w/the complaint and stay AWAY from the old clinic. I understand that they may not be increasing you as fast as you would like at your new clinic, but at least they are. The old clinic wasn't willing to do anything for you before and was so hateful to you. The clinic director flat out ignored your meetings and phone calls and blew you off, that was until he realized you were serious about your complaint and that you were going to go through with it. Now he's trying to "suck up" to you. I would stay away from them, but that is my personal opinion.

Again, only you can decide what is best for you in this situation. We are here for you EITHER way and always will be. Be sure to let us know how it goes, ok?

If you go back to the clinic, what are you going to do about the complaint? Or has the director made that a "stipulation" of them giving you and increase that you will withdrawl the complaint?

One other thing, and I don't mean to keep sounding like a naysayer, but let's say you do go back and agree to drop your complaint. What's to keep him from going back on his word about things. Then because you already filed a complaint once and withdrew it, it's going to make things look bad for you if you end up needing to file on them again, or any other clinic for that matter.

Ok, I will quit for now. Again, you have to make the decision yourself. You've heard my two cents worth and from your post it seems that a lot of the other members on this forum and at the AT WatchDog also think you should not go back, but YOU are the one that has to be ok with the decision so it has to be what YOU think is going to be best for you.

Good luck with your decision and keep in touch and let us know how things are going and how you are doing, ok?


RuthAnn
aka lilgirllost

We are not bad people trying to become good, we are sick people trying to become well.

Methadone; A Flicker Of Light In The Dark
www.medicalassistedtreatment.org
www.suboxoneassistedtreatment.org
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If you cannot afford to call us, send us an email and
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Finallyachance

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Number of posts : 68
Location : Over the rainbow
Registration date : 2011-10-11

PostSubject: Re: Resolutions and outcomes from grievance filings   Sun Dec 04, 2011 4:07 pm

He went through with the grievance and put both of them on one week no pay and 90 days probation that they lose their jobs if any complaints were made in their name. He said that was "not fair" by the rudest nurse so she quit and the other one signed a contract and is off until next week. He has agreed to let me do my take homes on Saturday if indeed I am afraid of retaliation but he would hope I would keep my schedule as was to show this last nurse and anyone else that there are clients that will follow thru. I thought the one nurse had been fired but when I called yesterday to confirm my appointment with them and the doctor on Wednesday he got on the phone with me and clarified that he had took one week time off no pay and a contract with several stipulations as his course of action the leader of the pack nurse gave a two week notice so he told her to go ahead and take the two weeks off but he would pay her for one just because he could see her attitude was a poor attitude. He said in my defense several of the nurses had spoke up on my behalf that they too had seen unacceptable behaviors with the one nurse and that they all felt I was a very compliant client with a good disposition and in fact one of them called me the model client. He said the one nurse had not denied my accusations but try defending her position by saying (almost quote what I had said) that why was he taking the word of a self admitting drug addict and...People were beating the doors down for a place in the clinic. If you remember I said in my grievance that she had said to me "well if anyone doesn’t like the way I run my window they can leave that Asheville is full of drug addicts and they can be replaced very quickly" Close enough to my complaint to validate my grievance.
I never took the grievance any higher than the clinic. Not yet that was. I was trying to get myself acclimated to the new clinic before I followed through on filing with CARF and State Methadone Authority but he did know I was serious because he gave me the information of how and where to file, but he said when the doctor got involved it gave him a bit more support in following thru even though I had left. Personally I think he did some fast foot work in case I did file so he could indeed report he had indeed made efforts to resolve the issues. Nonetheless, I think he sees me as a serious client and did something at least. I hate this new clinic. For more reasons than slow increases. My counselor OMG is the nicest man but he should not be in this line of work. I know I sound like a real whiner and even pomp as but I can go on and on of his many short comings (and his favors as he at least tells me the truth even when he shouldn't be) and the doctor I am waiting any minute for him to put a stop to my increases. He sends back demands to my counselor to do things my counselor says he himself has never done so I am to humor him like checking my pupils checking for a runny nose etc... He (the doc) implemented a new form last week with this big long letter attached to my request telling my counselor to do these things and I had to have five complaints in order to get the increase and three of the complaints had to be witnessed from my counselor in a twenty minute time period do you know how foolish I felt? Out of the ones listed there were only three or four he would be able to witness unless he follows me around for hours to include the bathroom. So he checked pupils (although he admitted he had no idea what to look for) Runny Nose (which I did have) Goosebumps flesh which I complained comes and go so he took my word for it and just for good measure he said I am going to check you seem anxious. Which I was. I have heard of other clinics having the nurses look for some withdrawals etc... but this is too weird it has come about on my request the sticklerism. I mean why????? He was the one that viewed my P&T results which he believes in and said I needed to be increased when he admitted me. If he thinks I am diverting my medication which is the only reason I can see why he would be so relentless in figuring out if I am in withdrawals or not then why doesn't he just come out and ask me or deny me etc....Let me ask you a question Ruthann. If he were to ever decide to detox me etc...Can I leave that clinic and go find another one that would not follow thru on his orders to detox me??? My biggest fear is that admin detox I have heard of if they think you are diverting your meds. I swear, I never even thought about it. I never even knew it was such a big issue with clients until I was trying to figure out why I was being treated so badly and someone said they must think you are diverting your methadone. WOW was that a big blow to me. I felt like the big drug addict again. The life I had left behind for almost two years now was once again being thrown in my face etc... Remember when I first started writing/posting and saying these nurses were asking ne weird questions and implicating something but I had done nothing wrong. I started accusing a friend of mine for making up a lie on me because she was mad at this guy at the clinic and she had told me she was going to tell his counselor he was selling his medication etc... Well I can't help but still think she started something with me back then and now....it is being carried over to my new clinic although I must say my counselor does not act the least bit like he thinks or has been told any such thing. In fact I think he would flat out tell me. He treats me like staff instead of a client because I told him my history of working in treatment and such. (Twelve step not mmt) I have to admit the one very large defect I have and it runs much deeper than MMT I am super/hyper sensitive to being accused of something or defending myself against defamation. So....there is a big possibility I am imagining some of this crap. In the same though I have a keen intuition when things are sketchy too and it is truly what kept me from not being busted or arrested all my years of drug addiction. I always knew in a nick of time when and how to avoid danger.
I am sorry if I seem such a mess all the time. I wish things could just go back to the first eighteen or so months of MMT. I think that is why I keep fighting with the question of going back to the old clinic because all was well for the first eighteen even twenty months or so. Besides a few bumps with those nurses, the inability to get a peak and trough as with my veins and my fear of the EKG, (which the director says was nonsense because they would have let me remain on methadone if that was what I chose to want even with high QTC's) it went pretty smooth. I am meeting with the Doctor, Brian and my old counselor on Wednesday as a formality with the Grievance etc…. I still am indecisive to WHAT TO DO, but I am doing something even if I have to consider the last clinic in my area as a new clinic for me.
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PostSubject: Re: Resolutions and outcomes from grievance filings   Sun Dec 04, 2011 4:20 pm

I have a question to ask you. When you went over to the new clinic and the doctor told you on admission, he would increase you. But then afterwards when your counselor did not give the results to him for your Peak and Trough resulting in not getting the increase you had put in for because he "forgot" about the P&K is that right?

Have you gone back to the doctor at the new clinic yourself to speak with him yourself to ask him why he hasn't given you the increases as he first stated he would? Or have you relied on the counselor to do all of this for you?
Past experiences with anything has taught me that if I want any results especially when it deals with something as important to me as something like this, I have to follow up myself.
At the clinic that I attended (and I will say this was about 6 years ago so times I'm sure have changed.) the doctor came in twice a week. Tuesday's when he came in to do physicals and see the patients who had questions and Thursday's when the intakes were done.

If I wanted an increase I had to put in for it by Tuesday or Wednesday so that I could get it on the following Monday as there weren’t any increases given during the week unless you were new. All doses were brought in on Monday and kept in a very large safe against one wall behind the nurse’s window; everyone's doses were kept in their own numbered slot with one column allotted for new patients which allowed for those increases when needed. If I needed to see the doctor I made sure it was done on Tuesday when he was in rather than rely on my counselor who was more interested in talking about who she was dating at the time.
I know I took the long away around to say this, but what I’m asking is have you thought about making the trip over to see the doctor when he is there and talking to him yourself about the increase that you need instead of relying on your counselor to put in the paperwork or whatever needs to be done.
I know that you want your increase and you should have it as should everyone else who needs one.
In reading your post, I get the feeling that what you really want, is to go back to the old clinic but you are hesitant because if you do go back and you don’t get what has been promised, you will be back at square one.
It is a very difficult decision to make. Do you miss the old clinic? Were you comfortable there other than the dose problem?
Do you think you can accomplish getting what you want if you go back? If you do go back, and if you don’t get the increase, what will you do? I’m sure all of these questions are ones that you have asked yourself and at the end the only thing that matters is- “What is best for you”?


"I will let yesterday end so that today can begin"



Never take any online advice over that of a qualified healthcare provider
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PostSubject: Re: Resolutions and outcomes from grievance filings   Sun Dec 04, 2011 4:30 pm

I'm sorry it looks like we were both posting at the same time here. While I was typing you had already posted again.
If you hate the new clinic, I don't see how your going to be happy there.
You have been leaning towards going back to the old clinic for some time now.
If you feel things can be resolved and your not being led on or lied to. You are your own best judge on this.
You have already decided to go to the meeting, so go and keep in mind everything you have said and take any notes or questions that you might have with you. If at the end of the meeting you feel it would be in your best interest to go back, then do so.
This is your recovery.
If you feel the new clinic is putting you in a position that your recovery is in jeopardy, don't stay.


"I will let yesterday end so that today can begin"



Never take any online advice over that of a qualified healthcare provider
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lilgirllost
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Number of posts : 863
Age : 44
Location : live in Louisiana but attend MMT clinic in Tx
Job/hobbies : COUPONING & GEOCACHING are my favorite past times but I also love reading and spending time with my husband and kids
Humor : I don't have a sense of humor.............
Registration date : 2009-05-25

PostSubject: Re: Resolutions and outcomes from grievance filings   Sun Dec 04, 2011 4:56 pm

yes, I do understand the turmoil you must be in even though I haven't been in that specific situation, I've been in similar. I too wish it was a simple solution but it really never is when it is a matter of the "hard" things.

Again, you are going to have to be the one to decide what to do and how you want to handle it. We can give you our opinion and what we would do all day long but in the end, you are the one that has to be ok with what is going on so it has to be your decision.

In response to your comment about the doctor now having this long form that has to be filled out w/a checklist, this sounds like the SOWS (subjective opiate withdrawal scale) scoring or the OOWS (objective opiate withdrawal score). Originally there was also a COWS (clinical opiate withdrawal scale) but I believe they use the SOWS/OOWS now more than the COWS.

http://www.dassa.sa.gov.au/webdata/resources/files/Assess_withdraw_opioids.pdf

http://www.toxicologyassociates.com/SOW_Scale.pdf

This is not something the doc just made up, clinic all over use this as a guideline to check for withdrawls and/or to determine if a pt needs an increase.

It has a series of questions that they need to ask you to rate your w/drawals. One has more questions than the other (The SOWS I think has 16 and the OOWS has 13??) Some clinics, rather than use the peak and trough only will use this scoring system to determine increases. Some will use this in ADDITION to the peak and trough. It is just another tool to help try and determine the correct dosing and/or need for an increase.

In answer to your question about "If he were to ever decide to detox me etc...Can I leave that clinic and go find another one that would not follow thru on his orders to detox me???" You can leave the clinic for sure, but there is no guarantee what the new clinic will do. They will speak to your old clinic and read your files from the old clinic so I guess it really depended on what was in your file and how the old clinic decided to "portray" your situation to them.

I personally don't see them ever detoxing you (unless there was something that came along later on that they could justify one), but I do see them promising the increases and such and they may give you one or two but then quitting and going back to what they originally told you about not increasing you when you left the first time.

Again, I've told you how I felt and so have others but it is going to be your decision so you must decide what you are going to do so you can move on in your treatment. Every day/week/month longer spent fretting about this is time wasted and holding you back from "moving on".

Take care now.


RuthAnn
aka lilgirllost

We are not bad people trying to become good, we are sick people trying to become well.

Methadone; A Flicker Of Light In The Dark
www.medicalassistedtreatment.org
www.suboxoneassistedtreatment.org
We are available 24 hours a day, 7 days a week.
If you cannot afford to call us, send us an email and
we will call you at our expense.
Office: 1-770-334-3655~ Cell: 1-770-527-9119
Email: mrdeanv@aol.com
ALL INFORMATION IS KEPT STRICKLY CONFIDENTIAL
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Finallyachance

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Number of posts : 68
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Registration date : 2011-10-11

PostSubject: Re: Resolutions and outcomes from grievance filings   Mon Dec 05, 2011 12:05 am

Yes I knew the form was a form not made up by the doctor but all of a sudden he was implementing the need for this form was why my counselor was so shocked that for years it was done one way and now we have to sit 20 minutes with the counselor as he observes what???? He didn’t even know what he was looking for. He admitted that to me and.....it was attached and sent back stapled to my request which had never been done with any of his increases to date. So the counselor made me more paranoid acting like it was fishy to him too. I am not so much scared of not getting increased because I have been making it for two years on no increases I just deal with the late night early morning discomforts and wait it out until 5:30 am as I do not want to ever get ahead of myself and be any sicker than I am at 5:30. I just wish I could get stabled out like my friends and acquaintances are. No cravings no discomfort, but I would survive. What I am afraid of is getting decreased or detoxed due to my QTC’s or because they have some kind of suspicion of me as if you can remember from my first few post months ago I told you all I felt a friend may have gotten mad with me and said something about me that made them all wary and that’s what I believed started the whole mess of the nurses acting funny and rude and the all of a sudden mandatory P&T and EKG and Physical all in the same day. Oh Dee and Ruthann I just want to stop all the worry.
As for “was I happy at the old clinic before all that mess”. Yes pretty much except for worrying about dodging the EKG for a year and a half, I was pretty happy. The nurses had said rude things to me and in front of me but I only took them personal when they said the crap they said the day I was told I had to do the EKG, Physical and begin the next week by doing a three day Peak and trough that I took their comments to heart. I felt everyone was ganging up on me for some reason. I still believe something was said by someone that made them put me thru the loops like they did.
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