Day thirty, not a bad day…

Still poo’ing all the time mind you. Cannot work out why. I am back to eating small quantities very regularly and diving back on a toilet an hour later. Maybe I should go back up to 40mg of the stomach ulcer drug? Hell, I don’t know. It is the only side effect left to speak of. I will have to try drawing a picture soon. Stuff handwriting, over it.

Te Whare o Tiki

Just got given a copy of Te Whare o Tiki, The Healing House of Tiki apparently. Cheese. At least it is not as bad as calling a lockdown ward RANGIPAPA. Ahem. Cough. Splutter – Almost like calling a jail Rangipo, bloody white men.

Anyhooooooo….

This booklet has been adapted by Dr Fraser Todd and a bunch of people under the banner of joint mental health and addiction workforce. This workfarce has based its work on Dr Tom Flewett and the co-existing disorders team of Capital Coast Health DHB, Community  Drug and Alcohol Service (CCBHD ADDICTIONS disSERVICES).

It is really long.

It has 42 qualifying factors. I will chose one at random by throwing the book up in the air and seeing how it lands…. Here goes….

Well, that didn’t work. It kept landing closed.

Here is a random entry (page 10) as produced by closing eyes and using fingers instead…

2 WELL-BEING & RECOVERY
Consider problems as barriers to well-being and see well-being as the key recovery outcome rather than the absence of dysfunction 
(nzfiend says ; well written… well done… Now, apply that to addiction!) 
Knowledge and Skills
Foundation Level
(Base Knowledge)
Capable Level
Knowledge and skills to support people with less complex needs
Enhanced Level
Knowledge and skills to support people with complex needs
2.3 Supporting Recovery
  • Has knowledge of recovery concepts relevant to people with substance abuse, gambling and mental health problems
  • Acknowledges and works with people to determine and define their own recovery processes and goals
  • Advocates for recovery approaches
Demonstrates support for people with less complex co-existing problems to achieve their stated recovery goals
Demonstrates the ability to collaborate with people with complex co-existing problems to achieve [STATED] recovery [GOALS]
(for some reason they left “stated recovery goals” off this bit, and simply put in “recovery” which is a bullshit open ended statement not worthy of such publication)
 

Wow. Well and good and proper. I chose a bad example. In some ways it is a good example. I will (attempt to) explain…

This handbook is full of “Demonstrates Skills” or “Demonstrate Abilities“. But it seems to fall very short of real empathy, caring, justice, relating. You have to have knowledge. You have to have ability. You don’t, it would seem, have to actually practise using these skills in a real world manner in a client considerate way. How about the ability to listen to clients as individuals. The word “individual” does not appear in this guide. We are ticks in a box.

This handbook could be less of a guide and more of a “cover our asses in case the panic buttons go off“, however well written and justifiable most of its content appears at first glance. As a checklist for someone entering the professional arena of addiction / mental health services it is very handy (until you get a job – then throw it away)…

But at the end of the day, someone who has been through the system from the “user / client” end is probably going to have their own take on proceedings that will include a few things not covered in a overly rigorous list

Empathy, out of the box problem solving and the willingness to do the right thing for the clients set recovery goals.

I have actually been referred to the original author of this work, Dr Tom Flewett I think, by my GP for my ADHD tendencies. He sounds like a good guy, but have heard various things from others. Including the rather unpleasing report he gives lip service to being all at one with the consumer and then resorting to the command and conquer corporate health structure as soon as you’re out the door. I hope I get to find out for myself. I hope he doesn’t disappoint me as much as his offsider, Sam McBride.

I have good reason to be spewing at Sam McBride. Other than the fact he botched my treatment and report (see here) but he failed on the above checklist too. This was taken at random, as I said. It was a good and a bad choice, as I said.

    • Acknowledges and works with people to determine and define their own recovery processes and goals
      Ahah. Not so much……
    • Advocates for recovery approaches
      Really? Must have been really wasted, missed this bit entirely. Sorry Sam, my fault for being too wasted.
    • Demonstrates the ability to collaborate with people with complex co-existing problems to achieve [stated / agreed] recovery [goals]
      Hey mate, I have complex co-existing problems. I am one big co-existing problem. I co-exist on this planet with you, and I am your problem. You just put me in the “too hard basket” or something Sam? I was clear on my goal. I told you I was giving up and needed a little help. You ignored me outright. Without referring me for inability to concentrate, without sticking your finger in my ass…. Nothing. METHADONE was your answer. GET FUCKED is mine.

Here’s another one (this time the book did fall open at a random page – page 28 as it happens)…

6 Management
Use clinical case management to coordinate and deliver multiple interventions appropriate to the phase of treatment
Knowledge and Skills
Foundation Level
(Base Knowledge)
Capable Level
Knowledge and skills to support people with less complex needs
Enhanced Level
Knowledge and skills to support people with complex needs
6.66
  • Has knowledge of and can recognise the signs and symptoms of substance withdrawal and the potential impact on physical and mental health
  • Has knowledge of who and when to contact for withdrawal management
  • Has knowledge of who and when to contact for outpatient detoxification
  • Has knowledge of the signs and symptoms of protracted substance withdrawal
  • Demonstrates skills in the assesment and management, including referral of acute and protracted substance withdrawal for people with less complex co-existing problems
  • Demonstrates use of detoxification protocols
  • Demonstrates withdrawal management skills, within professional scope of practice, for people with complex co-existing problems engaged in inpatient and outpatient detoxification

What the f ck? Are you serious? Is this really a random sample?

Uhm. I presented on day ten or thereabouts with serious, ongoing, protracted substance withdrawal. Sam McBride was rung by my G.P as, according to misleading information that would probably not stand up in court, Sam McBride had told my G.P that only Sam McBride could write a script for addiction services.

Sam McBride did nothing other than approve imovane* to sleep and a patch of transdermal stuff. He was told of symptoms including nervous twitching, dry mouth, dizziness, no appetite, diarrhea, nausea, aggression, sweating, palpitations, cramps, inability to sit still and a host of others including self harm and mental state that could have ticked off fifty different DSM categories including psychotic… My sister has just died, I am a depressed, emotional wreck, who only just managed to refrain from really hurting someone for looking at me less than ten minutes ago. As it was I shouldered the guy and sent his coffee flying all over the coffee shop in front of many professional people, including some nurses from the very ward I was heading to rapidly… I was sitting there grinding my teeth, displaying every sign of being very very very unstable.

So – He gets a tick for recognising the symptoms. There’s no way he could miss them. Just in case someone presents going through severe cold turkey, you’re the man Sam. He may or may not know whom to call for withdrawal management. He seems to have no interest in outpatient detox.. Did not demonstrate any skills of acute substance withdrawal or detox protocols. Showed very poor management of outpatient detox.

Overall, NEEDS DEVELOPMENT.

Not considered COMPETENT.

Please do 101 courses again, with particular attention to advancing your empathy and client relationships. Look forward to seeing you next semester where we hope for a fresh start. Maybe you shouldn’t be hanging around with all those druggies. They’re a bad crowd Sam.

.

.cc’d to sam.mcbride(@)ccdhb.org.nz
.it doesn’t come back as returned mail

(*) Imovane, Zopiclone, is regularly prescribed by idiot G.P’s and Psych wierdo’s as a “not-so-addictive” alternative to benzo’s. In actual fact, they sit on the same receptors and act alarmingly well (better than) most benzo’s do. As such, the withdrawal is the same (worse than) and you can go through acute withdrawal symptoms if stopping after only five days of use if you’re unlucky… As an ex halcion user with a large stash of Midazolam hidden in a safe place (now) I would have been better off taking the liquid Midazolam illegally than their Zopiclone. But there is no way they would listen to me. Oh no. In the end I went and bought some drugs illegally – Which kind of ruins the whole point of going through detox… I had to go visit the drug dealers whilst going through hell withdrawal. Lucky I hate myself, otherwise I would have got myself some f’ing good drugs.

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