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Archive for the ‘Safety of Physicians’ Category

Protecting the innocent: IS the State of MN/ #MinnesotaDHS in need of an overhaul in protecting their employees and the general public from violent mentally ill offenders?

https://kstp.com/news/nurse-assaulted-at-anoka-treatment-facility/5348988/

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IMPORTANT DISCLAIMERS: I am NOT a clinically or credentialed trained professional in medical and mental health. I have absolutely no education in medical, mental health, law, law enforcement and in public safety.

Unfortunately, due to the link above, my normal disclaimer of when people who are at high risk for hurting themselves or others does NOT apply because the victim that is the catalyst of this blog, as well as other victims were employees of Minnesota treatment centers for the severely mentally ill and MN DOC employees who were violently attacked or killed while their assailants were already incarcerated.

In full disclosure, as someone who has non violent mental health issues and came super close almost 11 years ago, of finding out first hand what it’s like to be a resident of the facility, that the above victim who was an employee, in above link was violently assaulted last night, in my case, (unlike the assailant/patient/resident who had past history of being convicted of violent crime prior to his commitment) with no prior legal history other than 2 traffic offenses and 1 psych hospitalization, 2 weeks prior to a suicide attempt that there was an attempt (which was stayed) to have me committed to Anoka Metro Regional Treatment Center in Summer of 2008 status post of my 1 and only suicide attempt, the only other civil legal history I have, was the unlawful detainer that I received after the commitment attempt and I had no prior civil or criminal history other than above mentioned citations in 2008 and I haven’t had any since then.

That will be a topic of another blog. As I wasn’t completely blameless, just in a non violent medical and mental health crisis who was never in danger of hurting anyone else other than myself.

I couldn’t though write this blog without being transparent about my own history and the factors that played into my medical and mental health history, I write about as a non monetized blogger, in hopes to help others in crisis, get help sooner and to advocate for more treatment options, so what I went through and the ones I love, didn’t go through in vain and to prevent that if possible from someone else having to go through the same thing.

***
I’ve been blogging for years now, about violent crime prevention.

I knew after though after writing blogs about local violent crimes and seeing the records of those who perpetuated those horrific acts, if something at the time, especially since many of those who I’ve written about in the last several years to a month ago, their criminal histories even for someone who has NO formal training in medical, mental health, criminal forensics could possibly forecast that their crimes could escalate to tragic violent physical harm to innocent others and to violent fatalities.

When I tried to research initiatives for safety improvements and injury statistics for employees at AMRTC where that nurse was violently assaulted, at St. Peter Regional Treatment Center, as well as Minnesota Department of Corrections stats, when an Oak Park Heights correctional officer who was  murdered ,when trying to help a fellow correctional officer who was also being brutally attacked by an inmate , last fall.

The above table in this blog, which was is ALMOST 30 years old, was as close as I got to finding any statistics online for AMRTC.

I got a little closer seeing a few articles about staff picketing about safety in the past  and even a little more insight when reading online employee review sites, where employees, even recently, where they share how rewarding it feels to help patients they work with, they DO NOT feel safe at work.

I have confidence that change will happen one way or another, I think primarily it will occur because employees are going to fight for safer conditions in that facility and in other facilities where people have to work with people who are confined because they of the public safety threat that they pose (which I need to clarify again ABSOLUTELY not everyone in a mental health treatment center or even in prison, long term committed/incarcerated  are violent predators or have past violent crime convictions , but quite a few do).

The problem is, that is too late for the nurse who could’ve been killed last night and if changes aren’t IMMEDIATE, more unnecessary risk is posed to these employees.

It’s also at the risk of employees in local medical centers where more acts of violence are taken place and those employees are also claiming fear of being harmed on the job, that there aren’t more safety initiatives in place.

As well as the risk to the general public, as exhibited horrifically last month when that 5 year old boy was thrown from the 3rd floor by someone who had incurred 3 charges in the Summer of 2015, 2 of them were for violent acts and one was for property damage, he then until 2019 had 6 traffic offenses, which is not a stretch that his blatant disregard for the law, didn’t lead to him weaponizing a motor vehicle to harm or kill someone.

What Emmanuel Aranda didn’t have though, was any civil legal action in regards to his mental health, which had exhibited propensity to be violent which he exhibited several times, in a short of period of time, 3 1/2 years before he would attempt to kill someone on purpose.

People who work to help others in medical, mental health and law enforcement deserve protection and a right to a violence free workplace and in public , just like the general public deserves that same kind of protection wherever they may be.

Changes in law have to take place, more initiatives on mental health need to take place and if people cannot feel safe when working with people who already incarcerated or confined due to the potential safety hazards they present to the general public, more innocent people are going to be violently assaulted, if not killed.

This is not Minnesota specific, obviously.

This is happening all over the country, as well as the world.

But we have to do something to honor these victims, to prevent these tragedies from happening over and over again.

It’s just going to take more effort to pass legislation that concentrates on the rights of victims or potential victims with a concentrated effort by public safety, DHS, DOC, legislators, law enforcement, psychiatric and medical professionals and violent crime activists, so innocent people have the chance of being protected like convicted assailants are.

And maybe for repeat violent offenders, whether they are incarcerated, confined or walking free like Brian Fitch (I should probably clarify Sr, as his son by the same name, is currently racking up his own record)  was who had dozens of violent felony convictions before he murdered Mendota Heights Officer Scott Patrick in 2014, by studying them more might be able to predict on the side of safety their inability to be rehabilitated.

My thoughts and prayers are with the victim of Thursday nights assault, family and friends, as well as all the employees who’ve been assaulted, if not killed while working trying to help people that may not have any control over their violent tendencies but their confinement doesn’t protect the people who are treating them.

Note: Being a disabled activist, I welcome ANY productive and constructive feedback from any entity or party where if I missed something or could be educated more, about prevention, planned enhanced safety initiatives or anything that can help people be safer.

I do also as an activist will address non violent mental health patients who are misplaced in either jails, prisons or the safety nets that could help prevent others like me, where safety nets for both myself and my family could’ve prevented an unnecessary loss of freedom in someone who posed absolutely NO threat to the public.

Just not on this blog, but given that I am a mental health activist, I didn’t want the population of people who follow me, who are non violent mental health patients to feel I am not going to address their right to freedom, safety and security initiatives , in future blogs.

Just NOT today.

This blog was published 5/10/2019

 

 

 

 

 

 

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When a physician cannot heal thyself…

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IMPORTANT Disclaimers: I’m not a clinically trained medical or mental health professional, I will ALWAYS urge those in crisis to seek immediate help from qualified trained professionals in an acute setting and/or hospital.

The nature of this blog, the caveat I face in writing this, is also the catalyst.

I knew over a year ago, that I wanted to address physician addiction and also physician suicide.

Truthfully though, I thought I was the last non clinically trained human that anyone though, especially a physician, wanted to hear that from.

I’m not a fun patient to treat and I’m a patient who’s had a life history with less than ideal encounters with a majority of  physicians, being an obese patient who is prescribed opiates and is a cigarette smoker with diagnosed mental health issues.

So yeah, I had to get over my own bias issues not loving having to deal with physicians who look at me like an ugly unicorn on crack, and on the offensive, react to me like I’m soley responsible for the opiate and obesity epidemic.

HOWEVER, I took the same oath that physicians do, when they become doctors, way before I started this blog, in my past life when I became a CPT (I was thin and fit for 6 years post rny gastric bypass) and wanted to be a bariatric specializing life coach  before that field was identified and magnified.

I took that same oath when I started this blog.

I think one of the many good things to come out of the digital era, is that physicians now have resources to online network with other physicians not just for good of patients but themselves when they need support.

I found that out when doing clinical research for all the things I’ve done in the past with my medical activism, led me to physician driven sites like Kevin M.D..

However, with physicians working in the occupation with the highest suicide rates, I’ve realized for awhile now, maybe that isn’t enough, not only due to stigma still, but that physicians need to know that support of them is extended outside of their peers, family and friends.

Even when it’s someone like me, who does call out physician bias as an activist, that I make it clear that I’ve always known the sacrifices that physicians make, the sacrileges they have bear witness to and have tried to prevent and heal, their heroic efforts to help and heal regardless of specialty and that their pursuit to a happy, balanced and healthy life is sacred to me and it should be to all of us.

The type of activism that I choose to do when it comes to being a medical and mental health activist, with a specialty in gastric bypass complications that lead to gastric bypass reversals, does lead me to cautiously borderline practice both medicine and psychology at times, when patients who find me when they are in crisis.

And I treat them, remotely.

In the comfort of my own home though, sometimes when they are in theirs and sometimes when their in a hospital beds near death, where the  patients are surrounded by medical and sometimes psychiatric specialists who cannot grasp the complexity of emotions in a patient, because they can’t relate to rarely seeing of patients of being in such unpredictable medical crisis and sometimes of psyche, when patients undergo what’s supposed to be a  transformative surgery that’s supposed to be life saving and life enhancing but they end up with a dire outcome.

(Important Note: I am a pro bariatric surgery including gastric bypass, with the same concerns that I am also pro opiates for pain management. When all other less invasive and/or risky treatments/interventions have been exhausted)

And while I only “treat” digitally, it requires a very unique skill set that’s sometimes cannot be taught in the many years of  medical school,  internships, or even when they start in action (I hate the word “practicing” as it applies to physicians) being the physicians, surgeons and psychiatrists that they become.

However, I don’t have the ego that ate the United States, as I’m VERY clear that nothing that I say should be taken in lieu of evaluation and treatment from physicians and other clinically trained professionals, but the one outstanding trait that helps my patients a lot and can be sanity and life saving for those patients, is very simple.

I CARE ENORMOUSLY.

And I think that to help a population of people such as physicians,who are suffering and either feel they have to do so in silence or amongst their peers or their own professionals that they NEED to know that others try to see their challenges, their fears and what they feel is their failures, as not everyone they try to help can be saved, but that we honor their efforts in caring and having multiple avenues for support, intervention, evaluation and treatment when they themselves are in crisis.

This is one calling, one profession where it unfortunately can’t ever to some, matter if the intention was honorable but the outcome was horrible and a patient dies and that we ALL in some way now have to support the psychological trauma that can cause physicians, if we have going to have a prayer in reducing the risks of suicide and addiction in our physicians.

It’s never been more needed like it is NOW.

And to start, all we have to do is, CARE…

Note: I’m amenable to feedback or constructive dialogue. Any comments that can be triggering to myself, any population of people I do activism for, such as  in this case especially, physicians, will NOT published.

Please also note that I’m  a cognitively disabled activist, it matters in the most important way, of what I say versus how I say it, as sometimes my syntax is bad or I misuse a homophone.

I still stand by my intent to help with this blog, in hopes it does greater good. Thanks!!!

Physicians with biases ARE physicians who HARM, even if it’s unintentional…

 

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Disclaimers: I am NOT a clinically trained or credentialed medical or mental health professional. NOTHING I say should EVER be taken in lieu of professional medical and/or mental health evaluation or treatment of ANY condition.

I can ONLY put my opinions, where I hope to help people, where I have in guiding them, at the very best, simultaneously,  at the same time to get the best medical or mental health treatment, from trained clinical professionals, in an appropriate setting , such as what I do with gastric bypass patients in various scenarios with gastric bypass reversals, among other things.

BUT,  what I have to say about how various biases carried by physicians and the potential for physical and emotional harm, still needs further civil, respectful and responsible but sometimes when appropriate, critical discussion, not ONLY by patients but the actual medical and mental health professionals within their own  communities.

I ONLY believe though, when dealing with a provider who one might feel is showing bias that effects one’s care,  of discussion of potential  misbehavior, if  one feels that they’re being treated unfairly or unreasonably, because of that bias (I’m talking about appointments, not to the point where blatant physical or emotional malpractices have occurred) of filing a grievance, if a discussion doesn’t resolve the issue and/or finding another physician.

It is NEVER okay to threaten the emotional or physical wellbeing of anyone, including a physician or any provider, for biases and if depending on the degree of physical and/or emotional harm has occurred, if that’s an actual issue, there’s legal remedies one can look into and/or take.

That’s it, making or threatening a physician’s physical and emotional safety and wellbeing is NEVER okay (more will be elaborated about that, in the content of this blog).

Also note, I have people I associate with where they may find my communication style at best, offensive, because I’m kind of open with my various disabilities and with those disabilities, it’s difficult for me to be concise or write well, even if this topic definitely needs discussion and resolutions.

***

All I wanted to do last weekend,  was to  have an okay weekend.

Let me explain, as most people know, that due to my disabilities, that I don’t have anything normal in responsibilities, like people my age do.

But in my case, I kind of dread weekends, while my blogs have been both personally and as an activist, VERY serious as of late, it’s kind of scary where I live, because on weekends, when staff isn’t here, people are more likely to act out.

Even with cameras, unannounced drug sniffing K9s and security during nights and weekends.

While I explain to those few about explaining where I live,  that 1/2 the building where I live are good to have as neighbors, the other half is people who have issues with drug addiction and what it takes to support an illegal drug addiction (dealing and/or other illegal and unsafe behaviors to support an addiction of themselves and who they associate with) , if one’s on their way or headed to rock bottom, especially for poor people, it’s not a fun thing to live amongst, even if I have some empathy for non violent addicts.

The best way I can describe where I live is my building is like a stupid drug cartel that’s badly managed and a church had a baby.

Seriously and it’s NOT funny or fun to live in, even though I’m grateful for my housing.

Also as a serious activist, if I’m going to point out where doctors fail patients in under medicating patients or being afraid to use opiates as a last resort, I also have a responsibility as an activist, to do no harm, myself.

To either patients or providers or to anyone.

The last thing I’d want to give the impression, as an activist,  is that people can be complacent nor would I want to enable, when it comes to the potential of drug addiction or feed into a denial pattern, if they actually are in the midst of drug addiction or heading into drug addiction with either prescription or  illegal opiates.

I know it sounds like I’m digressing, please be patient, I will make my point when it comes to physicians and their biases and how it harms.

Because of all the clinical data I have to read, both as a patient and as an activist, who’s trying to find answers both to opiate addictions and obesity surgery complications, is by using Google.

So when last Saturday night,  it was in my suggestions on Google,  to check out a physician driven site to support and educate medical providers, especially as it applies to interventional pain management or obesity related issues (among many other medical topics but those were the 2 most talked about ones, as well as ones I’ve discussed ad nauseum in this blog in the past) , I didn’t need that site, to know that bias among physicians was horrifyingly pervasive and permanenting who apparently were WAY unaware that they had a few of these awful biases that I’m going to discuss in this blog.

I just didn’t need to see it on Saturday night, when my building was a hotbed of not life threatening criminal behavior due to drugs, but it still was scary because you don’t ever know when that’s going to escalate.

I happen on that physician site to read an article a blog that  a pain management specialist wrote,  who was trying to make a point on how tricky it is to do pain management using a popular stereotype that’s perpetuated not only with non physicians, but within the medical community.

Patient #1:  was a morbidly obese patient who misused opiates claiming she was under medicated, that she was treating who had  needed a double knee replacement and severe  back pain  due to a disc issue (and apparently her inability to stop eating for more than a minute)  and had mental health issues and when the physician pulled her meds due to her non compliance and her quite clearly expressing the patient having NO willpower whatsoever, that patient trashed her online, so she thought, as right after that happened, she received a bunch of negative reviews on a bunch of medical websites.

Patient #2: Very friendly thin patient perfectly compliant dying of cancer, who used a moderate amount of opiates sparingly, despite her severe intractable pain due to terminal cancer with mets and in this instance, the pain management doctor had a nauseating borderline reverence, for.

I will admit, that I’ve had that kind of prejudice similar to patient #1 even though I’m not known for compliance with most meds, other than narcs due to high tolerance (and how I’m resolving that, will be in another blog, soon).

But that blog by that pain management doctor, hit me way harder as an ACTIVIST.

This is what I know to be true, due to the  activism that I do.

Bias can kill patients not only from physicians even if it’s not intentional, due to stigma, as well as by,  non physician peers.

I get that all the time, when I have to talk to a gastric bypass patient with catastrophic complications, into what may be right for them, such as a a gastric bypass reversal, who’s going to die, has a BMI of 19, even with weight loss of 200 lbs and NO surgery to correct extra skin, so their BMI is actually even lower, when that’s taken into consideration, but they’re afraid of and what’s worse, is their current bariatric surgeon is afraid of doing a reversal, in case they become morbidly obese, again.

Where they are more likely to DIE from their catastrophic complications, before Obesity again could put them in mortal danger.

Or in the case because I’m a body diversity activist and find thin shaming repugnant, if I say that someone who’s thin, they’ll usually share their skinny shaming stories and if they’ve had a past or current history with bulimia and/or anorexia.

Or when I see within the weight loss surgery community, patients who get very thin because they’re terrified they’ll be fat again, not realizing that it’s not ideal, it’s actually unhealthy,  to be exercising intensely like an athlete, on 400-1000 calories a day, not only does that make them more at risk for exercise related injuries, it kills their metabolisms, in the long run, if not creates other health risks.

So doing behaving that way is no insurance policy that a bariatric patient won’t gain weight again or have any other severe health problems.

Or if they have bariatric surgical complications, quite a few bariatric patients actually think they deserved them, because they were fat in the first place and had to resort to bariatric surgery.

Or when patients who are morbidly obese to medical and mental health issues and want bariatric surgery or to lose weight, they sometimes become obese due to inactivity due to their health issues and their medications, they can’t have their total knees without losing weight or their bariatric surgeries and they can’t lose weight without either surgeries and are absolutely in a no win situation.

With weight stigma, especially when it comes to Obesity, it hurts both fat and thin patients.

With fat patients, they hate getting medical care, because if they go the doctor for strep, it’s going to be blamed on their weight.

And it shouldn’t be any surprise but it will be to providers, if they have fat bias, the patients who they are treating are FULLY aware of that and that’s why people of weight loathe to seek medical treatment which can sometimes kill a patient, but even at unfortunately, at best,  unnecessarily makes getting any kind of medical treatment, a lot harder than it should be.

It also hurts and potentially harm  thin patients, because they may less likely to think they could have health issues, and their physicians feel the same way, because if they’re a “healthy” weight, it’s presumed, that they’re actually healthy,  when they may not be.

With opiates due to stigma, if a physician has a patient who’s in intractable severe pain, there is a risk they will self medicate and possibly harm if not accidently kill themselves,  they engage in unsafe and unhealthy behaviors to treat their pain and/or they kill themselves, if they aren’t appropriately medicated and/or suddenly taken off their medication.

Especially now, with the opiate epidemic, patients who are compliant, but have been on opiates for a long time are now starting to die, because they find a dealer and/or patients are actually commiting suicide, becoming collateral damage because of the opiate epidemic,  due to unbearable physical pain, because they don’t feel they have any other options and they have no quality of life and they have no options as a last resort for pain.

Absolutely NO physician should be congratulating themselves or encouraging as a positive behavior,  that a terminal patient has great “willpower” by not using opiates for severe intractable pain, if medications are working properly, when the risk of addiction in that patient is next to nothing and the patient is ONLY afraid to take opioids, because of stigma due to drugs, and would rather die a horrifyingly  painful death than be considered a drug addict due to stigma , even if the patient is going to DIE.

NONE OF THIS IS OKAY!!!

I’ve said this before, as a medical activist.

HOW and WHY, in this evolved technological era, why are people becoming MORE backwards in our society, has to be discussed openly, without stigma.

BUT medical and mental health professionals take an oath to try and not do harm.

IF they have personal biases, regarding fat patients, challenging patients to treat or mental health patients and/or any other kind of  biases, who are coming to them for any kind of treatment, they OWE it to their patients, to give them the best possible care.

And they can’t do that, if they have ANY kind of  preconceived particular bias towards ANY population of people.

In the defense of physicians or any medical or mental health provider, while I’m not excusing bias that limits their ability to care for their patients, they shouldn’t have to worry about physical or emotional harm, either.

Also patients LIE, like all the time or don’t even realize the dangers if they are aren’t lying a lot, but about things that may seem trivial to them but it’s not and it makes them a liability to both themselves and possibly their providers, especially one who is prescribing narcotics to them.

But even if 9,999 out of 10,000 patients are lying, especially about what they’re actually ingesting, all of them deserve to be given the benefit of the doubt, especially if the 10,000th patient may be, if not, is actually telling the truth

Every patient deserves an individual patient tailored approach to their unique physical makeup being able to feel safe with their medical and mental health providers.

Every provider should feel that they don’t have to worry about being physically or emotionally harmed, because they say something or take a course of an action that a patient doesn’t agree with.

Patients should just stop seeing that provider in that case, in case of negligence or harm, consider a legal remedy, that’s it, if a reasonable (as patients can be respectful, responsible and critical at the same time) discussion or resolution is NOT possible with a provider and/or seek a different provider, if possible

But pretending that bias doesn’t exist, that it can harm patients in their ability to get appropriate (and sometimes lifesaving) treatment of their health conditions,  that resolving one addiction and not addressing the nature of addiction, can lead to another, is harming people, both patients and providers, alike.

Because we aren’t having the responsible and respectful dialogues we need to, as as society,  because of STIGMA.

So while I will hold a physician to the hippocratic oath, it couldn’t hurt anyone, if we actually all took it.

Note: Constructive feedback, only.

Also note: Again, I believe in both any of the obesity surgeries AND opiates, as an absolute last resort. I’m not against any weight loss surgery, I just have a unique situation in being one of the more long term gastric bypass reversal patients out there, of being asked about that, a lot.

As it applies to opiates, I have lost people I’ve cared about due opioid addiction as well as see it in other case, such as described above, ruin people’s lives, so again, it bears repeating, I’m not trying to feed into or enable the opioid epidemic, as an activist.

Although, I’m also not going to apologize for being supportive of invasive medical treatments for different health issues, i.e. both obesity surgeries and opiates, but I will always strongly urge people when you take drastic action, make sure you have a long term plan, are well educated and are well supervised, medically (and mentally), life long.

Nor am I going to apologize for the length of this blog, due to the sensitive nature of what I addressed in this blog,  that I had to so  comprehensively and fairly, to do  justice both to patients and providers, alike.

And if you saw at times, what frightening words or phrases sometimes end up in search engines for my blog, well you’d understand better, why I have to have such a lengthy in depth disclaimer.

Thanks!!!

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