i don't usually add my commentary to posts anywhere other than the tags, but just wanted to add some things i've observed from working at a non-profit methadone clinic for the past 4 years. the first year and a half i spent working the front desk, aka, interacting directly with our patient population from 5am until 3pm.
what got me through some of the toughest days and most draining interactions was hanging on to what the Goal was. the Goal, for most patients, was to get them to the dispensary to dose. that's it. and my job was to make sure they were able to get that, no matter what, and be very clear about how that could happen. our clinic has no 'security' staff--no guards, nothing of that sort--we have hospitality staff, who engage with people as people. (to my knowledge, at least from the time i've been working here, we only have actually called local cops once, and it was related to a firearm on site). so if someone was yelling loudly or causing a disruption, the priority was to speak to them and basically just explain, hey, we want to get you dosed, but you can't yell in the waiting room. if you have to yell about something we can call your counselor down and see if they have time to hear you out. or you can go yell outside and come back in when you're done. that sort of thing.
with that said, as much as i know that i was always trying to help people, there were MANY of my coworkers that brought their prejudices in with them. a woman who trained me on the front desk was incredibly harsh and judgmental, often talking about patients behind their back. we had (and have) clinicians or counselors who bring their own ideas of treatment into work. despite us being a harm reduction clinic, there are people who only see 'full recovery' and complete cessation of use as the only acceptable outcome. these are the kinds of people i've seen experience this kind of 'empathy fatigue' the most. the people who have a very set idea of what THEIR goals, not the patient's goals, are.
those kinds of people typically don't last super long at our clinic, but some are also carryovers from previous eras and have been there for 20, 30 years.
a lot of the time, just from my experience and what i've seen, this lack of empathy comes from a ridiculous set of expectations that have nothing to do with the person in question, and it's always boggled my mind why people would pursue this kind of work if they can't see that. if i didn't like getting yelled at at the front desk i'd always be willing to say, hey, talking to me like that and treating me like that isn't nice. i'll obviously still send you through to your appointment or dose or whatever but that really hurt me and i'm just trying to tell you the message on your chart, i'm just a messenger. and i have had some people come back and apologize. and some didn't. and the job was definitely draining, and there were good days and bad. but i didn't feel much different from like...retail. like, sometimes i had people at the register at nordstrom treat me worse.
anyway. quality of patient care is dependent on a lot of regulations and rules placed by regulatory bodies that typically don't give a shit about the realism of a lot of people's situations. for a while there was something saying that if patients got a dose to take-home, they were responsible for bringing all those take-home bottles back to the clinic, which is ludicrous, given how many of our patients are unhoused or in unstable living situations. so we chose not to enforce that regulation despite it making us appear 'worse' to those regulatory bodies. (this is anecdotal, from when i was working as a medical admin, so the language of this is almost certainly not completely accurate.)
