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Re: Managing Malingerers

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hi,

Due to the legal comebacks of medical documentation i tend to keep my

personal opinions to myself, if the management think someone is malingering and

asks for my advice towards this, i would give them clinical speal only stating

what your investigations have found and only after the patient has agreed to

disclosure of this information.

Regards

Ian

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Threaten to send tham ashore with the resulting loss of salary & rig days

that will sort the wheat from the chaff....

Mashford

>From: Kishore H <kishorep1914@...>

>Reply-

>Remote Medics < >

>Subject: Managing Malingerers

>Date: Wed, 25 Jul 2007 04:50:27 -0700 (PDT)

>

>Hello All,

> Would like to hear from you, how you handle malingerers on your

>installations. I have seen that most of the time whenever anybody wants to

>slack off or wants to get off the rig prematurely, we are the ones they try

>to use. Most commonly used tricks are the abdominal pain mimicking urinary

>stone / appendicitis, and back pain. A lot of the time, it is very

>difficult to prove or disprove pain, and if I convey to the management that

>I feel the guy is putting on an award winning performance, then he is

>danger of losing his job. Plus the co-workers tend to believe the act, due

>to lack of specialised knowledge and you get seen as the unfeeling,

>management suck up.

> Feedback welcome.

> Kishore.

>

>

>---------------------------------

>Be a better Heartthrob. Get better relationship answers from someone who

>knows.

> Answers - Check it out.

>

>

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Good Morning Kishore,

Wow, touchy subject. First are you clumping malingerers in with

hypochondria?

Usually Hypochondrics, have depression and anxiety, usually just need

attention, reassurance and TLC. A doctor once told me, " Even hypochondrics,

will get seriusly ill sooner or latter. " Meaning, always consider them, don`t

let their past history bite you in the ass.

As far as malingerers go....The remote site is not a prison. If they want to

go, they can go.

They may not return, but they are always free to leave.

As far as pain goes, I will never allow a company to manipulate me into

saying, " He or she is faking an illness, and they need to stay. " The company

hires these people, they can deal with them.

Of course the only time, I would deny or delay transport is when conditions

endanger the transport crew.

And last but not least, I would never let the words, hypochondriac, crock,

or malingerer leave my lips in a clinical setting. And never, never documkent

such.

Kishore, I hope my insight was helpful.

regards,

Kishore H <kishorep1914@...> wrote:

Hello All,

Would like to hear from you, how you handle malingerers on your installations. I

have seen that most of the time whenever anybody wants to slack off or wants to

get off the rig prematurely, we are the ones they try to use. Most commonly used

tricks are the abdominal pain mimicking urinary stone / appendicitis, and back

pain. A lot of the time, it is very difficult to prove or disprove pain, and if

I convey to the management that I feel the guy is putting on an award winning

performance, then he is danger of losing his job. Plus the co-workers tend to

believe the act, due to lack of specialised knowledge and you get seen as the

unfeeling, management suck up.

Feedback welcome.

Kishore.

---------------------------------

Be a better Heartthrob. Get better relationship answers from someone who knows.

Answers - Check it out.

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Thanks a lot ,

It's not the hypochondriacs that I am worried about, they are usually

convinced with a good discussion and treatment whenever warranted. As you

rightly said, hypochondriacs can fall ill too. That was a good insight indeed.

Kishore.

Vahle <robert_vahle@...> wrote:

Good Morning Kishore,

Wow, touchy subject. First are you clumping malingerers in with hypochondria?

Usually Hypochondrics, have depression and anxiety, usually just need attention,

reassurance and TLC. A doctor once told me, " Even hypochondrics, will get

seriusly ill sooner or latter. " Meaning, always consider them, don`t let their

past history bite you in the ass.

As far as malingerers go....The remote site is not a prison. If they want to go,

they can go.

They may not return, but they are always free to leave.

As far as pain goes, I will never allow a company to manipulate me into saying,

" He or she is faking an illness, and they need to stay. " The company hires these

people, they can deal with them.

Of course the only time, I would deny or delay transport is when conditions

endanger the transport crew.

And last but not least, I would never let the words, hypochondriac, crock, or

malingerer leave my lips in a clinical setting. And never, never documkent such.

Kishore, I hope my insight was helpful.

regards,

Kishore H <kishorep1914@...> wrote:

Hello All,

Would like to hear from you, how you handle malingerers on your installations. I

have seen that most of the time whenever anybody wants to slack off or wants to

get off the rig prematurely, we are the ones they try to use. Most commonly used

tricks are the abdominal pain mimicking urinary stone / appendicitis, and back

pain. A lot of the time, it is very difficult to prove or disprove pain, and if

I convey to the management that I feel the guy is putting on an award winning

performance, then he is danger of losing his job. Plus the co-workers tend to

believe the act, due to lack of specialised knowledge and you get seen as the

unfeeling, management suck up.

Feedback welcome.

Kishore.

---------------------------------

Be a better Heartthrob. Get better relationship answers from someone who knows.

Answers - Check it out.

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Guest guest

I know malingerers can be a problem...just remember the credo " do no harm " I

always tx my pt.s as having whatever probvlme they complain of till proven

otherwise; good way to not get bit in the ass.

Matt

Kishore H <kishorep1914@...> wrote:

Hello All,

Would like to hear from you, how you handle malingerers on your installations. I

have seen that most of the time whenever anybody wants to slack off or wants to

get off the rig prematurely, we are the ones they try to use. Most commonly used

tricks are the abdominal pain mimicking urinary stone / appendicitis, and back

pain. A lot of the time, it is very difficult to prove or disprove pain, and if

I convey to the management that I feel the guy is putting on an award winning

performance, then he is danger of losing his job. Plus the co-workers tend to

believe the act, due to lack of specialised knowledge and you get seen as the

unfeeling, management suck up.

Feedback welcome.

Kishore.

---------------------------------

Be a better Heartthrob. Get better relationship answers from someone who knows.

Answers - Check it out.

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Guest guest

Kishore,

Thanks for asking this question. As says this is a very

touchy subject. I think the answer is really quite simple. Where

in the definition of medic, or your employment agreement is the

phrase " unfailingly identify layabouts and malingerers " ?

Do your job conscientously (as I am sure you do). Treat people

appropriately, and let the managers make their own judgements. If

they ask questions answer them honestly based on your findings

without adding any opinion or commentary. " I am unable to determine

the source of this mans pain " is an honest answer without making you

a rat. Remember patient confidentiality can help you out there as

well.

Your job on the rig is to ensure the health and welfare of the

crew, maximizing productivity, and minimizing unnecessary

evacuations. Don't let yourself get caught up in the " Doc says your

a faker " scenario.

I hope this helps. Stay Safe. PBL

> Hello All,

> Would like to hear from you, how you handle malingerers on your

installations. I have seen that most of the time whenever anybody

wants to slack off or wants to get off the rig prematurely, we are

the ones they try to use. Most commonly used tricks are the

abdominal pain mimicking urinary stone / appendicitis, and back

pain. A lot of the time, it is very difficult to prove or disprove

pain, and if I convey to the management that I feel the guy is

putting on an award winning performance, then he is danger of losing

his job. Plus the co-workers tend to believe the act, due to lack of

specialised knowledge and you get seen as the unfeeling, management

suck up.

> Feedback welcome.

> Kishore.

>

> ---------------------------------

> Be a better Heartthrob. Get better relationship answers from

someone who knows.

> Answers - Check it out.

>

>

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Guest guest

To be honest:

Malingerers are a daily occurrence on most platforms, my way of dealing with

them is:

Treat everyone the same, unless you dont know them - if they say they have a

huge migraine and going to bed for the day (First day on the platform) will sort

it, then i except the reason and self diagnosis and then say " No worries dude,

im just going to get the OIM and get a breath test from you, then swab you for

drugs, then ill give you some magrileve and send you off to your bed. " The guy

who creates and starts shouting and moaning is the guy who is trying it on.

Now: that being said, if its someone who you know has been offshore for-ever and

has never been to see you, then they will more than likely have the migraine,

then the sympathy will come flowing from me.

On another note: Saying that people are malingerers is a diagnosis in its self,

i learnt from a very early point in my career that even saying someone is

pulling a fast one can come back and hit you hard. There is a saying that you

should tell the OIM everything - I would think twice about giving the OIM your

personal opinion and only give them the facts. I would not want anyone to be

dragged into the courts over a slander claim or deformation of character action.

Well maybe my enemy's!!

If you feel that you have a patient who is pulling the wool, get rid of the

patient for 30 mins and call the topside Dr- I would rather treat the symptoms

than assume anything.

Now with that out the way. Get a sign made up saying

" If you can read this sign whilst stood up and without holding your chest in

pain, then go away get a coffee and ask yourself DO I REALLY NEED TO BOTHER THE

MEDIC ON SUCH A TRIVIAL MATTER, If the answer is still yes then please make an

appointment with my secretary. Remember if this was the NHS you would have to

wait 2-6 days for an appointment with your GP, so waiting 30 mins whilst im

having a shite wont kill you "

Safe trips all.

Mitch

Offshore / Remote Medic

FA Instructor.

Re: Managing Malingerers

I know malingerers can be a problem...just remember the credo " do no harm " I

always tx my pt.s as having whatever probvlme they complain of till proven

otherwise; good way to not get bit in the ass.

Matt

Kishore H <kishorep1914> wrote:

Hello All,

Would like to hear from you, how you handle malingerers on your installations. I

have seen that most of the time whenever anybody wants to slack off or wants to

get off the rig prematurely, we are the ones they try to use. Most commonly used

tricks are the abdominal pain mimicking urinary stone / appendicitis, and back

pain. A lot of the time, it is very difficult to prove or disprove pain, and if

I convey to the management that I feel the guy is putting on an award winning

performance, then he is danger of losing his job. Plus the co-workers tend to

believe the act, due to lack of specialised knowledge and you get seen as the

unfeeling, management suck up.

Feedback welcome.

Kishore.

------------ --------- --------- ---

Be a better Heartthrob. Get better relationship answers from someone who knows.

Answers - Check it out.

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Dear All

I would really like to thank all of you for the numerous responses to the

malingering issue. It was truly a learning experience for me, and I feel I am

better equipped to handle such situations now after all the feedback.

Kishore.

<sumoparamedic@...> wrote:

Kishore,

Thanks for asking this question. As says this is a very

touchy subject. I think the answer is really quite simple. Where

in the definition of medic, or your employment agreement is the

phrase " unfailingly identify layabouts and malingerers " ?

Do your job conscientously (as I am sure you do). Treat people

appropriately, and let the managers make their own judgements. If

they ask questions answer them honestly based on your findings

without adding any opinion or commentary. " I am unable to determine

the source of this mans pain " is an honest answer without making you

a rat. Remember patient confidentiality can help you out there as

well.

Your job on the rig is to ensure the health and welfare of the

crew, maximizing productivity, and minimizing unnecessary

evacuations. Don't let yourself get caught up in the " Doc says your

a faker " scenario.

I hope this helps. Stay Safe. PBL

> Hello All,

> Would like to hear from you, how you handle malingerers on your

installations. I have seen that most of the time whenever anybody

wants to slack off or wants to get off the rig prematurely, we are

the ones they try to use. Most commonly used tricks are the

abdominal pain mimicking urinary stone / appendicitis, and back

pain. A lot of the time, it is very difficult to prove or disprove

pain, and if I convey to the management that I feel the guy is

putting on an award winning performance, then he is danger of losing

his job. Plus the co-workers tend to believe the act, due to lack of

specialised knowledge and you get seen as the unfeeling, management

suck up.

> Feedback welcome.

> Kishore.

>

> ---------------------------------

> Be a better Heartthrob. Get better relationship answers from

someone who knows.

> Answers - Check it out.

>

>

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