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Bill Kinkle, EMT-P, RN, CRS🇺🇸 Profile picture
@billkinkle
Jun 15, 2022 • 12 tweets • 7 min read • Read on X
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A THREAD REMINISCING AND REFOCUSING.

One thing I’ve had the opportunity to do while sitting in this room for the past 2 months is reflect on my past advocacy efforts and refocus on the direction we are going in the future based on my neck injury and hospitalization.
One thing I miss is working in the field as a harm reductionist. Spending time in the encampments, providing #naloxone, sterile syringes, basic wound care etc. was a highlight of my life. ImageImageImage
Testing drugs for my friends…(fake pressed Xanax bars in photo). Image
Making balloon animals to bring out a smile with my friends experiencing homelessness… ImageImage
Bringing buprenorphine to where folks were via telemed in the field.

Article here:

rollingstone.com/culture/cultur… Image
Various advocacy roles whenever we could…
USA Today piece here:

usatoday.com/in-depth/news/…

Inquirer piece here:

inquirer.com/philly/health/… ImageImageImageImage
ImageImageImage
This is Kensington, Philadelphia. I took a bunch of photos of the community to highlight its beauty amid so much negative press and hung these photos in my office to remind my friends that there is hope in the darkness. ImageImageImageImage
More Kensington. ImageImageImage
Our podcast with @sean_fogler
Episodes here:

stitcher.com/podcast/health… Image
I’m fairly certain our focus is going to be more focused on destroying stigma now that I’ve experienced its effects first hand. I think this will allow me to speak from experience and give me credibility.
I’ve tried to raise awareness in real time throughout the past 2 months and I will continue to do so. This work is important and I’m saddened at how deep stigma is embedded in American healthcare. My life is dedicated to changing this.

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More from @billkinkle

Bill Kinkle, EMT-P, RN, CRS🇺🇸 Profile picture
Aug 18, 2025
A 🧵 On the Need for Pain Scoring Research

There needs to be a multi center research project analyzing subjectively reported pain scores and subsequent nursing intervention.
This would primarily be looking at inpatient hospital stays, but would provide valuable insight into the perceived importance of treating pain by nursing.
A nurses job is to advocate for the patients under their care. Moreover, many times nurses have several PRN or standing orders where they can perform interventions independently from calling a physician. The question is: do they?
Read 25 tweets
Bill Kinkle, EMT-P, RN, CRS🇺🇸 Profile picture
Aug 10, 2025
Summary of the Opioid Epidemic

Purdue uses a letter to the editor to say opioids have little addiction risk.
Publish video about how patients got their lives back—-many actually did.
Pill mills pop up and decimate rural America.
Read 24 tweets
Bill Kinkle, EMT-P, RN, CRS🇺🇸 Profile picture
May 21, 2025
The Real Root of my Addiction: a 9/11 Story.

On September 11, 2001 I was a junior in nursing school. I had already left the steet as a paramedic in order to learn more in the ER at @PennMedicine. When the first tower was struck, we were sent home from school.
I got a phone call telling me to pack a bag for as long as possible; we all did on that day, except I was told to head in, not to safety. We were less than 90 minutes from Manhattan, we could see the smoke when we were told to, “stand down.” The rescue had become a recovery.
I was born on July 4th, I ate a piece of the bicentennial cake in 1973 in my hometown, Philadelphia. I watched Johnny Gage make it look cool to hang a bottle of D5W as he gave an amp of D50 (we liked sugar back then😉) Image
Read 26 tweets
Bill Kinkle, EMT-P, RN, CRS🇺🇸 Profile picture
Jun 21, 2022
Here are a few papers/case reports to support the long thread on bupe induction I tweeted earlier.
pubmed.ncbi.nlm.nih.gov/32650192/

The findings of this study might explain recent reports of difficulty in bupe inductions for persons who use fentanyl, and point to a need to better understand the pharmacokinetics of fentanyl in the context of opioid wd in persons who regularly use fent.
This paper explains the mechanism behind PW and is a nice comparison of some of the various methods of bupe induction.

journals.lww.com/cja/fulltext/2…
Read 8 tweets
Bill Kinkle, EMT-P, RN, CRS🇺🇸 Profile picture
Jun 21, 2022
This is an example of why I need to be absolutely vigilant about my care.

I was experiencing a burning sensation and palpitations whenever something is infused through my PICC. Naturally the first thing the physician ordered was a chest x-ray to make sure it hasn’t moved.
The first CXR was ordered for “palpitations.” Interestingly, the radiologist never noted the PICC which made me wonder if the order for “palpitations” directed the method of interpretation.
After the doc called and asked about the PICC an addendum was placed. However, noting the catheter was retracted compared to the previous image on 6/9 confused the PICC team when they showed up because the line is sutures to my arm and the hub is in the same position.
Read 14 tweets
Bill Kinkle, EMT-P, RN, CRS🇺🇸 Profile picture
Jun 21, 2022
ON BUPRENORPHINE INDUCTION AND NURSE/PHYSICIAN ADVOCACY (RE:ACUTE PAIN)

Sitting in a room for 2 months with no windows facing the outdoors lends itself to quite a bit of time to observe the subtleties of my interactions with staff.
First, it has been a rare event to get more than 3-5 minutes with any clinician, so you need to hone communication skills akin to speaking with a politician; unfortunately brevity is a necessary skill you must learn to get your needs met.
However, even if you are able to harness the attention of your treating physician or assigned nurse away from their phone or obvious thoughts about the burden of their other patients, there is still the issue of having them actually hear what you are expressing.
Read 73 tweets

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