RedheadedReptile
Joined: 09 Mar 2003
Posts: 69
Posted: Wed Oct 01, 2003 10:59 am Post subject: Yes, if you can improve one patient's compliance...
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... it is worth it-- but that one patient isthe one who should have to play the game, not the rest of us who know what we are doing.<
><
>This sounds like something that should be used when there is a serious problem with coming to treatments, or with
and-new patients who have not yet adjusted to the regimen. Forcing this on ALL patients is what I'm against. We have been coming to treatments without any incentives, and we should get respect for that and not have to play a game just because the company says so.<
><
>My social worker has started a support-group which I will be attending, to try to help the patients who can't get the hang of fluid restriction and treatment attendance. I think talking face-to-face with the patient will accomplish a lot more than having him/her play games as if they're a 6-year-old. Face-to-face conversation will uncover depression, resentment, and grief-- there's no way a game can do that.
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Pollyanna
Joined: 18 Mar 2003
Posts: 22
Posted: Wed Oct 01, 2003 2:08 pm Post subject: URGENT NOTICE TO DIALYSIS DAVE
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Your presence is urgently needed on Oct 16 -17,2003 in Washington DC. Please carefully fold yourself in your suitcase that nothing is left behind. Have a sympathetic dialysis patient address your suitcase to the following address.<
><
>Send him to the Senate Committee on Finance in C/O Senator Charles Grassley Washington DC. Your presence is needed to be a probable witness in education. You problably wont be able to get a word in edge wise as they love the microphone.<
><
>
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FMC Clinical Manager
Joined: 01 Oct 2003
Posts: 3
Posted: Wed Oct 01, 2003 2:08 pm Post subject: To play or not to play
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No one is being forced to play the game. Simply tell your dialysis unit that you would rather not be involved. It is as simple as that. There will be no "black mark" placed on your chart. It is your choice. Do you think that you know so much that you could not learn one thing? If nothing else you should know more about the state of Maine. As far as incentives for coming to treatment....isn't taking care of yourself the best you can incentive enough? You reap the rewards from your efforts.
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Lin
Joined: 28 Oct 2002
Posts: 337
Posted: Fri Oct 03, 2003 1:46 am Post subject: Mentoring
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is what would work, maybe! In the unit I go to (believe it or not) there are no pts. who skip txs. but they're going through with the Dave thing because FMC insisted on it. I get tiried enough of dialysis, but add to that the contests, talks with the social worker about bills, pt. surveys, ect. I'm tapped out! I'm with Dar. on this one, involve the pts. that skip txs. and fluid overload, and leave the rest of us out of it. I know the unit will take credit for my education, but they had diddly squat to do with it; I needed one just so I could know when mistakes in my tx. were being made by staff!!! Lin.
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leadsag
Joined: 31 Oct 2002
Posts: 263
Posted: Fri Oct 03, 2003 3:31 am Post subject: bills
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Lin, you mention talking with social worker about bills...we don't even get that chance - they turn us over to collection agency as soon as they get a chance to it seems.
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RedheadedReptile
Joined: 09 Mar 2003
Posts: 69
Posted: Fri Oct 03, 2003 7:10 am Post subject: Incentives for coming to treatment not necessary?
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OK, if taking care of yourself should be its own reward, why do we need the Dialysis Dave program? (This is in reference to the comment by FMC Clinical Manager.)<
><
>In our unit, out of three shifts of 14 people each, I'd say we have maybe three or four people who are chronically fluid-overloaded and/or take time off of their treatments. Knowing the personalities of these people, they'll just become angrier when they are told that they have to play the DD game. Fluid overload is a bigger problem than attendance at our unit, and the DD game doesn't address that. What we really need is an assessment program that would target each patient's weak spots and then get them the help they need in just those areas, instead of a one-size-fits-all thing. (Which is also the problem we have with treatments, but that's a whole 'nother topic!)
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Marty
Joined: 28 Oct 2002
Posts: 160
Posted: Fri Oct 03, 2003 7:30 am Post subject: DD
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Redheaded Reptile.....You have more commonsense than any of the unit managers I have seen post here. When are they going to get it......ALL dialysis patients are not a group of the same. If they started treating patients as individuals they more than likely would see some progress.<
><
>Lin....I am with you also doing dialysis and knowing how to take care of yourself are enough. Who needs to spend more time on questionnaires and games. Especially since I have yet to see the proof that any of these provided any substantial benefit to the patient. I lop these all under one heading "dog and pony shows" and for who's benefit is beyond me.<
><
>Sure would be nice if I could live long enough to see Corporate America and Our Government see the individuals that get dialysis and not just 1 group which they assume are all the same.
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Worker Bee
Joined: 29 Oct 2002
Posts: 28
Posted: Fri Oct 03, 2003 9:47 am Post subject: Dialysis Games
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These companies just do not get it period! <
> <
>The biggest complaint I get from patients is that the so called "games and education material" is written at such an elementary level that 9 out of 10 patients find is insulting! This "Dialysis Dave" program sounds just like all the other ones I have seen over the years. <
><
><
>If the companies had done the job right with each patient from the very first and had throughly educated them with 1 on 1 education and shown a personal interest in tailoring it to their specific needs, there would not be an need for these silly and insulting "games".<
><
>But the less patients know, then the more blame can be put on them for not participating in their little "
ainstorms". So patients can then be labeled as non-compliant. It's basically a no win situation. Patients who educate themselves have already done so and are beyond the elementary level provided in the education material and those patients who are not interested in taking care of themselves will continue until they have a personal wake up call that really affects them. I've been in this field too long to see any real and lasting benefits from these little "games".<
><
>Give me a good solid education program that starts with a patient from day one and you have a far better success rate than all the "games" ever played in dialysis units.<
>JMO
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FMC Clinical Manager
Joined: 01 Oct 2003
Posts: 3
Posted: Fri Oct 03, 2003 10:10 am Post subject: never enough
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/>
It doesn't matter what is done in the clinics it is never enough for some.
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RedheadedReptile
Joined: 09 Mar 2003
Posts: 69
Posted: Fri Oct 03, 2003 10:11 am Post subject: Exactly!
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The patients who are interested in their care will find the information on their own, and the ones who aren't interested certainly won't be cajoled into it with games. <
><
>It would take a lot less effort if they'd just spend some time with each new patient, instead of trying to undo years of bad habits all at once with thousands of patients. Long-term survivors of dialysis should be helping other patients in their unit with compliance issues, since dialysis patients give far more weight to the words of fellow patients than they do to healthy doctors and staff... and since patients see each other far more frequently than the doctors do, we can gauge the knowledge base and intelligence level of our fellow patients a lot more accurately than the doctors can.<
><
>I guess one good thing has come out of this Dialysis Dave thing-- it's made me more determined to help my fellow patients, rather than have everyone forced to play a stupid game. The patients with a bad attitude will just have that bad attitude reinforced if they think that the company thinks the only way they can learn is if they are treated like little kids.
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Marty
Joined: 28 Oct 2002
Posts: 160
Posted: Sat Oct 04, 2003 12:16 am Post subject: Clinics
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I don't know how one can make the statement no matter what the clinics do it will never be enough when I don't believe they have ever really focused on educating the patients. One of the patients in the slow nocturnal program made the remark that every patient should have the training a home patient gets. It's one on one and when the training is over all the pieces of the puzzle fit together.
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Lin
Joined: 28 Oct 2002
Posts: 337
Posted: Mon Oct 06, 2003 1:46 am Post subject: Adults
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The reason programs like Dialysis Dave won't work is because we are adults, and the minute an adult sees such a thing they turn off and tune out! I'll bet staff wasn't educated with cardboard figures; why should the pts. be? <
>Some one else mentioned responsibility, and that was to the point. Although most pts. are responsible there are those who have the idea that the machine can undo everything, and/or they just don't care about their health. To, some of the population at large doesn't care either, so it's not just dilaysis pts.. Case in point, the other day a pt. came in fluid overloaded, AGAIN, and the tech. said "doesn't he know he's killing himself?", and then she promptly left the floor so she could have another cigarrette! <
>Another point made was that pts. will listen to pts. better than anyone else, and I must say I have to agree. Lin.
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patient
Joined: 29 Oct 2002
Posts: 137
Posted: Mon Oct 06, 2003 3:07 am Post subject: healthier than the tech
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I had a tech just like that. Used to iritate me that I could smell her cigarette
eath when she worked on me, yet she would not mask up when she worked on my catheter. I started going to another unit and one day I heard that she died from cancer.
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RedheadedReptile
Joined: 09 Mar 2003
Posts: 69
Posted: Mon Oct 06, 2003 3:27 am Post subject: Sometimes knowing the risks is part of the problem!
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There's one aspect of being knowledgeable about your treatments that has been overlooked-- attending all of your treatments also increases your chance of being the victim of an inattentive nurse and/or a poorly-maintained machine, simply due to frequent attendance. It's similar to the way that your risk of dying in a plane crash rises if you fly every week. In some ways, the more you learn about your treatment, the more you know can go wrong, and the greater your anxiety can be. There is a point at which more knowledge only reinforces the idea that occasional skipping isn't dangerous-- the day you skip might have been the day that something horrendous was going to happen to you. Dialysis IS risky, no matter how you look at it... and the risk isn't solely on the non-compliance side. What do you do about patients who watch compliant patients come to all of their treatments, follow diet and fluid restrictions, and still end up dying? It's pretty tough trying to convince them that following doctors' orders is the right thing to do when other patients have done it and died anyway.
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leadsag
Joined: 31 Oct 2002
Posts: 263
Posted: Mon Oct 06, 2003 4:02 am Post subject: fluid gain
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I hate when the dietician makes her month appearance and tells you you are gaining too much between treatments based on a number. If a person wieghs 70 kg and gains 3kg between treatments that is 4.29% of body weight but if the patient weighs 110kg and gains 3 kg that is only 2.73 % so is that 3 kg too much for the 110kg patient?
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Lin
Joined: 28 Oct 2002
Posts: 337
Posted: Mon Oct 06, 2003 4:05 am Post subject: Looking in wrong place!
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More pts. would keep their tx. appt. if their txs. were more comfortable, and they knew the staff caring for them were more competent. If you are in one of the units where a high percentage of pts. don't show, perhaps it's because they are scared! If you're management, look around for cleanliness, competency of staff, high percentage of infiltrations, ect. . Are a large percentage of pts. having rough txs. and if so is it their fault, or might staff be poor in determining dry weights? machine settings? ect.. Before you cast blame and send Dave in to "do the job" make sure staff is doing there's too; it's not always just the pts.. Lin.
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Marty
Joined: 28 Oct 2002
Posts: 160
Posted: Mon Oct 06, 2003 12:00 pm Post subject: DD
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Lin, Well Put!
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blackeye peas
Joined: 06 Oct 2003
Posts: 1
Posted: Mon Oct 06, 2003 6:10 pm Post subject: Dialysis Dave or
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Dialysis Dunce? Maybe the staff needs the Dunce to remind them that they need to get an education before they work on patients
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RedheadedReptile
Joined: 09 Mar 2003
Posts: 69
Posted: Fri Oct 10, 2003 8:38 am Post subject: DD voted down at my unit
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Yesterday I asked the charge nurse if she'd heard about the DD program, and she told me that they'd had a meeting about it and it was almost unanimously rejected by the nurses-- most of them agreed that it was insulting to patients and wouldn't help with most compliance issues. So our unit is officially a DD-free zone! (Although we still have to keep that dippy DD cut-out in the waiting room, I guess for the benefit of any FMC official who might visit the unit.)
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Lin
Joined: 28 Oct 2002
Posts: 337
Posted: Fri Oct 10, 2003 9:18 am Post subject: LOL
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I just can't stop lauging! Yesterday noticed that DD and his "chart" were right beside the scale, which is in front of nurses's station. I guess they figure it's a safe place for him; rumour has it someone has put a hit out on DD; can't imagine who Lin.
