Lory
Joined: 25 Apr 2003
Posts: 1
Posted: Fri Apr 25, 2003 1:29 am Post subject: Good vs Bad centers
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I have been reading alot of the post here. This is an excellent site, with well informed people. I see alot of talk about good vs bad centers. How do you know when your in a good center? I saw a list of some things posted, I have a question to you all... what makes your centers so good and others so bad?<
>I see that re-use is a big issue, we don't do that at my NJ center (thank goodness). Our center is clean and presentable. I think the only real problem is with the arrogance of staff; they want you to sit down shut-up and be good children. And I believe that attitude comes directly from the TOP. That in itself makes the center suck to me, I feel helpless. Does that make it a bad center? I dunno?<
>I read posts from some folks and you know your treatments so well, and your labs, and your meds...and so on. When I try and ask questions and educate myself they say I am being a pest or make a remark like "I know my job-just relax and your outta here in 3 hours".<
>God forbid if I make a request or questions something -then all hell
eaks out, and that makes me very SAD.<
>I want to be informed too, I want to know what is going on with me, is that wrong(???) How many of you are really pro-active in your care? was it hard to accomplish?
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advocate
Joined: 25 Apr 2003
Posts: 20
Posted: Fri Apr 25, 2003 6:03 am Post subject: HI LORY WELCOME ABOARD
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What separates the good units from the bad? Good units are honest and professional-bad units may look good on the outside, but use deceptive practices and are based on control. <
><
>The majority of the time, if staff want you to sit down and shut up, its because they are hiding the fact that they are inadequately educated to care for you. They are mandated by management to get you on and off as efficiently as possible to get on the entire shift of patients to fill those chairs ($$$) and to do so without incurring overtime ($$$), and that means there is no time for educating the patients (even if they could, which they usually can't..remember inadequate education). <
><
>The techs and RNs, too, are trained so inadequately (trained by companies for 2-6 weeks usually-- not college educated or degreed) that they think they know all there is to know about dialysis, when in fact, they're comprehension of the treatment is very limited. So what happens is, they come to believe that dialysis is done a certain way, and when that rigid way hurts you, the patient, they go into denial. <
><
>It is easier to go into denial than to face the fact that they were incorrectly trained and their knowledge is indequate. They also put on this tough exterior making you feel like a nag and a complainer for questioning your treatment. Sadly, there are not too many honest staff who have the capacity to question this whole setup and tell the patient he is not imagining the wrong attitudes and inadequate care. <
><
>The patients are scared for their lives--the workers are scared for their jobs. Eventually, you will run into a courageous worker (either at your unit or on the boards) who will tell you the truth, and you will know that you are not imagining what you have been experiencing. <
><
>The way to become an educated, informed patient is to simply study dialysis every day. The patients and staff who come to the boards are your best teachers. Ask questions, and before long, you will know how your tx should be run and that will give you the confidence to politely stop your tech if he is doing something wrong.<
><
>Because you are in a unit that is not one of the good ones, your staff will not like it when you correct their errors or method of doing your tx. You may have to have a talk with the administrator to let him know where you stand. Sometimes this helps, because the admin. knows you are educated and rather than admit to his own lack of duty, directs the techs to let you conduct your tx without hassling you. But other times, the Admin. may give you lipservice, but then allow the hassling to go on. I have found if there is a dishonest admin, the doctors are dishonest,too, which accounts for why patient care is poor.<
> <
>Things will not get better and then you have to either sue them or find a better unit. And if that's not possible, because there are no other units, or no other better units in your area, then you need a
eakthrough. <
><
>Miracles do happen, because one hapened to me. The day came when I was able to move to a new location and did get into a better unit. The attitudes of the staff were greatly improved and that made dialysis much better for me. It is still not an optimal situation, because the staff still lacks education, but at leaste this is a staff that is more respectful of me as a patient. <
><
>How will this situation improve for the dialysis population? It will improve when more patients, their caregivers, dialysis staff and others get involved with the advocacy end of things. The group of advocates will never be large, but if those who can will speak out, and if others will just do whatever small part they can, our voice will grow loud enough to be heard and respected.<
><
>One learns advocacy the same way he learns dialysis - a day at a time from those who are presently advocating. Just listen, and learn, and then <
>take your first steps to help others, and you will see that you, too, can be an advocate!<
>
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Another
Joined: 25 Apr 2003
Posts: 3
Posted: Fri Apr 25, 2003 9:04 am Post subject: good board
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for education is dialysis_support. DE is the board where the patients who have the guts for advocacy come. The patients at other boards aren't the ones who fight back, or only fight in a limited way.
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RedheadedReptile
Joined: 09 Mar 2003
Posts: 69
Posted: Fri Apr 25, 2003 5:38 pm Post subject: For starters...
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If you're "outta there in 3 hours", you're in a bad unit!<
><
>In my unit, most patients are 4 hours... we have some 3 and a half hour patients, but NO 3-hour patients; that's considered sub-therapeutic in my state (MA).
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DE person
Joined: 26 Apr 2003
Posts: 2
Posted: Sat Apr 26, 2003 4:57 am Post subject: Hope
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Its very hard to hold onto hope when one on dialysis is battered by a cycle of abuse. You have the constant fear of the disease to deal with, and on top of that, you are being treated inhumanely at your unit. <
><
>If you are being mentally and physically hurt it is hard to stablize and live with the disease. Nevertheless, you must hold onto hope and do your best to gain knowledge of your tx each day. <
><
>Once the knowledge begins to grow, you will be able to increasingly stand up for yourself. The techs will still try to push you around, but you will nonchalantly not budge on what you know you need for your treatment. <
><
>You will then begin to feel better when your body is no longer being hurt. You will have a sense of control. It will still be difficult for you as the techs will find other ways to abuse you. For that, the best way to handle them is to just block them out and keep busy by reading, watching tv etc. <
><
>Distance yourself from their abusive ways. Bring a notebook and document their abuse to you and the other patients. This way you will have evidence against them should you ever decide to sue the unit.<
><
>Have faith and a door will open for you to escape the abuse. <
><
>
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Remember
Joined: 26 Apr 2003
Posts: 2
Posted: Sat Apr 26, 2003 5:28 am Post subject: If it is not written it never happened.
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This is once
again a great time to remind all that a journal with the date,time and names.<
><
>Remember if it isnt written,it didnt happen. These units own the paper and charts. You need to document the surroundings on the harassments and abuses that happen around you or with yourself.<
><
>Our lawyers suggest that you get a journal that is in a book form and after each entry use/ and your initial.<
>This is legal in a court of law,as the same weight as the clinics. The journal should be kept at home,as not to intimidate the staff. You never let a person know that you are going to hit them over the head with a two by four....so the journal is your only protection. It is the only way to make those accountable. We cant fight for you,nor can our attorneys if they have nothing to work with. It may seem unimportant to you,but just keep a running diary..this is how patterns are established.<
><
>If you see someone harmed at a unit,many contact us and we report it for you. All we need is an email,but for our purposes we need a phone number to have someone ask questions before it is reported. You will be kept confidential. We put the complaint under dialysisethics and we track the surveys. We need the date the patients first name and incident. <
><
>With the new laws in effect you ALL should ask to review your records. You now have the right to change any untruths in your charts. You all need to do this and your run sheets are a help to copy. You are intitled to them.<
><
>I cant stress the above enough. If it isnt written it never happened. Protect yourself and those around you.<
>Arlene<
><
>
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LuLuW
Joined: 27 Apr 2003
Posts: 46
Posted: Sun Apr 27, 2003 9:30 am Post subject: What makes a Good unit?
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Okay, I'm new to all this, but it seems to me that a good center should have the following qualities:<
><
>1) Properly medically and technically trained staff. This means EACH staff member should be proficient in all pertinent areas of administering hemodialysis treatments to patients. <
><
>2) All staff should be accessible, approachable and should possess proficient communication skills, and the lines of communication must be kept OPEN. Anyone in a service occupation should be proficient at not only delivering information, but at receiving it as well.<
><
>3) Unit should be kept unscrupulously clean, and staff must adhere to all measures to decrease chance of infection.<
><
>4) Patients should be treated like CONSUMERS, i.e. a "the customer is always right" school of thought should be kept in mind by the unit. After all, we are PAYING them, not the other way around. Their job is to provide the quality of service we want to continue paying for.<
><
>5) Patients should be treated with RESPECT. It is bad enough that we are chronically ill, therefore rubbing more salt into our wounds with disrespectful treatment should be avoided at all cost. <
><
>6) In regards to patients over 18, patients should be treated like adults. We are not children, and we don't need to be talked down to or treated as if we can't make our own educated decisions. (i.e. what we should eat, drink or do while "in the chair.") As long as what we do does not impede anyone else's care, the staff should not make these choices for us.<
><
>In my mind, any unit that does all of the above is definitely on the right track. Unfortunately, we might be hard pressed finding a unit that fits the bill, but I know there must be some out there. I bet if we put together a real system of rating the units, and PUBLISH the findings, it might raise some eye
ows. If anyone is interested in joining me in this endeavor, let me know.
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Lin
Joined: 28 Oct 2002
Posts: 337
Posted: Mon Apr 28, 2003 1:07 am Post subject: Hmmm!
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there are bad, and better units, but I doubt there are any really good units. The one I go to is good, but not great. Oh, it's neat and clean, for the most part well educated and pleasant staff, but some of the old school thoughts about dialysis persist. The higher the pump speed the better the dialysis, the more fluid taken off the better, the larger the needles the better the clearance, pts. who get a bad lab result are always "noncompliant", blah, blah, blah,. Staff tells pts. "I know what I'm doing, I do this for a living after all" My reply is "well yeah, but I do this to live" nuff said! <
>I don't think dialysis will change unless all pts. and their caregivers/families become educated. When I look around the unit I go to it's pitifull the amount of people who have been on dialysis for years and still don't know about their treatments. We all need to become better educated about our txs..people will be less likely to take advantage of someone who knows what is going on. Lin. <
>
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DE person
Joined: 26 Apr 2003
Posts: 2
Posted: Mon Apr 28, 2003 9:16 am Post subject: Educated?
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Lin, <
>If your staff believe and practice all those old school myths, then how can you say they're educated?
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Lin
Joined: 28 Oct 2002
Posts: 337
Posted: Mon Apr 28, 2003 11:48 pm Post subject: Perhaps
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I should've qualified that; they are educated in that they are RNS, and techs with training. Staff goes to a dialysis training that lasts six weeks or so, and they have "continuing education", however, some of the same things are being taught about dialysis and dialysis pts. that has persisted for years and years. Staff continues to think they know alot about dialysis. I think the education is antigue! Lin.
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Right
Joined: 29 Apr 2003
Posts: 2
Posted: Tue Apr 29, 2003 5:59 am Post subject: they are educated
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in the company propaganda!
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Lin
Joined: 28 Oct 2002
Posts: 337
Posted: Wed Apr 30, 2003 12:59 am Post subject: The truth
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is that dialysis should be a specialty in and of itself! There needs to be a special course one has to take and pass to work in a dialysis center. Both nurses and techs. need better training when it comes to dialysis. Of course I also feel that pts. need a better edcuation about dialysis, after all it's our body and life! Lin.
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yes
Joined: 29 Apr 2003
Posts: 5
Posted: Wed Apr 30, 2003 5:44 am Post subject: that's the truth alright
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Amen!
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better
Joined: 30 Apr 2003
Posts: 1
Posted: Wed Apr 30, 2003 5:49 am Post subject: to admit the truth
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then to play the game "Let's Make Believe We Know How to do Dialysis" when we really don't know a rat's a__ about what we're doing..
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Clarify
Joined: 13 Mar 2003
Posts: 2
Posted: Sat May 03, 2003 2:41 am Post subject: dialysis vs kidney disease
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I think the term dialysis is used to loosely. The dialysis machine does the dialysis the education of staff needs
to be 2 fold. 1. Being more educated on kidney disease and the medical conditions resulting from the dialysis treatments and 2. The technology of the machine which performs the dialysis. It gives 1 the impression, the patients don't know what they are talking about when everything is lumped under the heading of dialysis. I happen to be wife of a home patient and I do one terrific job at giving dialysis but I don't know a thing about kidney disease that I leave up to the nephrologist; nurse; dietitian to take care of and give me advice on.
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Worker
Joined: 17 Mar 2003
Posts: 5
Posted: Sat May 03, 2003 4:32 am Post subject: Dialysis
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Many clinics train the technicians and Rns and after being mentored for 6 weeks, the worker is put on the floor.I actually was given the correct answers to the questions that I missed to have in my permanent file for the inspectiors. <
>Then you have anywhere from 4-6 patients right away to take care of and you have to concentrate on what your doing. As a skilled worker you had to worry about the newbies 6 as well as your own.<
>We always were worried about the worker who didnt
eak down in tears with frustration. It happens to all! You are overwhelmed with the number of patients and our unit has only a 15 min turnaround. That is taking patient off and 15 to get your machine strung and primed for the next. It is a jiffy lube. <
>The workers turnover is due to the fact that you simply are on automatic pilot and dont have time for that cup of coffee. Its one on, one off all day long. <
>I will never work dialysis again as long as I live. I simply could not handle the emotional and stress of that schedule. That schedule never took into account if something goes wrong.
