Marty
Joined: 28 Oct 2002
Posts: 160
Posted: Sat Feb 01, 2003 5:19 am Post subject: From Experience
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In our nocturnal program tech's monitor and nurses are on call. This isn't near as risky as having so many tech's to RN's in center. First you have to consider we are well trained ourselves before we even go home. We can spot a problem we can solve, a tech can solve, or when a nurse is needed.<
>And we know enough to get off the machine if necessary. The rules at our center are like this. If an alarm goes off "we the patient" have about 2 mins. to correct it. If it's not corrected the tech calls us, (or we can call the tech). We explain the problem. If they don't know the answer they immediately call the nurse or if a machine problem the people who service the machine. I have always had a faster response from a nurse on nocturnal than I saw in-center. For one thing they aren't tied up doing something else. If it isn't felt that you are capable of handling what needs to be done you simply won't get into the program and if by chance you do get in and have too many issues it won't take too long before your back in-center. It's not difficult to judge who should have home hemo and who shouldn't. I think what NJ is requiring is the best; but I really think it's overkill.
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Marty
Joined: 28 Oct 2002
Posts: 160
Posted: Sat Feb 01, 2003 6:12 am Post subject: It is as it is.
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If the unit suspects the educated patients without proof this will stand regardless. If it were me I would just blow it off and make an anonymous report. Let's face it if someone else files an anonymous report your still going to be suspect so why concern yourself with who they suspect as whistleblowers.
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Because
Joined: 01 Feb 2003
Posts: 1
Posted: Sat Feb 01, 2003 6:52 am Post subject: they
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will accuse, ostracize, withold care or attempt to dump.
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Arlene
Site Admin
Joined: 02 Feb 2003
Posts: 49
Posted: Sun Feb 02, 2003 6:30 am Post subject: Inspections
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Many patients and family members will fax in complaints or mail them to us. We then call in an inspection and we get the results of the preliminary in 30 days. We use our name and we fax the information to the dept of health.We give you a copy of the report, We keep a copy for our records to show the trend of no accountability.<
><
>What we need is the clinics name and address and if a patient has died due to neglect,remember this is not automatically reported. We need the incident,date and patients name if possible. If you dont have the patients name then the date and incident is reported.Your name is only known by us.<
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>You can go to the "How to contact us" portion of the board and it goes directly into the email. It helps us if you would include the number for the Dept of Health for us. <
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>My favorite ones alway came from Arizona and they black out everything. One paragraph had the word had only. The state of California who didnt get back to us until a year later,then the clinic closed voluntarily. So the stated problem solved.It just amazes me the disregard of human life.<
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>
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There is
Joined: 02 Feb 2003
Posts: 3
Posted: Sun Feb 02, 2003 8:21 am Post subject: NO
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protection for the educated patients in the unit when an anonymous inspection is called. DE can call the State, but then the unit takes it out on the one or two educated patients, because they are the only ones who are aware of violations. What can be done to protect these patients?
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patient
Joined: 29 Oct 2002
Posts: 137
Posted: Sun Feb 02, 2003 10:03 am Post subject: Being Targeted
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Your really screwed!!!! You catch it if you don't file the complaint you catch it if you do I call this a no-win situation. Looks like you have 2 choices be abused by the violations; or be abused by having someone trying to correct them. There isn't away to can convince your staff the educated ones aren't the whisleblowers if that is what they decide to think. I just wonder what makes you think you or the staff knows who the educated ones are. Silence in center does not equal dumb.
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staff
Joined: 02 Feb 2003
Posts: 1
Posted: Sun Feb 02, 2003 11:30 am Post subject: knows
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who the educated patients are, because they are in command of their txs. Educated patients are not silent - they speak up when something is going wrong with the tx.
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patient
Joined: 29 Oct 2002
Posts: 137
Posted: Sun Feb 02, 2003 12:41 pm Post subject: Speaking Up
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Give me a
eak; I know a lot of patients who know a lot about the treatment but don't speak up for various reasons. If speaking up made someone intelligent, I'd be the smartest person in dialysis. What a way to make an informed decision on who knows alot about the treatment whether they speak up or not. But then this doesn't surprise me a lot of dumb assumptions are made by people evaluating other people on outside appearances only.
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Ill give this
Joined: 02 Feb 2003
Posts: 1
Posted: Sun Feb 02, 2003 6:33 pm Post subject: one last shot
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Uneducated patient lays there sleeping and doesn't wake up until he's screaming with cramps. Educated patient is alert, observes everything about the tx and is vocal when something is off. Staff recognizes the difference in patients.
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leadsag
Joined: 31 Oct 2002
Posts: 263
Posted: Mon Feb 03, 2003 1:37 am Post subject: watching
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Take a look around your unit. Last week I saw the Asst. Director, who is one of the few RN's that work as a charge nurse at the unit, sneezing into her ungloved hands. Then she proceeded, after wiping her hands on her scrubs, to draw up peoples meds, still ungloved with unwashed hands. How scary!!!
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patient
Joined: 29 Oct 2002
Posts: 137
Posted: Mon Feb 03, 2003 2:03 am Post subject: Uneducated
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Hey, do you suppose she is uneducated. Oh can't be she was awake.
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jfwag
Joined: 11 Jan 2003
Posts: 140
Posted: Mon Feb 03, 2003 4:15 am Post subject: From my...
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...point I don't see it all that necessary to even have the monitors, but I suppose it does help as a backup. We hadn't got into nocturnal yet but I doubt I seriously would have fallen asleep. Anyways, like Marty said though, you are not going to get into a Home program if you don't know what you are doing. We were well trained in every aspect of running
the machine and TX's and almost every emergency situation we could think of and then some. We did have our nurse on call up untill 11 pm every night and then other emergency numbers to call after hours. In general though I can only think of two times that we did a TX in the middle of the night. Ah yes the flexibility you have on homehemo. Night, day afternoon, however you wanted to fit it into your schedule.
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Observing
Joined: 03 Feb 2003
Posts: 3
Posted: Mon Feb 03, 2003 4:26 am Post subject: Patients
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The staff sees in a patient what they choose to see in a patient because they have no way of knowing a person. My husband was quiet and shy around "professionals". At dialysis he wouldn't say a word but boy when he got home did we know what went on. I used to chuckle to myself when the staff would tell me what a mild manner man he was. Little did they know he was spending his time plotting to get out of there into a home hemo program; because as he saw it there was no hope in trying to deal with them. I can still remember the dumb-founded look on their faces the day he told them he had been accepted into a home program and such and such was his last day of in-center treatment. How does the old saying go "Still Water Runs Deep"
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Owww
Joined: 03 Feb 2003
Posts: 1
Posted: Mon Feb 03, 2003 5:19 am Post subject: Way to go Observing!
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Those are the kind of stories I love to hear!
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Glad to
Joined: 03 Feb 2003
Posts: 1
Posted: Mon Feb 03, 2003 5:21 am Post subject: hear
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that your husband was a mild mannered man who never opened his mouth in dialysis, yet spoke up at home that he recognized the tx/service was a joke. Ok, so what did he do when his blood pump speed was set incorrectly or his sodium was not changed from the last patient's etc? Did he keep his mouth shut then, too? Or what did he do when he saw another patient cramping in pain, let's say, due to the patient being in the dark about how to avoid cramps?..I hope he didn't keep his mouth shut then, too.
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Observing
Joined: 03 Feb 2003
Posts: 3
Posted: Mon Feb 03, 2003 10:28 am Post subject: Kept his mouth shut
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My husband kept his mouth shut and let the alarms make the staff aware when something was wrong. <
>He did not speak up for or to other patients it is just not his personality. As I told you he is quiet and shy. It isn't until he really knows and trust someone before you see the other side of him. The time spent with patients and staff at dialysis in a controlled setting did not give him the feeling that he knew anyone well enough to make judgements or tell them how or what to do. By the way my post was to point out you really can't judge patients without knowing them. It wasn't to discuss my husband his in-center treatment or his personality.
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sorry
Joined: 03 Feb 2003
Posts: 1
Posted: Mon Feb 03, 2003 11:12 am Post subject: shy patient's wife
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But when there are tx errors an educated patient speaks up. He doesn't wait for the techs to handle the alarms and wrong settings or he will be fried! Now if you're saying that your husband had competant staff so waitied on them to make corrections, but just didn't like the in-center environment and chose to get into home hemo, thats different. In a case like that one could keep his mouth shut if he so chose. But in a unit where competency is at a minimum, one better speak up or he will become very sick, fast. Incidentally, I see a lot of wives or daughters that speak for the husband or father who is the patient, because the men are too shy or too sick to speak for themselves. Not saying you do that.. just saying its common. I also see a lot of people who escape the in-center environment and get into home hemo where they are safe and sound, but don't do a thing to help the patients that are left behind. I don't care what your husband's personality etc is..my remarks had nothing to do wtih him, personally. I care about making dialysis units safe.
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Observing
Joined: 03 Feb 2003
Posts: 3
Posted: Tue Feb 04, 2003 2:35 am Post subject: Treatment Errors
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My husband knew the difference between an error that would cause great harm and those of minor significance. He never saw an error which would cause "frying" .
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Curious 2
Joined: 04 Feb 2003
Posts: 5
Posted: Tue Feb 04, 2003 6:16 am Post subject: Congrads on homehemo
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I think it is great that he was a canidate for homehemo.<
>It can be tough to rock the waters while still a patient. Many patients learn early to go with the program as to avoid retaliation. <
>Laws need to change.
