Marty
Joined: 28 Oct 2002
Posts: 160
Posted: Wed Jan 22, 2003 1:51 am Post subject: Under estimating Patients?
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I just read an outcome of a poll taken in Nephrology News & Issues which stated 85/86 percent of dialysis patients WANTED more control over their treatment. I always see posted where patients and staff think very few patients want to get involved in their care. It makes me wonder why the poll is so high when what we see seems so low. It also makes me wonder if home hemo were as common as PD or in-center if we wouldn't see some of the docile patients come to life? Do we make patients appear uninterested by giving them no "hope" of having any control and very little education?
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ptsw
Joined: 22 Jan 2003
Posts: 24
Posted: Wed Jan 22, 2003 2:44 am Post subject: Maybe
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Maybe 85% of those patients who responded, who would be already very active in their care, would answer that they wanted more control over their treatment? In other words, those who don't need the preaching, those who already want more control and are more knowledgeable are answering these surveys. Either way, I think patients should be given full opportunity to take on whatever part of their treatments they can with support of staff.
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Lin
Joined: 28 Oct 2002
Posts: 337
Posted: Wed Jan 22, 2003 5:14 am Post subject: Things I've noticed!
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We have printed material posted in the unit I go to, plus handouts stating that pt. education is important, however it's ALWAYS geared toward pt. compliancy. I realize how important following diet and fluid restrictions are, but I know full well that staff too must be doing all the right things, but no one seems too willing to educate the pts. so that they know if their tx. is being run right! There are some staff who don't mind us knowing things, but I think the majority would rather not have us doublechecking what THEY are doing/not doing right. The only way a pt. gets to know these "secrets" of how a tx. should be run so that they will feel better is if they choose to do home hemo! I've been lied to about dialysis flow rate, backfiltration and tmp, pyrogenic reactions, conductivity, and on and on. I've even been "quizzed" to see just how much I know! I have a super primary nurse, but when he's not around things can happen.<
>Sorry to be so cynical, but when pt. education encompasses not just what WE must do, but what THEY should do, I won't be that trusting. That is why home hemo should be offered. I don't know how many pts. want more control, I just know that the ones who do should have a voice and the modality that is best for them. Lin.<
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Marty
Joined: 28 Oct 2002
Posts: 160
Posted: Wed Jan 22, 2003 12:29 pm Post subject: Patients Wanting More Control
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Lin, Well said!
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ridgerunner
Joined: 11 Jan 2003
Posts: 101
Posted: Wed Jan 22, 2003 6:10 pm Post subject: patient control
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if the patient becomes more educated they will start to ask questions they will learn that reuse is bad speed kills that slow loger treatments are more humane and the patient lives longer, there is no way a patient can be compliant on a three hour jiffy lube three times a weektake copies of dialysistn the us AND REUSE.
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Lin
Joined: 28 Oct 2002
Posts: 337
Posted: Thu Jan 23, 2003 2:03 am Post subject: Super
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I think we should compile what all of our posts have said and send those thoughts to the network and the big dialysis providers! Lin.
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patient
Joined: 29 Oct 2002
Posts: 137
Posted: Thu Jan 23, 2003 7:43 am Post subject: educate the patients!
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Your post is right on, Lin. Yesterday I was in dialysis and a patient who is a big, 6 ft. 4 in. war veteran was shaking like a leaf. They said he had an infection and needed vanco. Well what do they expect when they don't even wash their hands! I have read about infections many times, but have never had one thank God. This guy was picked up by the ambulance service and taken to the wrong hopsital in that condition. Oops..the nurse got it wrong, again. Dialysis is a circus and a scarey circus at that. All this has made me think, forget about training the staff..TRAIN THE PATIENTS!!!! I would like to be thoroughly trained so I can protect myself from my staff!!!! I would like training so I can increase my chances of staying alive. If my staff doesn't want to do a competent job.. train me..I'm available!
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observation
Joined: 23 Jan 2003
Posts: 5
Posted: Thu Jan 23, 2003 9:07 am Post subject: dishnonest doctors and nurses
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From what I've observed of most of my doctors and nurses, they are plainly dishonest. My doctor gives me a tx prescription and my nurses will rig the machine settings to prevent the alarms from going off. They could care less that they are dumping the wrong rate of chemicals in your body. All they care about is making their day as smooth as possible. Why are the machine alarms going off? Poor maintenance. The doctors know this kind of thing goes on. They all cover for each other. Is it any wonder they all have that liar look? Wonder how they face themselves in the mirror.
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Lin
Joined: 28 Oct 2002
Posts: 337
Posted: Fri Jan 24, 2003 3:41 am Post subject: To patient
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I had a similar problem as that pt.. It wasn't from not washing hands! In my case it was a pyrogenic reaction. At first they said I was coming down with something, even though I was shaking so violently I had to hold my needles in! I spiked a temp. and that is when staff immeidatley took blood samples and called the neph. . Vanco was immediatley administered right in the unit. Neph later told me it was a pyrogenic reaction. Two other pts. also had the same problem. There apparently was a problem with water treatment, but staff was quite reluctant to admit that. I think they were told not to! Lin.
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Reporting
Joined: 24 Jan 2003
Posts: 1
Posted: Fri Jan 24, 2003 5:47 am Post subject: abuses and violations to Dept of Health
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When a patient dies due to neglect or training error,water issues,too many infections in your unit...either call your States Department of Health and report it. If it isnt reported,it is never investigated. <
><
>Remember the patient goes to the funeral home of their choice and does not have to be reported or investigated.<
>No records are kept and many chemical reactions have just been buried...and no autopsy is performed. Can not tell you enough how that benefits the companies as no autopsy is done. It can be done,but more difficult.But they sure know how to protect themselves/<
><
>Patients I can not stress enough to journal your treatments and ask for run sheets,count on record cleansing to be done,. They own the paper work and what goes into it. This journal is the only legal stance you have in many cases.<
><
>When you report the complaints to the health dept,you need to know the dates and the patients name of the incidence. You can even go into the "How to contact
us" segment of this site and we will contact you to get the facts correct and report it for you. TO see a fellow patient abused and say nothing,does not benefit you. You will be alone if patients dont continue to say NO MORE.<
><
>We have that case in TEXAS and are waiting until Monday and then their chances are over. They clearly as to date drew the line in the sand. We will not let down and will hopefully not have to make an example of them. We arent going away.<
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>Arlene<
>++++<
>+++
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observation
Joined: 23 Jan 2003
Posts: 5
Posted: Sat Jan 25, 2003 6:32 am Post subject: units detest the STATE
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because they give them all kinds of regulations to follow. They are always under the State's thumb with what they consider extra tasking, everything from labeling trash cans and separating trash. The result seems to be that they do everything to cut corners, because the State is not around. <
><
>If the State investigates them, yes they will have a big black mark. But the State doesn't go far enough with disciplinary measures. It gives the unit time to correct the violations as it can't shut the unit down or there would be no unit. It will shut the unit down after numerous failures to comply and cathcing them at it, but that rarely happens. <
><
>As soon as the State is out the door, the unit will be right back at it. The unit knows this and the State knows it. So then what? The State can be called in a 2nd time. If the problem is the workers are not washing their hands and spreading infection, it is hard for the State to catch them at it. When outsiders enter the unit, staff automatically know it and is on their best behavior. <
><
>So, unless the State is called back in, repeatedly, the units get away with everything. If the State is called in, repeatedly, and the unit gets shut down, then the patient has nowhere to get dialysis if there are no other units nearby. The units do fear the State, but until the State's reprucussions are more strict, and effective (i.e. financial sanctions, closings), what does calling in the State achieve?
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Night Owl
Joined: 25 Jan 2003
Posts: 1
Posted: Sat Jan 25, 2003 10:20 am Post subject: Awareness
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It achieves some and you never know if enough complaints are filed maybe someone at the state level will
eak and say enough is enough. I know it is discouraging but it will take a whole lot of persistance to get attention and action. And the longer it takes for the complaints to pile up the longer it will take before someone
eaks. So if you have just cause file those complaints!!!!!
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DJ
Joined: 31 Jan 2003
Posts: 19
Posted: Fri Jan 31, 2003 1:27 pm Post subject: state inspections
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I think night owl is right-it's better to say/do something than nothing at all! I have been thru an inspection where the state found errors, and they came back for a follow up visit, as scheduled. If the errors would not have been corrected to their satisfaction, the unit would have been closed down immediately. A physician was owner of this unit. I think the inspection depends on the state you live in (some are stricter than others). Maybe if patients called, we would get inspected on a regular basis (usually its 3-6 years between inspections-too long in my book!)
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Lin
Joined: 28 Oct 2002
Posts: 337
Posted: Sat Feb 01, 2003 2:40 am Post subject: New Jersey
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I live in one of those states that inspects more frequently, usually a matter of months, not years.<
>They are really picky here too! Last time they came in the only thing they found wrong was that the tx. supply carts had wheels on them; they actually came back to inspect and make sure they had been removed as they said they weren't allowed in the tx. area "contamination". Now they are giving the co. a problem about home hemo.. The central monitoring unit which is in Indianna uses only techs to monitor, and a nurse is on call. Apparently this doesn't meet with the approval of the state of NJ. Lin.
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are you
Joined: 01 Feb 2003
Posts: 2
Posted: Sat Feb 01, 2003 3:38 am Post subject: serious?!
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Using only techs to monitor? Anything to save a buck. I talked to a RN from a home hemo program once and she was enthusiatic and seemd to be more knowledgeable than the RNs in my unit. Made me think there would be better support in a hh program. But according to this report, it sounds like you can get a less than good hh program too.<
><
>About busting units by calling the State, can anyone think of a way to be an anonymous whistle blower without the unit suspecting the one or two educated patients and accusing them of causing them trouble?
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