Have been hearing a number of complaints about workers in dialysis, harassing and assaulting dialysis patients. It is assault under the law to touch someone when they have asked you not to touch them. http://codes.ohio.gov/orc/2903.13 I have heard complaints of dialysis patients having their feet stepped on by dialysis personnel during a treatment, blood being thrown on the dialysis patient or dialysis patient's being hit with a salt water bag. In addition, I have heard complaints about patients asking that certain dialysis personnel not perform fistula sticks on them, after that dialysis worker hurt them the first time of the sticking. Again, if the patient asks you not touch them and that worker ignores the patient, that is grounds for an assault charge.
I have also heard of complaints where patients are being discharged and they have no clue that is coming..... I have also heard of "meetings" where the Kidney specialist, FA, Nurse, and Social Worker are in a room and stacked against the patient, who is ambushed and is unable to defend themselves. Please be advised, if the charges are false, the patient can hire an attorney and file a lawsuit for libel and slander. If the patient dies because of these actions, there is a possible wrongful death suit pursued by the patient's estate, in addition to a libel and slander.....
I really like the vast majority of you and I think you really care about the patients. However, as we all know, there are bad apples in any field, police included. I have advised patients who are assaulted by dialysis staff, to call 9-11 and press assault charges. I have also advised dialysis patients who are assaulted to contact their local district attorneys or victim's advocates.
I have also been told of cases where dialysis patients have been unfairly discharged, and given an option of a dialysis clinic 50-60 miles away from their home. Yes, I know this type of harassment goes on, it happens in government, all of the time. I was also told of a case where a man in a wheelchair with no legs, was discharged from a dialysis under police escort. As a former police officer, it is outrageous. Honestly, what do you think a man with no legs in a wheelchair is going to do to you???
Having worked as a police officer, I know and understand that there are two sides to every pancake and I have been cussed at, called every name in the book, ****** on, you name it, I have experienced it, before you say, "You do not know what it is like."
I have also heard of patients been discharged for disagreeing with reuse and for asking questions about their treatments. I also know that in those "meetings" the patient is not allowed to see the comments and charges against them, sounds like the old Soviet Union or Nazi Germany. Yes, if you are curious, my family is from Germany.
Yes, I know, many times management blames Nursing and it always is it so..... In fact, it happened to my mom. I know that many of you are good people :) However, my word to the wise to the bad apples, is that you are going to have some very unpleasant results if you abuse or assault dialysis patients. If you go to jail for this crime, I hate to tell you that the other inmates at the jail hit back. If you are curious, a misdemeanor of the first degree or M1 is six months in jail and a $1,000 fine.
99.9 percent of physicians and nurses really try to the right thing, it is just .1 percent that is the issue :)
NDXU--I am familiar with your postings. I do not think that you are for one minute a "contrarian."
I think you (as a dialysis patient... and advocate) and those of us "on this side of the needle" are pretty much on the same page.
I'd love to wave my magic wand and make it all go away for ESRD patients, but until I find that misplaced wand, we're all in this together. There has been no patient demographic that has touched me (or p*ssed me off) in all my years and specialties as an RN as much as renal patients.
Similarly, my guess is is that it is some of the most "pain-in-the-nuts" dialysis staff that have left the most indelible marks on your soul.
Also keep in mind that staff are constrained by any one facility's protocol and procedure--and even then, that is not enough to assuage the most contrary.
Yes, Guttercat, you are correct. I really wish you would find your wand. One of the solutions to these issues is home dialysis. It has been estimated by a number of kidney specialists that around 40 percent of In-Center patients could do home dialysis, that would leave alot of room for individuals who would be unable to perform home dialysis...... One of the other issues is that they want everyone to have a partner for home dialysis, this leaves out a huge population. If you are performing Nocturnal dialysis, the IU Nursing Supervisor(38 years of experience) said at at blood flow rate at 300, you really do not need a partner. One of the reasons that the partner issue is pushed is because we are taking off fluid only 3-4 days per week, at most, simply, the body is not made to work in that fashion. The IU Nursing staff and I agree that is not enough dialysis when the normal kidneys are running 168 hours per week. Per the IU kidney specialist(30 years of experience), the body is not made to take off more than one day of dialysis at a time. Most of my viewpoints are from what I have experienced and talking with the staff at IU, who are outstanding.
If dialysis was being performed at least 5 days per week, ERSD individuals and the Nursing staffs would not be at each other throats. In addition, both sides would not have all of the issues with the limited amount of dialysis. I do not think the problem is patients or the Nursing staff. I think the problem is not enough dialysis. :) I do not know of any patient who likes going to the hospital or any Nurse who likes sending the patient to the hospital and the IU kidney specialist detests infections and hospitals.
As a diabetic, I need dialysis 6 days per week, Nocturnal and short treatments. I am thirsty and believe it or not, my sugar scores are perfect, 109 after a meal and 5.4 for my three month score. My potassium is too low and my calcium is too low, as well. When I was in center, I had to take the horse pill for potassium and I also had to take 2,400 mgs of calcium per day. In addition, my diet included milk, cheese, and yogurt. With all of this calcium, my scores were barely normal and the kidney specialist would shake his head and laugh and say, "ND, you are my only patient that I have to encourage to eat more calcium and potassium. My phosphorus was 2.8 :) My diet includes, believe it or not, one glass of low sugar orange juice per day. I have never, ever had high potassium on any form of dialysis, not even close.
Yes, I know, that the Nursing staff is just doing what they are told to do. It would be like blaming the gas attendant for the price of gas, which is silly. Guess what, the gas attendant, who is low wage, is paying that price as well. I had one Davita Nurse that I really liked, she had a B.S. in Chemistry. I loved talking to her when I was on the machine.
Patients can and will get thru to other patients to tell them to stop being abusive or acting like fools. NO ONE, nursing staff or patients deserves to be harassed or abused. In addition, a badge and a firearm does not make you above the law. Would I tolerate a fellow officer who was drunk on duty or was cited for DUI, no way! Would I tolerate an officer who used his badge to harass women, NO way! Government must, must have the consent of the governed and not the the other way. We work for the taxpayer, the taxpayer does not work for us. We are servants, "Protect and Serve the Public." Here is how I viewed my job, the blue line protects the disabled, women, and children, from thugs, felons, and criminals:
Specializes in Nephrology, Dialysis, Plasmapheresis.
To NDXUFan,
I listen to your perspective and I know it must be so difficult, dealing with this disease every day. It sounds like at one time, you struggled to gain some control and influence over your own treatment plan and didn't enjoy the traditional route. I am happy to hear you have found the right treatment plan for you. I agree that all patient would benefit from more dialysis, or longer treatments, however, some patients are happy doing the bare minimum in order to keep living and get the heck out of there as quickly as possible.
I enjoy reading your posts, because it puts things into perspective for me. But I think it is also important for you to imagine what it may be like to be a nurse, who also struggles with lack of control and having no say in what happens. We have so many rules and regulations to follow, and so many "t's" to cross and "i's" to dot. If we simply forget to initial one tiny box or miss one check mark, we will get called out at our monthly review. Each monthly meeting entails becoming more efficient with less supplies, less staff, and more patients. If the patient isn't on the machine within 10 minutes of their treatment time, somehow we are always to blame. We forget to sanitize our hands once and get written up. We complain to our managers that there just isn't enough time in the day to SAFELY get the job done, and yet there's nothing the managers can do. Sadly, it's also out of their control as well. So, my point is that we are all unfortunately unhappy about the same principle, lack of control, despite evidence of better patient outcomes and safer care. This is not just in the dialysis industry, this is much of nursing today. Do more with less.
Whatever the case, many of your nurses are in this together with you. We too feel frustrated in our own ways, and we would love to give all our patients daily dialysis, more dialysis, more one on one care, you get the point. If anyone has any suggestions, that would be great! But I am afraid to say, a lot of this is completely out of our control. We are doing the best with the job we have and trying to take the best care of you as possible.
I would like to point out that nurses (remember you came to AllNurses, not EverythingDialysis, or DaVita Incorporated) have little to control over how frequently dialysis treatments are doled out, little say in dismissing patients (though we may contribute to the case for dismissal), little to no control over how supplies are doled out.
Just saw this on my FB, thought it was worth putting here. . .
I come to AN Dialysis specialty to read and learn from other dialysis nurses and professionals. I know how ICHD patients feel. I'm in touch with 26 pts a day and they certainly let me know how they feel!
We agree, 100 percent, no disagreement. One of the things that really drives me bonkers is not the Nursing staff, is the patients who do the bare minimum. I think, "What is wrong with you?????" If they only knew how good Nocturnal or Short term daily is, they would never go back. Yes, come to think about it, some would, no matter what you or I tell them. I grew up in a very German household who hated, hated to spend money on anything. Yet, being cheap, is not always cost effective in the long term. I can control my fluids, easily, because I am on Nocturnal. The vast majority of the time, the kidney specialist looks at my sugar scores and says, "ND, I simply cannot say anything to you about your sugar scores." I went out to eat this evening and I had one glass to drink and I am still coughing, and I hit my dry weight on Nocturnal. A few days ago, I was under .6 on my dry weight and I am still coughing. I have been 3 liters under my dry weight and I was still hacking. The issue is that I have had asthma since high school and I use inhalers and a breathing machine that I can use in the car. Normally, I get pneumonia every winter in December and I do like to walk and exercise. However, if the cold air gets into my lungs, I am in serious trouble.
Having worked for the government, the paperwork in dialysis has become outrageous, as it has in the rest of Nursing. Many Nurses that I know really complain about paperwork and they are correct, it is out of control. A fact of life, is that Nursing school is much, much more demanding and difficult than any MBA program, bar none. I would submit to you that Nursing school is like law school at Stanford. My undergrad is in Economics. Nurses are not compensated as they should be........ My sister makes $28 per hour as an RN and that does not even begin to compensate her for the position, she is under compensated. Would I pay a much higher wage to her and the rest of you, you are blank, blank right. It was the Nursing staff who saved my life a couple of times in the hospital. It was the head RN who made sure that I was fed in the dialysis unit at the hospital, when the kitchen did not want to come to the unit and give me a meal, diabetic. It was also the head RN who chewed out the kitchen when they tried to act like Nazis. My potassium is generally very low and it was the other head RN who made sure that I had my orange juice ordered by the kidney specialist. My potassium score was 2.2 entering the hospital. Honestly, I really hate ringing that stupid bell at the hospital, that Nurse needs a lunch break to control blood sugar and to think straight. I only ring it if I am told I must...... Sometimes, I did not want my sister to go into Nursing, because I know some physicians are abusive and if I saw it, they were going to regret it.
You would love me in your dialysis center. I do not ask you for things, I do my own needle sticks, I am able to take myself off of the machine, I know my medications, dosages, and what they do. I will come in on my own time to have you show me how to run the machine that is used by the center. That way, you will not have to bother with me. I am very successful in controlling my blood sugar. I bring food in case my blood sugar is too low.... I do not ask you for food. I am always on time for my treatment sessions and I am not late. The only time I am late is when I absolutely have to use my breathing machine, because of my asthma, before I leave. If I do not, I will choke or have to call 911. Yes, I have had to use steroids for my breathing. If am going to be late, it is for a serious reason, not a stupid one, and I will call you in advance to schedule a make-up. If you call me at home for more dialysis, when do I have to be at the center? If you want me to come in at 6am, to help you finish early, I will do it, so I have the whole day when I am done. I treat you with respect and I will not tolerate any other patient who does not.
If I were to list every time a Nurse did something nice for me, treated me with kindness, or hugged me because I missed my RN mom, you would need to pull up a chair and we would be talking all day. I would love to give a tight hug to each and every one of you. Now, I have to get ready for my morning home Nocturnal treatment. By the way, when I am in the hospital, when I leave, I throw a pizza party for the Nursing staff. Get the pizza you want, your choice, I will pay for it. :)
Yes, Tiffy, I do love each and every one of you, more than you can ever imagine :) I do my own sticks and I would hate to have to stick someone else. I do tell the nurse that they cannot hurt me, because I been stuck so many times, it just does not matter anymore....... When I was working, I never let anyone use the Nurse as a punching bag, if I saw it. There is a way to deal with that, it is cuffs and disorderly conduct charges. Generally, the courts take a very dim view of someone who assaults hospital personnel, especially the Nursing staff.
You mean to tell me that it is always the Nurse's fault if the patient is not on in 10 minutes???? PLANET EARTH TO MANAGEMENT, COME IN, PLEASE!!!!!!!! I think management is drinking the Old Granddad bottle or they have been smoking too much pot or dope.
When I came home from working downtown, dealing with the jerks did not end when I walked in the door at home. I need something to eat and drink, when I came home from the night shift, which is a pain. I needed to decompress for at least 2-3 hours, along with a very cold shower at home.
Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.
You "have heard" This and you "have heard" that. I am horrified at the stories you tell, however, there are always more than 2 sides to an issue. And a pt being hit with a saline bag? REALLY? Don't have an easy time believing that. If you have actually WITNESSED the behavior you outline here, then you commit a crime not reporting it. If you have not, then what you are doing is describing "heresay" and I don't have a lot of time for that. Nurses, by nature, want to deal with *facts*, *clear evidence* and *truth*. No one here would witness what you describe and do nothing about it. And the lecture you are giving here is not well-received because it sounds like conjecture, not clear fact.
You have certainly stirred the pot coming on here posting as you have. If there is something to be learned or behaviors to be changed, you need to use your chain of command/supervision in dialysis. EVERY clinic has a grievance procedure and there are anonymous hotlines you can call for unresolved issues. But coming on here, threatening us with Ohio Code does not make for positive response to your post.
First, if you know anything about the criminal justice system, we take cases to court that we can prove in a court of law. Second, if you are unable to prove it beyond a reasonable doubt, in the eyes of the law, it did not really happen. Third, as we all know, there are individuals who make claims because they are seeking retaliation, not really because there was any violation of criminal or civil law.
Most people do not realize in a criminal case, the game is uneven to start with, think about it. The prosecution has the police force, armies of detectives, and another army of prosecutors, and compared to the defendant, unlimited monetary resources. Davita and Fresenius also have unlimited resources to hire attorneys and anyone else they would want to hire in any legal case. In the vast majority of cases, dialysis patients have very, very limited resources and are on Medicaid.
Think of how long it took for people to take domestic violence and rape, seriously. In so-called "good old days" people simply looked away from these crimes or stated "The woman asked for it, by dressing in that manor." Never underestimate the level of cruelty that will be done by individuals with absolute power and control. History is replete with these kinds of acts of tyranny of people towards their neighbors and other human beings.
Yet, from my experience on the streets, we have to very careful when we accuse people of crimes, that may or may not be true. Many people think police investigations are perfect, far from it. Detectives are people, as well, and people make mistakes. In addition, most of the public does not realize that there are many crimes that go unsolved for years or are never solved. In an abuse case, to be honest, I do not trust either party, the accuser or the accused. In police work, sometimes, there is a quick result, but many times, it is a long grind in certain types of cases.
I am well aware that people who witness a crime are legally bound to report it. You do not need to lecture me as a child. Sadly, real life is not as dark and white as we would like it, there is also alot of gray. Now, back to your lecture, I have advised people that who have made these complaints to me to contact their local police or sheriff's department, along with the city or county attorney's office.
Yes, you are correct, every organization has a chain of command structure, yes, that is correct. Yet, how things work in theory are different from the every day, practical administration. For example, if you are speeding five miles per hour over the posted speed limit, I can pull you over and issue a ticket for your violation of the speed limit. However, this type of enforcement is impractical, as if we issued a ticket for everyone exceeding the speed limit, we would not have time to protect the public against more serious violations and offenses such as armed robbery, etc. There are costs and benefits to every policy and enforcement and sometimes, the costs outweigh the benefits.
You state that I should use the grievance policy and chain of command, in theory, I agree with you. Yet, from practical experience, that is not how the world works. When one of my previous FA's screamed at me over the phone and tried to be verbally abusive, I did report it to the chain of command....... Do you want to guess what was the result, a big and fat ZERO and my complaint went to file 13. That was fine, I have the resources to go to another clinic, and I fired her loud and abusive mouth out the door. However, before I left, I went to another FA and told her the situation that if they did not teach that woman basic manners of civilized conduct, they would be looking at a lawsuit. Trust me, people have sued for much less.
I wonder if you would have the same attitude towards a patient who was accused by staff? Not every Nurse is as clean as the wind driven snow and not every patient is on the side of Angels. It is easy to wish someone luck, if you do not like the situation, you can just leave. Dialysis patients do not have the same luxuries as you do. Yet, we are people just like you and your family.
I know an attorney who is a partner at one of the major law firms in town, huge firm. I have known him since 1977 and I know everyone in his family, brothers, sisters, I know them all, very well. Sometimes, when I hear him talk, he clueless about the real world. He has the perfect family, perfect wife, has never been downsized, always had a good job, makes mega bucks, yes, he is a "Daddy Warbucks." Yes, if you are curious, perfect house, perfect kids, makes enough money to send three children to Catholic schools. I do not live this way and nor do the majority of people in this board. My point is when I talk to him, I feel like I am listening to the very same clueless people in dialysis upper management. Meaning, I know and realize that the very same dingbat policies come from people like him and naive people in dialysis management, not the nursing staff or the folks who work on the front lines. When I worked downtown, I heard the very same nonsense from management that I had to enforce and to which I would get the blame, even when I thought the policy was stupid or I disagreed with the policy that was instituted by management. In fact, in the vast majority of places I have worked over the years, this seems to be standard procedure.
NDXUFan
299 Posts
99.9 percent of physicians and nurses really try to the right thing, it is just .1 percent that is the issue :)