Indiana University Nursing vs Davita Management of Nursing

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1. At IU, there are at least 7-8 RN's on duty at the Indiana University Home dialysis clinic.....

2. At IU, the dialysis clinic Nursing staff enjoys good wages and plenty of time off....

3. At IU, the vast majority of the Nursing staff has been there at least 20 years and many have been there over 30 years, a few have been there 35 years.

4. At IU, the Nursing looks at long-term costs, instead of short term costs.....

5. At IU, the Nursing staff has a great amount of power to make decisions......

6. The IU staff teaches home dialysis how to correctly clean fistulas, the IU infection rate for fistulas is zero.

7. I would do anything the IU Nursing staff would ask me to do. This includes getting up at 4 am to receive a treatment at the clinic and afterwards to have my fistula looked at, by a IU nephrologist/surgeon...... at the IU Hospital in Indianapolis. If you are curious, it is a 120 mile drive one way from my house to IU.

8. The IU Nursing staff looks out for the Home dialysis patient and is constantly reading the latest research. Many in medicine, I have noticed, could care less.

9. The best thing is last, they always ask me how they can improve, and honestly, I cannot think of anything. My RN case manager jumped my case about my blood sugar scores, my three month scores and she was right. The issue is that I was not getting enough sleep or I put off sleeping. The IU Nursing staff said that controlling blood sugar without the proper sleep is nearly impossible... With sleeping, my A1C score tanked to 5.4. Without her, might have lost my vision in the long run, that would have been a disaster.

I like Davita Nurses, what I do not like is how they are treated. This is more about bashing Davita management. Making money is not evil and every group has to make money at some point. However, as my RN mom said years ago, 12 hour days is not good or healthy for the Nurse nor the patient, I would have to agree..... The Nurse also needs a meal break to control their blood sugar and to be able to think straight and rationally for the dialysis patient. It is also insane that the Nurse cannot get any time off, this is very unhealthy. I worked for a company like that and after a certain point, I really started to resent them. You mean to tell me that you cannot have enough staffing when you are spending how much on that drunkfest, every year? I know that many Davita Nurses resent the management excesses of Davita management and so do the Davita dialysis patients. Many Davita Nurses are fired for disagreeing with this style of management and many Davita patients are discharged for complaining about the crappy care that is dished out by Davita management. I have had many Nurses who worked for Davita say that they were afraid for the safety of the patients, that does not surprise me. The Davita RN is taking care of how many patients at time, again? Then, if something happens, it is all on the Davita RN, how goofy. You can better believe that management will not be taking the blame that the care standard was started by them in the first place. I would love Thiry and his management friends to have some of the care that he thinks is so great for us or take care of zillion patients at one time. When I was In-Center, I learned to put in my own needles and run some parts of the machine.

I love being at home and that is one less patient that the Davita RN has to take care of, God knows they have more than enough work to do......

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Specializes in Dialysis.

Davita's sole purpose is to obtain a return for shareholders. When that model is applied to healthcare it can get ugly, fast. While Indiana U provides a high quality service you know there has to be some consideration given to the cost and I don't see how a public university can ever deliver care that costs less than a private company. I'm with you on the quality argument but how can the question be turned so that quality has a higher value than cost?

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Johns Hopkins has lower costs than the majority of hospitals.

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Specializes in Dialysis.
Johns Hopkins has lower costs than the majority of hospitals.

Do you have any numbers on per treatment cost? John Hopkins gets a huge amount of funding from the federal government so how can you compare costs against a private company providing the same therapy? Again, I'm with you on the quality argument and I wish the public would see this too but the Walmart mentality has affected every aspect of healthcare.

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Indiana and Johns Hopkins treat dialysis patients that Davita and Fresenius would not touch. In fact, when "problem patients" are sent to the IU dialysis clinic, the Nursing staff generally never has a problem with them, as the majority of the IU Nursing staff has told me privately. Why, you ask me? There is a sign at the IU clinic that says, "I may have lost my kidneys, but, I did not lose my brain." The IU Nursing staff does not treat dialysis patients like babies or stupid fools. IU Nurses have told me privately that they detest Davita and Fresenius care standards. I have also heard from Nurses that have worked for the big two that the care they were required to give, scared them to death. I would rather pay an IU bill every month than be paid to go to Davita and Fresenius for a million dollars per year.

Now, to your question, hospital costs are like wages. It is hard to compare costs because Johns Hopkins and IU treat much sicker patients than do the big two. In wages, all of the factors must be the same to compare the wages. For example, if you are going to compare a woman's wages to a man's, they would have to work in the same field, have the same education level, have the same amount of experience, etc. Then, you could compare their wages, unlike the nonsense you and everyone else hears in the media. The Wal-Mart medicine practices, are much more expensive in the long run. I cannot tell you how many times, I would repeat to the IU Nursing staff what I had learned at Davita or Fresenius and to be told, "that is wrong or we have never, ever heard of that practice." It is like a individual who does not fix the car right the first time, and the customer has to come back to have it fixed again, which is free, when if the individual fixed it right the first time, he or she could use that time to make a profit on fixing another car, instead of working for free. When Davita does not teach the home patient how to clean a fistula correctly, they are not paying the cost of that incompetence, the people paying for it are Medicare and Medicaid, the majority of the time. Yes, it does help Davita's bottomline in the short term...... Davita does not pay the cost, when the tech works on a patient's access, after not washing their hands after taking out the trash. Who pays that cost, Medicare and Medicaid, i.e. taxpayers.

Many at Davita tend to be very obsessed about lab scores, because they want a bonus, instead of truly taking care of the patient's long term health. NO, making bonus money is not evil or morally wrong..... Yet, if they did a good job taking care of that patient's long term health, it would benefit the patient and benefit the Nurse with more bonus money. :) I love to see great patient care and Nurses prospering financially.......

Some in the dialysis community have complained that the big two refuse to call the paramedics when the patient truly needs to go to the hospital, because of bonus money. Not sure, if that is true, if it is, it is disgusting. I know the IU Nursing staff does not act in that manner. Anyone who tells me that they do is being mislead. Are patients perfect, God, no........ Yet, many times and in many ways, dialysis patients are set up to fail, 12 hours per week is not cutting the mustard.

For example, IU for a week of dialysis charges $1,175 per week for dialysis, Davita charges $2,000 per week, and Fresenius on the high end charges $2,500 per week for dialysis. I will tell you from experience that the care at IU is 10 times better than Davita and Fresenius. In addition, IU pays 30% less for nephrologists than nephrologists in private practice. I will take IU Nephrology, each and every time. It does not bother me in the least that they want to make money, fine, not an issue. What I have is a serious issue with the crappy care and practices that is provided by Davita. The other issue I have is how patients are being treated. As a former police officer, I know that patients are and can be major jerks. I have advised patients that were being abused that they needed to file criminal charges against abusive dialysis personnel. For example, some of the stories that I have heard, if are true, someone needs to be going to jail. As I did investigations, finding out the truth is sometimes harder in reality than in theory. I support dialysis patients being told the truth about their condition, yet it can be done in a way where the patient is being told the truth and the Nurse feels that he or she can be totally honest. The easiest thing in the world is to lecture someone on how they should live, when you are not living in the same manner. I have really loved many nursing people, however, I have thought some Nurses were jackbooted thugs, which is a very small minority......

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Specializes in Dialysis.

Very interesting. When I first developed an interest in dialysis I wanted to know the history of ESRD and it is very fascinating how the federal government became involved. But once they were the government set the standards for what was allowed. That's how patients became trapped in 3x week dialysis with the government defining that as "adequate". Thats why our country has such horrible mortality stats compared to other countries. Then we became slaves to the K/tv formula because again the government said that's how you determine adequacy. Well guess what? A K/tv of 1.2 will still leave most patients feeling crappy and taking alot of medications that they wouldn't need if they received a higher dose of dialysis. But the government won't reimburse for that. Davita didn't rig the system, they are just exploiting it and making a huge profit doing it. I think they are many areas where this occurs, the most glaring examples in the military weapons systems that the government contracts for. That's how we get 800 dollar hammers. Evidence based medicine and education are the key to change and it sounds as you are up to speed on both. We can change the way dialysis is done in our country but as long as we let the government define certain levels of dialysis as "adequate" and let private companies success be determined by delivering that bare minimum companies like Davita are here to stay.

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Specializes in Dialysis.

Despite making a profit Indiana University is laying off 800 employees. Any opinion on how this will affect quality of care?

Worried about the future, IU Health cuts 800 jobs, even as income soars | 2013-09-12 | Indianapolis Business Journal | IBJ.com

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Specializes in NICU, ICU, PICU, Academia.
Despite making a profit Indiana University is laying off 800 employees. Any opinion on how this will affect quality of care?

Worried about the future, IU Health cuts 800 jobs, even as income soars | 2013-09-12 | Indianapolis Business Journal | IBJ.com

Well, I CAN tell you that they are laying off BEDSIDE nurses, and ALL (that's all, folks) ALL 300 Diabetes Educators in their entire statewide system. I'm guessing quality will be affected, and not in a good way.

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Specializes in NICU, ICU, PICU, Academia.
Despite making a profit Indiana University is laying off 800 employees. Any opinion on how this will affect quality of care?

Worried about the future, IU Health cuts 800 jobs, even as income soars | 2013-09-12 | Indianapolis Business Journal | IBJ.com

Oh- and 'soaring income' does NOT equal profit when you have soaring expenses as well.

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Specializes in Nephrology, Dialysis, Plasmapheresis.
Oh- and 'soaring income' does NOT equal profit when you have soaring expenses as well.

I would like to add that a friend of mine works in one of the ICUs at John Hopkins and she said they use Davita services. So I guess their standards may have changed and gone to "cheaper" services. Many hospitals are going to have no choice but to go with the more efficient way of dialyzing inpatient and go with one of the outside contractors, who gets the job done without losing so much money. Inpatient dialysis is one of the lowest grossing departments, they never make money. So unfortunately, I see the hospital run dialysis programs slowly being bought out. There's only a few hospitals in every major metro city that don't use Fresenius or Davita. Good or bad, the job gets done and unless there are major mistakes, the hospitals will accept those services.

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First, you show me a dialysis patient that would be willing to do anything longer than 12 hours a week and I'll show you someone with mental illness. Even the most gung-ho patients wants OUT by 3 1/2 hours. And if any of my patients require d/c to an ER they go! I'm an RN and it's my license on the line and almost 100% of my coworkers feel the same. I'd love to know where you come up with these numbers and this info as almost none of it corresponds to the reality I deal with daily.

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Specializes in RN, BSN, CHDN.

I do not agree with the information discussed on this thread. Davita treats their employees very well, they also care very much about their patients.

The big dialysis companies are a business in fact I think that you would have to search far and wide in the US to find health care that is not about Money-how can they provide care, pay wages etc if they do not make a profit! Even the non profit companies have to make money or they will close.

Money is an ugly word, but it is reality!

Good labs and adequate dialysis equals healthier dialysis patients

The government tells you what labs you have for each patient-the dialysis companies dont make the rules

It is a known fact that every dialysis company in this country loses $40 per treatment for every medicare dialysis patient, many companies do not refuse uninsured patients so where you get the information that they do is wrong.

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