My dialysis center has always had bad management, but now they've reached a new low. Normally, because management don't want to pay new staff competitive salaries, the best people eludes the center. Then because of poor training of the people coming in from the street, despite there genuine trying, the level of care has degraded horribly. Inadequate cannulating, poor reaction to machines,and a lack of knowledge about dialysis all together. Being short staffed now for months, treatment times are mangled, rarely getting patients on or off the machine on time.
Worst still, disregarding the interest and time outside of dialysis of the patients (and staff for that matter), there has been a sudden move into a SMALLER facility, while the old faciility is upgraded. The patients have been given new atrocious times, keeping patients in the center until after 10 pm, worst still, because of the short, overworked staff, and the sheer stupidity in believing a large facility could somehow fit into a small facility without little to no problems:
the treatment times of the patients are being reduced more and more just to keep a ragged pace. Another case were money takes priority over health, short sightedness, stupidity, or just a plain blind disregard for the majority. I truly love my doctors, we've been through a lot, they are infinitely competent, and I wouldn't trade them for the world. But the conditions at the facility are just absurd.
Is there a rating system for dialysis facilities that is available for one to find a new facility?

I too had a horrible dialysis unit environment. I now dialyze at home.
You might want to consider this as an option.

If not home dialysis, how about self care in the unit?

If you are able to do self care or go home,it has been my experience that you will feel better, safer,and learn alot about your illness and treatment. I have also not been hospitalized once since going home 18 months ago. Before going on home I was in the hospital about once every 6 months with an access problem. I am much better at sticking myself than the staff at the clinc will ever be ! I use the buttonhole technique.

Home dialysis or self care. Think about it.
I highly recommend it.

Hi! I feel very lucky I dialyse in Canada in a Satilite unit. I have not been hospitizied in the 3 years I have been on dialysis, feel better than ever. It's great! One question what is the button hole technique to self needling. I have heard about it in several locations with no explanation of the process.
Thanks for the information.
Nancy

I am in a unit that also has had a decrease in the quality of the staff. They have also made some other money saving decisions - for example - they now dress your site with non-sterile gauze. Over the last week we have had mice running around during treatment.

Hi Nancy:

I, too, live in Canada and agree with your comments.

Far as the buttonhole technique is concerned, I understand that two tubular inserts are are inserted in your arm
allowing for daily self-needling in the exact same site.

After a while, a bit of scar tissue develops, making the daily insertion extremely smooth.

I, on the other hand, used chest catheters, but I know many doctors are getting away from them because of the higher risk of infection.

Hope that gives you some idea.

Best,
Mike

Try PD! No needles, no access problems, no dirty units, no crowding, better diet, less fluid restrictions, you can do it!

I did not use any "tubular inserts" to create my buttonhole sites. Just sticking in exactly the same place each time following the scar tissue track that was developing.
It took about 2 weeks before I had a good track established, but from that point on it worked like a charm. Like you said Michael, extremely smooth.

If you are unhappy about the care in your facility I urge you to talk to the social worker, nurse manager or administrator. If they aren't listening, and you live in the USA, you can contact your local ESRD network. Your facility should have a grievance procedure and you should be able to get the phone number from the clinic. Good luck!

Talk to social worker? Well, we have a sign on a door that says there is or was one at one time but she is never around. I spoke to the Dr's about the gauze - one Dr said yes sterile gauze is best for you but it is no longer our policy. Talking to ESRD network did nothing. trying HCFA - see if we get any results from them

quote:

Originally posted by leadsag:
Talk to social worker? Well, we have a sign on a door that says there is or was one at one time but she is never around. I spoke to the Dr's about the gauze - one Dr said yes sterile gauze is best for you but it is no longer our policy. Talking to ESRD network did nothing. trying HCFA - see if we get any results from them

Hey, make sure you let us know how that turned out.

Blacchrist: First call the local media (newspaper and TV) and ask for their investigative reporting team. Since this is a gov't paid treatment some young reporter would love to get their hands on your situation. I would also contact an attorney and check out your rights. The idea of "for profit dialysis" should have it feet put to the fire when the patient is punished! We tax payers should demand it.

The Medicare website (www.medicare.gov) will add a "Dialysis Facility Compare" database in the near future. "Nursing Home Compare" is already available on the Medicare website. "Dialysis Facility Compare" database is scheduled go "live" in mid-January 2001. It will start with some basic information and more will be added as time goes by.

dear blacchrist, i agree with the patient advocacy response. I have been on dialysis for 8 years and i have travelled from state to state and seen many different facilities and encountered numerous scenarios in dialysis clinics. My approach has been to seek out "good" clinics, which has meant changing docs, cities and clinics...but it has kept me out of the hospital and in good shape (mostly due to God's grace) It has been my experience that these dialysis units do not change..in fact the situations are getting worse, and the only recourse is to take legal action and/or get media attention. I believe it would be a good idea to form a patient advocacy alliance on some web site and allow patients from all over the country to have their opinions. Change is happening; and we need to come together as a dialysis community to unsure that dialysis is a humane, sanitary and positive environment. There is no excuse for the continued abuse and poor management of patients. In the meantime, i have found it very useful to demand sterile conditions at the units i am at. THe phrase," well, i will have my attorney contact you" seems to get more response than any other thing i have tried. Feel free to contact the Network, though since they are affiliated with HICFA they are not "patient advocates" and i have been told so by the Networks themselves. Let us pray for a united Dialysis forum where these issue will be soon past. Much love and respect...hang in there...

The Health Care and Financing Administration (HCFA) monitors dialysis facilities since they are reimbursed through Medicare. State survey teams respond to formal patient complaints by visiting the site and looking around. Provider numbers can be taken away if conditions are severe enough. It may cut off your nose to spite your face though. If your poorly run facility loses it's provider number, you could be forced to drive long distances to dialyze. If you do call, be sure and mention to the surveyor that Medicare's ESRD program necessitates the facilities cost savings through low payment for dialysis services.

If your dialysis provider is part of a large corporation, I would suggest first making a call to the corporate offices and making a complaint if you have exausted local administration.