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Thread: Patient Compliance
October 12, 2006, 09:50 AM #11Anonymous Guest
Dori, Pat it in a top notch program. Dad is in the same program. You just have no idea how good it is to be in a program where the objective is to work with the patient to make dialysis the best as it can be and to make their life easier. They truly know all patients aren't the same and their situations aren't all the same. They have rules but these rules are more guidelines than enforcement issues. I can remember when dad came home from the hospital I called in to say I know I am suppose to call in dads BP's etc morning and night. But for a while I would like to call at night and instead of calling you in the morning, I'll give you dad's off treatment information the night I call in to start treatment again. The reason I did this was because dad had just come home from the hospital
and if he was sleeping when he I took him off the machine I didn't want to have to wake him. So as long as the BP and Temperature was OK they allowed me to bend the rules. They too figured for a couple of weeks rest was probably more important for dad than the rule of calling in right after treatment. This whole thing with "compliance" just boggles my mind. Every patient would be compliant if you took the time to understand their needs and yours and worked together to solve the problem. Once the problem is solved you may not have followed the rules but you do have a compliant patient.
January 16, 2007, 12:51 PM #12Unregistered Guest
what is this whole concept of 'punisment' for non-compliance?
I think dialysis professionals don't really have a clue about how it really feels to be a dialysis patient,and being so judemental towards them is BS
September 28, 2012, 04:26 PM #13Junior Member Registered User
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Re: Patient Compliance
I have been a home dialysis nurse for 5 years for both PD and Home Hemo patients. I absolutely love what I do and I understand that dialyzing at home can be a challenge for most patients. I also realize that everybody is totall and completely differnt. Unfortunately, the nurses in the home programs are held completely and totally responsible for wha the patient does and doesn't do. It is very frustrating when you are written up or verbally beraded because your patient did not draw labs or send in their treatment records. Both of which affects payment to the facility because your insurance both private and Medicare will not pay without specific outcomes and treatment records. Although I do what I do because I absolutely love it and can not see myself doing anything else, my position is always threatened becuase of these issues. Those of you who work just imagine being held accountable for what someone else does or doesnt do. Personally, I don't believe in harrasing patients. We are all adults and have to live with the choices we make. However, dialysis management requires that we continue to make attempts to retrieve these items because they are looking at the bottom dollar while the nurses (on the front lines) if you will are put right in the middle, between the patient and managemen. This is a very difficult place to be. There were 3 nurses in my position before me who could not handle the stress of this job. I care for my patients and want to remain consistent in their care so I just can't leave. I do however, fear, that if a patient who is not following the home dialysis requirements and something happens to that patient, under my direct care, I will be held accountable. Regardless of how much documentation I do, some of the most "non-compliant" patients are the first ones to talk about law suits. It will always come down to..well you are the health professional and you should have done more. I have had patients tell me one thing and out right lie on me in front of their nephrologist.
I respect every patients opinion but just remember there are two sides to every story. Just like each patient is unique and different, so are health care workers. Some really care and some just want a paycheck. Some health care workers are have awesome knowledge and skills and some are clueless. However, somehow, we all get lumped together as well.
I think that if a patient wants to "self care" withiout rules or guidlines, then there should be another modality called something like "Total self care dialysis". Then the patient could live however they choose to and health care workers would not be held accountable for it.
March 29, 2013, 01:54 PM #14Senior Member Registered User
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Re: Patient Compliance
As a former police officer, I have been in the middle, many times in my life. Yet, many dialysis personnel act like individuals on dialysis are small children. At Davita, I was tired for being called every single day, because some one wanted some form or God only knows what else. Dialysis is a medical treatment for individuals with kidney failure, not a jail with correction officers. I would not blame the nurse, if I did not turn in a flowsheet or do a blood test, when they asked me, I told the truth, either I did not turn it in or I did not want to do the lab, very simple. No, I did not lie to the Nephrologist and he did not freak out as did Davita, about every little thing.
I was really trying to do my best in performing my treatments. Every blue moon I would miss a blood test, because of something that would happen with the cycler, is that my fault that the machine is not working correctly? At Davita, it was blame the patient, first, ask questions later. Davita just did not want labs once a month, which is very easy. They wanted labs for this, that, and just about everything under the sun. For some reason, they thought I had every disease under the sun. Guess what, they ran all kinds of tests, they found nothing, as I told them they would not find a thing. Yet, to them, patients are fools.
Being a part of the Davita Home Dialysis program is very, very demanding, because they tend to be very, very obsessive and complusive. On a Davita home visit, they started to look thru my refrig without asking, that is a jailable offense. That is how criminals on probation are treated, not someone on a medical treatment.
The dialysis clinic that I currently going to, is very laid back, not obsessive or compulsive. My former Nephrologist and his office were outstanding, but, I was not going to tolerate the Nazi mentality at Davita. I have had alot of experience with people and money and I have never, ever seen people as obsessed with money as Davita. I agree, Nurses are not being paid enough. I love the Nursing staff at my current clinic. I turn in my flowsheets and labs on time, because I want the clinic to get paid and so they can do the right t hing for me with the labs. The clinic truly cares about the people that need dialysis. I want my clinic to make money so they will always stay open. If you are curious, someone on dialysis claimed that I did not know what a Nazi was? My family is from Deustchland(Germany).