[QUOTE=Beth Witten MSW ACSW;20800]It sounds like you were having a bad day that only got worse. Since all you can control is you…Was there anything you could have said or done that would have avoided turning the interaction(s) with the nurse (and possibly the doctor) into a war of words. For example, so far as the instruction about what your blood flow rate should be, could you have asked the doctor to explain why he recommended that speed which were concerned was slow enough that your blood might clot? How would your doctor have reacted if you’d offered to look up information on the NxStage website about usual blood flow rates to share with him/her? The goal is to have adult-to-adult discussions instead of triggering a defensive response that leads staff to assume a “parental” role where staff “talk down” to you which likely triggers more anger in you. This can easily become a negative pattern of communication.
I can understand how much you want to do extended time dialysis. But I believe NxStage is still doing studies of extended time dialysis with their machine to prove to the FDA that it can be used safely. Until the FDA gives the green light, other clinics can’t use the NxStage machine for extended time dialysis. I bet your clinic (like others) thought the FDA would move faster than it has. I don’t believe they intentionally lied to you. One option you have is to find out where extended time dialysis is offered and call to see if you could get on that treatment if you transfer.
So far as falsifying flowsheets, please don’t ever do this because:
- It prevents the clinic from identifying and correcting problems with your dialysis prescription, medications, etc.;
- It may lead to billing errors that could backfire not onlyl on your clinic but on you;
- Most importantly, it opens the door for the home training nurse and doctor to not trust you. Trust is essential with home dialysis, even more than with in-center dialysis because patients are not seen as often and there is already concern that some patients who are not followed closely may not follow their treatment plan. Without trust, the doctor may refuse to treat you or the clinic may refuse to allow you to continue to do home dialysis (as the nurse threatened), and you would need to go in-center, to transfer to another clinic, to switch to another type of treatment, or stop dialysis (which you threatened back).
I hope that you and your home training nurse can patch things up and move on. However, if the relationship is too damaged, perhaps you should look for other options of dialysis facilities where you can get the treatment you want to do. Keep in mind that as much as we wish this was different, every clinic does not have to offer every treatment or every home HD machine.[/QUOTE]
First, I have complained to the Nephrologist about this obnoxious behavior, it is also communications and actions that they have started. If you have ever seen the movie “Full Metal Jacket” and Gunnery Sarg Hartman, you will see their attitudes. I seriously doubt you would allow someone to talk to you in this lifetime, in that fashion. The problem for them, is that I have known the Nephrologist for 10 years, six years before I ever knew or saw them. The Nephrologist and I talk like adults, not like idiots, as they do. Home Dialysis have certain obligations to the consumer. Legal, I hate to explain to you that you can sue for what ever you feel is warranted, does not mean you are going to win anything, judgement or otherwise. In this part of the Midwest, juries are very, very cheap, know many attorneys and a partner in a 300+ plus attorney firm. Many things and crimes are extremely difficult to prove in a court of law, many felony crimes go unsolved, each and every year. It is essential for me to be able to trust them, trust is a two way, not a one way back alley street. As the Nephrologist will tell you, I do not respond well to threats. When I give the Nephrologist a very valid reason something was not done, he does not see a problem, not unlike Gunnery Sarge Hartman, who wants to bark and complain, along with acting like everything is some kind of National Emergency. I have seen Armed Robbery, Murder, People bleeding and dying in the streets, parents beating their children, neglecting their children, people dying alone, and I have almost met my maker. If you think Gunnery Sarge Nurse scares me, anyone who believes that is out of their mind. I do not take abuse from ANYONE, regardless of position or title. I am very gentle and compassionate. However, I do not take trash or abuse. If you want to talk crazy, go somewhere else, because I will not listen. My God, it is amazing to me that people in the centers take this crap, unreal. Now, you know why I left, I guess the Drill Sarge wanted to follow me, LOL! He will not enjoy having his teeth smashed out with a PR-24(nightstick). I am happy to do anything you ask of me in a reasonable adult fashion, have a nice day.