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Crisis in Confidence

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  • Crisis in Confidence

    Briefly, I was diagnosis with kidney/bladder cancer 3 years ago (Stage 4) and have been on dialysis since that time. And even though my cancer prognosis is grim, I am more fearful that I will not survive dialysis than the cancer. I should also preface this post with my opinion on the dialysis healthcare providers I have experienced over the last three years; many are truly angels. I have had a number of techs, nurses and doctors who are professional and compassionate.

    But a number of situations have rattled my confidence. First, the ‘turn-over’ rate at my local dialysis center is scary and has been a chronic issue for the last 3 years. It puts the more experienced techs in a constant ‘training mode’ and drives them to rush and hurry more. The new techs appear to be cut loose before they are fully ready to treat patients. In the last year and as a new tech was taking me off the machine, she asked me “do I administer the Heparin before or after the I do the flush”? Another time, the tech hooked the catheter lines without scrubbing the hubs. When you are sitting in the chair as a patient, these are not exactly confidence builders.

    But even more frightening are some of the mistakes that are made by the nurses. Twice attempts were made to administer medications (EpoGen) to me when there were orders in my file to not administer them. Another time I was given a TB test and yet no one ever checked it a day or two later to see if I reacted to it or not. Again, this greatly impacts my confidence in the level of care that I am receiving during dialysis.

    This morning as I am finishing up the session, a roach ran across my arm! While the facility appears clean, this was unnerving. On Wednesday of this week they opened with one nurse and three techs (two of whom had less than 10 months experience) when they are supposed to be 5 techs on the floor. I watched as one tech put on 5 patients in less than 30 minutes; he was literally running across the floor at times.

    Because I also am on chemo I have a unique opportunity to compare and contrast the level of care provided between the dialysis center and my infusion center. It is night and day difference. The delta between ‘health care providers to patient ratio’ is astounding (i.e. scary). The morale of the health care providers between the two facilities is also very striking. The emphasis at the infusion center is one of patient care while the emphasis at the dialysis center feels more like ‘treat them and street them’.

    I have no idea if my experiences are local to my dialysis center of it they are more systemic. I have offered to volunteer my time to become a patient advocate in an effort to make improvements. If anyone has any other insights on how it might be possible to help improve my care please let me know.
    Last edited by 51studebaker; 12-18-2017, 11:21 AM.

  • #2
    Hi, thank you for your post. Can you please send me a direct message with more information? I can help pass these concerns along to the correct team. If you would prefer, please reach out to the DaVita Guest Services team at 1-800-400-8331 or I hope this is helpful.

    Libby Thompson
    myDaVita Community Manager


    • #3
      Welcome to the "Dialysis-Industrial Complex"! One thing I've noticed about these large profit-driven dialysis providers (Davita, Fresinius, etc.), is that they run their clinics like a McDonalds; never enough employees, dubious cleanliness, frequent errors, minimal service. You might try changing clinics, but I doubt that unless your clinic is TRULY bad, you'll notice much of a difference.


      • #4
        Hi my mom is at one in Jonesboro Ga, and it's so unprofessional, the doctors are just as much a problem, they set the standard or lack of for the rest of the staff, my mom came down from a davita in Austell ga and they were awesome. She has had so much blood on her clothing, not given her oxygen and then they run into problems of having to call EMT's , at the hospital they can find no problem, vitals stable etc, . We've tried to leave but the doctor is pretty much blocking it. someone please help, she's afraid to be there and so am I.


        • #5
          Hi, thank you for your post. Can you please also send me a direct message with more information? I can help pass these concerns along to the correct team. If you would prefer, you can also reach out to the DaVita Guest Services team at 1-800-400-8331 or I hope this helps.

          Libby Thompson
          myDaVita Community Manager


          • #6
            Yes indeed, navigating the confluence of health care and corporate world is challenging. I am certainly willing to deal with some of the false economy (i.e. I bring my own Tegaderms and have a bag full of other supplies to handle the chronic and inevitable monthly medical supply shortages). And I fully understand the value and need for standardize procedures; but like many others I have no options for accessing competitive dialysis center. My opinion is that this is a significant factor in some of the issues with the low employee pay and poor morale.

            With the new tax break that the dialysis providers will see this year (should amount to over 50$ million for them), it will be interesting to see if any of this windfall finds its way down as pay raises to those whom we put our lives in the hands each day.

            I try to do what I can to help the local techs and nurses, bring them cheese cakes and other small gifts. For example, I had these shirts made up and gave each tech and nurse one this year...


            We have to keep up good humor!


            • #7
              Anyone have any news if DaVita will either give bonuses or pay increases using some of the $100 million windfall they are getting from the new tax cuts (cutting the corporate tax rate from 35% to 21%)? Even Walmart has announced that their hourly workers will now start at $11 per hour. If a person can go work an easy job at WalMart, why would they work a much more difficult and stressful job at DaVita for a similar pay?

              DaVita has the perfect opportunity to make a significant improvement for both their employees AND patients. This is especially true in the rural areas where they have no competition and they pay less for the same job in urban areas where they have to compete. From my patient chair, the message being sent to me is that my life is worth less than a patient in an urban area.

              It is bad enough that they allow techs to push Heparin, if you are going to give them this level of medical responsibility then please at least pay them more than they can get paid at Walmart. This is our lives at stake and is no place to save money; demonstrating that they are willing to use some of their corporate windfall would go a long way to sending the message that they truly care about the patients and the caregivers.


              • #8
                DDavita tecs get paid well, don't let anyone lie to you. They do in Michigan, I can tell you that much. They get excellent training and education, etc. Anywhere you go you will find bad Drs, nurses, carpenters, plumbers, etc. The bad ones just need to be weeded out just like anyplace else.


                • #9
                  Thanks for the feedback imama23.

                  Perhaps it varies by location, at my location the employee turn-over rate (last two years) is double what is considered normal. This metric indicates a problem. I certainly understand an occasional 'blip on the radar screen' for employee turn-over but the high turn-over is what I attribute the frequency and number of the mistakes that I see being made.

                  When it comes to corrective action, it appears that some people only want to blame specific, individual personal. But from my perspective, I see that as treating a symptom while the root cause remains low morale and high employee turn-over. Of course there is simply an occasional bad employee; I have no heartburn identifying them and weeding them out. But when the same pattern or trend occurs over 2 or 3 years, there are deeper issues at play.

                  With 150 treatments per year and a serious mistake rate of only 1% of the time; as patients we are facing a preventable possible death threatening situation once or twice a year. This puts every employee under a large amounts of stress and is something that deserves higher than normal pay.

                  In my experience how well a company hires, advances, and fires its employees is one the best metrics in determining the quality of the organization. Building, and retaining, a great team is not done cheaply. As previously stated, DaVita has a golden opportunity to step up and demonstrate their commitment to the patients and their employees. While I am wiling to concede that I cannot assume the entire organization has a low pay, low morale situation; but I stand behind my remarks concerning my facility. Improvements are needed.
                  Last edited by 51studebaker; 01-15-2018, 05:49 AM.


                  • #10
                    I'm sorry your Davita clinic is like that.I can assure you with utmost confidence that all are not like that. I go to a small rural clinic in Kentucky that has 12 seats. It runs three shifts, six days a week. My nurses and techs are well trained and professional. No one is placed on the floor before they are ready and they are observed for weeks afterward by senior staff. We are a 5 star Medicare center. That is hard to achieve but tells you just how good this place is. I'm really sorry you have you such a bad time at your clinic and wish you had other options. Take it from me,all Davita clinics are not bad. It's not a businesswide model. It's an individual clinic choosing to be poorly run.


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