I Hate Dialysis Message Board
Dialysis Discussion => Dialysis: General Discussion => Topic started by: PatDowns on June 03, 2011, 05:08:19 AM
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@ OKAROL - Since you locked down the referenced thread, I had to start another to respond to your comments.
First of all, the majority of the edits you mentioned were mine. I will assure you the content stayed the same with only additional thoughts or spelling/punctuation corrections (I don't always use spell check before hitting post). No "personal attack words or phrases" were removed. In fact, I can tell you what the edits were for each post if you wish Plus, Andrew always quoted what I had written in his responses. That's the unvarnished truth since those cannot be edited by me.
While still a "jr. member," I've posted enough for my style to be recognized and that does not include personal attacks unless provoked first. I can be blunt and abrasive, yet, towards the content of a post - not the poster. Even with Andrew's nastiness, I refrained from attacking back because I felt my points about his facility's M and M stats and wondering why quality of treatment concerns were not a priority for him in determining a "good" facility were important issues.
Also, a huge red flag FOR ME is when one of a "newbie's" first posts is to say his DaVita clinic is great. First thing I do is head for propublica and pull a report for that clinic. You know, it is not out of the question for ringers to come on IHD.
It is also no secret that I do not think very highly of DaVita's delivery of care, especially incenter. I've been with them and personally experienced how they operate. I know of others who have been harmed by DaVita. Some left without long term repercussions and a few, unfortunately, didn't. So I guess if anything, my attack was towards DaVita, not Andrew, the messenger.
Lastly, Karol, the thread in question had died its own death after my "Yes, Ma'am" response to Rsudock at 3:49 p.m. and lmuchkins' kind words at 10:36 p.m. You decided to revive it early in the morning (east coast time) to add your 2 cents after Sluff and Paris pretty much spoke on behalf of site administrators. Then you lock the thread down without allowing me to respond.
One last item. I would still like an answer to why administrators are able to ban or censor posters, yet, no link is provided for people to remove themselves from the site.
Thanks - PatDowns
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NOTE: The fpllowing is posted as myself, and not as a mosterator of IHD (who incidently do not have authority to ban users)
I will respond to the last point to say that the banning of users is a extreme measure not taken lightly and certainly not often done in my experience. As for why there is no link to "remove" yourself as a user - many forums do not provide any kind of "remove account/membership" option - if someone doesn't want to participate in the forum anymore then the simplest way to do this is simply not login or access the site further.
With regards to Karol's comments about edited posts I can assure you that stnce was taken in the interests of fairness to all. While I do not, and would never, presume to write for karol, it is clear to me that when an admin or mod comes to a post/thread after the fact and sees that there have been edits, there's no easy way to determine what the original state of the messages, as posted, were (some forum software does allow edits to be saved as it happens). So, to be fair it is best to not judge on what you see at a later point in time. This comment is NOT made to insinuate your response is inaccurate regarding what you edited out, or Andrew's quoting of the original posts or whatever - I myself did not see the thread originally so again, I take a similar view to karol in this respect.
Finally I'm really not certain what all the agro/angst is about regarding ONE person's positive comment about ONE dialysis center. You've made generalised comments about DaVita and your opinion of their standard of care, but certainly individual units can be both good and bad - as with any large company - and even if his particular one is not so good, his own experience could bv very good and he wanted to share that. Even if gthe poster is/was some kind of "plant" is it really that important? it's one opinion posted on a message board - and is just as valid as your opinions, or mine, or anyone else's. Not more or less important. Equally. IHD is a community involving varying opinions and viewpoints. Not everyone will agree. We can debate our disagreements or rather differing points of view no problem, but we don't need to drop to personal attacks of ANYONE (and I am not simply talking about any one poster here).
I'm not actually trying to take sides here and from what I read of Andrew's responses I feel those could have been more restrained, but I think the whole thing got out of hand very quickly, and I'm a bit puzzled as to why.
Again, this post is written as an expression of my opinion ONLY and does not reflect my role as a moderator or indeed any opinions of the IHD administrators, and should not be taken as such.
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@ OKAROL - Since you locked down the referenced thread, I had to start another to respond to your comments.
No, you didn't have to. Another option is to send me a private message. I locked the thread so we could move on.
The software does not allow removals by members. Epoman set it up and we are still using his system.
Thank you Richard, you eloquently expressed my views. That saves me a lot of typing.
I am on the west coast, by the way, and you'll see I post late at night.
okarol/admin
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Pat, I think you are thinking clearly and responding appropriately. Please continue. The shutting down of threads when they become controversial is a fear reaction. The real way through controversy is the sifting of ideas and emotions.
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:oops;
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The shutting down of threads when they become controversial is a fear reaction. The real way through controversy is the sifting of ideas and emotions.
I have to disagree, some threads need to be locked because of it carrying over to other threads when two parties disagree heavily. It is like putting the thread in a time out for the two parties (or more) to go cool off instead of aggravating each other more and ruining it for the rest of the members or potential members. If one wants to keep attacking relentlessly, then a ban would be necessary. Some post just need that to happen. :twocents;
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I have to disagree, some threads need to be locked because of it carrying over to other threads when two parties disagree heavily. It is like putting the thread in a time out for the two parties (or more) to go cool off instead of aggravating each other more and ruining it for the rest of the members or potential members. If one wants to keep attacking relentlessly, then a ban would be necessary. Some post just need that to happen. :twocents;
And, do you feel the thread in question had actually progressed to that point?
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For what it's worth...
If I a had been on here the day the thread started and read it, I would have posted something along the same lines as PatDowns. I'm also a former DaVita patient and have very little complimentary of their incenter delivery of care.
Andrew immediately got defensive after PatDowns showed him the propublica stats for his DaVita clinic. If he had just responded back with something like, "thanks for the info, it's something I'll consider," I would have let it go at that. Even with my disdain for DaVita. For whatever reason, Andrew wanted this to go on and Pat was more than willing to accommodate!
As for locking down threads - that option should be reserved for only the most egregious of offenses. I think OKarol overreacted, especially since 2 moderators - including the site owner - weighed in and let it go. Both Pat and Andrew had seemed to have moved on and did not continue the disagreement on other threads. Plus, as PatDowns stated in this thread, it was dying on its own.
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I think this is a very important and very sensitive subject. People with kidney failure may be overwhelmed or have made peace with their situation. They don't need the needling suggestion and insecurity of knowing the ugly issues lurking behind the cheery curtain presented by their dialysis provider.
Others of us know about DaVita and are outraged, both patients and staff. We have nowhere to go but this site.
DaVita has myriads of sites and links it provides to keep the happy patient busy. They have a patient newsletter. They would love to have you write a testimonial they would print with your picture in a slick format and mail to teammates to distribute "with a greeting and a smile" to thousands of patients across the country.
Is that a fair observation?
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I AM NOT A DAVITA ''PLANT'' in fact I am not crazy about the management in the food chain above the BERLIN CLINIC. my comments were about how the nurses and techs were with the patients..I should have tempered my remarks. the bad stats could be because this area has a large retired population, That doesn't explain the infection rate. we have a new FA, she is a RN, Friday she was there at 530am working as a tech, because they were a tech short (3 patients per 1 tech ratio) so this IMO shows what kind of clinic this is.
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I also am impressed by the administrator showing up at 5:30 and acting like a nurse, not an MBA. You sound like you have extended your trust to these individuals and they are reaching out to deserve it. I have also met many dedicated and impressive clinicians at DaVita--not the kind who show off in meetings but the kind who show up and work hard to help people. I believe, Andrew, that their presence at DaVita is an accident because DaVita does not nurture or reward this kind of worker and eventually they sift out for better environments, and this is a factor behind the statistics Pat linked.
I think that when you come to a site called "I Hate Dialysis" you are forewarned to expect a dissonant chord.
But your feelings about those individuals, and the relationships you are making with them, are very important: a sign of your mental health.
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Yes, that is a more than fair observation.
I absolutely agree with you that coping methods for those who must live with esrd (or any chronic medical condition for that matter) vary from person to person. Many are so overwhelmed by it all that they turn to religion and adopt a "let go, let G-d" outlook. It helps them to hold on to faith to make sense out of what seems to be a hopeless situation. Others deal with their new reality by taking a more proactive attitude. They accept the responsibility for treatment and learn how best to integrate dialysis into their lives.
Yes, DaVita does a good job at pacifying the sheep with its patient newsletter, incenter "walls of fame" initiatives, on-line offerings, etc. They know their customers very well.
I think this is a very important and very sensitive subject. People with kidney failure may be overwhelmed or have made peace with their situation. They don't need the needling suggestion and insecurity of knowing the ugly issues lurking behind the cheery curtain presented by their dialysis provider.
Others of us know about DaVita and are outraged, both patients and staff. We have nowhere to go but this site.
DaVita has myriads of sites and links it provides to keep the happy patient busy. They have a patient newsletter. They would love to have you write a testimonial they would print with your picture in a slick format and mail to teammates to distribute "with a greeting and a smile" to thousands of patients across the country.
Is that a fair observation?
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RealityCheck, here's where my cynicism with DaVita comes in. My take is the reason for the FA working on the floor was to make sure state mandated requirements were met. She probably couldn't bring in a PRN tech because that would have put her over budget for staffing, therefore, upsetting her regional director and DaVita's bean counters. Plus, going over budget would mean losing her monthly bonus.
Fair analysis?
I also am impressed by the administrator showing up at 5:30 and acting like a nurse, not an MBA. You sound like you have extended your trust to these individuals and they are reaching out to deserve it. I have also met many dedicated and impressive clinicians at DaVita--not the kind who show off in meetings but the kind who show up and work hard to help people. I believe, Andrew, that their presence at DaVita is an accident because DaVita does not nurture or reward this kind of worker and eventually they sift out for better environments, and this is a factor behind the statistics Pat linked.
I think that when you come to a site called "I Hate Dialysis" you are forewarned to expect a dissonant chord.
But your feelings about those individuals, and the relationships you are making with them, are very important: a sign of your mental health.
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Pat, you and I know the same DaVita. She doesn't want to go over budget because she'll get bludgeoned.
Plus, I notice new FAs do this kind of thing. It stops within 6 months.
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Pat, you and I know the same Davita. She doesn't want to go over budget because she'll get bludgeoned.
Plus, I notice new FAs do this kind of thing. It stops within 6 months.
could be she is a hard worker, why the negative thoughts? I really feel sorry for both of you :sir ken;
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In real life, people with disparate opinions on this issue would simply stop communicating with each other. On a message board like this, there is the possibility of continued communication and learning. :flower;
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In real life, people with disparate opinions on this issue would simply stop communicating with each other. On a message board like this, there is the possibility of continued communication and learning. :flower;
it's clear you are a DAVITA hater, you must have good reason,..I see where you are coming from now. :flower;
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Dialysis facility morbidity and mortality statistics are adjusted for differences in patient characteristics, such as age and complicating medical conditions.
Nothing special about your FA being an RN. The vast majority of DaVita's FAs are RNs, and for a reason. They are qualified to work on the floor if staffing is short. Saves from having to hire a temp. and go over budget. A major no-no in the DaVita environment.
She was at the center at 5:30 a.m. for a reason - to make sure the staffing ratio was within state mandated guidelines.
I AM NOT A DAVITA ''PLANT'' in fact I am not crazy about the management in the food chain above the BERLIN CLINIC. my comments were about how the nurses and techs were with the patients..I should have tempered my remarks. the bad stats could be because this area has a large retired population, That doesn't explain the infection rate. we have a new FA, she is a RN, Friday she was there at 530am working as a tech, because they were a tech short (3 patients per 1 tech ratio) so this IMO shows what kind of clinic this is.
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I think there are two seperate issues here and I'd like to briefly address both, again as myself and not a part of the moderation team of this site.
1. thread locking
The task of moderation/administration of internet forums is a thankless one at times and this issue comes up all the time no matter the forum. For example I am a member of a aussie rules football club supporters forum (go the tigers!! :) ) and some people take issue with actions taken over there by administrators to lock some topics for one reason or another. The whole point of moderation is to try and keep things on an even level and make the site a pleasant experience for everyone who visits and keep things in check. This is nt an effort to stifle debate, or to "take sides" or refuse anyone's rights of free speech but when things get personal and uigly and seems like they'll just get worse without actually debating the issue at hand, or going off the issue at hand, then that's when, at times, it's best to step in.
Again I don't want to speak for karol in terms of her decision to lock that thread, indeed she has responded herself, but I can say that a site like this often functions very well because of actions behind the scenes that many members don't know about and never see. I know personally there have been times that the admin team have worked hard to keep things in good order around here, and the vast majority of members would have no idea what had gone on (which is the point). Nobody gets paid to maintain the site, and everyone's human - the goal is to keep the site a place everyone can visit and express opinions on, but do it in a polite and constructive way.
As example, the recent comments in this thread have been very good I feel focusing on the points rather than the personal. :)
2. DaVita, FA's, lies damn lies & statistics
I admit it. I've never even seen a DaVita center being on the other side of the world looked after by a public health system however I've read enough. I can certainly understand people who have been through any companies' "services" who have had a bad experience, or many, to have a certain opinion about them. By the same token, as with every large provider (and that inclues the health system here I am cared for under) you have your good parts and bad. One other issue is that you can often have very good people working within a system that can often constrict them being able to give the best service or work the way they want to.
Also stats can be massaged to support just about any point of view in my opinion. While stats are very helpful in some ways, I still think that those stats are made up of extremes at both ends, and a medium but may not reflect any one person's personal experiences. It's like transplants - say the average is 5 years, that means some folks get one after 1 year, and others have to wait 10. Now say I got my transplant after 2 years I'd reckon that was pretty awesome given the average, but if I had to wait 7....not so good. I believe the same general idea can apply to Andre's experiences at his particular unit. A unit that has many patients, but he's finding his service there to be good and he's happy with it. The guy next to him might think it sucks. Personally I think we should recognise this and be happy that someone is happy with the service they are getting. Perhaps the focus should be more that we'd hope EVERY patient at that, and all dialysis units, could get the level of service where they are happy and looked after. Of course that won't happen, and that's sad.
Regarding FA's coming in early, working the floor etc - I've noticed this too in my own unit. It was rare, but I had known the head of the unit, who is a RN, but basically a paper pusher, work the floors. heck once he even needled me (and wasn't too bad it must be said :) ). I've found in general nurses do pitch in when they need to because patient care is paramount. Yes, I get the budget thing, but that is a cynical response. As a customer Andrew sees something positive in terms of his experience of his unit - does it really matter what's motivating it? In my view the end result is that the patients are looked after - isn't that what is most important?
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I have to disagree, some threads need to be locked because of it carrying over to other threads when two parties disagree heavily. It is like putting the thread in a time out for the two parties (or more) to go cool off instead of aggravating each other more and ruining it for the rest of the members or potential members. If one wants to keep attacking relentlessly, then a ban would be necessary. Some post just need that to happen. :twocents;
And, do you feel the thread in question had actually progressed to that point?
I was not agreeing nor disagreeing about this thread, but your comment about locking a thread is due to fear over controversy. In some but rare cases threads do need to be locked. There is a need to be some control to keep things as smooth as possible for all. There have been many threads in here that have controvery that have not been locked over the years.
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Usually a thread is locked when an admin feels it no longer serves a purpose. Most of the time there are always two sides, the one who wants the thread to be locked and the one who doesn't. I know that sounds funny, but it really is that simple. An Admin makes a decision and that is the way that thread goes. Just refrain from personal attacks and everything is fine. I like a little controversy as it brings out all viewpoints. So we agree that there were personal attacks going on in that thread and now it has been handled, so lets move forward. Thanks. Oh yeah for the record Epoman hated Davita... :rofl;
Sluff/Admin
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New people to dialysis usually LOVE their caregivers and clinics because they have been so sick that they start feeling better. Then after the honeymoon is OVER they realize what they have gotten into and there is few ways out of it. Then they come to their senses.
Sad but true. :waving;
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New people to dialysis usually LOVE their caregivers and clinics because they have been so sick that they start feeling better. Then after the honeymoon is OVER they realize what they have gotten into and there is few ways out of it. Then they come to their senses.
Sad but true. :waving;
Hence a Metallica song, Sad But True comes to mind as Rerun sings it! :rofl;
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I am learning a lot!
xo,
R
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The more time people spend here the more they'll realize what's worth fighting over.
Some never will, but they just like to fight.
Keeping a thread on-topic is what I strive for.
It's really no more devious than that.
:)
okarol/admin
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People used to have deep faith in their doctors as not only being skilled but wise and caring. Research shows that trust has eroded and now people perceive doctors as being significantly concerned with personal wealth. Is that a bad thing--?
I mean, what is it about medical school and internship that would create wisdom and compassion? Nothing, really. Unless I'm missing something.
Isn't it better to think of doctors as no wiser or more compassionate than people in other professions? Although certainly the profession does contain some wise and compassionate people.
I think similar things about people with innocent faith in the corporations behind their medical care. Is that faith really, in the end, a good thing for them and the community?
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@ RichardMEL - June 4, 2011 - 6:14:25 p.m.
The morbidity and mortality statistics on propublica are based upon the actual number of reported facility deaths, actual number of reported facility patient hospitalizations, actual reported number of patients in the hospital due to septicemia and actual reported number of patients in the hospital due to access related infection. Adjustments for differences in patient characteristics, such as age and complicating medical conditions are made so to reflect an apples to apples comparison between clinics.
And even if what you say is true about massaging stats, I have a strong suspicion that the government would "massage" towards better outcomes, therefore, incenter conditions are probably even worse than what's reported.
Although you have qualified both of your previous posts as coming from you personally and not as a moderator, some of your statements reflect what you do know and agree with for being in that position. For example: "I know personally there have been times that the admin team have worked hard to keep things in good order around here, and the vast majority of members would have no idea what had gone on (which is the point)..." Well, YOU know, and you are basing your comments on that knowledge. It would be extremely hard for someone in your position not to show a bias. Like the rest of us on here, you're human as well.
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I mean, what is it about medical school and internship that would create wisdom and compassion? Nothing, really. Unless I'm missing something.
Isn't it better to think of doctors as no wiser or more compassionate than people in other professions? Although certainly the profession does contain some wise and compassionate people.
"I swear to fulfill, to the best of my ability and judgment, this covenant:
I will respect the hard-won scientific gains of those physicians in whose steps I walk, and gladly share such knowledge as is mine with those who are to follow.
I will apply, for the benefit of the sick, all measures [that] are required, avoiding those twin traps of overtreatment and therapeutic nihilism.
I will remember that there is art to medicine as well as science, and that warmth, sympathy, and understanding may outweigh the surgeon's knife or the chemist's drug.
I will not be ashamed to say "I know not," nor will I fail to call in my colleagues when the skills of another are needed for a patient's recovery.
I will respect the privacy of my patients, for their problems are not disclosed to me that the world may know. Most especially must I tread with care in matters of life and death. If it is given to me to save a life, all thanks. But it may also be within my power to take a life; this awesome responsibility must be faced with great humbleness and awareness of my own frailty. Above all, I must not play at God.
I will remember that I do not treat a fever chart, a cancerous growth, but a sick human being, whose illness may affect the person's family and economic stability. My responsibility includes these related problems, if I am to care adequately for the sick.
I will prevent disease whenever I can, for prevention is preferable to cure.
I will remember that I remain a member of society, with special obligations to all my fellow human beings, those sound of mind and body as well as the infirm.
If I do not violate this oath, may I enjoy life and art, respected while I live and remembered with affection thereafter. May I always act so as to preserve the finest traditions of my calling and may I long experience the joy of healing those who seek my help." ~ Hippocratic Oath (Modern Version/1964)
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PatDown - two responses.
1. Regarding statistics, reported cases etc. My point that I perhaps didn't word at all well, but what I was trying to get across is that while the stats say xyz about a particular unit, I don't think it's worthwhile beating one person over the head (or having a go at their posted experience - which is how I read your original posts to Andrew) when they posted that they were happy with their experience/care at that unit. So he's one that hasn't reported and issue or found things to be concerned about. I don't think basically suggesting that his view/experience/post is invalid because the statistics say otherwise is very fair.
It's like the unit I was in which I loved very much - the staff, the treatment etc (of course I saw flaws, but in a public hospital system like we have that's part and parcel of it).. but I also know a few patients who absolutely HATED it for one reason or another. I have no ideas about complaints or statistics about our unit (or even if such things are kept down here) but I'm saying that I could post that I loved my unit but if one of the other folks read that they'd probably disagree. Both views are valid because they're based on personal experience/opinion.
2. moderation & bias.
Yes, I see your point. I was simply trying to illustrate that the admin team do their best to keep things as smooth as possible. I'd also suggest that I don't NEED to be a moderator to know that. The other main board I post to (which I mentioned earlier) I am just a regular user with no special rights, yet I know there some of the things that go on. I suspect there are some longer term users of this site who also understand some of the things that happen that most don't see.
Incidently moderators actually have limited ability to do things on the board: we can't ban (and wouldn't anyway) users, and I don't think we can lock threads. We can move them to more approprlate locations, and edit ONLY to correct typos in quotes etc, to fix formatting issues etc. There are very specific guidelines that the site creater, epoman, set out. I only post this as a FYI not trying to justify anything or defend anything.
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Here, again, the thread has gotten off topic, which was to criticize my locking another thread.
This is an example of a thread that people might skip because it looks like a note to OKAROL.
I am so tempted to lock this one. :rofl;
Prior to this I don't think I had locked a thread in 2 years.
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Carol, the question of what is healthy and acceptable to discuss about this subject is not off-topic. It goes to the heart of the board's purpose for being. It is something people want to work out. There is nothing wrong with people talking about what they think should be censored and should not. You are feeling personally criticized and diving into your defenses.
It's not about you. Step back and take a breath. If you suppress the issue here, it will pop up again and you'll spend your days locking down threads.
The issue is: how do people reconcile their need to feel secure with their treatment with what they hear from other people about the corruption of the economic system delivering it?
I don't know the answer but I am willing to listen to both sides.
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Carol, the question of what is healthy and acceptable to discuss about this subject is not off-topic. It goes to the heart of the board's purpose for being. It is something people want to work out. There is nothing wrong with people talking about what they think should be censored and should not. You are feeling personally criticized and diving into your defenses.
It's not about you. Step back and take a breath. If you suppress the issue here, it will pop up again and you'll spend your days locking down threads.
The issue is: how do people reconcile their need to feel secure with their treatment with what they hear from other people about the corruption of the economic system delivering it?
I don't know the answer but I am willing to listen to both sides.
Thanks for your comments. I have been an admin here for 3 years. It's a volunteer job and it takes a huge amount of my time, but I think it is time well spent.
You are totally missing the point. A good topic to come from this thread would be, as you say, "how do people reconcile their need to feel secure with their treatment with what they hear from other people about the corruption of the economic system delivering it?" I encourage you to continue the discussion in a new thread, because I do not think Pat should have started a new thread to criticize me. You may not agree but that's how I feel. It IS about me when it says OKAROL in the subject line. There's your reality check.
okarol/admin
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Thread locked. Off topic
Please start a new subject about treatment centers, statistics and trust in the section Dialysis: Centers http://ihatedialysis.com/forum/index.php?board=3.0
okarol/admin