Report Cards v Lab Values- Discuss v Grade! Slight rant enclosed. ;)

[hotnspicyazgirl]

Hi everyone!

I recently attempted to introduce myself on this site, but was not in the right frame of mind to say anything uplifting. Thank you all for your kind responses. Anyway, I am in a much better place today, and I have a  I would like your thoughts on.

Once a month when the Dr. does rounds in the center with all the "important people" (ie: dietitian, nurse, etc) and goes over lab values, concerns, and what not, the dietitian hands me a "REPORT CARD"...    On this "report card" are my lab values with a  or a  next to the values.
I find this to be offensive, degrading, and all around juvenile!! I did not come to dialysis to be educated, receive a report card, or anything else like that. I came for treatment. I do not want a report card, I do not want smileys next to my lab values. I am a 40 y.o woman who has an education, and the ability to read and understand. I want to discuss these issues in an adult manner.
I mentioned this to the gal in charge, and she really didn't have much of a response. I honestly know this will not change, so complaining is probably a moot point. I don't know but this is making me sooo mad. I think next time she hands me one, I am going to hand her a report card. UGH! Am I making any sense? I feel like I am 8 years old, and about to be grounded. 

I am not sure if this is ONLY at my DaVita dialysis center, or at all of them but I am sure you will all let me know.

[Rerun]

Oh, yeah, the infamous "report card".  My dietition is too nice!  or stupid!  She puts a smiley on even when my Phosphorous is 6.8!  Then she gently reminds me to take my binders.  Hmmmm.... could be that I bit her head off once. 

H&Sgirl, keep reading the older posts and you will see we all hate the report cards.  Just give me the original lab sheet and that will do.

LOVE YOU!                 

[monrein]

Could you speak to her privately and just tell her adult to adult that the loss of kidney function  is difficult enough without being made to feel that you've lost your brain cells along with it.  I would explain that you are very interested in dealing with the lab values but that in fact the smilies and kindergarten approach puts you off.  Calm discussion, simple request....having said all this I share your view and it would drive me nuts to be so infantilized.

[jbeany]

Yup, we all hate them!  Just wait until they want you to join in on "Dialysis Bingo" for dorky prizes!

[Stacy Without An E]

It would be pretty entertaining to hand her a report card when you receive your next set of labs.  You could grade her on professionalism, bedside manner, and personal hygiene.  That would certainly drive your point home.

I agree with the earlier poster that if you simply speak to her about how demeaning this is, she'll most likely understand and cease with the third grade antics.

And thank God Dialysis Bingo died a quick and painless death at my clinic.  Half the patients don't speak English, so someone yelling letters and numbers out loud must have been quite confusing for them.

[Rerun]

And our stupid bingo had "pictures" of food we could not eat.  B..... Milkshake   N...... Chocolate

Isn't that close to waterboarding?

                       

[monrein]

And our stupid bingo had "pictures" of food we could not eat.  B..... Milkshake   N...... Chocolate

Isn't that close to waterboarding?

                       

Yup, except it's potphosboarding   (potassium phosphorus)

[Bill Peckham]

It would be pretty entertaining to hand her a report card when you receive your next set of labs.  You could grade her on professionalism, bedside manner, and personal hygiene.  That would certainly drive your point home.

Brilliant

[jbeany]

Heck, grade her on her weight - how well is she doing at restricting the food she puts in HER mouth?   

[sullidog]

I'm glad we don't do childish things like that at our center.
Troy

[RichardMEL]

I've always thought this to be a bizarre practice. Here we don't have any of that nonsense. The nurses either print our labs (they do that for me because I bug them as I want to see everything ) or tell the patients who ask. To those that don't seem to care (most of them) they don't bother (but the dietician will come along if there's a need). I think it's handled pretty well and certainly not with smiley faces or stuff like that. If we need to know something's out of whack they'll tell us and suggest what we need to do. Simple as that.

Another reason to love living in Oz!! 

[YLGuy]

I am in a Davita center with the emoticon report cards too.  I request that they print me a copy of my labs that the doctor looks at.  It is much more comprehensive and does not have the offensive emoticons.  I discuss the labs with the dietician and/or my neph.  If you ask them, they should do it for you.  Since I did not respond to your introduction thread I would like to welcome you now. 

[hotnspicyazgirl]

Thank you all so much for the responses. I am going to make a point of rejecting the report card, and ask that they speak to me in an adult manner. I am going to give them a report card along with an explanation of why this is so degrading. I will FAIL them for not seeing that we are adults who are willing, and able to comprehend our labs. I am finding this site full of amazing people, and I am loving it. My name is Deanna, and I am 40 years old. I am very strong willed, and NEVER let anyone walk all over me. Im super sweet until someone screws with me, then stand by cuz it aint gonna be pretty. 

You are all great people! Looking forward to learning all about you.

[Zog]

The smileys are on all DaVita labs on the back pages.  If you get the front pages they just list the numbers.  What is funny to me is that the reference ranges on the smiley face pages tolerate more PTH, potassium and phosphorus than the normal ranges on the front pages.

[Rerun]

The front page are "normal ranges" for "normal" people.

The back page are ranges for us.

[thegrammalady]

it's simple, the first time i got a report card with smiley faces i handed it right back to her told her i wasn't 5 years old and if she wasn't going to treat me like an adult she didn't need to bother to talk to me at all. in my first yea of dialysis we had quite a turnover of dietitians. i stooped one in the lobby one day and said i hadn't received my labs. i was told i would get them next week. now this was 2 weeks after they had been drawn. i simply told her that if they were that important didn't she think that 3 weeks was a bit late to be getting them and i would appreciate mine now. she gave me a somewhat blank look, but went and got me my labs. now i don't wait for the dietitian.  the wednesday after lab day i ask the nurse for a printout. i get the same report the doctor sees. it's not printed in pretty little report card form but has the actual lab values current and previous plus a whole lot more that they don't bother to tell you about. your doctor can explain anything you don't understand, tell you what he doesn't pay any attention to and why. the thing to remember is knowledge is power. the thing to remember is everyone is different. milk is high in phos, some of us can drink it and some of us can't. some of us can handle some cheese some of us can't. you just have to find out what works for you.

[tyefly]

 I just started with a new clinic because of the Nxstage training..... and Yes I too got smiley stickers on my lab reports.... I too thought that it was kind of petty......  like grade school.....  I was not sure if this was just something that this particular dietitian did...but sounds like many of them do this.....  Sad .... I wonder if they learn this in school....    STicker  101    and to think not even a upper division class.....

[okarol]

 

[Zog]

If you analyze labs for years and discover that you aren't going to die if a number is off a little, you start to care less about the .2 over on this and .5 low on that and you may even develop an appreciation for the smiley faces.  If you see an unhappy face you go to the front pages to get the normal reference ranges and associated labs... that is what we do.  I guess they could put (ACCEPTABLE, WITHIN LIMITS) for us "adults", but the smileys are easy to scan quickly for an unsmiley.

Labs can vary greatly over a days and even with the location the blood is drawn, etc.  Don't worry about tiny changes unless there is a trend down or up.  However, we did demand the front pages and the pages showing week to week values scanned and emailed to us weekly when Jenn was pregnant, so we could correlate it with the hospital labs and treatment regimen.   For most people though bad labs don't equal a miscarriage just feeling bad and feeding chronic conditions which ultimately shorten your life.

Most dietitians seem like they are preprogrammed to rant the same stuff for each high or low lab value.  Don't sweat hearing the same stuff too much.

[kitkatz]

I check my own labs on the paper sitting on top of my machine almost every week. I know what the blood values should be by now.

[Treasure]

I started asking for my lab values via email and that took care of the "report card" issue. hehehe

[RainingRoses]

Those report cards have been worrisome gnats about my consciousness for 3 years--annoying, but I couldn't articulate why I found them so demeaning.  Thanks, everyone for being so articulate.  At one clinic, I had to insist on getting the actual lab sheets, not the report card.

[caringpct]

The only good thing I can say about the smiley faces is that the patients that have a hard time seeing the numbers can scan the report and see the faces whether good or bad. I do agree that the report card is childish. I wish more of my patients would get involved with their treatments. Maybe they don't because no one but me and one other tech are willing to explain things to them. I have started asking the patients how long do you run, are you on any profiles, how much heparin, etc. To me knowing more about your treatment and lab values puts you in more control and more proactive in your own life.

[RichardMEL]

sounds like you are one of the rare ones!! Luckily since when I started 4 years ago I had some great nurses that WOULD explain stuff to me, and wouldn't treat me like a moron or a kid with smiley faces and stuff like that (and maybe being treated like a fool with stuff like that helps to alienate some patients from wanting to be involved in their own treatment - I think I would find it demeaning and an insult to my intellgence!).

Now I demand(well politely ) my labs as soon as they are done and like to go through them myself and point out what I think are problem areas. I always discuss this stuff with my primary nurse, and if there's stuff I've got wrong, or am not clear on she explains to me, and we come to agreement on things like any minor changes to tratment or whatever.

And you know what I love it! Well not dialysis or that, but the fact that I am treated with respect, and that I understand in general the important things, and that I *want* to know. As I say to anyone that asks - who cares about my body more than ME?

I do understand that this isn't for all patients. A lot of people I notice don't WANT to deal with it all; either they are overwhealmed by what is happening to them, or they are in denail, or simply it's all too hard and they figure they'll be told if there's stuff they need to know - or a combination.

For me though, being part of my own treatment team is very important to ME and really makes me feel empowered to do my best for myself.

If only there were more nurses out there who were so supportive and willing to teach to those that want to know - surely the outcomes for those folks would be that much better?!

[caringpct]

The only problem I have explaining things to people is that we are always shorthanded and I don't have the time to sit and explain and discuss things as well as it needs to be. Sometimes we work 16 chairs with only 2 techs and a nurse that doesn't really do anything besides give the meds. So I do get frustrated because I feel that my patients don't get the best care I can give when I'm stretched so thin.