Respect

[Comeback Kid(ney)]

I feel it is of utmost importance for a dialysis patient to be treated with the utmost respect. Unfortunately, that is not a practice that is observed in certain dialysis clinics. I am at my third clinic in 3 years and I think I finally have found that in the new clinic I am in.



EDITED:  MOVED TO PROPER SECTION - RERUN, MODERATOR

[Comeback Kid(ney)]

I agree

[Ang]

  comeback kid(ney)

  how are ESRD patients different to anyone else,  don't  all people deserve the utmost respect?
  ilness or otherwise?

[Comeback Kid(ney)]

You are missing my point completely. Of course everyone should be treated with respect but when you have a chronic illness, you expect the staffs at these clinics to look out for your well being. The last facility I was at, the nurse out and out lied to me with a straight face and there was no doubt in my mind that because I have a positive attitude, this was not looked upon favorably. Let's not forget this is a business and one that is growing by leaps and bounds every year. So, the respect I am talking about is only pertinent to the care we have the right to reserve. Please don't take my comments and treat them simplistically. We are dealing with a hidden epidemic in this country and as more people develop ESRD, the quality of care needs to be of the highest quality or there is going to be a lot of people who will not receive adequate medical attention and will unfortunately perish. I hate to have to talk that way but in 3 years, this is what I have been exposed to and when the truth is spoken, the kidney world doesn't like that. Too bad!!!

[dialysisadvocate]

Patient Respect and Dignity is part of the Federal level regulations, as well as in some states. Patient's Rights are often overlooked when staff are being oriented and trained in their facility. This I realized during a recent conversation with a provider at which time it was agreed that more education in this area needed to be given to new staff and experienced staff. There are so many areas of patient respect/dignity. I will share a few
(1) Patient need to be FULLY iincluded in their care. This means that staff must '''buy-into'' the fact that (a) if it were not for the patient, they would not have secure jobs, (b) understand that the patient, or their loved ones, have the right to question what is being done to their body and why, (c) patients have a right know know what staff will be doing e.g. correct implementation of practices.. this results in patients, if they observe an incorrect practice (e.g. no hand washing, or changing gloves when needed) reminding staff. However, unless staff understand it is the patient's right to remind them, well, it turns often into staff retaliating against patients. "How dare you, the patient, ask me, the technician, to wash my hands,etc.

Retaliation is alive in units and I have, for a fact, worked with patients, at all providers units, who have experienced such. This ranges from the patient with no education, to a physician dialysis patient (elderly pt).

Respect should start from the beginning with training of staff -- when patients and/or staff are given a piece of paper stating all the rules around respect, well, this is not sufficient. Many units show favoritism to some patients, some patients are labeled as 'trouble maker' 'problem patient or family' , or as I was called when I attempted to ensure safe care was delivered to my father, 'challenging'. I found that interesting... Staff do not, nor do some physicians, see patients or their loved ones as advocates for safe care, but see them as interfering. Staff are cohesive and stick together when there is a problem, protecting each other --- an unspoken word.

When anyone reads their facility survey, there are identified problem areas.... these are the areas that patients should be educated on so that they can become part of the dialysis team. A few years back, I wrote an article, how the patient prevents errors...... by educating fully, the patient, (those who want to be educated) we as loved ones, and patients can help staff prevent errors.. It is about working together.. The defensiveness amongst staff is contagious and it only takes one staff to ruin it for all.

above opinions of Roberta Mikles
Roberta Mikles BA RN - Dialysis Patient Safety Advocate
www.qualitysafepatientcare.com

[Rerun]

I agree about respect, but most of these Techs are hired off the streets with no formal education and trained on the job.  Part of that training should be on respect, but when most of them were drunk at the bar all night (as they tell us) what do you say???

I tend to get respect by bringing TREATS once in a while.     

[daveosaurus]

I'm lucky because at my center, Davita south in Greenwood Indiana, everyone is very nice and always willing to answer my questions. I like that treat idea. Thanks for that.

[brandi1leigh]

I am very lucky. My clinic (Fresenius) treats us with a lot of respect. And if one of the staff doesn't, the other techs and nurses police it themselves.  There is one patient in our clinic who is awful! She yells at them every day for no reason, and even with her they stay calm, collected and professional. My only complaint is that they sometimes let interpersonal disagreements among themselves (ex: two techs who don't get along) onto the floor. I think these types of arguments should happen behind closed doors. Still better that they argue with each other than with us!

[Ang]

You are missing my point completely. Of course everyone should be treated with respect but when you have a chronic illness, you expect the staffs at these clinics to look out for your well being. The last facility I was at, the nurse out and out lied to me with a straight face and there was no doubt in my mind that because I have a positive attitude, this was not looked upon favorably. Let's not forget this is a business and one that is growing by leaps and bounds every year. So, the respect I am talking about is only pertinent to the care we have the right to reserve. Please don't take my comments and treat them simplistically. We are dealing with a hidden epidemic in this country and as more people develop ESRD, the quality of care needs to be of the highest quality or there is going to be a lot of people who will not receive adequate medical attention and will unfortunately perish. I hate to have to talk that way but in 3 years, this is what I have been exposed to and when the truth is spoken, the kidney world doesn't like that. Too bad!!!

sorry my comments are not simplistic and not missing anything.everybody deserves respect, the chronically ill just that much more care and attention.
whatever part of the globe you reside in, dialysis centers are run by corporations who give a sh*t about dollars and not care. In australia their all in or affiliated to a hospital.
as another poster stated most are hired off the street.
unfortunately its a sad that you have to move to different centres to find one your happy you with, how do you fight the machine that is esrd?
most suffer in silence as debilitating as the disease is ,  they have nothing left for the fight against corporations.In australia nurses are trained in the hospital environment.(you still get good and bad D staff) majority good
 oh yeah
been there done that,9 years waiting for dialysis to come, dialysis 4 years , both kidneys removed, transplant
 

[RightSide]

Staff do not, nor do some physicians, see patients or their loved ones as advocates for safe care, but see them as interfering. Staff are cohesive and stick together when there is a problem, protecting each other --- an unspoken word.

Perhaps that's because a staff member that a patient discovers has not been following safe care practices can be reprimanded or even punished by the head nurse or other superior?  And so they are afraid to have problems discovered because it might mean their next raise or even their job might be jeopardized?

I had this discussion with the head nurse at my own dialysis clinic.  I had noticed some problems where certain staff members were not following proper anti-infective protocols.  But I made it clear to the head nurse that a) it was NOT my intention to get any staff member in trouble, and that no such trouble should result from my complaint; and that b) more generally, there need to be ways to correct such deficiencies without it seeming punitive to the staff.  IOW, detection of problems should be viewed as a learning exercise, not as a way to grade the staff for raises, promotions, etc.

[dialysisadvocate]

Respect --- I must share that recently, during a conversation with some upper management people, I learned that there is minimal training/education in this area. Sad, truly sad. Often,  from my experience, these technicians, and even nursing staff, once they are so-called (cookie-cutter) trained, they become 'oh so powerful and they are always right'. They have not been educated propoerly as to the fact that (1) if it were not for the patient they would not have a secure job, (2) the patient IS the center of care (3) the patient should be able to know all policies / procedures, if they want, so that they CAN prevent errors from happening

Staff do not, for the most part, as far as I am concerned, truly understand that which the patient experiences. If a tech does not want to go to work, he/she calls in sick. A patient on dialysis, even when feeling bad, MUST go to the unit. Does the technician know what it feels like to be tied to a machine for so many hours? Do technicians and nurses understand that one's life changes when they start dialysis. I am sorry, but as far as I am concerned, the educational training programs are greatly lacking ..

And, until staff understand, as well as physicians, that the patient has a right to ask questions and remind staff of any incorrect practices, things will not improve.

Retaliation is alive in units, although many do not want to admit such. I experienced it, my father experienced it to the point that he feared for his safety from one staff.

Oh, let me know forget the staff who told all, or most of the patients and their families about his personal life with his girlfriend and how he had to go to anger management classes Can you imagine that? When I told the unit manager, her comment to me was 'oh he is having a bad time now'. HELLO.. where does someone come to tell a patient such a thing

opinions of Roberta Mikles www.qualitysafepatientcare.com

[RichardMEL]

The only time I was not treated with respect was when the topic of my footy team came up. Given I barrack for a pack of losers it was quite understandable they laughed at me when I came in with my scarf on!! 

Seriously though I found my (generally) positive attitude was always VALUED by the staff and sometimes used as an example to others - or at least they would sometimes put newbies next to me so I could welcome them as a positive example of a good patient doing well on D.. and if I was down or not my usual happy go lucky self the staff would definitely notice and indicate that they were unhappy to see when I was unhappy and it was very obvious to them because I wasn't my usual self.

As for a nurse "lying" about something - while I wasn't there obviously and don't know the situation - it may as much be ignorance or misunderstanduing that contributed to the "lie" more than a direct desire to lie to you about something. I think you need to be careful when assuming people are lying about stuff. Of course maybe they are - as I said I wasn't there so don't know. Just trying to offer another explanation.

I think I was shown more respect when I showed an active interest in my treatment, labs, etc and rather than just sitting there like a rock actually got involved and asked questions. I knew I was being respected if I would ask for something to be adjusted or whatever and indicated why based on my understanding of things. Often it wouldn't be an issue becaue they could tell I understrood the issues and had a reasonable point. Sometimes they might disagree, but we'd discuss it and they'd explain why and not treat me like a fool or anything and I appreciated that.

Maybe though because I am under a public health care system as opposed to a private for-profit compoany like most D centers/chains in the US are where standards may be different - I don't know.

I definitely agree when you rely on others such as doctors, nurses and tech for your care, and something like dialysis which, here at least, is considered life support (as in nurses in D can't strike because it's considered a critical service)) then you do need to be treated with respect and for the staff to have your needs front of mind. I'd like to think every medical interaction Iv'e had or witnessed it has been that way but obviously not everyone has similar experiences sadly.

[dialysisadvocate]

Those of you who have had good/positive experiences with staff, regarding respect, are very lucky. There are many patients who are not treated wiht respect -- I have witnessed this in numerous units.

It starts from the heart and many believe 'it is just a job'.