Unnecessary paperwork

[Tío Riñon]

This may be specific to PD patients, but if not, I'd like to hear from anyone who endures the same.  Every month my nurse goes over the "topic" of the month and then asks me to sign a sheet stating that we discussed it and I attest to understanding the expectations.  For example, this month was a "quiz" on the procedures involved in connecting and disconnecting from the cycler.  In the past, we have also covered emergency evacuations (very important for the 10-15 min. I'm there) and other inane topics.

Having done this modality for many years, I don't understand why we need to go over the exact same topics year after year.  I know what I'm doing--often more so than the medical staff!  I could understand this need if I had some issues, but my dialysis has gone perfectly for quite some time.  In fact, when this routine a few years ago, the nurse said that it was in response to some patients not doing some procedures correctly. 

I was OK with this initially, but the amount of paperwork that I keep getting asked to sign each month is getting ridiculous.  My New Years resolution is to stop completing frivolous paperwork.  It should be an interesting year.

Are you seeing a similar situation at your clinic?  How do you handle it?

Thanks for allowing me to rant a bit.

[obsidianom]

I am a physician and we still have to do it. Its the nature of the beast as they say. WE just do it and say nothing as there isnt anything to gain by creating a fuss over it. We pick our battles and argue when its worth it only. There is nothing to be gained on this issue worth arguing about.

[cattlekid]

I had the same issue with my home HD clinic.  I wasn't on home HD very long (less than 2 years) but the paperwork was repetitive.  The nurse would say "you know what to do about (insert topic of the month here)?" and I would say "yes", sign where she told me to sign and that was it.  It's mostly an issue at the state level anyhow because the state inspectors will write up a clinic if they don't have that paperwork completed.

Unfortunately, while I applaud your "less paperwork" goal, I think in the medical world, it's a losing battle. 

[Deanne]

I don't remember needing to sign something regularly, but I've noticed the topic of the month thing. They only spend a couple minutes quizzing me every month, so I just humor them. I think of it as choosing my battles. The small stuff isn't worth the effort it would take to object to it.

[jeannea]

This is only 5 minutes out of your life. Your clinic needs to do it so they don't get in trouble. It's an easy way to be cooperative and have them on your side.

[noahvale]

*

[Tío Riñon]

I don't mind doing the items that are required for state and federal regulations and understand the need.  However, I was told that this was something mandated by corporate and it appears to be another CYA procedure.  If so, that could be done annually instead of monthly.

As far as educating the patient, that can be a good idea.  Why not ask us what areas we are concerned about.  Besides, mix it up a bit.  I have "gone along with the inconvenience" for the past few years.  I've got the information and comprehend it.  Make this worth my time (and the clinic's too) if you're going to do this.  We all know that familiarity leads to the dismissal or ignoring of information.  Staff may actually have something to share some time and patients aren't going to listen/hear because they are the same topics, same order every time.

Regarding picking my battles, that is an interesting point now that I'm hearing from others.  In my world, this issue is the thorn in my side.  I am generally happy with my clinic.  Given that I only see them for short periods of time monthly due to my modality, there isn't much that can go wrong.  Reading other peoples' posts, they seem to have more interaction with the staff which can result in more conflicts or substantial issues.  For many of you this is insignificant given your perspectives and experiences, but based on mine, it is something that I want to tackle.  Maybe I'll cause a change; maybe I'll change my mind; perhaps nothing will come of it.  Who knows.  I'm going to give it a try.

Thanks for your comments. 

[okarol]

Jenna is on PD and yes, she gets education presented, not required to sign anything though. This time it was emergency preparedness and when asked what to do if an evacuation is required, Jenna said, "Clamp, cut and run" which is from her old in-center hemo days. The nurse actually laughed and told Jenna to never cut on the catheter side. She gave her a clamp to bring home. Then we started making up scenarios and quizzing the nurse, like what if it's a zombie attack. I know it can be really inane and I'll bet Jenna will get tired of it to after being on PD for awhile. But luckily her nurse has a good sense of humor so it's not so bad (for now.)

[Simon Dog]

CMS (Medicare) regulations require dialysis centers to provide monthly education for home and incenter patients.  The cliinics like the extra paperwork even less than you! As Jeannea said above, it's a minor inconvenience.

Perhaps they should just get decent internet in the centers and give patients for perusing ihatedialysis.com or renalbusiness.com.

[Simon Dog]

like what if it's a zombie attack

Die.  Dialysis clinics are weapons free zones.

[Joe]

Karol, I found that my PD team had a pretty good sense of humor for the entire time I was with them. And that helped me get through the time on PD a lot. Just keep your sense of humor up and you'll do just fine.

[jeannea]

During Hurricane Irene, we were under a tornado warning for most of the night. I skipped hooking up to the cycler. Later I told my nurse and said I didn't know what to do if I heard a tornado and I was hooked to a 35 pound machine. She said she would cut the tube and run. But no one had ever asked before and there was no official plan.