This is not just a "one clinic" problem.

[bioya]

These problems exist in many of the DaVita clinics. The "Catch the wave" and the issues of cutting staff and turn around time is nation wide. It is very unfortunate that this happened. However, maybe something good can come out of it and hopefully, DaVita will start training people correctly and giving the staff adequate time to to their job. I know in my home town DaVita clinic, even today with the mess going on in Texas and other states, DaVita is cutting staff and staff hours as I type this. At some point, people will have to stand up to the chain dialysis companies and say no more "cattle calls" as the news article calls it. I have said a million times, in all of my years as a manager for Gambro/DaVita, I never felt so badly as when I was told in 2006 to cut the staff hours to make more profit. These are, for the most part, hard working people that had been hired in at 40 hours a week. Then, after the DaVita buy out, my clinic (which made a profit every month, NEVER lost money) was told that we had to cut hours on the floor (production costs) so that we could up our profit. I am not going to pretend that I have a clue how FMC operates, I do not, but I do know about DaVita.
Something has to change at the national level. There needs to be more oversite and more requirements to protect the people on dialysis. As you read these three articles about this one clinic in Texas, keep in mind that this is NOT an isolated incident. Poor training is wide spread. PCT's and RN's are forced to the floor due to budget constraints. You have to get them "on their own" so that your training dollars don't get whacked in the butt.
Yes, I do have a issue with DaVita and their management (Senior management). I have been to their meetings and I have heard the "gospel according to KT". I have seen the tears turned on and off to gain sympathy. I have heard 3000 managers from DaVita sing "Oh when Cantor, comes marching in", in a effort to get a Virginia Rep to vote for more money for dialysis. I have been there, I have lived it for years. If DaVita (and possibly others, I don't know) would spend the time and effort that they do on their parties and their self serving meetings, on their patients and on proper training, many of these problems would disappear. Agian, this is a tragic event, but maybe some good will come out of it.  Enjoy the articles.

I wanted to come back and add something, I was in the shower after I typed this and I thought of something to try to make people understand what happened to Gambro after the DaVita buyout. When we were Gambo, we had meetings every year. However, those meetings were "scientific" in nature. We "learned" things that would benifit us when we got back to our clinics. Things like calcification of the heart, things like that. I will never forget this one guy came in and gave us a 2 hour lecture. It was amazing, the only problem was he was so smart, and his information that he presented was so scientific that we all sat there scratching out heads. But for the most part, the meetings were geared to learning. Now, fast forward to Davita. I went to two national meetings and one academy. Each meeting was the same. KT had some grand entrance in a costume and then he talked for hours on "where we came from". How we were losing money then "I" came around, then we made money, then someone said we should name the company for "he/she gives life". Then it was all about profit and how to make more. The meetings were not to help us learn how to take care of our patients, what would make the patients more healthy and live longer, it was all about profit, and getting people together to write letters to congress, etc, etc.  Even the breakout sessions were designed for profit. Things like "how to make catch the wave work'. How to cut staffing as patient census drops, etc, etc. I hope that makes sense. That is why hundreds of us said enough is enough and left. When your job becomes more profit oriented than it does patient oriented, then you have a huge problem, or at least many of us did. Again, I hope this all makes sense. This is why I have said in the past, and I say again, Davita, as it is now, is bad, very bad.  Hopefully, things will change in the future.



http://www.lufkindailynews.com/biz/content/news/davita.html

http://www.lufkindailynews.com/biz/content/region/ETtoday/stories/2008/05/08/dialysis_concerns.html

http://www.lufkindailynews.com/biz/content/news/stories/2008/05/06/dialysis.html

[E.T.]

I work with a patient care tech who also works shifts for Davita and he told me that after they bleach their machines they don't test them for residual bleach as we do at Fresenius. Needless to say I was horrified. I don't know if this is current Davita policy across the board but my coworker told me even though that particular Davita clinic does not supply the residual bleach test strips, he is personally putting the machines through extra rinses.
How much could it cost for a few little bottles of test strips as compared to someone's life? I am not joking, you can kill someone if there's bleach in the system, that's why we check and check again.

[bioya]

I work with a patient care tech who also works shifts for Davita and he told me that after they bleach their machines they don't test them for residual bleach as we do at Fresenius. Needless to say I was horrified. I don't know if this is current Davita policy across the board but my coworker told me even though that particular Davita clinic does not supply the residual bleach test strips, he is personally putting the machines through extra rinses.
How much could it cost for a few little bottles of test strips as compared to someone's life? I am not joking, you can kill someone if there's bleach in the system, that's why we check and check again.

I know DaVita has a lot of "policies" but the fact remains that many of them are for looks and paperwork (CYA) only. I don't know how many times our regional trainer said something to the effect, "don't worry about doing that, just document that you did".  Its a sad state of affarids, but thats the way it is. Again, I don't have a clue about FMC and how they operate and if they do cut corners, but I know Davita does. Any manger that says they don't, is lying to you.  I left, I am glad that I left, and I will do whatever I can to preach the problems of DaVita.

[Mongo]

Agian, this is a tragic event, but maybe some good will come out of it.  Enjoy the articles.

I don't care how you feel about DaVita one way or the other...but this is just sick! Posting articles about a tragic situation in Texas and then saying "enjoy the articles"! Tells you everything you need to know...   

Check out this article...

"5:51 P.M. UPDATE: Bond set for former DaVita nurse charged with allegedly injecting two patients with bleach"

http://www.lufkindailynews.com/hp/content/news/stories/2008/05/31/DaVita_update.html?imw=Y

Mongo

[flip]

This really scares me because Davita is trying to buy my center.

[Mongo]

I know DaVita has a lot of "policies" but the fact remains that many of them are for looks and paperwork (CYA) only.

What good are P&P if they're not followed?!?!? It only makes you look worse if you have "alot of policies"...as bioya admits there are...but you don't follow them! Bioya's ascertion that the P&P is window-dressing is pure lunacy!     Why waste the time, energy, and money to have P&P if you're going to ignore it?? If DaVita is all about the money, as bioya claims, then you'd have less P&P and not more...easier to sweep things under the rug. Instead, "a lot of policies" only creates a trail of breadcrumbs for state surveyors to follow and cite you on if they're not being followed. Does anyone else see the sense of this?? 

There are many former FAs who are no longer with the company for "cutting corners"...and I'm sure that there will be continued weeding as those unable to manage the responsibilities of being an FA are shown the door. Being an FA in DaVita is no easy job...those who aren't able to meet or live up to the high standards and expectations of the company are no longer with the company.

To paint DaVita with the broad brush that bioya is using is hyper-generalization to the nth degree.

Mongo

[bioya]

First let me say I am sorry if I have misspelled words here. I am on the laptop and I don't have my glasses with me so I am squinting... lol  I hope you can read this.

Please Mongo, don't make it look like I am happy that patients died in a clinic. You said, and I quote "but this is just sick! Posting articles about a tragic situation in Texas and then saying "enjoy the articles"! Tells you everything you need to know..." To insinuate that I was "happy" that this happened is wrong. Yes, I said "enjoy" the articles. Most people enjoy being informed, and not led around by the nose by a company as you are.

Hey Mongo. I wondered when you would come back. I hope you had a good time in DC. Yes, DaVita has a TON of P&P. We are told to follow them, but then told to make sure and document that you did it, even if you did not.  The regional trainers are very good at telling you what to do to cover yourself. They make sure their ton of P&P covers them as a corp. You know, the CYA thing. The P&P window dressing is required for their clinics to stay in operation. The same reason DaVita does not.. REPEAT DOES NOT WANT THEIR DIALYSIS TECHS TO BE REGULATED. If the techs were regulated as they are in my state, in every state, that would be more training that DaVita would have to document. Ok, there is a good question for you Mongo, can you tell us why the Company as a whole, has fought the regulation and licensure of Dialysis Techs?  Tell me why a company as great as DaVita would not want their techs licensed.... FMC has not problem with it, so why does DaVita?? Just curious.

I might suggest you read the articles from the patients that said how terrible they felt during and after dialysis at DaVtia and how good they feel at their new clinics.... Read about the lack of training and the rush to get patients on and off. For Gods sakes, Read the survey that was posted. Please, don't try to make this out as a one person thing. This was a horrible clinic managed by a horrible manger. READ THE SURVEY... Read the comments from patients. Oh, and there was one positive patient comment that I did read, I did not want to leave that out.  Tell me why the intentional use of the wrong bath by the unit did not result in terminations of the FA and other staff including the ROD? (according to the news I read, they were never removed from their job).

Mongo, you can keep saying that many FA's left because they could not meet the "high expectations" (I think those were your words), but you are wrong. I have told my story, and that is the same as hundreds of others that did not drink the kool-aid and did not put their principals of good patient care on the back burner to profit margins and cost cutting.

Nothing you say will change these facts. As somone from the Texas clinic (employee) that was involved in this horrible incident said in a press article, knowing their FA and leadership in that area, they would not put it past them to set someone else to take the blame off of the company (less lawsuits). I am not saying that is true, I would have no way of knowing, just like you do not know if someone did it until a trial, but knowing the way DaVita wants good press, I have to agree with the Texas employee, nothing is impossible with DaVita.

Again Mongo, its good to see you back. But please, stop trying to insinuate that I left because I could not handle the great Davita and that I cut corners (I did not), and that I could not as you say, manage the responsibilities and meet or live up to the high standards and expectations.  By saying that good managers who left due to mismanagment and cost cuts as well as staffing cuts, etc could not handle the responsibilites, you sir are the one painting with the broad brush. 

Would you please respond to the post by "ET" about not checking the bleached machines? It is P&P that they be checked for residual. How do you defend that clinic not following P&P? Is it possible that the texas clinics deaths were due to not checking for bleach as ET says his clinic does and not by the intentional placement of bleach in the lines (how would you do that and not be seen while pateints are on circ??). Gee, do we have a training issue and a issue with not following P&P at more clinics in DaVita land?  Come on Mongo, don't try to let on like lack of training, poor training, cut hours, cut staff, and "catch the wave" are not a factor in mistakes in multiple clinics.

Have a great weekend Mongo. I hope you and your family are doing well.  I am probably going to hate myself after I read this and see the mistakes in spelling. Sorry folks, no glasses with me

[nursewratchet]

Oh my God!!!!!  It is certainly P&P to check for bleach residual... The fact that some tech, at some clinic did not, or was told not to, speaks only to THAT clinic, and THAT manager.  As for Catch the Wave,  we don't do it, never did, I said no.  Again, FA with a loud mouth.  BTW,  when I was a charge nurse at FMC,  we were told, and it was done,  to keep the gauze count to 2 packs\pt.  Any more, and the tech had to go to the charge nurse to justify using more.  As I have said before,  Dialysis is Dialysis.  All falls on the Manager to do what is right. 

Also, remember the nurse Jenine Jones that killed a bunch of babies?  She worked for a hospital, neonates.  Are you then going to say that all Neonate  hospitals kill babies?   Really?