Phlebotomist certification for Techs?

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As I’ve mentioned, we got our 2007 Colorado state bill renewed once again this year (also renewed in 2012).  We are very happy about it, but I was fairly recently reminded of something we couldn’t address years ago – techs coming in with no medical education.  I was reminded on a Marti Oakley internet radio show I was on and one of the hosts, Greg Coleman, mentioned the fact that as a dialysis patient he didn’t much like being practiced on by new techs!  I then recalled catching some flak years ago from Colorado’s Department of Regulatory Agencies (DORA) about our bill not addressing the number one complaint of patients: bad needle sticks 

As it was, we were lucky to get through what we did (only got through the one committee by one vote in 2007).  But over the years I’ve often wondered why techs couldn’t at least come in with something like Plebotomist certification: a semester at a community college.  Years ago staff was mostly nurses as Deborah Hayes testified recently (at minute 18:45).  She was someone who went on dialysis in ‘85 and has had a total of 11 ½ years on dialysis.  I recall staff used to be more like 4 nurses to 1 tech, now it seems that ratio has been reversed – more likely 4 techs to 1 nurse.  Money doesn’t seem to be a problem, looks like these companies figured out how to charge very well: 2007 fact sheet  (top of sheet).  I mentioned Phlebotomist certification on the last Marti Oakley show I did and it seemed well received (starting at minute 16).  And I should mention Arlene Mullin, who helped host the show has been talking about the need for phlebotomist training for forever!  I would have to credit her with being the originator of this idea.

We could try and start another state bill that would require Plebotomist certification here, but there aren’t too many of our original 2007 crew left.  And to further complicate it, Deborah Hayes has had a transplant for the last 15 years and my daughter hasn’t seen the inside of a dialysis clinic since 2000 – both things to be thankful for, but we might have a hard time starting anything like a state bill anymore.  So I thought I could float the idea out there and see if anybody else more current with dialysis might be interested in starting a bill in their state – we can at least offer a template with our history (see next post).

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    1. Before I start I’ll mention what led up to my wanting to get involved legislatively.  My then 18-year old daughter was in a fresenius clinic in Colorado back in 2000 for six months, and shall I say I was less than impressed with what I was finding out about things like reuse (which my daughter was on until I complained) and the clinic’s lack of use of crit lines.  I was shocked that techs came in with no medical background.  As Deborah Hayes - who I mentioned in the previous post testified: “Would you trust the brakes on your car to a mechanic who had picked up a wrench two weeks ago!”.  Not sure when I found out techs could be nationally certified – and weren’t required to be, but I do recall finding that also quite upsetting.  The topper was the mortality rate at the time: 30 year mortality history etc... Not only was I upset, but also freaking out!  I was quite vocal about what was upsetting me in the clinic (though I may have kept the mortality rate under my hat).  It came to a head when the charge nurse dragged me into her office after one of my questions and informed me there had been a meeting about me (huh?), they had decided to allow my daughter to stay in clinic and they would “learn to put up with me”.  I remember thinking they can do that?  And for what, asking questions!  I mention this because the threat of terminations and blackballing is still very real today and a person might consider how their clinic would react before undertaking this sort of endeavor.  If a person wants to know about blackballing and terminations I would suggest listening to the Marti Oakley shows with Arlene Mullin and Dialysis Advocates.

    2. Anyway, after my daughter got her transplant, that was about the time I could unzip my lip even more and started writing letters-to-the-editor and my state legislators about what was going on with kidney dialysis.  My current state rep at the time wasn’t answering my letters and I found I agreed a lot on other issues with his opponent - so I volunteered for my state rep’s opponent, a fellow by the name of John Kefalas. Anyway, I would go door to door with John looking for votes.  In between houses I would tell him what I was seeing in kidney dialysis. We both agreed this field of medicine needed at least techs who were certified or licensed - and from there a bill was born.

    3. Deborah Hayes, another dialysis patient by the name of Starla, and Lorene (a retiring fresenius dialysis nurse) came on board after Deborah saw one of my letters-to-the-editor.  We also had NANT involved (National Association of Nephrology Technicians - believe they are still around) - can’t remember who found them.  And I believe it was State Rep. John Kefalas who wound up getting the Colorado Hospital Association’s endorsement and found a patient who caught hepatitis from a dirty dialysis machine.  We also joined forces with a kidney patient support group based in Denver, George Bravdica the president, and Archie Jones from Black Transplants wound up also testifying for us (both dialysis patients).

    4. It was pretty clear sailing through a state house committee and the state house floor, but then we hit the state senate committee.  Davita shows up with a clinic manager, a pct, and patient. The davita people talk about how everything is sunshine and lollipops in davita land and they don’t need a stinking bill.  I’m sitting there thinking this is a load of crap, we get of committee but it is only by one vote! Felt like we came in loaded for bear and they had a pea shooter. But hey, a win is a win right!  After that my state senator made it a cake walk on the state senate floor, a fellow by the name of Bob Bacon.  And then Governor Ritter signed it.

    5. We then had a bill renewal in 2012 - a cake walk.  This year davita and fresenius came on board and backed the bill.  We got through the statehouse without a single nay vote.  If you want to hear audio from the hearings we testified at, here is a link: http://ihatedialysis.com/forum/index.php?topic=35038.msg529445#msg529445

Looking back on it all it feels like a miracle the way everything fell together for us.  Wondering if there  might be people out there ready for their own miracle.

[iolaire]

Thanks for the history and your efforts. It’s a good reminder that those of us who are lucky to be post transplant should be promoting dialysis changes.

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Being post-transplant is ideal!  A person doesn't have to consider what their clinic might think - though I like to think there are more good clinics out there nowadays that might actually be on-board with this sort of idea.  It was a long path for us from my daughter's transplant in 2000 to our group's success in 2007, but still amazed it came about.  I went in with the attitude I just wanted to see how far we could get, and now we can look back and see the results!

With all the bad press, lawsuits, etc... this field of medicine has received over the years I'm wondering if the powers-that-be have been softened up for further improvements.  So maybe other's path might be a bit shorter than what we had.

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It has been strongly suggested from a trusted source not to go for a semester of phlebotomist training - BUT TO GO FOR 9 MONTHS OF TRAINING!!!  From the background rumblings I've been hearing I would say 9 MONTHS is doable - very doable.