Do you sign (sight unseen) a dialysis treatment plan?

[iolaire]

So every so often the nurse comes and has me sign my dialysis treatment plan after some meeting where they go over my information.  It always bugs me because clearly they have come up with documentation, which they want me to sign to say I'm aware of it, but it’s the one thing that they do not offer to actually let me see.  So each time I'm in the awkward state of do I ask to read it first before I sign it or what?  I think once I looked at it, but overall its one negative experience I have.

Are you required to sign off on a treatment plan?  Do you read it first?

[OldKritter]

Davita is my provider.  They always send me a formal invitation to attend the meeting the doctor, nurses, dietitian, and social worker have to go over my progress and treatment.
After the meeting they request I sign the report, if I don't wish to attend I get a copy of the meeting to sign and return.

It's your right to be informed.  Read it before you sign it.  If you don't understand - question them.  They really do want you to know what's going on and  want to have you involved with the treatment. 

[iolaire]

Davita is my provider.  They always send me a formal invitation to attend the meeting the doctor, nurses, dietitian, and social worker have to go over my progress and treatment.

Interesting, I'm at DaVita as well and have never been invited.  Don't know if it matters but I'm very stable, compliant etc. so they probably don't have to talk very much about me.

Also I should say I'm fairly happy with my center, this is the one area that seems a bit off.

[LorinnPKD]

Yeah... I'm at DaVita and I requested a meeting and it was denied.

I was also asked to sign -- "I need to you sign this" -- by one of the nurses without anyone going over it with me. 

I was so unhappy that I complained and now I have a new nurse managing the process.

[Michael Murphy]

Yep but they bring me a copy.

[Xplantdad]

Fresenius tried that with us. A no go....they had to provide documentation for us to review. 

[cattlekid]

I was a home hemo patient with DaVita.  I was working full time and my center was on my way home.  I scheduled my monthly meetings with my nurse in the mid-afternoons and I would then go to the hospital and meet with my nephrologist (he did not round at my clinic).  I had a hard time getting my dietitian and my social worker to meet with me, even though I scheduled my monthly meetings at least three months out.  They claimed that they were always available to me via phone and they didn't have to meet with me face to face.  So I would dutifully sign my care plan every month without actually having a discussion with them.  They would discuss without me and the nurse would relay the information.

Well, one month I had it.  I flatly refused to sign until everyone involved (nurse, dietitian and social worker) met with me.  They were freaking out because "the state was coming in" and they needed all their paperwork ducks in a row.  So I got my meeting, even though it took the force of a potential ding at a state audit to do so. 

Wouldn't you know I received my transplant a month later.  I'm sure they were glad to get rid of me, the "problem" patient.

Yeah... I'm at DaVita and I requested a meeting and it was denied.

I was also asked to sign -- "I need to you sign this" -- by one of the nurses without anyone going over it with me. 

I was so unhappy that I complained and now I have a new nurse managing the process.

[Riki]

I have never signed anything other than a consent for treatment.  The team has monthly rounds where they talk about every patient.  For me, specifically, if there are any changes to be made to my treatment, I am told and I have to approve of it before anything is actually done.  I don't think that is done for everyone, but I've flipped on them too many times when something was changed without telling me or without explanation that I think the doctors are a little afraid of me

[Charlie B53]

My Fresenius clinic has asked me if I wanted to come to their meeting.  Thanks, but no Thanks.  It wasn't one of my treatment days.  I didn't feel like making the trip in.

They ALWAYS have a copy of their meeting drawn up for my review and signature.  I barely scan it and sign.

I have yet to miss a treatment or have one cut short.  I am very strict with my fluids.  Mondays I often come in only Point six over my dry weight.  It ain't so easy, but I try, hard.

[Tío Riñon]

As a DaVita patient, they contact me twice a year (if my memory serves me correctly) to sign the Plan of Care (POC).  You are supposed to be invited to a meeting where they (nephrologist, soc. wkr., dietitian, and nurse) discuss your treatment, what is going well, and any concerns.  However, since I'm a PD patient that only visits twice a month and they all work out of different facilities during the week, they simply type up their comments into the document on the computer system.  It is eventually passed around and everyone signs it.  I used to skim it and then sign despite having questions or concerns about their comments.

This year I took a different tact--especially since I'm active on the transplant list and the transplant committee reviews everything in your file.  I asked to take the POC and reviewed it at my leisure at home.  There were a few areas with which I took issue.  I noticed that there is a section on the document for patient comments.  I composed an addendum with my thoughts or anecdotes, copies of lab results from other clinics or hospitals, and references to relevant articles which I attached to the POC.  I signed it and made sure it was clear that I had included personal information.  It was quite interesting (and reassuring) to have my team at the next clinic discuss the points that I had made and provide explanations or offer changes.

It is your right to have a say over your treatment!  Give it a try and see what happens.

[smartcookie]

CMS dictates that a dialysis provider must to assessments at regular intervals.  From the assessments, a plan of care is formulated during a team meeting with the doctor, nurse, social worker and dietician.  You are supposed to get an invitation to the meeting; we have to have signatures documented in the chart to show that we are informing the patient of the meeting and how they would like the assessments and plan of care discussed with them.  Most choose not to go, but we have a handful of patients and family members who want to come and participate.  We discuss all of the patient's labs, any dietary issues, any psychosocial issues and any other issues the patient brings up.  I kind of enjoy these meetings and have learned a ton from them.  It is a good time to get individual attention from your doctor and ask any questions without having to make an appointment.   

[kitkatz]

The nurses howl in laughter at me because I read the entire thing end to end and if I do not like I say something and add to it as needed.  I was brought a treatment plan with the signature page open and told sign it.  I said "Not without reading it first."  They were very much taken aback the first time.  Now they bring it to me marked where my signature should go and let  me read it at my leisure.

Never ever ever sign anything to do with your care without reading it first!!!

[Charlie B53]

As a Disabled Veteran with a very warped sense of humor, every time I am asked to sign ANYTHING, well, other than the reciept at the restaurant, I ask if it is an Enlistment Contract, then I quickly scan most of it.