It is a truly shocking report. it confirms our worst fears: US dialysis is in crisis. The most expensive dialysis service in the world has the highest dialysis mortality rates.
Two for-profit giant companies (DaVita and Fresenius) deliver 70% of the care, overwork and underpay staff while making enormous profits. From this report, it is clear that the industry is overwhelmed by bad incentives, poor oversight, and profiteering.
Any wonder why over 70% of the fistula rupture stories on this blog are from US readers.
The one small light at the end of the tunnel is the California Dialysis staffing bill.
But first, have a look at the report (Language warning!).
Medscape has a great article about\ the California bill, (it’s free, but you may need to log in), that has attracted a huge number of comments, all in favor.
For example, one nurse wrote:
…The problem arises when you take care out of patient care. By this, I mean that the monetary value of running a clinic outweighs the quality of care provided by the staff. You can not expect Staff to give the quality of care when they are overloaded with 4+ patients to care for and only have 15 minutes between each patient to rinse back, take VS, close up their access (be it a catheter or a access (graft or AV Fistula)) and put another patient on by doing their VS, quick assessment, cleanse their dialysis catheter/ graft/av fistula, start their treatment, document on the patient and give report to a charge nurse.
…I was tired of on-call and went to work in-center and my ratios in New Jersey were 3 patients per tech, nine patients/RN. I had to assess 9 patients and put on 3 every shift and when you have techs they may put the patient on the wrong bath, not do vital signs timely, with no time between shifts if you had a patient hypotensive, it was insane. A patient died on that unit, but not assigned to me that day because the techs did not do their vital signs and the nurse was busy doing something else. The B/P kept on dropping and no one assigned in that area ever told the nurse assigned there. You still have to do care plans, monthly notes, give blood, give meds, and get yelled at because you are not doing turn over fast enough.
How the No boosters keep a straight face is beyond me.
One interesting thing from the video: when these companies are sued, they settle.
Food for thought for anyone who has had a loved one die from a fistula rupture in one of their units,