Again, I’m a little late to the party, (this aired in May) but have you seen this story?
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,
Anna emailed me last week:
I stumbled across your blog while looking up info on PD catheter surgery info.
I am a 47-year-old mom of a beautiful 2-year-old child in California. I inherited high blood pressure and kidney disease. All my siblings in our family have kidney failure. It kicked in around late 30’s and early 40’s. I was diagnosed the latest at 45 and think it advanced due to my pregnancy. We were hoping my numbers would go back to normal after the baby but no such luck. (more…)
As I hoped, here is the video of my speech to the Diaverum Annual Conference at Cascais, Portugal, last month. It was called: The View from the Chair, a Patient’s Perspective.
It covers a bit of ground, but the highlights (apart from the joke at the start!) are: (more…)
Now for something completely different, from googleMWgalaxy42.com, dated 29 June 2019.
I’m a Hemo Dialysis Ghost and I’m OK
A couple of weeks ago the bosses at the HDGhosts.com asked us to write a review of our job for their recruitment website (for money!). Here’s my review.
I’m getting ready for my fifth session as a HD Ghost. So far it’s been an OK job. Not exactly hard work, though it does take a day or two until you feel well again after each session. But the pay is pretty good, and since it’s the first real job I’ve ever had, and I’m 28, and my dad has never had a job, I’ll stick at it for a while yet. (more…)
Joe (not his real name) has just been through what we all dread: an infected fistula, with complications.
Most of his fistula is in his upper arm, and over the last couple of weeks it became sore, larger and more difficult and painful to needle. Joe started antibiotics, but unbeknown to him, it had also developed a clot that grew in size until the blood flow through it was minimal. So, though he was on the machine for the same time each session, less blood being cleaned meant he was actually getting less and less dialysis and becoming less and less well. Realising that it was not just because of the infection, he was referred to his kidney specialist for treatment. (more…)
Firstly, many thanks to our intrepid BigD-ers, especially Carl, Cath, Henning, Debra and Adam for their needling stories, advice and suggestions.
This Briefing is a How To for putting in your own hemodialysis needles. It covers five parts: Theory, Practice and Visualization, to help you understand the mechanics of needling, Know Your Fistula, so that you know and understand the lay of your particular territory; and eventually, charged with the skill and insight you need, it will be time for The Real Thing.
More power to your arm! (more…)
Christine from the University of New South Wales emailed me a couple of weeks ago with the following request:
My name is Christine Chau, and I’m a 4th year Industrial Design student studying at the University of New South Wales. I stumbled across your BigDandMe blog and I’ve been reading all your posts with great interest! (more…)
As any reader of the blog knows, I’m a big believer in holiday dialysis. So it is with much delight that I can report that there’s a new Holiday BigD player on the block (near you). The world’s first Big Red Kidney Bus is taking a complete dialysis service (three chairs) to BigD-ers in holiday spots around Victoria, where no dialysis has been before.
The Bus was launched Officially outside Victoria’s Parliament House a week ago (13 March), and it leaves on its maiden voyage this Saturday at Traralgon at 10:00 am from Traralgon Farmer’s Market (outside St Michael’s Primary School Hall) in Church St (incidentally, just across the road from where my Grandparents used to live and I used to holiday!). (more…)
Dulcie emailed me recently with this home HD question:
I’ve been reading your blog for about six months now and it has been a great support. My husband’s kidney failed last year after eighteen years and he has started dialysis again. He’s in the process of training up for home hemo and I wondered if you had any advice as to how many times a week he should dialyse for when he starts at home? In centre he has been doing Monday, Wednesday, Friday 3.5 hrs each.
My reply: (more…)
Last week was a big week for questions, and rather than answering them in the Comments area, it seems like a good idea to discuss some in a post.
First, Dan wrote:
Hi Greg, I’m 30 years old and I have PKD, I’ve had a transplant which unfortunately failed in January 2012. I spent a few months training to do haemo myself so I could do it at home (thinking that would make it much better) how wrong I was! I’m not sure if it’s my age and the need to stay active but dialysis is driving me mad! I get very fidgety and agitated especially when I’m on the machine and sometimes I get so angry when I’m on there I just want to smash the bloody thing up! (more…)