songbird0620
(?)Community Member
Offline
- Posted: Sat, 31 Aug 2013 04:35:09 +0000
This may be a strange place to post this letter, but I just have to get this off my chest, and I have to do it anonymously, and I can't come up with a better way to do it.
I have worked as a dialysis technician for the past 12 years. It is not something I aspired to do. I did not go into healthcare because I wanted to help people; rather it was an opportunity that I took advantage of. I am writing this anonymously because I don’t want to jeopardize my job, but if I could financially afford to get out of the business, I would.
Over the years, I have come to realize that there are many things about the business of dialysis that I don’t agree with. I will rant about just one of these things here.
I believe that dialysis should be offered only to those patients whose kidneys are expected to recover or to those who are eligible for a transplant. Not that they necessarily have to be on the transplant list, but that the same criteria that disqualifies a person from receiving a transplant (i.e. age, heart condition, drug addiction, cancer) should also disqualify him or her from receiving dialysis. If you think this is too harsh, consider these examples which I have seen in my work:
The man with Alzheimer’s who has no idea why he has to come and be hooked up to this machine for 4 hours at a time, 3 days a week. He is frightened, becomes combative and a danger to himself and to dialysis staff.
The woman who is immobile and constantly in pain. She rings her call bell every few minutes, begging for dialysis staff to make her more comfortable, but there’s nothing we can do.
The man who bounces between the jail, the hospital, and the streets. He sometimes comes intoxicated to the dialysis center. Whenever he’s incarcerated, a sheriff’s deputy has to transport him to and from the jail, and sit with him during his treatments.
The non-compliant patient who doesn’t show up for her treatments for a week, then comes in at a non-scheduled time, short of breath from fluid and toxin overload. The staff squeezes her into the schedule, giving her the best possible treatment, and she has the gall to complain about the care she received.
We can’t cure these people; all we can do is prolong their death, and at the taxpayers’ expense.
Medicare covers 95% of all dialysis patients, thanks to a 1972 decision by congress that allows all people with end stage renal disease who are entitled to Social Security benefits access to Medicare, regardless of age. Medicare spent $9.2 billion on dialysis in 2009 alone. It also spends billions of dollars for the hospitalization of dialysis patients, who are hospitalized six times more than other Medicare patients. And on top of the Medicare, about half of all dialysis patients also are on Medicaid, which covers the 20% of costs that Medicare doesn’t, for over another billion dollars of the taxpayers’ money.
Consider also that of the 100,000 or so new cases of kidney failure each year, most could have been avoided, if only people would take better care of themselves. 44% are caused by uncontrolled diabetes, another 25% are caused by high blood pressure, and a portion are caused by drug or alcohol abuse.
I suggest that there be three stages of dialysis eligibility: 1) the patient has no known disqualifying factors and is offered dialysis for an indefinite period of time, 2) the patient has one or more disqualifying factors that might be reversed, (i.e. obesity, cancer, drug addiction); he/she is allowed to dialyze for a determined amount of time (1-2 years) while undergoing treatment to try to become healthy enough for a transplant, and 3) the patient is not eligible due to factors such as old age, terminal cancer, dementia, heart condition; the patient is denied dialysis and allowed a natural death.
I have worked with many patients who were absolutely miserable, but struggled with the decision to stop dialysis, or were too incapacitated to make their own decision, and it was the families who didn’t want to let go. My proposal would take this very difficult decision right out of their hands, and make things easier for everyone.
It has been said to me: “you would feel differently if it was (your family member)”, but no, I wouldn’t. I have seen too much suffering to want to put any of my loved ones through that.
I welcome your comments.
scream
I have worked as a dialysis technician for the past 12 years. It is not something I aspired to do. I did not go into healthcare because I wanted to help people; rather it was an opportunity that I took advantage of. I am writing this anonymously because I don’t want to jeopardize my job, but if I could financially afford to get out of the business, I would.
Over the years, I have come to realize that there are many things about the business of dialysis that I don’t agree with. I will rant about just one of these things here.
I believe that dialysis should be offered only to those patients whose kidneys are expected to recover or to those who are eligible for a transplant. Not that they necessarily have to be on the transplant list, but that the same criteria that disqualifies a person from receiving a transplant (i.e. age, heart condition, drug addiction, cancer) should also disqualify him or her from receiving dialysis. If you think this is too harsh, consider these examples which I have seen in my work:
The man with Alzheimer’s who has no idea why he has to come and be hooked up to this machine for 4 hours at a time, 3 days a week. He is frightened, becomes combative and a danger to himself and to dialysis staff.
The woman who is immobile and constantly in pain. She rings her call bell every few minutes, begging for dialysis staff to make her more comfortable, but there’s nothing we can do.
The man who bounces between the jail, the hospital, and the streets. He sometimes comes intoxicated to the dialysis center. Whenever he’s incarcerated, a sheriff’s deputy has to transport him to and from the jail, and sit with him during his treatments.
The non-compliant patient who doesn’t show up for her treatments for a week, then comes in at a non-scheduled time, short of breath from fluid and toxin overload. The staff squeezes her into the schedule, giving her the best possible treatment, and she has the gall to complain about the care she received.
We can’t cure these people; all we can do is prolong their death, and at the taxpayers’ expense.
Medicare covers 95% of all dialysis patients, thanks to a 1972 decision by congress that allows all people with end stage renal disease who are entitled to Social Security benefits access to Medicare, regardless of age. Medicare spent $9.2 billion on dialysis in 2009 alone. It also spends billions of dollars for the hospitalization of dialysis patients, who are hospitalized six times more than other Medicare patients. And on top of the Medicare, about half of all dialysis patients also are on Medicaid, which covers the 20% of costs that Medicare doesn’t, for over another billion dollars of the taxpayers’ money.
Consider also that of the 100,000 or so new cases of kidney failure each year, most could have been avoided, if only people would take better care of themselves. 44% are caused by uncontrolled diabetes, another 25% are caused by high blood pressure, and a portion are caused by drug or alcohol abuse.
I suggest that there be three stages of dialysis eligibility: 1) the patient has no known disqualifying factors and is offered dialysis for an indefinite period of time, 2) the patient has one or more disqualifying factors that might be reversed, (i.e. obesity, cancer, drug addiction); he/she is allowed to dialyze for a determined amount of time (1-2 years) while undergoing treatment to try to become healthy enough for a transplant, and 3) the patient is not eligible due to factors such as old age, terminal cancer, dementia, heart condition; the patient is denied dialysis and allowed a natural death.
I have worked with many patients who were absolutely miserable, but struggled with the decision to stop dialysis, or were too incapacitated to make their own decision, and it was the families who didn’t want to let go. My proposal would take this very difficult decision right out of their hands, and make things easier for everyone.
It has been said to me: “you would feel differently if it was (your family member)”, but no, I wouldn’t. I have seen too much suffering to want to put any of my loved ones through that.
I welcome your comments.
scream