Personal responsibility

Where I work most of the patients use the same few lines:

“My insurance pays for these supplies, it is my right to take them home” – after they are caught taking an entire box of gauze, actually it doesn’t.  Medicare pays for a partial treatment, which 40 odd years ago you wouldn’t be getting if not for some innovative doctors.

Also, if you ask for supplies we will more in likely give you them, we aren’t complete trolls.

“I have the right to leave at any time, it’s my right,” yes, it is your right to leave anytime, however, it is our right to deny to put you back on dialysis after you walked your ass down the street, bought some food and walked back to the clinic with your needles still in your arm.  First of all, that is gross and I am just a tad curious as what other laymen people thought of the needles and tubing taped to your arm.  Second of all, we are responsible for you, we can’t say for sure that you don’t put anything into your needles, like heroin or cilantro, and if the needles were to say, fall out, while you were walking through the streets of Seattle and your blood was gushing everywhere, well, we are responsible for that too.  It puts us in quite the pickle.

“If I don’t get my cocktail, I am going to blow this place up” – your cocktail of lorazepam, phenergan and benadryl is not medicallynecessary to be on dialysis, believe it or not, in the five years I did dialysis in California, no one, and I mean no one was allowed to be given that cocktail IV during dialysis treatments.  Only benadryl if itching or other allergic reactions were noted.  So, count your little blessings my friend, for you are one of the few.  Also, threatening the people who put you on a dialysis machine, in my mind, is never really a good idea, I mean really. 

I believe it comes down to personal responsibility and a tad bit of honesty.  As a patient, whether of dialysis or just normal preventative care, we are responsible for ourselves. 

In dialysis there are those patients that try so very hard to do the very best they can to do what is right for themselves.  I am in incredible awe of what those people go through day in and day out.  It can’t be easy, it can’t be fun and I can’t imagine myself being that strong to do it.

Then there is the other group, the drug addicted, violent, needy group that takes away the care from the first group. 

It is the state of our healthcare system.

It doesn’t get me down, it makes me try harder for those who meet me halfway to battle the ghoul of dialysis.  As corny as it sounds, we are a team, the center of the team is the patient, they are our quarterback.


~ by Kim on October 28, 2008.

10 Responses to “Personal responsibility”

  1. Have you heard. . . .”I can eat anything I want, you are just going to take it off with the machine.” “I don’t like you, you don’t know what you are doing.” and “I pay your salary!!” ????

    or had them come in with clotted catheters because they were using them to shoot up? or had one come walking back into the unit, blood spraying everywhere, not making an attempt to stop it, and refusing to touch it? or been cussed out because the patient in the chair ahead of them had problems and you’re not ready for them when they think you should be?

  2. Never understood the whole “I’m bleeding” thing with patients, D’oh, hello, hold pressure. And yes we always have caths that are clogged, heroin doesn’t go well with dialysis central lines, sorry.

  3. I am a friend and reader of Tracy Kaply’s blog and found yours through her comment section. I too am a nursing student just trying to survive. I had an overnight clinical last night after a long day of school and could not sleep when I got home this morning, needless to say I was feeling a little grouchy. Then I read your blog and it got me smiling and laughing so hard it felt great. I tried to explain what was so funny to my husband, but, as I am sure you know nurse humor does not always translate to the general populaiton.
    Anhow, are you thinking about staying in Dialysis as a nurse? I like the population and am thinking about it myeself. I would love to here your thoughts.

  4. Wow.. I can’t believe patients actually do that.

  5. Sarah –

    I will probably do critical care for a few years then move back to dialysis…I love it but feel the need for critical care.

  6. Leaving with needles in your arm, EWW.

    A “cocktail of lorazepam, phenergan and benadryl”. Is that to knock them out? I would need that, or a sledgehammer. I hate needles, and blood. But I wouldn’t threaten to boom the place. Sheesh, crazy people.

  7. ah, bomb.

  8. Before I started school, I was working in a pain management clinic. We heard so many threats and other curses, it just became de rigeur.

    I miss my office, but I definitely do not miss the entitlement factor.

    It definitely makes you appreciate the team more and the patients who don’t feel the need to make asses of themselves.

  9. not a drug addict, drinker or anything vile…but i receive dialysis…i receive it because of things and stuff that have happened in my life

    and i dread it so very much.

    i dread it b/c it is an inconvenience. i have always felt that it was an intrusion on the person helping me…it is an inconvenience b/c i have a lil one and no one to take her while i have the treatments…it is an inconvenience b/c i am imposing and using medical resources that maybe someone else needs more

    it wipes me out, makes me ill, fills me with regret and helplessness…it hurts (not as badly as some of the procedures i’ve had over the last two years, but it does hurt). it is humiliating b/c the tech is guessing my reason for needing it before even knowing me…assessing me with a glance. with a disapproving glance.

    it is humilating in so many ways! and i’m sry…truly, truly sry for the many days i ruin your (or any other tech’s) day by getting ill…or being so unconfortable that i dont respond to inquiries and commands as rapidly as i should

    i’m sry

    you may think me a coward or maybe even less than a human being…but if there were some way to ease the experience for me…so i am not quite so useless to my baby girl afterwards…(i do try) if there were some how a way you could find an understanding and compassionate smile to give me hope…i would be grateful.

    i might be too sick to express it…but i would be grateful for kindness.

    i hate dialysis! hopefully you will never have any idea of what it is like.

    ps: (i always ask for extra gauze b/c i can rarely make it home…with baby in tow…without making a mess of things) i’m sry.

    truly…i am sry!

  10. Tiny and Lily

    There is nothing you need to be sorry for. Perhaps the patients I most talk about are the ones who abuse the system.

    Not the ones who, like you, who need the supplies, ask for them and try so very hard to be civil and nice even though you are in so much pain. I appreciate your words and I do apologize for only talk about “those” patients.

    I stated that when asked I willingly give supplies even though I am told by upper management not to. I even wrote a post about willingly making supply bags because I have seen what a broken open fistula can do to the inside of a car.

    If asked I will give an entire bag full of gauze and tape, but this post wasn’t about being asked, it was about how some patients treat staff (interestingly enough I also wrote a post about how some staff treat patients). So again, there is nothing really for you to apologize for, this was not a generalization it talked about a group who took away from the care of people like you. Like I mentioned in the post, towards the end.


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