by Anna Bennett
So now the CMS Report from the Lufkin Unit is public. Many people smarter than I will be analyzing this for months to come, but I have one question: Where do we go from here? The fingers have been pointed. A rogue staff member, bad charting, poor staff training etc... all encapsulated in a 41 page report.
What about the numbers though? There are pages and pages of citations from the chats of patients # 1 - #24, I'm going to give you a snapshot of just one, patient # 7 (pages 19-20). On paper, this person is anonymous, but we know that patient # 7 is someone's daughter or mother or father or son. Patient # 7 had a BP of 277/138 was given clonidine and sent to the emergency room. But was then sent back to the unit later that day to have their dialysis needles REMOVED. I had to read that entry three times. The unit didn't pull the needles when patient # 7 was in their care?
Let's face it, charting is forensic, and that is all that we have to go on in this very public case. I know how it gets in today's dialysis units, charting can often be secondary or even tertiary to emergent care situations. The economy is bad, and it is only going to get worse. And the CKD-5 population is growing exponentially. Staffing is at a bare minimum. We are fighting a war in this health care climate, and these units are the trenches.
How do we avoid being a casualty in this war? If you are on dialysis or someone you care about is on dialysis, you have to be proactive. Know your meds, know your body, your blood pressure, your lab values, be your own advocate. Obviously the system is stretched beyond its limits and cannot advocate for you.
Dialysis isn't magic, there are basic principals here at work. The patient dialyzor needs to be at the center of their health care team. If the person on dialysis is unable to advocate for themselves, then hopefully a family member can engage enough to help them. The disaster(s) that happened at Lufkin should not happen anywhere.
Adding to all of this, RenalWeb has posted a press release on an article admitting that more frequent dialysis can indeed keep you healthier and extend your life from 2 - 24 months, but it is really expensive, so until someone can figure out a way to save money, people are just going to have to survive with the 3x a week therapy that is in place.
So, sorry patient #7, I know that your BP is out of control, you were sent to the ER with your needles still taped to your body, and you could be healthier and live longer, but we just can't afford that right now.
I want you to go home and look at someone you love, and imagine that they are patient #7. This isn't on paper anymore. This is hitting home. This year it was Lufkin and patients # 1 - # 24, who will it be next year?
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