One Nurse’s Campaign to Optimize Safe Dialysis for Patients in the Midst of a For-porfit Corporate Takeover

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'Heroines & Heros' is a new blog category inspired by the movie, Escape Fire.  In this light, we will celebrate people who are challenging the status quo to make healthcare safer, kinder, cost-effective and more rewarding to work in. Bucking the system is extremely challenging for a lot of reasons,  yet people like Kathy Day are out there doing the work.  I invited her to share a little bit about herself and her recent fight for dialysis patients in Maine. 

Tell us a little about your background as a nurse and patient advocate.

“I have been an RN for 42 years, many of those years in Emergency Rooms and Walk In Clinics.   In 2000, I left bedside nursing to advocate and volunteer in a variety of capacities.  My father died in 2009 of hospital acquired MRSA pneumonia.  He had been admitted to the hospital for an ankle fracture for 12 days of rehab.  Two days after he was discharged he collapsed with MRSA and never walked again.  He died in an isolation room of a nursing home a few weeks later a very diminished, thin, frail, old man.  His infection was preventable like most healthcare harm.

John P. McCleary
(Kathy’s father)

I began my advocacy/ healthcare activism work by introducing MRSA prevention legislation in Maine that resulted in a law that required all high risk patients to be screened for MRSA on admission to Maine hospitals (2009).  My work and interest in patient safety has continued.  I am involved in the Consumer’s Union Safe Patient Project, Northeast Voices for Error Reduction, Maine Quality Counts consumer advisory council, Critical Access Hospital Safe Patient Project, and I am a retiree member of the Maine State Nurses Association.”

What inspired you to get involved with Eastern Maine Medical System‘s (EMMC)  sale of it’s dialysis clinics to Davita?

“A local newspaper reported 3 pending lawsuits against Davita.  I also heard from my Patient Safety colleagues that about Davita’s history of patient harm and dismissing patients without cause.  I began communicating with a 14 year veteran of dialysis patient advocacy who put me in touch with former Davita patients.  These intelligent and heroic patients were willing to share their stories of retaliation, dismissal, abuse, and harm that they incurred in Davita clinics in all parts of the country.  I am forever grateful to them for sharing their experiences with me and Maine citizens.

The concept of profit before patients holds huge potential for harm. Every dollar that goes to staockholders or high salaried CEOs takes from dialysis patient care.  I wondered, what is taken from patients to meet stockholder’s demands for more money? Cheaper products?  Less nursing staff? Shorter dialysis sessions?  How would Davita deal with  under or uninsured patients in Maine?  EMMC cannot turn away patients because of inability to pay, but Davita can.  I was concerned, am concerned about what will happen to dialysis patients in central Maine.”

What steps did you take?

“I made connections with pro active patient advocates, former Davita patients, The Maine Certificate of Needs office, Maine State Nurses Association,  and Maine People’s Alliance.  I contacted and made use of the media by writing letters to the editor.  I researched dialysis treatment, standards of care and complication as well as Davita and their history.  I testified at the Certificate of Need informational meeting and hearing.  I organized others who also had powerful testimonies to offer.  Our mission was to protect local dialysis patients and to help preserve local control over our dialysis clinics. ”

What do you think are the primary reasons that EMMC sold their clinics to Davita?

“Money, more specifically, $17,000,000 received from Davita for EMMC dialysis assets. ”

What worries you about the sale?

“We have lost control over our dialysis clinics.  I sincerely hope that Davita will improve the safety, quality, and accessibility of care that my Maine neighbors receive.  But, my greatest concern is that services will suffer and patients will not get the same attentive and quality services that they have received from EMMC.  Although most of the staff is the same, the management is completely different.  Davita recently settled a lawsuit regarding overuse and overcharging for an anemia drug.  Overuse of that drug can cause blood clots, strokes, heart attacks, etc.  Questions about how many patients were harmed and/or how much profit Davita made will never be answered, but we know that millions, if not billions of dollars were made on this drug alone.  It is my understanding that Davita management encouraged and promoted the use of the anemia drug at the levels that they were used.  Of course, they have paid a $55 million dollar settlement, and they admit no wrong doing.  We will never know the truth, but this seems to be the perfect example of profit over patients.”

What would you ask of Davita as they take over the clinics?

“Put patients first.  Empower them to be involved in their own care.  Encourage them to step forward with questions, concerns and suggestions.   Treat patients with respect, dignity, and honesty.  Provide a safe, clean environment and highly qualified caregivers with appropriate staffing levels.  Observe safe nurse to patient ratios.  Never cheapen their care or medical products to support profits.  Listen to this community and most importantly to patients and families.”

What advice do you have for dialysis patients?

“Patients should expect and know they deserve safe, high quality care.  They should try to be active participants in their care by asking questions, expressing concerns, and of course, offering suggestions for improvements to care.  Always ask for clean hands, environment, and supplies.  Patients are the experts of their own bodies and healthcare so use that expertise to help guide your own care.   If the system or staff does not respond to your concerns, don’t hesitate to take them to the next level, the End Stage Renal Disease Network, (ESRD).  I hope to be part of that entity.”

Thanks, Kathy for all of your hard work and commitment to patient safety as well as those who helped you in the process.   You can reach Kathy at: kathydayrn@aol.com

To understand and get involved, watch the movie, “Escape Fire” on Itunes or through  “Escape Fire” Website.  The trailer itself will sell you!

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