Nurses, patients, and other health care workers outlined proposed legislation to regulate dialysis treatment during a briefing hosted by New America Media at SEIU-United Healthcare Workers West on May 4.
Dialysis is a life-saving treatment for people with end stage renal disease, according to health experts.
Senate Bill 349 (the “Dialysis Patient Safety Act”) aims to improve safety and care for all patients receiving treatment at outpatient clinics in three ways. It will mandate staffing to safe levels, increase inspection frequencies, and require companies to allow workers adequate time between patients to clean the dialysis machines, as well as allow patients sufficient rest time after treatments, according to a United Healthcare Workers (UHW) fact sheet, entitled “More Than Numbers”.
The requirements are long overdue, said several dialysis nurses and patients who briefed reporters.
According to statistics, Blacks are nearly four times as likely to need dialysis as Whites, and in California, almost 10,000 Blacks receive dialysis in the state’s 562 clinics.
In addition, in 2014, an average of 13 dialysis patients died per clinic, and one in eight of those were due to infections, the fact sheet further indicated.
Several dialysis nurses and staff said they have worked extended hours with imbalanced nurse to patient ratios.
According to Cass Gualvez, organizing director, SEIU-UHW, dialysis workers from the multinational corporation Fresenius Medical Care North America approached them about a year ago. They were concerned about their working conditions, and interested in forming their union with UHW, she said.
Workers talked about being rushed, working six days a week for 12 hours, and people being timed if they took too long to get the next patient into a chair, Gualvez stated. She added, “I was floored when I was told that people were encouraged to get the next patient in the chair within 15 minutes.”
Megallan Handford is a retired police officer, and has been a caregiver and dialysis nurse for 15 years. He stated that day in and out, he and colleagues are rushed to work within policies and procedures that are set up for them to fail.
“When you look at all of this, let’s be clear about this. It’s all about profit. It’s all about money,” charged Handford.
“When you see patients dying for reasons that they should not be dying for, as an individual, you have to stand up for what’s right,” he said.
According to Hanford, most doctors spend about an hour or two, doing rounds in clinics, and then they leave. They do not see when a patient is crashing, is coded, or the trauma they experience, he continued.
If a patient dies in a chair, Handford said workers place them in a back room until an ambulance or coroner picks them up, but they then have to go back to work with other patients, who just witnessed it all.
“As a police officer, if I got into a shooting, I at least was given the courtesy of having to be off of work for 3-4 days after a traumatic incident like that, but we’re expected, as caregivers, to go back into that environment at that same time, and put on a face, and do our work,” Handford said.
Much of the workers’ ire targeted DaVita, Inc. and Fresenius, the two leading kidney care and dialysis treatment centers in the United States, according to Gualvez. The healthcare workers stated DaVita’s conditions are the most horrendous.
According to Sherry Yatts, who has also been a dialysis nurse for 15 years, she and a co-worker were fired from DaVita, because the company failed to take responsibility for equipment failure.
“I kept telling them that there is a problem with the system, which they failed to look at, so a patient got sick. I was like, you guys need to check this out! Every time I put a patient on this, they get sick at this port,” Yatts said.
“They failed to investigate, so instead of it falling on them, it fell on me and the bio med guy, so we had to be terminated,” she continued.
DaVita had not replied to the Sentinel’s requests for interviews at press time.
“Fresenius Medical Care opposes SB 349,” stated Jon Stone of Fresenius’ Public Relations and Corporate Communications office.
Stone did not address the healthcare workers’ claims about poor working and treatment conditions, and practices, but stated that the company is part of California Coalition, a group of patient advocacy groups, providers, and others opposed to the bill.
A California Coalition press release dated April 19 countered the bill proposes rigid dialysis clinic staffing mandates, which put politics before patients. It would jeopardize access to dialysis care for thousands of patients, the document went on.
The coalition, which also includes nurses, physicians and clinics specializing in dialysis care, are against, among other things, a specified 45-minute transition time between patient shifts.
“… SB 349 would harm patients by reducing access to care while increasing costs to the Medi-Cal program and the overall health system in California,” the release read.
Dr. Randall Maxey, past president of the National Medical Association, said he feels SB 349, in a sense, its misdirected. The target should be the federal government through the U.S. Congress, and Medicare, to affect dialysis companies, he told reporters during the May 4 briefing.
He said one of his fears in passing legislation that means more regulations is that it won’t hurt the big companies at all. “They’ll just pay the fine. It’ll hurt small people – companies like me, doctors like me – trying to do the right thing, and making it simply harder. So, it’s not thought out,” Maxey argued.
Maxey said the issue is very important to him, because Blacks are less than 15 percent of the U.S. population, but make up more than 40 percent of the dialysis population.
“So all of these millions and billions of dollars that are being made are being made on the backs of people who look like me,” he stated.
According to Maxey, his father was and his brother is a dialysis patient. He has worked for both DaVita and Fresenius. Now, he owns 18 dialysis centers in Puerto Rico.
Latinos and Blacks don’t get care in time, which results in catheters, he said. That increases chances of infections, which increases probabilities of death, he said. By the time many people got to dialysis centers, they only had about three-to-four months to live because they couldn’t get care ahead of time, he explained.
“If you’re going to solve a problem, it’s not just that we need more staff. We need a better system,” Maxey said. What doesn’t work is looking at the problem as a silo, he said.
Maxey said a key solution is to develop a relationship between the workers and nurses, and care technicians and doctors. He said frankly, he doesn’t trust the motivation of the unions to do that.
“We know what’s happening with the patient. I would say that the motivation of most of the health care workers are pure, but they’re being used,” he said.
