Thursday, January 14, 1999
Nurses, patients voice opposition to privatization of dialysis
center
STATUS: Despite objections, administrators believe Total Renal
Care has upheld quality care standards
By Kiyoshi Tomono
Daily Bruin Contributor
For six months, Total Renal Care (TRC) – now the nation’s
largest provider of dialysis services – has managed UCLA’s Dialysis
Center, evoking mixed feelings from nurses and administration.
When the UC Board of Regent’s decided to privatize the dialysis
center in June 1997, they were met with petitions and charges from
the California Nurses Association (CNA) filled with concern that
the board might be placing critically ill dialysis patients at
risk.
"Patient safety has already begun to deteriorate as a result of
the loss of nurses experienced in acute hemodialysis," said Hedy
Dumpel, CNA’s chief director of nursing practice and patient
advocacy in a letter to the regents dated June 22, 1997.
But, according to administrators, none of these concerns have
been realized under TRC’s tenure.
"I haven’t seen any differences in patient care," said Annie
Corea, former administrator with the UCLA Dialysis Unit.
Following TRC’s purchase of the dialysis center, Corea decided
to accept a position as a regional manager with the company.
According to a few nurses and administrators, the transition has
been relatively uneventful, if not beneficial.
"I have been affected for the better, better staffing, and a
raise," said Don Waite, a chronic dialysis nurse. "A few kinks had
to be worked out in ordering supplies, but I haven’t seen any big
differences."
According to Lee Hart, assistant associate director of
professional and ambulatory services, "TRC is better able to handle
the complexity of our patient’s situations."
"There really haven’t been any big problems," Hart added.
Hart cited administrative and policy procedure changes as the
major hurdles faced by the unit.
"It has been a transition between the dialysis center using our
facilities and TRC’s facilities, our policies and TRC’s policies,"
Hart said.
In June, patients of the UCLA dialysis unit voiced their
concerns in a petition submitted to the board. Among these concerns
was how TRC’s policies could compromise and endanger their
health.
Miriam Blum, a former UCLA dialysis patient, warned the regents
of "TRC’s plans to implement changes that increase their profits,
but decrease our care." Included in these plans, Blum claimed, was
the reuse of dialysis filters.
Blum has since moved to Arizona where she is under the care of
another dialysis unit. But, she asserts, "It was clear to me that
patient care was no longer a primary concern (at UCLA)."
UCLA administrators claim they have always been concerned with
the quality of care and that they choose TRC based on a shared
mission.
To the alleged reuse of dialysis filters, Hart said "While the
corporation’s policy allows for their reuse, they have not
implemented that policy." Hart further indicated TRC has no plans
to act on such a policy in the near future.
As promised, TRC has offered all employees of the dialysis
center positions with the company at their current salaries.
"All staff members were offered jobs at the same salaries; some
chose to take it, some chose not to," said Corea.
Staffing difficulties arose when some dialysis nurses decided to
continue to work for UCLA – but not for the dialysis unit under the
management of TRC. While these nurses are currently being
reassigned to different departments, they are under contract to
train their replacements.
Among these nurses is Fran Gray, who has been a dialysis nurse
for 27 years. Gray indicated that like several other nurses, she
stood to loose retirement and other aggregated benefits if she left
the UC system.
"I have been here a long time and have major invested interest
in my retirement, all of the things that I have built," Gray
said.
In addition, she felt "devastated that UCLA sold a dialysis
program that worked so beautifully – it tore my heart out," she
said.
Gray indicated she and other nurses had worked over the past two
decades to assemble an optimal team for the care of all dialysis
patients.
"It was a beautiful place to work at and come to for dialysis
services," she said.
Gray understands the circumstances that led to the privatization
of the dialysis center, but she felt like a mother whose baby was
being taken away.
"I guess the economy is to blame," Gray said. "The real crime,
though, is that they took 27 years of experience and watered it
down by redirecting it."
In the meantime, administrators believe TRC will uphold the
mission of the dialysis unit that was established under the UCLA’s
control.
"TRC’s mission has been the same one employed by UCLA," said
Corea. "While we will continue to work with quality management I
feel that TRC really does believe in quality."
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