“Blood dripped from the man’s lip and pebbles were stuck to his face after his fall.”

While he sat in his wheelchair I attempted to explain to his daughter that he could not be put on dialysis that day.

My patient, a 60-year-old double amputee, had fallen face first from his wheelchair on his way to the dialysis clinic. He needed to be taken to the hospital right away, and it was my duty as his nurse, to let his daughter know her dad needed emergency care. Instead, the supervisor of our clinic, who had no medical experience, insisted we needed to dialyze him.

Speaking up about what is right has always been important to me. I knew the risks of putting my patient on dialysis. Dialysis patients’ blood pressure typically drop during treatment, and he was at unusual risk because of his accident. I knew I had to take a stand against management’s decision and do the right thing. I refused to put him on the dialysis chair.

As a kid growing up in South Los Angeles, I saw many injustices going on in my community. To address them, I became a police officer and served for seven years. While on a visit to the L.A. County Hospital, I got into a conversation with a nurse about the sense of duty she felt caring for her patients. Her passion spoke to my values, which are to serve and protect my community, and inspired me to become a registered nurse.

I’ve now worked in the dialysis industry for more than 15 years and I continue to carry the same sense of duty for all my patients. But in recent years, doing what’s right for our patients has become an uphill battle: there are days we dialyze up to 12 patients at once and when I’ve tried to share my concerns about patient to staff ratios with management, I’m quickly reminded that caregivers don’t have a say when it comes to their bottom line.

The standoff on the dialysis floor that morning was all too similar to the previous times I tried to voice my concerns. But this time, I refused to allow the procedure. I couldn’t dialyze her father knowing his life was at risk.

The supervisor got another nurse to put him in the dialysis chair; they inserted the needle and attempted to run the machine. They tried several times, but his pressure was too low from the physical trauma and his blood wouldn’t circulate properly. Finally the supervisor realized he was not fit to be dialyzed and got him to the hospital.

At the hospital they found he had several broken bones in his face. I will never forget the glare from my patient’s daughter. She trusted our judgment and we didn’t deliver. That day, it seemed to me that management put profits before the safety of my patient, and I was powerless to stop it.

I got into this field to serve and protect my patients. I can’t just stand by and let managers with no medical experience make life-altering decisions, putting our patients and our careers at risk for the company’s bottom line. The only way we can protect our patients is by pushing for legislation ensuring all dialysis companies follow safe staffing practices.

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