Summary

A patient's chair time at a dialysis center is unilaterally changed by a new administrator, Boss B, leading to a conflict with the patient's schedule, but is ultimately resolved when the patient's nephrologist intervenes.

Abstract

The narrative describes a situation at a dialysis center where a new administrator, referred to as Boss B, attempts to change the chair time for a patient named Ben without proper consultation. This change conflicts with the schedule of Ben and his caregiver, who is also his employer and has already made multiple adjustments to accommodate the dialysis schedule. Despite resistance and a refusal to sign a form acknowledging the change, the issue is escalated to the regional manager and eventually resolved when Ben's nephrologist, Dr. E, steps in, ensuring that Ben's chair time remains unchanged. Additionally, Dr. E suggests the possibility of reducing Ben's dialysis frequency to once a week if his condition continues to improve, offering a glimmer of hope for the patient.

Opinions

The author expresses frustration with Boss B's management style, particularly the lack of consultation before changing chair times.
There is a clear sense of dissatisfaction with the administrator's reluctance to apologize for previous mistakes and her failure to communicate effectively.
The caregiver/employer values their work schedule and is unwilling to make further compromises for the dialysis center's administrative changes.
Nurse N is seen as a mere messenger, caught between the administrator's decisions and the patients' needs.
Receptionist L is perceived as an ally to the patient, providing the administrator's contact information and suggesting further escalation to the regional manager.
The author is skeptical about the nephrologist's promise of reducing dialysis visits, considering it potentially false hope, but acknowledges its positive impact on Ben's morale.
The overall sentiment suggests that the medical professionals who refer patients to the center, such as nephrologists, hold significant influence over administrative decisions.

Boss B Does It Again — Almost

Our dialysis story — chapter 40

Photo by National Cancer Institute on Unsplash

There is a new administrator at the dialysis center; I call her Boss B. You can guess what the “B” stands for.

In early January, I wrote about a run-in I had with her:

I Don’t Care What’s on Your Clipboard

Our dialysis story — chapter 36

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That confrontation ended with Boss B reluctantly admitting I was correct about Ben’s chair time, although she didn’t apologize for accusing us of being late for an entire month.

Last Friday, Nurse N greeted me in the lobby while I waited for Ben to come out. She handed me a form that said his chair time was changing from 11:15 am to 10:00 am.

The administrator changed several chair times. As of Friday one week from today, Ben’s time will be 10 am. I need you to sign this form and here’s a copy for your records.

I read the form and said:

First, this says his current chair time is 11:15. It’s 11:30.

Nurse N sighed:

I didn’t prepare the form, and it really doesn’t matter since the time is changing anyway.

I replied:

It matters to me because we get accused of always arriving late. As for the new time, why weren’t we consulted? That time is not doable for us. I work on Fridays while he’s here, and I’ve already changed my schedule with that client twice to accommodate Ben’s dialysis. I can’t do it again.

Nurse N shrugged:

I’m only the messenger. I had nothing to do with the changes. Please sign my copy of the form.

I angrily shook my head:

I don’t agree with this, so I won’t sign.

Nurse N insisted:

By signing, you’re only acknowledging receipt of your copy and that I discussed the change with you.

I signed, and Nurse N left. I heard the pass-through lobby window open, and Receptionist L called me over. She handed me a business card.

This is the administrator’s card. Call her. She’s not in the office today, but her cell phone is on the card. I told her that a 10 am chair time wouldn’t work for you and Mr. Ben, but she ignored me.

I pocketed the card and left. At home, I called Boss B’s cell and left a message, explaining why a 10 am chair time wouldn’t work for us. I also took my copy of the chair time change form and wrote across it with a thick black Sharpie: WE DO NOT ACCEPT THIS CHAIR TIME CHANGE; IT DOESN’T WORK FOR US.

When I returned to the center four hours later, Receptionist L asked if I’d spoken to the administrator. I told her I had left a message but hadn’t received a call or a text from Boss B. I also gave her the form on which I’d written that we don’t accept the change. She made a copy and put it on Boss B’s desk and said:

I can give you our regional manager’s number if you want it.

I thanked her and said I’d wait to see if I hear from Boss B before next Friday when the new chair time goes into effect. I didn’t mention that I was prepared to call Ben’s nephrologist about moving him to a different dialysis center.

When Ben and I returned to the center yesterday, Receptionist L again asked if I’d heard from Boss B. When I said no, she replied:

Wait here. I’ll go get her.

I wanted 10 minutes — neither woman appeared, so I left. As Ben entered the treatment area, he said he’d talk to them about the chair time change. I was unsure who “them” might be and felt relatively certain that Boss B rarely went into the treatment area, and even if she did, Ben wouldn’t know who she was, and talking to the nurses would accomplish nothing.

When I picked up Ben four hours later, he was smiling broadly and said:

I took care of it! My chair time stays the same.

In the car, he explained that his nephrologist came to the treatment center in the early afternoon. Dr. E has several patients at the center but spreads his visits across three shifts. Ben last saw him in December.

I told him about the chair time change and how it conflicts with your work schedule. He said we shouldn’t worry about it; he’ll talk to the administrator and tell her that my chair time needs to remain the same. He also said I’m doing great and if I continue doing this good for the next six months, he may switch me to once-a-week dialysis!

Boss B may think she’s the boss, but the doctors who send their patients to the center are really the ones in charge.

Although I’m tickled pink that Ben may be able to decrease his dialysis visits to once a week, I also worry that the doctor gave him false hope.

Then, again, having any hope, even a false one, might be okay. Ben has little to look forward to at this stage of his life, so why not give him something to be excited about?