Is this true? If so how can something like this happen in this day and age? Could any of you imagine the uproar if the president-elect of the AMA or the New England Journal of Medicine worked for a device company? What is going on with many of you IV therapy RN's? As I have written in a prior post: I was shocked when my surgical group took over the PICC program to see how many of our IV RN's were on the payroll of this vendor and were making decisions in behalf of this vendor as opposed to the hospital let alone the patient. It is unbelievable in this day and age that conflicts of interest like this take place. In my hospital we can no longer accept a dinner or golf outing from a vendor. But in IV therapy it is common place for many RN's to work for device or drug companies. I think many of you are way out of control and it is relationships like this that will force strong government intervention in the medical profession. Apparently, some of us health-care professionals are not capable of conducting ourselves in an ethical manner. If it is true that the president-elect of AVA also works for the leading PICC catheter manufacturer there is at the very least an appearance of conflict of interests. Everything in this organization maybe perfectly by the book, but I would look at the articles in AVA and wonder if they were truly independent because of this egregious conflict. Mark my word: If we don't clean up the medical profession somebody will do it for us.
NStenhouseRN
I used to work in a hospital and our IV department was based in the pharmacy.
It was totally "amazing" how much food and other amenities were brought in on a regular basis from drug companies.
As innocent as it may be on the surface, the fact is, its hard to turn down doing business and "paying back" someone that has already given so much.
Its so easy to scratch your back if you scratch mine first!!!
Repeatedly, I saw products brought in that were confusing as to why they were better than the existing and is some cases, were worse being less useful and we could not change because we were under "contract".
I've always hated politics.... not because its politics, but because it almost 'always" is vulnerable to corruption.
Because of that, entities with strong political influence, simply cannot be trusted as true.
I know this will offend the guilty parties and the innocent will merely confirm.
Bringing this home.... when we ask a question out here as to which product is best for the patient, its nice to know the answer we are getting is based on experience and knowledge in field events rather than the truth of who can wine and dine the best.
I could talk all day about this subject but it makes me sick.
I see nothing wrong with a companys taking care of their client if the product is truly superior and the best.... thats a wonderful relationship.......
But its rarely the case when the next new product comes along thats superior, that that relationship will not skew buying decisions that affect all who are serviced thereby.
Some do what they do because they love it, but they need a salary also to get by or they will starve, so they will not do it for free.
Others do it because they love it and support themselves through other means to support their "ministry".
Then others do what they do merely for what it gives them and they have no heart to give.... so the end always justifies the means..... this is where untruths, and politics take the reins.
I have no idea who works for who out there, who's in bed with who, and what morals any abide by......., but if this forum and PICC nursing is to be trusted by the community.... it does need to be trustworthy.
I have witnessed a "rape and pillage" mentality that says "lets take as much as we can as fast as we can at the expense of the public until the gig is up.
Yes, there is always a dark side.
______________________________
Always remember that you're unique. Just like everyone else.
The second mouse gets the cheese!
As someone who is an independend contractor for a Picc Vendor as well I have experienced similar in my own work environment.
But if we are honest, a lot of us have some ties to vendors and I believe in our specialty it is hardly avoidable. In my job I constantly have to evaluate products, does my relationship with an employer means I can't do that ? But I am the specialist, so who else is going to evaluate this? I see this often enough: Radiologists determine what US machine is bought without the imput of the people which are going to use it. Is this in the best interest of patients? So where I work I can give my input, but I am not the one which is making the final decisions.
This is how I see it with AVA. I see AVA as an organisation which is to promote better patient care by advancing Vascular Access. I don't believe that AVA's job is to promote products, so I am not sure how the position is in conflict with the employment for a vendor.
Beside that, I am sure there are Bylaws in place as well as a describtion of what responsibilities this role includes.
I am just saying we have to look carefully at this before blasting around......One of the reasons AVA is well respected amongs clinicians is because it is run by people which live and breathe vascular access. I rather have someone in charge who knows the ins and outs than someone which is politically correct and has no clue......we have enough of these people running our hospitals.
If we eleminate the people who have ties to vendors, we probably eliminate at least one third of our elite practicioners to be involved where vascular access is going to go.
Michael Drafz RN, CRNI, VA-BC
Clinical Lead Vascular Access Service
Sharp Metropolitan Medical Campus
San Diego, CA
But if we are honest, a lot of us have some ties to vendors and I believe in our specialty it is hardly avoidable. In my job I constantly have to evaluate products, does my relationship with an employer means I can't do that ? But I am the specialist, so who else is going to evaluate this? I see this often enough: Radiologists determine what US machine is bought without the imput of the people which are going to use it. Is this in the best interest of patients? So where I work I can give my input, but I am not the one which is making the final decisions.
I rather have someone in charge who knows the ins and outs than someone which is politically correct and has no clue......we have enough of these people running our hospitals.
If we eleminate the people who have ties to vendors, we probably eliminate at least one third of our elite practicioners to be involved where vascular access is going to go.
[/quote]
You had some good points.... I too hate when the people calling the shots have no real insight as the the struggles and or benifits that could be had because they are not on the front lines and either have never been or it was very long ago.
Often they carry tons of degrees, none of which are medical....and if they are medical, the don't relate to the field at hand.
Indeed, the people in the field know best what works and what doesn't....
Most hospitals and doctors trust we are the professional and know what we are talking about.
The example you gave about the radiologist is a perfect one.... because remember, he is the one using it.
Its true, we don't want to stir up mud thats unfounded, but at the same time, we must police our field or others without our heart will.
I can't speak for the author of this thread, but I think we all share the desire to share in the decisions that govern us and our patients rather than entities that have no interest for either party, but rather are only out for themselves.
If there are any strong ties between members that have executive decision making powers in our systems and the vendors, I see no reason to have those issues in the open and let the cards fall as they may.... accountability is always a good thing.
How many places have you worked at and your hands were tied to empower improvements because the people who make all the decisions just could not see what you saw... nor would they even give you a platform to present the issues?
Those are the people you never see, because they are untouchables behind closed doors.
Instead they "react" and only when a wildfire is at hand and only then are they willing to consider options to put out the fire? When you bail them out...they of course take the credit and put you back in your box with a nice pat on the back... "confidential" of course.
Wonder why I hate politics, greed and power?
How fast does a facility like that grow?
Or a country for that matter?
How about a medical specialty?
______________________________
Always remember that you're unique. Just like everyone else.
The second mouse gets the cheese!
Dear "Spqr":
Please note Chris's comments. There are no contracts being handed to manufacturers in AVA. This is a multi-disciplinary organization, in which vendors have equal status with clinicians, therefore employees of device manufacturers have the right to run for office, as well as physicians, pharmacists and nurses. You misunderstand the structure of the organization if you believe that only people with no tie to industry should be on the Board of Directors. You also misunderstand the role of the Board. That role is strategic, not operational. Operations are run by the CEO, who cannot have financial ties to a vendor. The Board also does not run the journal, JAVA. There is a separate group, also without vendor ties, editing and publishing our journal. The professional roles of the members of the Board of Directors have no bearing on any purchasing decisions. Yes, we do have a conflict of interest form we sign. No, the Board makes no purchases that would benefit any of our sponsors or Board members. You are confusing AVA with a hospital that would have reason to purchase catheters and such.
If you have concerns about a hospital employee being "bribed" into influencing purchases inappropriately, call their Corporate Compliance hotline. That is a legitimate concern.
Leigh Ann Bowe-Geddes
Although this is stirring the pot further, no one can deny that there can be some degree of conflict of interest going on here, be it at the local level or the national level.
I firmly believe that there needs to be some standards or guidelines set when it comes to working for manufacturers (as a side job) and working for organizations or hospitals EVEN FOR NURSES. There is always that degree of bias when it comes to product selection if that person is working for a certain company.
A wise man once said, with great power, comes great responsibility. I am not saying that this is happening all the time. I know an educator who works for a platinum member company of AVA, and openly discloses that everywhere she goes, but ALWAYS gives an objective opinion. Can everyone here honestly say that?
When you are sitting at that product selection committee, everyone looks at you as the "EXPERT" and that carries much weight when it comes to your opinion or preference. It may or may not be the superior product(matter of opinion), but nobody really knows that but you. Especially for state and government institutions at the minimum, there should be some regulations or standards in place.
He is right, if we don't do it, somebody will do it for us. It all boils down to ETHICS. A lot of you say, "I don't see anything wrong with that", but the truth is, THERE IS SOMETHING WRONG WITH THAT SYSTEM!!!
Wow, it sounds for me someone likes to play with dirt.
Fact is, there is a difference between CNS and CNT!! Most of the Picc nurses with passion for there job care about there patients and the development of the vascular access. We are in facilities and teach and share experience. So, where is our education coming from? We get trained because we like to learn more! We like to do a difference, for patient and Nurses!
If you point your finger to the president elect please be fair and open. It would be a start with WHO YOU ARE!
Andre
I am not personally pointing my finger at the president elect of AVA, I am just chiming in and I am referring to the whole system of CNT/CNS environment in general.
Whether you are a CNT or a CNS, fact is.. you are getting monetary compensation from the company. Now how would that look to you when you are the CNT for a company and you can't even bring that product into your own facility right? I totally understand.
I share everyone's passion for IV therapy and vascular access here, and I understand the need to spread the word out regarding our cause. I have nothing against learning. All I am saying is (and I believe the original poster) that there should be checks and balances and ethics or standards applied to what we do as care providers. The government has not looked into this yet because it is "small potatoes" for now, but if they do this for doctors, they will soon do this to us.
When YOU sit at that product selection committee table, and say "X COMPANY should be the one we are using instead of Y COMPANY" are you preceding that with "I am a CNT for this X company."? If the rest of the people knew that, they probably would not want you in that table any longer.
Seems to me that a lot of people here became defensive all of a sudden when this came up and trying to sweep this under the rug, and if it is not talked about, it is not happening. Well, all the original poster was trying to do (I believe) was raise awareness of a potential problem. Now we know this is happening within our community, do you want this to go outside the nursing community and be blown up by the press maybe becoming a national SCANDAL talking about nurses. How is that going to affect our cause of spreading our passion?
To the insider it looks all kosher because it has become aceptable, but to the general public as the outsider looking in, it stinks to high heaven.
We all try to enforce INS and AVA standards, why not enforce some ethical standards?
Andre, If you are referring to my comment about Denise's comments about Rymed, I believe in FULL Disclosure in any comment one makes when supporting a product from which you are being compensated as a professional and enjoy a position in a related professional organization. It is only fair. Whenever a professional speaks at any medical conference, that professional must disclose his affilliations. What makes this forum any different?
Judy Hopkins-Hyde, RN
Pownal, Maine
Kathy Kokotis
Bard Access Systems
By the way how do you think doctors are trained
workshops sponsored by vendors with industry paid physcians who work for hospitals and serve on organizational boards
I know quite a few of them
It is training
Kathy Kokotis
Bard Access Systems
Judy is correct. The issue is not that the pres. elect of AVA or any other top AVA professionals ever received some form of compensation from any vendors, for work they completed. There is no question that all of the professionals on the board or in committees would recuse themselves in any situation involving that vendor if a vote or decision was required. Recently three US supreme court justices recused themselves from decisions involving certain companies because those justices owned public or private stock in those corporations. it happens all the time.
Experts in every segment of medicine have relationships that are very similar to those at AVA. The standard ethics requirement is that when someone in a position to comment or provide information in a professional capacity, comments or presents information that could affect that vendor or their products, to other professionals within the profession, the respondent must disclose that they have a financial relationship with that vendor when they present the information. If some resondents on the site don't disclose their affiliations, then there may be a conflict of interest when they comment.
How many of you decision makers in an IV team, vascular access team or PICC team were approched by venders especially from Bard Rep. to work for them as a consultant? Were they just looking for your experience? I belive it is a business tactic that some venders are using. If I you are a consultant for any vender, you prefer to use their product only.
One of my coworkers, is very very friendly with the Bard group, and she will not even try any other products. There are other venders with the same product like "purple power PICC" and the employer can save tons of money. But, SHE DOES NOT LIKE IT. SHE IS COMMITTED TO BARD MORE THAN HER EMPLOYER. I WONDER WHY? I know that Bard rep. offered her and her friend as a consultant job. I do not think they are working for Bard.
May be IT is time to look at the big picture of venders business practice. How many are working for Bard on a PDM basis or are friend of Bard sales rep. Do they use Bard PICC only? How many are decision makers?
To answer your question. if you are referring to the CEO of AVA, she did at one time work for a vascular access company but resigned that position prior to taking on the role of CEO. As for being the President and working for a company, I believe it would fall to the integrity of the person, to separate herself/himself from that employment loyalty when functioning as the President of the Association. Some of the most qualified individuals in our field either work for a company or have their own company. I would not like to see a blanket ban of all this knowledge and experience based on this one fact. I again state, it would fall to the integrity of the individual.
Kim Mills
Nurse Manager
IV Therapy Services
Cumberland, Md
I personally do not see any conflict of interest with the President-Elect, the President or any other elected offical of AVA working for a manufacturer as AVA is not a nursing organization. As is stated on their web site "AVA is an exciting MULTIDISCIPLINARY composed of clinicians, educators, regulators and MANUFACTURERS from the medical field of Vascular Access." If they stated they were a strictly nursing organization I would have issue with the influence a board member who was employed by a manufacturer could exert on organizational policies and positions but since they are clearly not a nursing organization and make no secret of their relationship to device manufacturers I have no problem. Just my two cents of course.
Is this true? If so how can something like this happen in this day and age? Could any of you imagine the uproar if the president-elect of the AMA or the New England Journal of Medicine worked for a device company? What is going on with many of you IV therapy RN's? As I have written in a prior post: I was shocked when my surgical group took over the PICC program to see how many of our IV RN's were on the payroll of this vendor and were making decisions in behalf of this vendor as opposed to the hospital let alone the patient. It is unbelievable in this day and age that conflicts of interest like this take place. In my hospital we can no longer accept a dinner or golf outing from a vendor. But in IV therapy it is common place for many RN's to work for device or drug companies. I think many of you are way out of control and it is relationships like this that will force strong government intervention in the medical profession. Apparently, some of us health-care professionals are not capable of conducting ourselves in an ethical manner. If it is true that the president-elect of AVA also works for the leading PICC catheter manufacturer there is at the very least an appearance of conflict of interests. Everything in this organization maybe perfectly by the book, but I would look at the articles in AVA and wonder if they were truly independent because of this egregious conflict. Mark my word: If we don't clean up the medical profession somebody will do it for us.[/quote]
Marvin Siegel RN CRNI
Director of Clinical Services
Town Total Health
NY, NY
Marvin Siegel RN CRNI
Director of Clinical Services
Town Total Health
NY, NY