Special treament of a patient with money

[jbp0529]

Guess this is a combo ethical situation/vent:

So in the ICU in which I work, we have a patient who had cardiac surgery, did well post op and all...but she is a well-to-do lady who apparently is buddy buddy with a hospital administrator and also frequently invests millions of dollars (through her business, I think) into my hospital every couple of years.

We all knew she was coming in for surgery. Several days prior to her admission, the hospital blocked off an ICU room, had it terminally cleaned, and taped off. Under no circumstances were we to use that room. Mind you, during this time, my hospital was on ICU divert in the ER (bc of lack of beds). They also blocked off/terminally cleaned a private room on the tele floor, in anticipation of her departure from the ICU. There has also been a shortage of tele beds lately, too.

The whole situation with her has been a headache for many reasons. One, the whole blocking off room thing. Two, her personality. Besides being filthy rich, she is demanding and unreasonable...wants a fresh box of tissue paper each morning, flowers in her room (which we do not do in the ICU), linens changed twice a day, special food that we have to obtain in the dead hours of the night.... She has even been dictating how she wants her nursing/medical care. Normally, unless a patient is unstable in my unit, we get all of our surgical patients out of bed every morning...well she doesnt like that at all, so we have been told to let her do what she wants. She also decides when she wants her medications, regardless of our medication schedule. My manager even said we have to make her a 1:1 assignment at all times (even though she has been completely stable the last few days, no drips or lines) and he even picked which nurses he wants to take care of her each shift, presumably bc he thinks some are better at "customer service" than others, regardless of how good of a nurse they are. She even has a hospital sitter in her ICU room to get her whatever she wants...again something we dont do in the ICU.

The whole thing is disgusting. It seems like money can get anyone anything. And its a shame that the uppers in my facility are just falling all over this lady and catering to every need, no matter how unreasonable. LOL the hospital CEO even telephoned into the operating room during her procedure to make sure everything was going ok.

The nurses in my unit are totally disgusted by all this show. We treat all of our patients equally and provide excellent care to everyone, regardless of their bank account. And keeping beds open for days before her arrival, in our opinion, is unacceptable when there is a patient in need of that bed. Makes me miss the county hospital I worked at, where there were no special privledges, only good nursing and medical care.

**Update** When I left work this morning they were planning on transferring the princess out to her telemetry "suite". The hospital adminstrators were planning on stopping by to escort her to her new room, which by the way, was supposedly going to be full of flowers and candy, balloons, and gifts...all from the hospital **GAG** What a spectacle.

[flightnurse2b, LPN]

that is a shame. gag is not even the word for it.

i find it really sad how people bend over backwards and stand on their head for patients who are VIP, yet find insurance glitches to magically send away people with no insurance who can't pay.

[jbp0529]

My thoughts exactly!! In many circumstances, money can get you anything from special treatment, to backdoor legal loop-holes (just ask some celebrities).

After this whole little show at my hospital, I must say I am truly ashamed to be working for them. As I sort of stated, I used to work at a county hospital just prior to this; I took this new job to get a change of scenery. While there was a whole slew of other issues at county, the majority of the patients were very grateful for the care they received. Management (in my experience) was not concerned with dressing up rooms, and photo opportunity moments with someone powerful, but with actual patient care. Maybe its not too late to get my old job back. lol

[ebear, BSN, RN]

Anybody have any Phenergan? I'm nauseated... :barf01:

[Kymmi]

Without her donations think of how much lower your pay would be and no one would have that fancy new equipment. :smackingf Seriousl.........Im being sarcastic and I know it. I totally agree that it is ashame how the average run of the mill joe gets good care but not all the "frills" but from the CEO's view my above comment isnt so sarcastic but more truthful as to his/her thoughts.

Im not saying that it should be this way in the hospital but it is a fact of life. It happens in all aspects of our world. The $$$$$$$ get the resturants to themselves, the private jets, the "frills" any place they go. We as nurses look at the $$$$$$$ patients as normal people because thats how we see them in all their glory....we still see the backside of them as we are changing the beds however from a adminstration standpoint they do not see the person as we do....they see the $$$$$$$$$$$$$$ when they look at them.

[jbp0529]

Some of us thought it would be worth losing our jobs to say to our adminstrator, "we put on our underwear the same way she does every morning. the doctor wrote orders to get her out of bed, take XYZ medicine, and eat XX diet, not steak and lobster. we are the nurses, and this is how we treat our patients...all of them".

[flightnurse2b, LPN]

Some of us thought it would be worth losing our jobs to say to our adminstrator, "we put on our underwear the same way she does every morning. the doctor wrote orders to get her out of bed, take XYZ medicine, and eat XX diet, not steak and lobster. we are the nurses, and this is how we treat our patients...all of them".

exactly!! and im sure if she develops pneumonia or DVT from inactivity, it would be your fault and not hers even though she refused to get OOB.

i had a pt in rehab facility my 1st clinical semster that was s/p internal fixation of open tib/fib fx. she had a special private room with a dining room table and chairs, minifridge, microwave, 1000 thread ct sheets, etc. she had strict orders for bedrest. she would ask me and my fellow students to let her get OOB and she would give us money. when i told her no, she said "dont you know who i am?" and i said "yes, a patient with a broken leg''. she threw a fit and called her family, who hired a private sitter to come in. the sitter got her OOB, and guess what... she fell. and sued.

the whole VIP thing drives me batty. i refuse to treat anyone differently because of how much money they have or dont have. i dont know if i could keep my mouth shut with this.... especially if you guys are on divert.

can you report it anonymously to the ethics committee maybe?

[canoehead, BSN, RN]

When other patients are put at risk because of her special accommodations, that's when lines need to be drawn.

Diverting when there is a bed available, flowers in the ICU, 1-1 for someone who doesn't need it if others are run off their feet- all ethically deplorable.

[Kymmi]

Canoehead-----excellent idea about the ethics committee...I didnt think of that but I know we have a ethics committee hotline here that we are able to report to anonymously however given that it is a inside ethics committee I dont know just how effective that would be or if they are also seeing the $$$$$$$$$$$.

[Kyrshamarks, BSN, RN]

And how do you know that she did not pay for those rooms ahead of time to be terminally cleaned? How do you know she is not paying a big old load of cash for her stay? I bet she is paying a pretty chunk of money for her extra treatment. There are concierge medical services here that will provide for those things but the people pay for them. I do not begrudge anyone anyhting they can pay for.

[Kymmi]

Kyrshamarks---you also have a valid point and I suppose if she is indeed paying for the extra "frills" then its a different story. As far as her not following her plan of care I guess all patients have the right to refuse anything they dont want to do or have done.

[Weeping Willow]

Wow, Kyrashamarks, great new insight. Maybe she is paying for the extras. I doubt it, but you never know. The same thing happens when President Bush and other dignitaries are in town, believe me. And you and I probably pay for it.

As for her not following the standard med times, diet, and so on, it makes you wonder why we insist that everyone needs to get up quickly and can't have flowers in ICU. See? It can be done differently. We really should examine why we do the things we do, as they might not really be necessary.

And personally, I'd be thrilled to have another nurse care for her and for her to have a sitter on top of it. It would keep her out of my hair.

As for how wealthy donors are treated - that's life. I don't know how staff can stop it. It would have to be her doctor who insisted on the med times, activity level, etc. She'd probably listen to the doctor.