Do You judge and treat patients differently depending on who they are ?

jadelpn, LPN, EMT-B · Aug 19, 2012

The OP asked 2 distinct questions. Do you judge, and do you behave differently because of that judgement toward a patient. People can feel however they want to. They are personal feelings, that could be thought of as judgement, should someone share or show those feelings. There's nursing judgement, that is a clinical feeling that something may not be right or correct with a patient. So yes, nurses judge, but the big difference is that we are to judge in a clinical way regarding care, as opposed to "this is the 345 time this patient has come into the ER" stuff. And going back to moral judgement--it is not ever a place to share those feelings with a patient. You can judge all you want to in your head if it helps you sleep better at night, but the minute your patient feels that hostility, it is all downhill from there--and as FMF Corpsman pointed out, puts one out there to then have your supervisor judge you on one's judgemental and uncompassionate care of a patient. We are not at liberty to know or to change the course of care for anyone who comes in that we feel is "not an emergency" or "drug seeking" or any other judgement that is not clinically based. It is an emergency to them. There are some patients who are in fact mentally ill. There are patients who are addicts and alcoholics and don't have access or wants to shower or keep clean or have a roof and a meal. And because of those things they are ill, ill often, and one sees in an ER often. If a patient comes in from a nice home, dressed to the nines and ill due to being an alcoholic any different? Because the smell of Chanel No 5 as opposed to not showering? As nurses, we see the depths of people's despair at their most vulnerable. We do what we can, when we can, and some even pray to all that is holy that the homeless mentally ill man doesn't freeze to death on the street when he leaves AMA. There are all walks of life in this world and judge in your mind and your heart if you must, but to then alter care because of it is just wrong.

Maevish, ASN, RN · Aug 22, 2012

I've done it, but it's something I don't realize I've done until after the fact and then I feel bad. At first glance, I took the post to be asking about VIPs etc and it got my blood boiling because one of the BIGGEST pet peeves I have is when we get someone in the unit and everyone's whispering "it's the CEO's mother so, you know...." like they deserve special treatment or something. I try to treat everyone the same way and there should be no such thing as a VIP patient.

joanna73, BSN, RN · Aug 22, 2012

I'd much rather someone admit that they have/are being judgemental, but they are able to provide good care. At least those people are being honest. On the other hand, if you're saying that you don't judge people....then you're not being honest with yourself. We're human, and we've all judged in some way, whether consciously or not.

Ruby Vee, BSN · Aug 22, 2012

I've done it, but it's something I don't realize I've done until after the fact and then I feel bad. At first glance, I took the post to be asking about VIPs etc and it got my blood boiling because one of the BIGGEST pet peeves I have is when we get someone in the unit and everyone's whispering "it's the CEO's mother so, you know...." like they deserve special treatment or something. I try to treat everyone the same way and there should be no such thing as a VIP patient.

The "VIP" patient is one of my pet peeves as well. Especially when THEY try to assert their VIP status. One of our cardiologists had his father admitted to our CCU years ago, and "Dad" went on to have heart surgery. I'll never forget the day after surgery when I wanted to take him for a walk. "Dad" insisted that he didn't need to go for a walk because his son was a bigwig here at East Goatlick University Hospital. "Page him," he said. "He'll tell you." I wasn't going to page the cardiologist to complain about his father's behavior, but a few minutes later I was called to the phone.

"I hear my father's giving you a hard time," he said. "I'm in the cath lab right now but I'll be up as soon as I'm finished to straighten him out."

Twenty minutes later, I heard overheard "Dad" start to complain about that stupid woman who thought he could WALK after HEART SURGERY. And twenty one minutes later, I heard the cardiologist say, "We're going for a walk right now, Dad. And if I EVER hear of you trying to take advantage of the nurses again, I'm going to take you to West Goatlick Community Hospital where nobody knows me. Of course the nurses aren't as good there . . . . "

metal_m0nk, BSN, RN · Aug 23, 2012

I did a clinical observation once at a rural facility that is locally acclaimed for their progressive policies and shared governance structure. They courted us students shamelessly and gushed the whole day about it being a great place to work.

It just so happened that on that day, a patient was admitted that was well known to the majority of the employees at this facility - a young person who is HIV positive. Throughout our day we were shuttled around to all different departments and units and in nearly every department, every unit we heard all about this patient's private, personal information, family issues, financial status, temperament, personality deficits, treatment compliance, and on and on - from RNs to coders.

I was quietly infuriated the whole day trying to reconcile why any semblance of professionalism, confidentiality, and decency regarding this patient was trumped. No one appeared to be uncomfortable with their behavior. There was almost this sense of entitlement to it. If half of those people had known what I was thinking when they were leaning in to tell me all the intimate details of that patient's life, I'd have probably been escorted off the premises.