A handful of readers might have had knee-jerk reactions after reading the title of this piece. Some of you were probably frowning as you muttered to yourselves, "High-value patients? Low-value patients? Who in the hell does the writer think she is?"
Let me get one thing straight. I'm not the one who assigned values to different clusters of patients. In fact, my personal belief is that all people have the same inherent worth and esteem, regardless of their current situation in life. To be more precise, the greater society in which we inhabit has ascribed different levels of importance to different groups. We sense this disparity when we see how well certain diseases are publicized while other afflictions are simply blown off. We know this gap exists by the types of responses people give when we inform them of our nursing specialties.
In previous posts I've speculated that the prestige of our nursing jobs is strongly tied to the various patient populations with whom we intermingle. To be straight up, society as a whole places an extremely high value on pregnant women (especially if they're middle class or higher), the very rich, infants, children, teenagers, healthy young adults, celebrities, thin people, politicians, and very good-looking people.
To flip the coin, society places a much lower value on the elderly, the overweight and obese, poor people, undereducated people, alcoholics, drug addicts, immigrant migrant workers, the mentally ill, the perpetually unemployed, the disabled, ex convicts, criminals, the developmentally disabled, and the chronically ill.
So if you are a nurse who works in nursing homes / LTC, jails, prisons, psychiatric facilities, group homes for the developmentally disabled, addictions / drug treatment centers, migrant worker community health programs, chronic dialysis, or free clinics, members of the public will not respond with much interest because you regularly work with patients that have been deemed 'low value.' Even many of our colleagues in the healthcare community will think your specialty is a supposedly 'lesser' type of nursing. Some will even ask, "Why don't you want to do real nursing?"
On the other hand, if you are a nurse who discloses that you work in a specialty where you encounter 'high value' patient populations on a constant basis (labor & delivery, postpartum, pediatrics, NICU, PICU, reproductive medicine, aesthetic plastic surgery, trauma, sports medicine, the ER, etc.), members of the general public generally respond with a higher level of interest, and your colleagues in the nursing community tend to view you in a more favorable light.
We see the bias in the amount of attention that certain health problems generate. Type 2 diabetics generally include the overweight and obese, the elderly, racial-ethnic minorities, and other less glamorous groups of people. Does a colored ribbon exist for all the people who died secondary to complications from diabetes? If so, please tell me about it. However, breast cancer has captured the minds of the American public after a young woman from a prominent family lost her battle against the horrible disease many moons ago. Now we live in a sea of pink ribbons.
To sum it up, some demographic groups are highly valued in our society while others are blatantly devalued. Society views some clusters of people as 'high value' and others as 'low value.' As much as I believe that all people were created equally, I know in my heart that all individuals are not regarded equally.
