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Chefs, Butlers, Marble Baths: Hospitals Vie for the Affluent

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The feverish patient had spent hours in a crowded emergency room. When she opened her eyes in her Manhattan hospital room last winter, she recalled later, she wondered if she could be hallucinating: "This is like the Four Seasons-where am I?"

The bed linens were by Frette, Italian purveyors of high-thread-count sheets to popes and princes. The bathroom gleamed with polished marble. Huge windows displayed panoramic East River views. And in the hush of her $2,400 suite, a man in a black vest and tie proffered an elaborate menu and told her, "I'll be your butler."

http://www.nytimes.com/2012/01/22/nyregion/chefs-butlers-and-marble-baths-not-your-average-hospital-room.html

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Altra is a BSN, RN and specializes in Emergency & Trauma/Adult ICU.

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I'm completely unfazed by this.

These units exist for the not-very-sick-at-all. And as the level of technological intervention that can safely be provided on an outpatient basis grows ... I see it as a shrinking, not expanding, segment of health care.

As my area of nursing is high acuity ... I am not concerned with someone well enough to relax in a plush robe in a library/lounge type area.

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162 Posts; 5,464 Profile Views

I read a few lines of this waiting in line for coffee. My first thought was as long as I'm not paying for it. My second thought was it must be nice to work there.

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OCNRN63 is a RN and specializes in Oncology; medical specialty website.

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I read a few lines of this waiting in line for coffee. My first thought was as long as I'm not paying for it. My second thought was it must be nice to work there.

I wouldn't want to work there. These are usually the patients who give you the most grief. ("Fluff my pillow! Bend my straw!) I'd rather take care of people who needed some extra TLC v being knocked around by entitled patients who think they can bully you because they have money.

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136 Posts; 3,692 Profile Views

Sadly, this type of facility caters to pts w/ insurance. In other words, the bills will get paid. There is very little incentive to provide care to the un or under insured. Often the hospital foots the bill and does not turn a profit.

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KelRN215 has 10 years experience as a BSN, RN and specializes in Pedi.

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I wouldn't want to work there. These are usually the patients who give you the most grief. ("Fluff my pillow! Bend my straw!) I'd rather take care of people who needed some extra TLC v being knocked around by entitled patients who think they can bully you because they have money.

That's exactly what I thought. I get enough of "my blanket isn't warm enough/my apple juice is too warm" working on a regular floor. I can't imagine choosing to work exclusively with the entitled.

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4,120 Posts; 40,983 Profile Views

I'm completely unfazed by this.

These units exist for the not-very-sick-at-all. And as the level of technological intervention that can safely be provided on an outpatient basis grows ... I see it as a shrinking, not expanding, segment of health care.

As my area of nursing is high acuity ... I am not concerned with someone well enough to relax in a plush robe in a library/lounge type area.

Oh I don't know.

At least here in NYC hospitals that can (Lenox Hill, Mount Sinai, NYP, etc) are falling over themselves setting up "private suites" that offer all sorts of boutique/hotel amenities and comforts to those whom can pay. Indeed remember reading an article about new hospital building design awhile ago that next to switching to all or mostly private rooms the largest growth or at least interest comes in the form of private rooms or suites.

Such suites can be designed where several rooms form rather grand spaces not only for a patient but his/her family but allows setting up of an office so the patient can continue with his work/business whilst in hospital.

Mind you it was not *that* long ago that the wealthy shunned hospitals at all costs and had what would be called "home care" including round the clock nurses and the most modern hospital equipment. Failing that there were "private" hospitals (the now defunct LeRoy Hospital (Manhattan) and Doctor's Hospital (Staten Island) which catered mainly if not totally to the rich.

Quite honestly while it does stick in the craw of some, having luxury suites fully paid by those whom can does provide a means for a hospital to fatten it's bottom line and or othewise keep the wolf from the door. Remember my lads and lassies the sad example of Saint Vincent's Hospital in Manhattan. Though excellent care the place provided the wealthy and otherwise with good insurance avoided the place making it a hospital of "last resort".

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4,120 Posts; 40,983 Profile Views

That's exactly what I thought. I get enough of "my blanket isn't warm enough/my apple juice is too warm" working on a regular floor. I can't imagine choosing to work exclusively with the entitled.

Did my share of private duty (mind you as a NA but still) both in hospital and at home for the Park Avenue set and have to say it is hard to paint them all with a broad brush. Some especially those from "old money" who are comfortable in themselves and know how to treat persons hired to work/serve them were quite kind. Long as one did what one was paid to do and kept to one's own business (that is stay out of theirs), things went quite well.

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VICEDRN has 5 years experience as a BSN, RN and specializes in ER.

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Read the entire article earlier today"

two thoughts...

the first was I was completely unsurprised that the example patient had "back pain." I am sure the hospital provided her with round the clock iv narcotics in her lovely suite. Definitely not my kind of patient!

the second? couldn't believe the NYTimes bought the story of the girl in the last paragraph! two days in the er, admitted for herniated discs (and they would do what with that??), AND no one brought her a bed pain in two days? uhh-huh. I am SO SO sure. lol.

As for the issue itself, i don't doubt that we shall see more and more of this. Hospitals are becoming more and more obvious and aggressive about their desire to shun underinsured, uninsured and government insured patients in favor of the ultra-wealthy private pay types. Sad but true.

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Multicollinearity has 4 years experience as a BSN, RN and specializes in Acute Care Psych, DNP Student.

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And for the have-nots...let them eat cake.

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nursel56 has 25+ years experience and specializes in Peds/outpatient FP,derm,allergy/private duty.

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"These kinds of patients, they're paying cash-they're the best kind of patient to have," she added. "Theoretically, it trickles down."

Architect Cohen, how would you know? And how (theoretically) does it trickle down exactly? Regular folks get your leftover mushroom risotto with heirloom tomatoes? Meh. Wonder what "jello cubes with beef broth" is for clear liquids patients on the gourmet ticket?

On the other hand I think class warfare isn't entirely fair as many people worked their tails off for decades - it's another perk of money. In many cases it's about the privacy and security of the "VIP" patients. I can't argue with that especially in LA or NYC.

I just couldn't work in a place like that unless it was the only choice I had.

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caroladybelle is a BSN, RN and specializes in Oncology/Haemetology/HIV.

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A few comments.

I once worked a few shifts in a WPB facility's VIP ward. You could not pay me enough to ever do that again. But admittedly it was "new money" that were quite abusive to deal with. More established (old money) people that I have worked with elsewhere were quite decent. but I got quite tired of the emphasis of "VIP status" by administration.

All my pts are VIP, and my care is determined by their need, not their money.

Having said that, my current employer has a VIP wing. First, the founder felt that the wealthy citizens of our community needed to pay more than the poorer ones, to insure care for all. It was part of his will and the bequest, that founded the facility. Along with that, he requested a nursing school by started that was founded prior to the associated medical school, and that an orphanage for destitute children of color be founded, in an era when that was almost unheard of.

To my eyes the VIP pavilion serves several useful purposes. Money that comes in via the higher rates helps fund the large amount of un/underreimbursed car in the inner city neighborhood that surrounds the facility. Second, those "VIPs" often make large donations that help us provide better/more equipment that helps all of the patient population, above and beyond the donors/VIPs.

Recent donations have been instrumental in building two new buildings - state of the art, 10 and 12 story buildings. They are replacing critical care units in the old buildings that have not been seriously upgraded in several decades. These buildings were serve poor and wealthy alike.

Third: I really don't like having "VIPs", real ones on a regular unit. It interferes with care of the other patients and the visitation for other pts, security gets in the way, etc. Privacy for all the pts become an issue, with invasion of fans and paparazzi.

Fourth, having taken care of several members of "royalty" during my career, I would rather not.

Interestingly in my specific area of expertise, in the vast majority of cases, the Attendings do not permit their patients to be transferred to the VIP, or cared for there. These are published and top in their field, and want the best nursing/medical support for their pts....and bluntly, that is available more so on our unit. Sending them to the VIP unit, pulls them across the hospital where few have expertise to our level, and predisposes them to risk of infection and other critical issues. If a patient demands to transfer, unless there is very good reason (major security risk, etc.), they automatically get turned down. Our unit is all private rooms, most of them substantially larger than the average room, and are relatively secure from paparazzi and other risks.

Edited by caroladybelle

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