Do some patients deserve special treatment?

[CNL2B]

Patient some time ago in my SICU was admitted after what was supposed to be an anterior approach back surgery of some type. Orthopedic surgeons made a horrific technical error (blamed it on a retraction device used, another story and issue altogether) and tore this patients aorta wide open. Patient also had some bowel damage/perforation from the device. Needless to say, patient nearly died intra-op. He came to the ICU after something like 40-50 units of blood products with a nearly 18 inch abdominal wound and a colostomy. This patient was an early 40-something male, narcotic dependent because of the back pain.

Had a prolonged recovery over several months. The hospital admitted to a grievous error and agreed (without attorney involvement, that's how bad it was) to cover 100% of the hospital bill/related costs, and I think a lump sum settlement was awarded as well but I can't verify that for sure -- they don't let that kind of info trickle down to staff very often, but that was the rumor.

Patient and family were horrible. Obviously they were stunned and upset over what happened, but I think even had things not gone that way, they were the wait-on-me-hand-and-foot type. Management went way over what is normally done, giving the patient's wife the direct number to the nursing supervisor after hours, pager numbers for residents, etc. There were multiple complaints against many nurses during their stay for BS reasons. Management pretty much backed up the family.

My question to you -- does this patient/family deserve to be treated differently/better than everyone else? I've still not really formulated an opinion on what should have been done in this scenario (or others like this) and really want to know what you think.

[neutrophil]

This question is very good. The problem with answering this question is that, what happened to this patient is a life changing experience that could have ended his life.

So from this point on, his life will never be the same. He could have died. So in this case. Upper management, need to be the buffer. They need to get into damage control and be very good at it. The nurses that are doing the step by step patient care, should be expected to do the best nursing job they can. But should not need to be part of that over the top damage control, customer service, that can actually take away from proper patient care.

The problem is that, nurses can see this, but the patient and family point of view is different. It is one unit and that unit needs to do what is necessary in the eyes of the patient. Very difficult.

There are other cases, where the patient and family have nothing over and above what other patients have. It never fails to amaze me that people are being treated and cared for by professionals, that if it wasn't for these professionals, they might die, or be more negatively affected, and yet they treat their nurses horribly. Have you noticed that some nationalities, treat you like you are special and your profession is to be respected. Some of this is cultural.

We, in the USA, have taught people that if they are paying money, they can demand what they want, reasonable or not.

In assisted living, residents are supposed to be helped to be as independent as possible and their privacy is essential. Which means encouraging them to do more for themselves, and only call if it is essential. Many complain that not enough is being done for them. In LTC's, their freedom has been taken away. So the only thing that they have control of, is expecting medication at a certain time, how good or bad the food tastes, even to the point of saying, "no, I don't want a shower today." I say, give them what they want, but don't cripple them and don't cripple your effectiveness to help all of the patients, due to a primadonna. Special treatment should depend more on acuity than capriciousness.