Special treament of a patient with money

Nurses General Nursing

Published

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.

It's a shame that this woman is a demanding princess, but just for once I'm going to cut the administration types a break. Do you think that they ENJOY ramming their noses up the butt of this PIA? (Especially since her only accomplishment in life very likely was to marry someone who accomplished something - in my experience, people who became rich through their own actions tend to be far less snobbish than people who married or inherited their money.) Like it or not, donations are a MAJOR source of funding for a lot of hospitals, and fundraising is a major part of most higher admin types' job descriptions. So, here are a couple of options:

1) you rope off a couple of rooms, have people kiss this woman's butt during her stay, and she cuts a substantial check to the hospital. The care of the "regular joes" is improved.

2) you hold the line, insist that she be treated no better or worse than anyone else. She gets offended, doesn't give the hospital any money, and tells all of her other (rich) friends what a horrible experience she had there. They also don't donate. The hospital has less money to help all those people whose care costs more than they can pay, but the staff feels better about themselves.

It's not a trivial problem, and it's a moral dilemma as old as humanity: how much of your pride are you willing to swallow for the greater good? At what point does appeasing someone become debasing yourself?

I'm not saying that you're wrong and the administration is right. I'm also not saying that you're right and they're wrong. I AM saying that CNOs, CFOs, and all the other administration types don't like demanding rich jerks any more than staff nurses do. I'm sure up in their offices with the doors shut they fantasize with each other about how they'd like to order q 1 hour blood draws just to torment the cow. But they put up with her for the good of the hospital.

Nobody has to agree with their decisions, but let's at least credit them with decent motives.

Specializes in ER/SICU.
frequently invests millions of dollars (through her business, I think) into my hospital every couple of years.

My guess is while she may expect some special treatment alot of the "special care" is the idea of the hospital admin. I remember one pt I had old money lawyer,his wife a docter. We rolled out the red carpet. I had him 1:1 for a couple of nights, hell i sat and watched basketball with him, he thought everybody got this kind of care was kinda suprised when i told him nah he was just specal.

Specializes in Med-Surg/Peds/O.R./Legal/cardiology.

Uhhh... I don't think she's paying for a damn thing. She's already paid.

If she paid for gourmet food, that's one thing. But even if she did pay for holding a room and unnecessary 1:1 nursing care that directly impacts the care of other patients and should not be allowed.

This also points out the hypocrisy of administrators who tout 'customer service' and claim to care about all their patients. If they DID, they'd expect all patients to be treated as "VIPs".

I absolutely despise this sort of treatment. Give me a poor, homeless, whiny "drug-seeker" any day.

Wealthy donors get special treatment because they give hospitals money. Like it or not, health care is a commodity, not a right. And there is no "health care equality clause" in the constitution.

Given how much we give away to people who cannot, or will not, pay for a bit of their health care, people like the patient described here are one of the last lines of defence from hospitals going bankrupt, large numbers of people losing their jobs, and large numbers of poor people no longer having access to the high-tech care we hand out like Halloween candy to everyone who walks into an ER.

This woman deserved special treatment, and good thing for the hospital that she got it. If you're worried about flowers, make the room respiratory isolation. If there are staffing issues, take it up with the house supervisor on duty. If she's non-compliant with her postop regimen, report it to her surgeon and let him/her deal with it.

But it is silly to begrudge this woman little extras and better customer service just because the heroin overdose down the hall isn't getting the same treatment. She paid for her extra service, and likely dozen's of other peoples' care as well.

Specializes in ER, ICU, L&D, OR.

Personally, I think special accomodations should be made for the wealthy at their request.

1- they can afford it, so be nicer to them.

I find it much easier to much more especially accomodating to the wealthy.

Specializes in Med-Surg/Peds/O.R./Legal/cardiology.
Specializes in midwifery, NICU.

Personally, I think it's disgusting! One rule for the rich, one more for the truly needy! Bed blocking, unreasonable demands..hey go check into a hotel and get a private nurse!!!!:angryfire

Specializes in CVICU, CCU, MICU, SICU, Transplant.

As Emmanuel pointed out, it is hypocracy, especially since my hospital, like many others, is into the "customer service for all" thing. Would the heroin addict down the hall get the same treatment? Surely not. If she didn't pay for all these little extras (and she probably didn't), should she get it? I don't know. Did we all roll our eyes in disgust at adminstration's transparent attempt at customer service? Absolutely. At the end of the day, I'm sure the hospital doesn't care, its just business and a big fat check to them, although they sure put on a front like they care. This lady was a headache to the nurses who cared for her (fortunately I did not), but when all is said and done, the real headache of keeping her supplied with gourmet food, flowers, and gifts belongs to those in a higher pay scale than me and my fellow staff nurses. We just tried to keep ourselves focused on her nursing care and go home.

It's just sad and mildly amusing that this is the world we live in.

That is discusting. Everyone deserves the same treatment, care, and respect. No matter what the " give" back.

At the clinic I work at we have a few " high profile" patients. I have seenothers show them "favoritism" , but I won't do it. I think I treat all patients with the dignity and care that they each deserve, without checking the wallet size first.

Specializes in being a Credible Source.

I recall the OP stating that this person provides revenue to the hospital in the millions of dollars per year. This is also the kind of person who may one day leave a large bequest to the hospital. Given the economics of healthcare, such a person does warrant special attention by the facility.

I'm not saying that I'm particularly happy about it but I do think it's the reality of the society that we've built for ourselves.

I think TiredMD put it pretty well.

Bottom line is healthcare is all about $$$. Nurses are about decent patient care. This is why nurses feel so overworked and undervalued, we are on the other side of the fence. We will never change the money factor. Basic patient care will not change until the powers that be see the cost savings or money that can be made from making the change.

Toq

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