vip floor in a hospital

[JM RN]

what is a vip floor in a hospital? what does this mean? thanks in advance!!

[DoGoodThenGo]

Don't know how things roll elsewhere, but every single hospital/healthcare system in NYC goes after two sets of clients. Those with excellent insurance and or those with very deep pockets. Once efforts to secure such patients have paid off for whatever reason it is expected the nursing staff will fall in line. If you've got a problem either keep it to yourself or make darn sure you have strong nursing management to back you up.

Any hospital in Manahttan would have given their eye teeth to have nabbed the Saudi king when he came to NYC for treatment last year. Once he arrived it is almost certain he got the VVVVVIP treatment. If his highness wanted a suite of nurses in whites and caps, what are the odds doctors who run the place would have said "no'?

Know there are many in this country and within the nursing profession who have a thing about persons of great wealth, but ya'll need to look at the alternative. Without such deep pockets and or their insurance you would have more hospitals closing than we do already. Indeed once a place is known as providing mainly "charity care" or is a hospital of last resort you can kiss the carriage trade good bye. My most famous example of this is or rather was Saint Vincent's Hospital in the Village. Surrounded by persons and or familes that could have bought and sold the place five or six times over (in cash), none would have set foot in the place if their lives depended upon it. Plans for the "new" hospital which was to be built across the street included a good number of VIP/private accomodations which one supposes was an effort to woo the well heeled.

[xtxrn, ASN, RN]

Uh, where do doctors run hospitals???? It's some MBA, attorney, or insurance company behind every decision.... The almighty dollar is your boss ...

[nursel56]

OMG....between MDs and RNs and lawyers as patients, not sure who's worse- but an intern has to be up there with the worst-- knows enough to be useful, but not how to use it !!

My guess was that he really hadn't a prior grasp of just exactly what sort of living hell the life of a 1st year is (or was..). Book smart like crazy but everything else seemed to broadcast "it's too haaaaaaaaaarrrrrd . . . " So he got a few days of TV and vacay and attention ... hopefully that was enough and he eventually grew up and succeeded.

I agree with a little bit of what everyone else here has said . .

If a nurse comes on to allnurses and says she loves her job on a concierge floor, spa, cosmetic practice or whatever it is not my right to knock her and say "you are not a real nurse" -- that happens and it is not fair. I would not be happy working in such an environment and I'm happy to leave it at that unless...

I actually got into a verbal sparring with one of our VIPs. He was in the ICU but didn't need it, just wanted "more attention." He was furious when I wouldn't rush out of the code I was running on his neighbor, a homeless fellow who died despite our efforts.

:mad: I just could not have kept my mouth shut. No medically justifiable reason and yet a doctor there admitted him or caved to financial pressures exerted on him by colleagues/higher-ups? That's offensive.

......I explained that I was assisting the patient next door. He screamed back "You are SO STUPID! I bet you don't even know what VIP means!" I replied "I sure do! It means whatever patient needs me most at the time, whether that patient is homeless or the President. This time, your neighbor was the VIP."

:cheers: :bowingpur

This would also apply to preferential treatment given to the nephew of the big donor re: medical school admissions, etc a practice that came to light with the UC Regents here in California some years ago.

Don't know how things roll elsewhere, but every single hospital/healthcare system in NYC goes after two sets of clients. Those with excellent insurance and or those with very deep pockets.

There is nothing inherently evil about having wealth and the special treatment of dignitaries or those with deep pockets stretches across the political spectrum. As an aside - and sort of an illustration . . . I got a huge kick out of watching Governor Brown - sort of a champion of austerity out there on the tarmac to greet William and Kate as they stepped off the Royal Plane :) no point whatsoever in railing against that sort of thing.

[caroladybelle, BSN, RN]

We do not have a VIP room - with have a building/unit devoted to them.

However, for all practical purposes, our Attendings will not admit one of our specialty pts there for care to the VIP unit.

You see all of my pts are severely immunosuppressed, most require very specialized drugs, may need cardiac drips, vasopressors, vents, CVVHD, and will need multiple units blood products. They also require frequent VS, temp checks, and blood draws, and need to be eating, drinking, walking - whether they like it or not.

You see many of the pts that request "VIP" treatment, also believe that they should be catered to, not woken for VSS, not pushed to walk, eat healthy, be compliant with care. However, in the case of the severely immunocompromised pt ( as with many others) this will kill them. They will develop pneumonia or complications, will not be treated adequately or quickly enough, and die. Or allowing them to eat an unrestricted diet and the will be vomiting/having diarrhea for weeks. And if the pt becomes critical, getting the proper interventions in place with crawling over/interrupting visitors, can be problematic and dangerous.

After various difficulties/issues with the VIP care concept, our dominant attendings decided "no more". Our rooms are a good size, and all are private - that should be good enough.

Given that some of them "write the book" on their specialties and are known experts - well if someone wants their care, they have to play nice with the staff and obey the rules. And our attendings don't consider that the VIP ward is safe enough or has what they want their pts to have access to.

Usually the pt is fine with it - but we've had a few families blow up about it.

[K+MgSO4, BSN]

In the UK, Ireland & Australia, there is the national health service that provides free care to its residents, if you want to beat the queues you can either use your your private insurance or pay outright to go to a private hospital. I can't blame people for using this option as for non life threatening surgery in Ireland you could be waiting up to 18 months for a cholecystectomy like my father where as my mother was operated on within a week for cancer.

The private hospitals are smaller & do not take students. so very few student nurses experience it esp like me who lived in Letterkenny, Co. Donegal 3 hours away from the closest private hospital & our uni was affiliated with the local public hospital.

I worked after graduation on a colorectal/general surgery ward where it was up, out & walking. We were trialling the fast track project that had been started in Europe.

When i moved to Australia I did agency nursing. I did quite a lot at this VERY posh private hospital. Politicians, footy stars, musicians etc. So I went into my patient who had surgery 2 days prior and was fine but refusing to get out of bed. i suggested very firmly that he should and he snapped at me and said @don't you know who I am? I have paid for this bed & I will lie in it if I want to."

I responded with I don't know who you are from a bar of soap as I have only been in this country for 6 months and have spent 5 of those seeing the country. Also, do you want to pay for the bed for the next week as well for the DVT/PE or pneumonia that you are at massive risk of developing?

He requested to talk to the NUM, which took about half an hour for her to be free, so I got her expecting to be torn to pieces & blacklisted. Instead she came out & said that I had made him think about his attitude to his health & his money. 2 hours later I was walking him up the ward & doing deep deep breathing & coughing exercises

In conclusion - money is not a bad thing if it can get you your care quicker but the attitude is what matters. I don't treat anyone differently because of there money or status. Which is probably why I prefer to work in the public hospital system. Where I work now we get the complex VIPs who are too sick for the private hospital and their surgeon wants them in the public where there is access to 24 hr services such radiology & theatres. they don't get a single room. My priorities are the confused/infectious/dying pts, then if I have one of my 4 single rooms out of 25 beds yeah you can have it!!

[xtxrn, ASN, RN]

OMG...

I spent 6 weeks on neutropenic precautions (like only bottled water, no tap; no fresh veggies/fruit with skin, no flowers in the room, nobody behind the closed doors leading to those designated rooms, etc). I had 25 units of PRBCs and platelets in the first couple of weeks...I was septic from an ear infection ( to the tune of completely swelling shut with NO hearing in that ear- had to have it pried open with hemostats by the ENT and a wick put in for the drops to seep into) that spread into cellulitis in my jaw, in spite of the precautions. I dropped 5 pounds a week even with the dietician in every couple of days, and every menu in the building (patient, cafeteria) on my bedside table for whatever I wanted (mouth hurt too much to eat, even with the 'miracle mouthwash' stuff that helped, but only to a degree).

I was on Vancomycin and Gent for a month. I had oral chemo twice a day. One round of 8 solid days of continuous chemo, and 4 doses of once daily injected chemo.... plus ac/hs accuchecks, I don't know how often they did vitals- seemed like a LOT the first month, then down to every 6-8 hours (I think). The oral meds (my routine stuff) were about 6 times a day, and insulin at hs, and prn with meals.... I was a handful with stuff to do- but I also did what I could on my own (got myself to the bathroom- could unplug the pump myself, etc).... all of that is nursing care- not VIP..... sorry....

You don't have to have a VIP room/unit/building to just give appropriate care for a diagnosis--- that's our jobs--- sure, it's time consuming- but the UNIT is set up for that- not some hoity toity VIP label . Yes, the rooms were behind doors to keep wandering visitors out- and they were private rooms, with microwaves and refrigerators (donated by the volunteer auxiliary- not some fat wallet)- they were nice by 'normal' hospital room standards- but they weren't the wood floor, daybed, coffee maker, and deliveries from dietary for the family (though there was a family lounge since it was an oncology unit- also stocked by the volunteers). That's what the diagnoses required- not some inflated ego...

Immunosuppressed patients need appropriate care for immunosupression- not butt kissing.... there is a difference.... JMHO And not every immunosupressed patient needs someone to do every little thing for them- at times, sure... but don't bunch everybody into a lump label.... I did all I could- and heard other patients in the halls- and their families bringing them things.... when I'd go out, there was a box of masks so I had those available whenever I walked past the door , but I had to stay behind the double doors (for 6 weeks, nearly all of it was 'contained'). I was too sick to argue, and too sick to want anybody bugging me, so knew I better do what I could.

Then, when I got the orificenic trioxide (50 doses) - 2 5-week cycles- I was on the same unit- just for the 4 hours EVERY DAY to get the dose & see the doc- I had to be on telemetry, so couldn't be in a chemo suite. I ended up with shingles near the end of the second cycle. On weekends, I got Neupogen... I was up there every day for 10 weeks (in 2 cycles, one split up by the shingles) AFTER the 6 weeks inpatient-- seen both sides...and this was not a VIP unit- but they were good.

The nurses up there were wonderful-- and I typically have not had pleasant nurses (think it's something about the whole midwest attitude, and other things- I go out of my way to not bug anybody- I know about busy shifts, and didn't want to add to it- OR give them any reason to be nasty (not the oncology place- they were nice- but other hospital experiences here have been humiliating and dangerous). The dietary staff, housekeeping (I had orders that my room had to be cleaned before they went into any other room), and holistic therapy staff were also wonderful....they treated patients with a great deal of dignity and respect. But there was no VIP about it- I'm on Medicare. You can't get a whole lot more un-VIP than that, other than maybe public aide (but I used to do what I could to send them home with eggcrates they had (when we used those), and other things (like packing their basin/pitcher/admit kit stuff up for them, etc). The most needy generally were too afraid to ask for things (even the disposable stuff that was rightfully theirs since it had been charged to them).

VIP is an attitude, in my experience- and it reeks of entitlement and complete disregard for the whole picture, and other people. When I worked neuro, I wanted to take the young male post-op (walkie-talkie types) patients who whined, and drag their happy butts into the vegetative teenagers' room, and ask if they had any more complaints.... couldn't do it (and wouldn't- those types never understand that the universe isn't all about them). But I could dream- lol....

I'm sorry- I've been on both sides of the immunosuppressed stuff (started working when HIV was new, and AIDS had ALL of the nasty stereotypes and deserted patients- their families dumped them, so the staff sort of adopted them while they were there- when patients stayed for many months at a time, and insurance companies didn't know what to do with HIV, so they shut up- one good thing). I've taken care of more dying AIDS patients than I can remember (this was back in the mid 80s when it was all new and still a mystery, and mostly symptomatic care- antiretrovirals weren't even a hope at that point).

But they weren't VIPs- they were sick patients....the only kind generally admitted to a non-VIP floor....

I'm sorry- this does bug me (LOL...thought maybe I was being subtle :) )- and God bless the nurses who can put up with the crap from egomaniacs (and that isn't limited to VIP units by any means- LOL:D). I miss working a LOT...it's been my identity for more than half my life, and since being disabled (the cancer is the least of my problems, I'm expected to do ok with the leukemia... I was on disability for 7 years before being diagnosed with AML), it's been horrible to feel so useless..... but I miss the patients that need care for their medical needs (or if I was working adolescent psych, their needs, or alcohol/drug rehab, those needs- I know many nurses couldn't stand those either- I liked them). I never was rude to a VIP, but I really resented the implication that some people "deserve" better care... that's not how I'm wired...

[nyrn5125]

I actually got into a verbal sparring with one of our VIPs. He was in the ICU but didn't need it, just wanted "more attention." He was furious when I wouldn't rush out of the code I was running on his neighbor, a homeless fellow who died despite our efforts. He heard all that went on. I walked in his room after a very messy postmortem. Wanted to make sure he was ok before I shaved and finished making the now deceased neighbor clean and presentable. He screamed "I've been waiting FOR THIRTY MINUTES to get some HELP in here!" I explained that I was assisting the patient next door. He screamed back "You are SO STUPID! I bet you don't even know what VIP means!" I replied "I sure do! It means whatever patient needs me most at the time, whether that patient is homeless or the President. This time, your neighbor was the VIP."

What did the VIP NEED so urgently? Lemon for his hot tea. He asked that I not care for him anymore. I asked the same. Both wishes were granted and we were both pleased with the outcome.

this reminds me of a guy that was annoyed on a tele floor(8:1) that I had that was mad at me for not coming back to him when he was calling me. at the time he wanted me in there to get him ice and fix his pillow. He rudely said where were you, what could take you so long when you said you'll be back. you should keep your word and come back!!

I calmly stated "the woman in the next room just died and that is my priority right now" I ignored his whining and walked out because that is the mentality that some people have. All of a sudden they come into a hospital and can't even wipe their bottoms anymore, oh I'll just get the nurse to do it for me. I can't hold a cup anymore it's too heavy, my nurse will hold it for me. It's sickening how some pt's act and how families feed into it

It' fine that people want better hospital care, we all do, but you couldn't pay me any amount to treat a pt differently based on who they are or their money.

[LemonDrop1234]

I am so confused by this concept! What do you do if the room is empty????? Can a regular pt NOT stay in the room? Where I work we have patients flowing into the hallway. It makes me sick that there could be an empty room available that they aren't "good enough" to receive.

[Horseshoe, BSN, RN]

I am so confused by this concept! What do you do if the room is empty????? Can a regular pt NOT stay in the room? Where I work we have patients flowing into the hallway. It makes me sick that there could be an empty room available that they aren't "good enough" to receive.

This thread is 7 years old, so it's possible that this situation doesn't even exist anymore at the OP's facility.