Published Oct 2, 2012
metfan
144 Posts
I have to do a paper on an ethical dilemma for my BSN program. It seems lots of students are doing end of life care and patient autonomy. I want to do something different and maybe a little newer. We have real issues at work with the treatment of VIP's. We move patients around and they get special treatment which bothers the nurses because we feel everyone is a VIP to someone. Do you think this would be a good ethical dilemma to do a paper on? Also, does anyone have any experience dealing with this type of situation?
Thanks.
MEtfan
brownbook
3,413 Posts
No real first hand experience other than the occasional......."she is the wife of so and so" with the implication that we need to provide ????? service above and beyond the normal ????
I hate it, as you said everyone should be getting the same treatment.
However we all are human. We all know co-workers who can be abrupt, grumpy, but very competent, and nurses who just exude charm and compassion, (and are also competent).
Honestly I think I might, within reason, assign the later nurse to "VIP", rather than the former.
I don't know if it is the same but I, we all, seem to go a little out of our way when our patient is a doctor or nurse.
classicdame, MSN, EdD
7,255 Posts
How would you relate VIP to the categories of ethics? You will have to consider a possible situation where the patient is not being treated ethically and, it appears to me, that would be someone other than the VIP patient. Let us know what you decide.
Classicdame,
I was thinking the same thing. I am just in the thought process right now. I do know that when I took care of this patient, I was asked to put the neighboring room patients on dial a flows so the pumps would not beep and disturb the VIP. I was not comfortable with that because I + O's were important for one particular patient. I am just trying to think of an ethical dilemma that is different than the typical DNR/end of live/palitive care dilemmas. Thanks for the input.
Metfan
I understand, but I think the scenario you described would be more for a dilemma to the nurse, not the patient. Consider pain management. What if the family does not want the patient to have pain meds? How could that affect the healing and well being of the patient?
Asystole RN
2,352 Posts
Specialized and customized care is a set doctrine in nursing care, it will be difficult to challenge this. Leininger was a advocate for specialized and customized care, she has a mountain of work you would have to challenge.
Now if you are referring to specialized care based upon fiscal means alone then you might have something, in that case though you would have to argue the case for socialized healthcare, which may be easier.
In my situation, The VIP was a big doner to the hopital so we were told to cater to every need he/she had. We moved patients all over so we could give him/her the room they wanted. We have one room which is bigger and better. We did this twice because of a noise issue. We disrupted many patients because of this VIP.
KelRN215, BSN, RN
1 Article; 7,349 Posts
I have seen this happen before. When I worked inpatient, we once had a princess from a middle eastern country on the floor. The hospital went out of its way to cater to the family and they wanted to give her the "best room on the floor". The best room happened to be the room that doubled as the hospice room when we needed it. One of our long term patients at the time was in the ICU and was going to need to come out to that room at some point in the near future. We were all up in arms thinking that her transfer to the floor could possibly be delayed because the room was tied up with "the princess." That didn't end up happening but the hospital did want to give them an entire double room to themselves....
Honestly, although the topic is interesting, I think you are going to have a difficult time finding adequate literature to support your position. If you attempt to challenge the ethics of treating a donor with special treatment you are going to have a rather difficult time fully supporting your thesis.
I did a quick CINAHL search on the topic and there really is not too much regarding this topic, at least in the opinion of VIP treatment being a negative.
You might have some ground in challenging the issue regarding CMS regulation and/or Joint Commission regulation.
Honestly this topic is weak, I personally would not write on it.
Thanks everyone for your input. I think you are right, it would be hard to do a paper on this topic. I will have to think of something else.
blondy2061h, MSN, RN
1 Article; 4,094 Posts
I think you could do the VIP dilemma with what said VIP wants vs what's best for them medically. IE, they're CEO, in for an MI, and wife brought in a fish fry for dinner. How do you as the nurse recognize that they likely know they shouldn't eat that, but they still want to? How do you step in while still recognizing their autonomy?
MrChicagoRN, RN
2,605 Posts
Actually, it's a viable topic. Generally, it is not unethical to give someone preferential treatment. It does become an ethical issue if someone else gets Lesser treatment because of the VIP's needs getting met instead. For example, if the VIP call light must be answered first, regardless of actual needs.