Special Treatment

“I need water!” The patient demanded when I answered the call light.

“I’m sorry, but the doctor needs to see you first and she may not want you drinking since you are having severe abdominal pain in case you need to go to surgery or something.” The patient looked at me and replied, “I’m a nurse, give me water!”

I had worked in Long Term Care before working in the ER and recognized this from the many times I’d heard it before. Patients, or family of patients, would often state that they were a nurse, that they knew someone that was in the healthcare field, that they were close to my direct boss, or even, that they know the “owner” of the facility where I worked. Some would preemptively notify me while others would wait until they wanted preferential treatment before notifying me of their special status.

Unlike patients that talked about their enjoyment of the profession they chose, these patients stated their profession or connections with the express goal of getting their wishes granted. Oddly enough, or maybe predictably, most of these patients grandly overstated their real status. The “nurse” usually turned out to be an aid. The administrator, they were so close to, often turned out to be someone they shook hands with once or maybe just read about in the local paper. They are often not what they say they are…but some are.

“This patient was with the group from corporate.” My charge nurse warned. In that one sentence it was communicated that I needed to make sure I treated this patient with the utmost of care. This goes against everything we are. We, in the field of healthcare, are supposed to give the best care we can to each and every one of our patients. Even if the Emperor of the World walked into our area of care, we aren’t supposed to worry about his hangnail when we have a homeless patient coding next door.

Recently, my mother was in the ER where I work. It was an emotional experience. I wanted all the resources of the whole hospital spent to make her better. I wanted special treatment, and I got it. ‘What?’ You might ask. ‘Why would you ask for special treatment when you are a professional and know that we are supposed to treat every patient as you would any other?’ The truth is, I didn’t ask.

From the awkwardness of one nurse that realized that I was the son of their patient, to the foreknowledge of successive nurses that had been forewarned, treatment was inherently different. I wouldn’t say that it was better or worse. The orders are the same, the medical treatments are the same, and my mother was not the only patient at the hospital. I know the struggle I’ve faced when I’ve been aware that I have had a VIP in my care. There is both an urge to spend more time with them and provide that little extra care as well as the desire to stay away from their room, because any little mistakes that one makes could become complaints to powerful people that could endanger one’s livelihood.

Sometimes patients are overt in their desire for privileged treatment. Sometimes coworkers want to convey a desire for exceptional care for certain people. But in many circumstances the lines are a little blurry. The requests are often not direct, maybe even underhanded, but possibly not even known to the person saying them. Sure, in a courtroom, few healthcare providers would want to admit that they pushed for special treatment for certain patients, but I am also fairly certain these same professionals would just as likely strongly deny such a desire when they asked themselves if they were pushing for special care. Some patients ‘are more equal than others’, but as healthcare professionals we have to be especially careful that we aren’t giving special treatment to certain people and extremely vigilant that we aren’t giving them oral fluids before an emergency abdominal surgery…even if they are a nurse.