It’s 2017, and one would think that all patients are treated equally. Nursing has certainly been educated to treat all patients with the same levels of respect and dignity and to provide excellent medical care regardless of age, race, ethnicity, or religious beliefs. In the theory of nursing, I think we all strive and believe that patients should be treated equally. However, at least for the reality of nursing that I work in, that doesn’t always feel true.

Recently, one of our beloved patients with colon cancer experienced a sudden and unexpected decline in disease progression. She has three young children, and her husband is the head cardiologist at a local hospital. In an attempt to get visiting nurses expedited and scans ordered quickly, we learned that his status as a well-known local physician made absolutely no difference. We were surprised. If you’re a part of the healthcare system, should that give you pull? Should your years of dedicated service give you and your loved ones an advantage? My colleagues and I were discussing this at lunch one day and having a healthy debate surrounding the issue. It’s certainly a complicated one.

That same day, the last consult was with an affluent professional female who’s very prominent in our community. She had a new diagnosis of non-Hodgkin’s lymphoma and needed to start rituxan, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP). During the consult, she refused to have her height and weight recorded.

Also, the oncologist ordered to give her CHOP one day and the rituxan the next day because of her tumor burden. The patient refused to split her treatment days because of her work schedule. She just wanted the R-CHOP the following day. The oncologist asked the schedulers to move other patients to make room for this patient’s preference. Apparently, the oncologist was receiving pressure from local physicians and local politicians to please her.

However, when the patient approached an RN and asked to make sure her medication was ready at the local pharmacy so she wouldn’t have to wait when she arrived, the RN responded that the clinic has no control over pharmacies. She let the patient know if she didn’t agree to have her weight and height done and verified by two staff members, then she wouldn’t—and couldn’t—receive her chemotherapy.

The patient, surprised by the directness of the RN, agreed to have her height and weight done and double checked. But the question remains: why was this wealthy professional treated differently than any other patient? No other average patient would have been able to dictate and demand how treatment was going to be given.

Some of you reading this may think that the oncologist should have been firmer or should have handled the situation differently. But sometimes it’s hard and challenging to treat all patients the same, especially when pressured by outside influences. I would like to think that as a seasoned oncology nurse I treat all patients equally, but these two scenarios have caused me to pause and reevaluate if that’s always true for all of us.

I can say that I, and my entire nursing staff, give all patients the best nursing and medical care at our disposal. Taking good care of patients with cancer is why we come to work each and every day. But it’s important to make sure we’re always treating our patients equally, and if we see that it’s not happening, we must say something. 

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