Ethical Dilemma: Hospital Ratings vs. Patient Welfare
By Christine Whitmarsh, RN, BSN
Nursing pioneer Florence Nightingale famously said that, “The first requirement in a hospital is that it should do no harm to the sick.” In today’s technological world, consumers have access to hospital records including mortality rates and other public health information. In light of that public knowledge, where can doctors and surgeons safely and ethically draw the line between acting in the best interests of the patients while protecting the reputation and profitability of the hospital? And what are the implications for nurses and travel nurses who work in these facilities alongside the doctors making these decisions?
A recent article in the Boston Globe questioned whether cardiologists in that state’s hospitals are going far enough to save the lives of cardiac patients with advanced procedures such as stent placement. The article was supported by data showing a decrease in recent years of patients receiving those procedures. They also reported controversy brewing toward hospitals with higher than average mortality rates in patients receiving the procedures. In other words – those hospitals are becoming less popular places to stay amongst patients who have the choice.
The decision about whether a patient is well enough to receive a risky surgery that may either save their life or take it on the operating table, has long been a challenge of ethics, patient welfare, statistical odds and probability for surgeons. The newest caveat in this decision is that doctors are now working in an information age where health care consumers can research and select which hospital to give their hard earned money to. How should doctors balance the profitability of the hospital, and therefore the level of service it can offer to patients, via public health ratings, while still making an unbiased decision based on the patient’s legitimate odds of surviving a procedure? As a nurse or traveling nurses who has undoubtedly witnessed these decisions being made, what do you think?
Christine Whitmarsh is a Registered Nurse with a BSN from the University of Rhode Island. She is a freelance health journalist and medical writer and a contributor to Travel Nurse Source and Allied Travel Careers.