A question of ethics

[Kris0215]

If a nurse is given a business card by a patient and the patient states, "If you ever need a reference for anything, you can use my name and number." Is this an ethical issue? The patient had stated his reason for doing so was because the nurse gave very good care, and had excellent people/communication skills.

It has been my understanding that gifts of value are not ethical to accept, but what about a person's word or opinion?

Taking the business card and saying thank you, may not be unethical. However if the nurse chose to use the patient as a reference, this may cross boundaries that are not meant to be crossed for ethical reasons. Plus if the nurse did use him as a reference to say get a job or something, and then benefited from a good reference then this would be a gift of value.

So how does this play on the ethics score? Opinions please.

[JustBeachyNurse, LPN]

Is this homework? Or a scenario that you are living? What do you think a prospective employer would think of a nurse candidate offering a former patient as a reference?

[blondy2061h, MSN, RN]

The nurse would have to provide the way she or he knew the patient in order to use it as a reference, which would make it a HIPAA violation.

[Kris0215]

Alright, I will stop being vague. I am a nursing student, and I had this happen to me recently. I have and had no intention of using the patient as a reference for anything. I took his card and said that I appreciated the offer, and I was glad that he thought that well of me. I later wondered if I did wrong by even accepting his card. As I stated I would never use it. I am also aware of the break in HIPPA, by identifying how I knew the reference.

[MunoRN, RN]

Usually the safest way to deal with this, other than politely declining, is for the patient to write a letter of reference which can then act as their recommendation. Normally I would just avoid this altogether, but it does become an issue in private care, where your patient is your employer.

[ICURN3020]

Normally I would just avoid this altogether, but it does become an issue in private care, where your patient is your employer.

Good point.....I was wondering when it would ever be appropriate to use a patient as a reference.

I'm not familiar with home care or private duty nursing. My question is wouldn't home care/private patients still use an agency to hire nurses through? That agency would then act as the nurse's reference.

[JBudd, MSN]

Since the patient gave you the card, and told you to use his name, you are not breaching HIPAA by only using his name. Do not reveal any details about diagnosis or care, but he gave you permission to use his name. No, you did nothing wrong by accepting the card. Good idea to take it to your instructor and say, look at the complement I was given! That way there is no hint of hiding anything.

No, it is not a gift of value. Can't declare it on your taxes. It is a thankful sort of endorsement. Would I actually use it? No. That isn't what employers are looking for. But you could have asked him to drop a note to the hospital or your school, for your record. Or not. Take it for a complement, and leave it there.

[JustBeachyNurse, LPN]

Good point.....I was wondering when it would ever be appropriate to use a patient as a reference.

I'm not familiar with home care or private duty nursing. My question is wouldn't home care/private patients still use an agency to hire nurses through? That agency would then act as the nurse's reference.

Not always. Some states allow field nurses to direct bill medicaid. Some nurses bill the client directly, often they obtain jobs from Craigslist. But, yes if you worked for an agency your agency would be your employer/reference.

[Kris0215]

I did mention it to my instructor. Thank you for your feedback.

[Delicate Flower]

I agree with all of the PP. Most hospitals I have worked in have had a process in place for patients who want to give a compliment or special recognition to an employee who provides great care and/or service. There are feedback cards and surverys which the patient may fill out. Many patients also choose to write a letter to the unit manager and hospital big wigs in which they can thank and recognize individual employees.

If he would put it in writing, you could potentially get a copy of this feedback and put it in your "portfolio" along with references, positive evaluations, and so forth. Just black out the patient's name to protect his privacy :)

[icuRNmaggie, BSN, RN]

I was in a situation of having to advocate for a patient and the family member, who is an international leader for fair employment practices and who has testified before Congress, handed me his business card and said, don't you worry, nothing is going to happen to you.

I was very thankful because telling the family the truth was in direct opposition to what the hospitalist was saying.

Nothing happened to me and I still have his card.

I do not see anything wrong with it if someone offers to personally give me their card. It is a gesture of goodwill in the business world. It would be rude to say no.

I would not use the family member or patient as an employment reference.

Is this another homework question?

[toomuchbaloney]

No, it is not an ethical issue.

It is not terribly useful for the nurse, but it was thoughtful and nice of the patient.

No, it is not a HIPAA breach in and of itself as the patient GAVE you the card with his name on it and told you how you may use it. However, as others have said, using that card in conjunction with discussion of a diagnosis or type of care WOULD violate his right to privacy.

I would also thank the guy, accept the card, and file it away in the circular file at the end of my shift without his knowledge.