Gifts FOR Patients

[EmilyUSFRN, RN]

I'm having a bit of an ethical dilemma and was hoping you all could help me out...

we have a teenaged pt on our floor who works to help support his family in a maintenance company and suffered a terrible accident related to his line of work... and has been with us in the hospital for just over a month.

His father stays with him and is absolutely wonderful. He does everything for his son and is just so attentive. He does not leave his side, but I think it also has a lot to do with nowhere else to go? I don't know if they're legal immigrants or not, nor do I particularly care. But anyway, the situation is just heart breaking to me. I want to stop somewhere and bring them some food to eat... although the pt is older we put in a lactation tray for his dad because I mean... he doesn't have anything else really.

My question is... would this be appropriate? I'm not expecting anything in return by any means, but I guess I do feel like I am unable to give them my all because of the communication barrier (they speak a certain dialect so even my bilingual coworkers can't communicate 100%). I was just wondering what you all thought?

[traumaRUs, MSN, APRN]

I don't think feeding a visitor is out of line, especially since the teen has been a long-term patient. Maybe getting social worker involved? (Sure this has occurred). Maybe pastoral care if they are of a specific religion?

[DutchgirlRN, ASN, RN]

I think it's a lovely idea and will be greatly appreciated...surely if you spoke to administration they would work something out to get his Dad regular trays? I cannot imagine them turning that down.

BTW, just curious, if this teen patient is a he how/why is his Dad getting a lactation tray?

[leslymill]

I don't think it is appropriate. I think getting him a guest tray is appropriate and making him comfortable. You really don't know him. You don't know if he has food allergies or the restraunt you get the food from doesn't get contaminated. LFarfetch I know , but I wouldn't risk it alone. If a group of you bought him a dinner with hospital approval....

[RN1989]

With these people unable to understand English, plus the fact that this young man is your patient, you walk a fine line between being caring and being an authority figure. This family could easily misconstrue your generosity and feel obligated to you in some way. In some states, this could constitute an abuse of power - especially if the family began to feel uncomfortable. What if other people heard of this and then claimed that you were playing favorites with patients? Others might come to the hospital and then become angry because you helped out this family but didn't help theirs. It is no secret that illegal immigrants, homeless persons, and even really poor people come to the hospital with physical complaints simply to obtain food, a shower, sympathy, someone to talk to. You could be starting a trend that could backfire.

Giving this family food one time will not help them in the long run. They likely need more assist than what you would be able to provide. Think "give a man a fish and he has dinner, teach him how to fish and he has a longterm job, food, house, etc".

I would involve the hospital social worker. They usually know the community resources available - even for illegal immigrants. A conference call to the ATT Translation Line will assist you to care for this patient and the family. If the hospital balks at the cost - remind them that there are regulations that require obtaining translators for patients and their families or the hospital gets in trouble.

Offer a kind word, a guest tray, and a prayer for them. And assist them to get the help they need to live, not just to have one or two meals.

[EmilyUSFRN, RN]

Thank you all for your input... it saddens me that these days just wanting to do good for someone can totally backfire.

The lactation tray was put in so that dad can get 3 meals per day, whereas a guest tray is provided for one meal only. I'm not sure if he still gets them when the pt is NPO for surgery, which is every two to three days.

Social work and pastoral care have both seen this family many times.

We're still working on the pt and salvaging what we can. Nobody knows yet, even after a month, if he'll end up with an amputation or what, but we're still working.

They're such nice patients to have, it's just a sad situation all the way around.

Thanks again.

[nyapa, RN]

Wow, this is interesting. We have official boarders with some of our patients for various reasons, and they are automatically provided with food. For example palliative patients, indigenous elderly patients with poor English language skills (most speak at least 5 aboriginal languages), children from outback communities...and here that is most of them.

Mind you, I think our situation is different to other areas in Australia because of our location. But to me, the question would rarely occur, due to the above reasons. We just decide if the person accompanying the patient is entitiled to a meal, based on whether they are an "official escort" or not. Then they are just admitted to the hospital as a "boarder", wear their own identity bracelets (as a patient would), and a meal is automatically organised.

Interesting, the difference in perspectives....