Scenario: young child has 16h/day x7days a week including school hours. A team of 4 nurses cover the shifts some full time others part time. Family is welcoming (including siblings) and have come to appreciate the assistance and care of skilled nursing. Two nurses are working on the day of child's birthday party. Party crosses between two shifts. Mom feels guilty that the other two nurses won't be there as they are scheduled off so casually invites them. ( more so because she doesn't want hurt feelings to impact her child's care as is a common fear of parents of medically complex children ). Child has been under agency care for several years. One nurse has been with the child since start of care. Newest nurse on case has been with child 3 months.
Clinical manager explains to nurses orienting to case that parent feels obliged to invite nurses to family celebration but traditionally and ethically all decline and only nurses scheduled to work attend.
Nurse A& B are working. Nurse A (the longest on case nurse ) brings a card. & token gift (something home made. & personalized, low out of pocket cost. Item is something child can use. & enjoys). Nurse B brings a card and token gift (say appropriate story book). Both nurses while present at party focus on attending to the child 'a skilled care needs , treatments, medications, etc. helping family & client enjoy celebration without being "obvious" ( as we know a good pediatric nurse knows how to be subtle/ in the background and still get the job done & ensure family has as typical of an experience as they desire. & is possible)
Nurse C is off as per usual schedule. Has been on case for a few years. Brings a card and token gift next shift worked as (s)he too has a fondness for child. & family. She politely declined the invitation as she does with all off -work requests from clients. Wishes the mom happiness & success in the birthday celebration. Mom understands.
Nurse D (newest nurse) decides to attend party. Brings one of her own children in same age range as the client & siblings. Brings a card & gift. (Gift is a little more expensive than the other nurses choices but not atypical for the types of gifts exchanged at children's parties in the community) Nurse D participates as a guest in the celebration along with their child. Doesn't offer or perform any skilled care but offers to hold/sit with child. Nurse D feels a "bond" with child/family as a mother with children in same age range as client/siblings.
Nurses working are a little uncomfortable with nurse D's off the clock presence/ participation in party.
Nurses who followed agency policy are uncomfortable but not enough to discuss situation with supervisors.
At next monthly supervisor visit parent makes an innocent comment to nurse manager about the party & who attended. She casually mentioned she was surprised nurse D not only attended but brought her child; ultimately she was glad client had a wonderful time & enjoyed the celebration, Parent is not upset.
Manager informally speaks with all 4 nurses to reinforce company policy. Notice reminder about gifts & professional boundaries policies is sent to all field staff.
I can understand feeling like you are friends with the parents/family as you work in closely in a home environment. But we are not. The client's school/home is our workplace. General policy is to wear scrubs
and look professional, in addition to wear ID badges when not in home to reinforce the professional image.
What do you think ?
Would you attend a patient/family (invited) celebration on your off time?
What about gifts?
Do you buy gifts, items that are in excess of official agency policy?
What about intentionally introducing client/parents to your family? (Not referring to incidental meetings on days off in the community as ultimately this is bound to happen at the store, school, etc and saying this is my child/wife/husband etc)
Disclaimer....this is NOT about YOU. This is compilation of a few issues I've seen/ heard of occurring in the past few years working private duty pediatrics.