An Unexpected Twist

Nurses General Nursing

Published

I work in an adult ICU where I had the privilege of caring for a wonderful patient for 3 days in a row. She was the kindest, sweetest woman, who unfortunately had something terrible happen to her. Despite the unfortunate circumstances, her positive attitude and spirit were inspiring. Her family was just as wonderful. I grew close to her and her family over the 3 days I worked.

On the last day, I transferred her to a step-down unit. After my shift was over, I stopped by her new room to visit her and her family. I wanted to check on them, make sure they were doing ok, and let them know I was thinking about them (I was going to be off work for a few days and didn't know if I'd ever see them again). After saying my goodbyes, hugging the patient and her family, and stepping out into the hallway, the husband pulled me aside. He thanked me for the exceptional care I had given his wife, told me I was a great nurse, and wanted me to know how much I was appreciated. He started to tear up and so did I. It was an emotional, touching experience. He went to shake my hand, and that's when I felt it....the folded up piece of money in his hand. My heart sank.

Immediately, I told him I could not accept his money. But he insisted. He wanted me to know how truly grateful he was. Again I told him I would not accept it. He wouldn't listen. Defeated, and not wanting to make a scene, or be disrespectful, I put the bill in my pocket and walked away. When I got to the elevator I was so confused. I wanted to cry. I felt guilty and ashamed. I wondered if I had done the right thing by stopping by to visit her after my shift. I convinced myself that if I hadn't stopped by, none of this would have happened. And worst of all, I felt alone. I didn't want to tell any of my co-workers in fear of being judged, getting in trouble, or worst of all being fired.

I took the bill out of my pocket when I got to my car. $50. The whole drive home, all I felt was sadness. I replayed the previous scenario over and over again in my head. What I could have said. What I should have done. When I got home, I put the $50 bill on my kitchen table. I decided that I wasn't going to spend it. I couldn't even think about spending it. I looked at it over and over. The guilt never subsided. A few days passed, and that's when I decided what to do.

I found a non-profit organization that dealt with the same condition that she unfortunately had to experience. Then I made a donation in her honor using the money her husband had given me. Instead of keeping the money, and feeling guilty, ashamed, and sad, I decided to turn this experience into something positive. I knew that the patient and her family wouldn't want me to feel upset, and I wasn't going to let myself be upset either.

Put in the same situation, I would have told the husband that if he wanted to thank me, he could write about his experience on our hospital survey. I would have told him to recognize our unit and our nurses as the best. Because we are.

Sometimes being a nurse can be a thankless job. We provide our patients with exceptional care despite hospital-wide budget cuts and staffing shortages. We come to work early and leave late. We don't always get breaks. Sometimes we don't even have time to use the restroom. We apologize for things that sometimes aren't our fault. We get can get spit on, bit, kicked, and be manipulated by patients. We work in high-demand, high-stress environments that would break the weak. We are exposed to all types of bodily secretions. We are advocates for patients who don't have family. We speak up for those patients who society has given up on; the homeless, the drug and alcohol abusers, prisoners, and gang members. But when it's all said and done, we have the honor and privilege of caring for patients and their families at their most vulnerable time.

I don't know about you, but I think our job is pretty awesome. And while I'm still uneasy about receiving money from my patient's husband, I know that he did it because he wanted me to know how much I was appreciated. How much nurses are appreciated. Because we are the heartbeat of the hospital. And we make a difference each and every day.

I'm home health and with patients' homes as our setting you can imagine the amount of gifts patients and families want to give without us anywhere near being pathological.

Money is just as big of a no-no for us as inpatient and I was given a thank you card on my last visit that I didn't open til later. I reported the $50 immediately to my supervisor to ask how to handle it. She said the 2 options were the family took it back or agreed to putting it towards a donation to our patient foundation. The giver didn't want to take it back and reluctantly agreed to donating to the foundation.

It was awkward and I hated embarrassing her but there is no way I would let that sort of thing hang over me.

I don't necessarily think the OP was behaving pathologically but I don't understand why he/she didn't go straight to the supervisor.

It is tough. Sometimes we relate to a patient for one reason or another. Sometimes our emotions cloud up professional boundaries. It happens. It isn't the end of the world, but it isn't something you should make a habit of. It takes a toll on you. Accepting the "tip" was wrong, but now you know that and know just how guilty you feel after. Again not the end of the world, but instead a lesson learned. Don't beat yourself up too much. Just reflect and decide how to handle things better next time.

Specializes in Vascular Access.

Have any of you had someone who was sooo grateful that they would be insulted if you did not accept their gift to you? I have been in this situation too, and I think one of two things could be appropriate: One, as long as it is a monetary amount/gift amount BELOW your hospital policy allowed, tell the family member how much you appreciate it, but that you do not need extra money for doing your job well, but that you will also be paying it forward to the volunteer dept. in your local hospital. Or, take the money and buy your fellow nrsg staff food. This shows appreciation for the entire staff.

The safest thing to do in that situation is to go to management, say "A family gave me this. They were very insistent, and I didn't feel I could say no without causing offense", and turn it in. Maybe specify that you'd like it donated to some fund or another if allowed.

If this was the first time you were given money than I would chalk it up to being so surprised you weren't able to think it through on the spot. If this happens again (and it probably will) then I advise not taking the money no matter what the family says. Tell them outright that it is against your instituion's policy and that you could be fired. I know we were warned that we would be fired if we accepted money or gift cards where I worked, but we could accept other presents if they were inexpensive or homemade. It was a pediatric oncology floor so we actually were given quite a few gifts, esp around the holidays.

As far as visiting the patient on another floor - we did that whenever our kids were in PICU. Somebody would run down and get an update. We would also read the PICU notes in the computer, but now that is considered a HIPAA violation and isn't allowed any more. I find the opinions on the visiting the other floor very interesting and I like reading a different perspective. The hospital I worked at also made sure to have respresentation at our kid's funerals too.

Specializes in Nursing Professional Development.

If the family really would not take the money back, she could have -- and should have -- reported it to her supervisor immediately. Also, she could have told the family that she would be turning the money over to the management if he did not take it back.

There is nothing wrong with caring ... or giving a patient or family member a hug ... etc. But taking the money is wrong and she should not have done that. Period. If she was incapable of getting the family to take it back, she should have gone to her supervisor and asked for help in doing the right thing.

Professionals do their job, go home and forget about it.

Sometimes I do go home and think I wonder if "so and so" is doing better on my days off. The childrens made me this way! Don't think it's unprofessional to think about patients once u go home. (Unless it starts interfering with your home life)

Not a reply to your comment:

It is Unprofessional to take money no matter how persist they are.

A LOL once gave me $20 and was so persistent.

I immediately told the son his mother gave me $20 but I put it back in her nightstand as I am unable to accept money. I would have felt so guilty taking that money even if it was put toward a donation.

Specializes in OB.

I had a few patients try to "tip" me over the years and honestly, even though I knew it came from a good place, it insulted me to think that they thought of a nurse as someone you CAN tip, rather than someone who is an educated, licensed professional doing their job. Granted, all were people on the elderly side who I'm sure have no real knowledge of the nursing profession and its educational standards. I always gave the money back with firm insistence that it is all part of my job. I like the suggestion someone made to tell the patient/family that the best "tip" they can give you is a compliment to your manager.

Additionally, while it is absolutely normal to wonder about how a patient is doing after you care for them, I think you overstepped your boundaries with this family and got too emotionally involved. It's human to care about people, but you will burn out if you can't learn where to draw the line. Just my two cents.

Specializes in Critical care.

Pizza and beer on me tonight! Just kidding .... or am I?

Cheers (hehe)

I think it helps the families when a nurse who had previously cared for them under emotional circumstances pops in quickly to say hello. It shows that the staff care about them, and it may even add to that all-important patient satisfaction survey. I would never fully go into the room or ask about their current health. I would just wish them good luck or best of health and then that's that.

Accepting money is a big no-no. Accepting anything, really. I once came to work and found a thank you note and a hand-crafted item left for me by a patient's mom, but it was not worth much. My manager handed to me. The mom had made several of these for specific nurses.

If one is getting that emotionally entangled with a family within a 3 day time period, one really needs to take a step back and reassess how to NOT do that going forward.

Having compassion for a patient is wildly different than keeping a "relationship" going from unit to unit.

Further, a few more of those kinds of situations and nurses get burnt out, suffer from compassion fatigue, and what goes on inside the walls of the facility seep their way into the front door of one's home.

No matter how well intended, there is a process of letting go. Especially if this patient graduated to a step down unit. Focus needs to be on function and goals and not that the nurse that took care of them in the ICU is reminding them they came close to death. Because of their own need to feel.....well feel needed, wanted, that they "saved life"? That the family saw your visit as some sort of obligation on their part?

"How nice of you!! But,I can not take this, as I will get fired. The best thing you can do is to buy your wife a nice dinner when she gets out of here!!" But again, OP you sought out this family. Lesson hopefully learned.

Specializes in Infusion Nursing, Home Health Infusion.

Check your organization's policies...many allow patients and families to expess their gratitude with gifts of less th

+ Add a Comment