An Unexpected Twist

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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.

Specializes in Management.

Another suggestion is they keep the $50 and purchase something for the entire unit. That way they could thank everyone including you in the process without violating protocols. I have done this myself and it worked out for everyone involved.

Specializes in 15 years in ICU, 22 years in PACU.

If you see a former patient in the cafeteria or other public place, by all means be friendly and say, "Hi". Do NOT inquire about their condition or even say the usually social "How are you doing?" Because they might think you mean it and try to tell you too much which at this point is none of your business..

Totally unprofessional to follow them to another room on your time off. Your professional relationship has ended and you need to let go.

All this being said, I totally get how this could happen and what an uncomfortable position you were suddenly in. Next time you won't seek out this situation and will be better prepared to handle it if you get caught unawares.

Good on you for giving exceptional care. Be proud of that.

Specializes in Critical Care.

We are human and at times we become attached to a patient. I think this may happen more so when we are new and idealistic, but even when we are older and experienced someone may come along that touches your heart. They obviously felt the same way when you came to visit. I wouldn't tell anyone ie your coworkers about the money and giving it to charity was a good idea when he wouldn't take no for an answer. You may even want to confess, but I don't advise it in the real world someone can be too open and honest and it can be used against them as you can see just from some of the negative responses you are getting here! My advice just let the guilt go and leave the patient in God's hands as you've done all you can.

You may never face a patient/family giving you money again. If it happens just suggest they do something for all the staff instead like pizza or cookies, something that can be shared with all the caregivers.

How many of us could only dream to have an attentive nurse like you Pinky. ... You did nothing wrong.

I would actually prefer to have a nurse who understands and maintains appropriate professional boundaries, and would consider it kind of "icky" if a nurse followed me to another part of the hospital to check on me. And even the OP knows that she did something wrong (professionally "wrong" as well as, most likely, a violation of her employer's stated policies) -- that's why she knows she shouldn't mention it to any of her coworkers.

Specializes in IMC, school nursing.

I have had that happen and I immediately told the family that it would go toward our floor petty cash for parties, etc. Thankfully we have that option. Judgement or not, the appropriate thing was to report it immediately, the guilt got worse the longer you held onto it, and you put yourself in a no win situation. OP, I prefer your nursing style over been there, done that's, I would much rather work alongside a nurse who has a semblance of compassion than one who is "professional". I have done this gig for 28 years, and the nurses who make me cringe the most are described as "professional". We also need to readdress this gift thing now that almost all physicians are hospital employees and physicians don't even give a second thought to gifts. Do hospitals hold them to this policy? I haven't seen a change in the physicians I work with.

I have had that happen and I immediately told the family that it would go toward our floor petty cash for parties, etc. Thankfully we have that option. Judgement or not, the appropriate thing was to report it immediately, the guilt got worse the longer you held onto it, and you put yourself in a no win situation. OP, I prefer your nursing style over been there, done that's, I would much rather work alongside a nurse who has a semblance of compassion than one who is "professional". I have done this gig for 28 years, and the nurses who make me cringe the most are described as "professional". We also need to readdress this gift thing now that almost all physicians are hospital employees and physicians don't even give a second thought to gifts. Do hospitals hold them to this policy? I haven't seen a change in the physicians I work with.

You really don't know my style, Mr. Nurse.

33 years of caring, advocating , and especially.. doing whatever it takes to control pain.

I feel nurses should be empathetic, not sympathetic.

That is the definition of professional.

The general reaction to this person's post is one of the fundamental problems in nursing as a career...a bunch of you jumped all over this nurse for giving in and accepting a monetary gift from a patient's family. (S)he tried to politely decline the gift but was afraid to insult the family member. (S)he ended up doing something positive with the cash, rather than keeping it. Are we all perfect? No. Are we all so good that we don't need to learn something new? Absolutely not. We are all human, we make mistakes, and we care about others. A bunch of you also mentioned that this nurse also went to check on the patient in the step down. There is nothing wrong with this either. It only crosses lines if addresses and phone numbers are exchanged and long term friendships are formed. Some of these posts sound like a group of jaded, burned out people to me. Embrace this (presumably) younger nurse for his/her caring, refreshing, unburned out attitude. He/she is a credit to our profession.

A bunch of you also mentioned that this nurse also went to check on the patient in the step down. There is nothing wrong with this either. It only crosses lines if addresses and phone numbers are exchanged and long term friendships are formed.

Well, everyone's entitled to her/his own opinion, but I strongly disagree about this. The line was crossed when the nurse went to another floor to check on someone who was no longer her/his client. That action is about meeting one's own emotional needs and curiosity rather than the client's needs, and is actively fostering an unhealthy and inappropriate dependence on the nurse who is no longer part of the client's care.

I'm not saying that that was the end of the world, just that it is a boundary violation and unprofessional behavior that it would be better to avoid in the future.

Specializes in Med/Surg, OR, Peds, Patient Education.
Yes.. I said it was unprofessional.

Standards of Practice state:Nurses use professional judgment to determine the appropriate boundaries of a therapeutic relations

nurses do not exchange gifts with clients

The relationship differs from a social relationship in that it is designed to meet the needs only of the client.

Even suggesting the husband give kudos by a survey violates that standard.

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

Now that I am retired, elderly and although still cogent, but not in the best of health, should I or a loved one need to be hospitalized I would prefer the nurse who was able to connect with her patients. It is sometimes impossible to "just go home and forget about it."

What about off duty? I was with my bf, who is an RN, at Starbucks when he ran into a past patient's relative. The relative praised my boyfriend for his care and then handed him a Starbucks gift card. I didn't see anything wrong with him accepting the gift, but I think if he were at work that might be different.

What about off duty? I was with my bf, who is an RN, at Starbucks when he ran into a past patient's relative. The relative praised my boyfriend for his care and then handed him a Starbucks gift card. I didn't see anything wrong with him accepting the gift, but I think if he were at work that might be different.

Your boyfriend is an RN 24/7/365. The professional ethical standards aren't any different outside of work. If it's wrong to accept a gift (esp. money) at work, it's wrong to accept a gift outside of work.

Okay! It wasn't a large amount of money at all and I did not know because I'm in nursing school but I will remember this in the future. I will also remind him in case it happens again. There have been a few times when I've been with him and patient or a patient's relative approaches him but this is the only time one of them has given him something.

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