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.
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.
He or she ( and you) need to realize that emotional attachment to the patient/ family is detrimental to the therapeutic relationship.
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.
Registered nurses are PROFESSIONALS. Professionals neither want or accept "tips" in any form.
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."
I am somewhat elderly, still working and learning.
I always "connect with my patients". They know I care,and assure the best outcome.
Specializes in Med/Surg, OR, Peds, Patient Education.
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.
Apparently you forget that some cultures would be highly offended if she did not accept the gift. Her donation to the charity supporting research on her patient's illness was the correct choice and the one she wisely made.
There was no need to jeopardize her professional future by reporting this issue to "management," a management person that may either not understand other cultures or be vindictive.
Apparently you forget that some cultures would be highly offended if she did not accept the gift. Her donation to the charity supporting research on her patient's illness was the correct choice and the one she wisely made.
There was no need to jeopardize her professional future by reporting this issue to "management," a management person that may either not understand other cultures or be vindictive.
I don't understand this line of reasoning. Did OP mention their patient was from one of these other cultures and I missed it? If not, it seems reasonable (that is, statistically likely) that the patient is a member of this culture. In which case discussion of what's appropriate or not in other cultures seems like handwaving.
Apparently you forget that some cultures would be highly offended if she did not accept the gift. Her donation to the charity supporting research on her patient's illness was the correct choice and the one she wisely made.
There was no need to jeopardize her professional future by reporting this issue to "management," a management person that may either not understand other cultures or be vindictive.
No, I didn't forget. The nurse needed to tell the patient than in this country/culture it is considered inappropriate for her to accept such a gift ... and if he will not take it back, she would be obligated to pass it on to her supervisor. She could/should say this with utmost kindness and respect and reiterate how much she appreciates his generosity.
And as for not telling her supervisor -- that's risky. It would be unlikely that a supervisor would get a person in trouble if they went immediately and reported, asking for help in resolving the situation. But to take money from a patient and NOT tell makes it look as though she encouraged the gift -- and might be taking money from other patients and families as well. Hiding it is the worst offense in this case.
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".
I think this is a false dichotomy, that a nurse can only be cold and professional or soft and fuzzy with porous boundaries. I literally spend my days talking to people who want to kill themselves or other people, getting them to open up about their traumas, abuse, substance use, criminal behavior, hallucinations and other things that fill them with doubt, fear, and shame. I've never found my professionalism to be a deterrent to them discussing things with me. I've found my professionalism is what allows patients to depend on me. My demeanor tells them that I understand what's going on and am educated and talented enough to help them. I'm neither cold nor fuzzy, I'm a happy medium of empathy, emotional connection, and understanding.
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.
My hospital holds all caregivers to the same standard: no employee can accept a gift worth more than $10 from a patient or family member. Whether physicians are held to the policy is a question I can't answer, since I'm not the Policy Police. I take care of my own practice and let them take care of theirs. :)
Specializes in Med/Surg, OR, Peds, Patient Education.
No, I didn't forget. The nurse needed to tell the patient than in this country/culture it is considered inappropriate for her to accept such a gift ... and if he will not take it back, she would be obligated to pass it on to her supervisor. She could/should say this with utmost kindness and respect and reiterate how much she appreciates his generosity.
And as for not telling her supervisor -- that's risky. It would be unlikely that a supervisor would get a person in trouble if they went immediately and reported, asking for help in resolving the situation. But to take money from a patient and NOT tell makes it look as though she encouraged the gift -- and might be taking money from other patients and families as well. Hiding it is the worst offense in this case.[/quote
My nursing education was in a large, metropolitan, very diverse area. Our nation has become even more diverse today. It sounds demeaning and disrespectful to cultures that differ from one's own to "remind" the patient's husband that s/he was not of his culture or nationality. What happened to this nurse is unusual, as most patients or families usually just show gratitude with words, or letters of appreciation. However, unusual situations arise everyday. Under the circumstances I still feel what she or he did was correct and the money apparently went to a good cause.
Reporting this to her/his manager was completely unnecessary and could compromise this nurse's future at that hospital. What would "telling" her/his manager accomplish? Would the manager take the patient's husband to task for giving the gift, in turn possibly insult the gentleman's belief system and breach confidentiality between nurse and patient/patient's family.
OP, I would not let any one on this page that is not treating you medically or psychologically to say that you have a pathological disorder. Also, I would not let anyone tear down your self esteem and nursing practice by calling you unprofessional. However, I will say that as a nurse it is necessary to draw a line between providing compassionate care to your patients and overstepping boundaries as a professional. Many excellent nurses that I work with struggle with this. While I wouldn't believe everything that was said in this thread, I would suggest that you read some of the comments and take them into consideration.
I agree! I have been in a situation very much like this one and in fact asked the family to write the Hospital and recognize our unit. That is what they did and I was very happy with the outcome. As was my Institution.
Been there,done that, ASN, RN
7,241 Posts
He or she ( and you) need to realize that emotional attachment to the patient/ family is detrimental to the therapeutic relationship.