Do Patients Try to Tip You?

Published

Yesterday I had a very difficult delivery- abruption, stat c/s, infant to special care nursery but doing surprisingly well. I followed the patient from OR to pp, and today (after answering about a zillion call lights from the pt) I was again called to the pt's room. "My husband has something for you," said the patient. "You have been very kind, taking such good care of us," The husband stepped forward and pressed a $10 bill into my hand. I quickly explained that tips are not allowed, that I am paid by the hospital and that while I appreciated the gesture, knowing that mom and baby were healthy was all I had hoped for. The couple (who are of Middle Eastern descent) stated that it is their custom to do so, and something to the effect that it would bring good health and fortune to the baby, and wouldn't take the money back.

The call bells were going off and baby was due in the nursery for IV abx- I was so flustered I just thanked the couple, and took the baby to the nursery, tucking the $$ in my pocket.

I didn't want to insult the family, but on the other hand it's against policy to accept gifts of cash. We constantly get candy/donuts & coffee/flowers etc. and occasionally a gift card, but this I think, is different.

What do you do when patients try to tip you? What's the best way to graciously decline a tip without insulting the patient/family? I'veonly been a nurse for 2 years, and I was just caught off guard by this gesture.

Up Vote Up Vote ×

Honestly, I think the admin. would be more upset if you offended the pt. I would have gone to my nurse manager and explained the situation and told her that I would like to place the $10 toward the next CF, Cancer, etc. walk that the staff participates in...

I can totally understand you being caught off guard!

Up Vote Up Vote ×

Thanks for the reply :) A nurse from our unit is raising money to participate in a mission to an orphanage in Africa next month- I will feel better knowing my windfall will go to help little ones far away. :)

Up Vote Up Vote ×

Other cultures (especially old ones) can have very complex and detailed customs surrounding major life events like birth, coming of age, marriage and death. In India, for example, the gift giving is very detailed and specified down to the details such as - on this particular day, you give this relative this, and this relative this and this relative this, and so on and so on. and on the same day, you give these frends these things, and these other ones this other stuff. It blew my american mind to see how complicated all of this stuff is, but every single custom had a reason behind the particular action. Also, there are many "money blessings" given new babies and given new wives, and husbands, and so that you would be given a "money gift" from this couple is not so strange.

Just please understand that they were not tipping you. That was a thank you money gift.

Does that make any sense?

Up Vote Up Vote ×

:roll When I first read this topic, I thought it said "Do your patients ever try to TRIP you, which is much more likely where I work!

Up Vote Up Vote ×

I had one elderly russian pt tip me $20 one night, I tried to trun it down but he was very insistant, I explained that the hospital pays me for "all those nice things" He glared, shook his head and with a lot of arm movement said No, You are more than hospital, You are friend. At his age I figured he'd been hospitalized enough to know when he was happy and when he wasn't and I couldn't argue anymore so I took it, but ended up slipping it back to a trusted granddaughter.

The hardest I guess was when I was a home health aide/ starving nursing student. My agency called and said they needed a HHA for a one time case- a family had requested that someone escort an elderly woman to her grandson's wedding. The daughter knew she would be too busy with the wedding and guests to properly attend to her and that she could not safely be at the wedding with out help. I was paid for my shift, and enjoyed the most extragent country club wedding I've ever been to! To top it off another grandson tried to tip me $100. I could have used that! They also wouldn't understand why I kept turning down cocktail offers, LOL

Up Vote Up Vote ×
Specializes in Peds - playing with the kids.

Hi,

Just a couple of times in all of these years. You politely decline, and if they insist, you don't want to insult them. Giving to the next charitable event sounds like a great plan.

They must have been very impressed with you !

Up Vote Up Vote ×

Took care of a wealthy Middle Eastern who very generously tipped me. Definatley cultural and a huge insult to turn it down.:nono:

I bought everyone lunch that day. ;)

Up Vote Up Vote ×

I think the most important aspect of this is to tell your charge nurse or someone else in authority immediately so that it doesn't look like you're just going to pocket the money. That way, if the patient or a family member mentions the gift to someone else, you're covered.

Then, as others have suggested, turn it into a donation or use it to buy a treat for the unit.

The nice thing about this solution is that if the patient finds out that you didn't keep the money, you can say that you spent it in a way that gave you great pleasure.

Up Vote Up Vote ×

Definitely cultural. I had this happen several times when I worked in Vancouver. It would be impolite to turn it down, so we would just explain that we weren't allowed to take money, but if it was alright with them we'd order some food and use the money for that. A lot of hungry fathers to be enjoyed the food too:)

Up Vote Up Vote ×
Specializes in med/surg/tele/neuro/rehab/corrections.
:roll When I first read this topic, I thought it said "Do your patients ever try to TRIP you,

Yes I thought the same thing! :lol2:

I think the OP handled the situation very well.

Up Vote Up Vote ×
Specializes in CV Surgery Step-down.

I had a pt who tried to give me ten bucks for shaving his beard!

Up Vote Up Vote ×
+ Join the Discussion