Doing favors or giving gifts for patients: Unacceptable?

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jadelpn, LPN, EMT-B

51 Articles; 4,800 Posts

In my faculty, we were told not to have personal relationships with patients, nor run outside errands for them such as food runs and such. However nothing was said about inside runs such as vending machine runs nor was anything said about giving gifts, nor running errands on off duty. This is where the gray area lays.

When running errands off duty, it is a patient privacy issue. And a conflict of interest. That is how it is stated in my own company policy. A personal relationship is what you are describing, and that is not allowed, as you have stated. Refer to social work.

tariqblaze

tariqblaze

16 Posts

I do agree about not creating friendships outside of work. We have one, very motherly, older nurse who is facebook friends with several former patients. This has always struck me as crossing a line.

Former patients? So lets say for instance you live in a foreign country and you rarely if ever see any people of your kind. One year after many years of working you come across someone you finally make a connection with on a deeper level. Two responsible adults. The patient gets discharged but you know you may not meet anyone like that patient for many months, possibly years to come. What do you do. Let them walk and do not decide to keep in contact, even if you are genuinely interested in following up with them after treatment?

It sounds like a case of workplace rule extremity. Every case cannot be the same. Sometimes truly timeless connections are made and great friendships can occur, but because of a workplace rule, two people who can benefit society together must not be because of some forbidden rule a few men made in suits. Allot of this doesnt sound logical. At least not all of it.

Maybe not...

tariqblaze

tariqblaze

16 Posts

When running errands off duty, it is a patient privacy issue. And a conflict of interest. That is how it is stated in my own company policy. A personal relationship is what you are describing, and that is not allowed, as you have stated. Refer to social work.

I understand. That makes sense actually. Social worker is fine I just wanted to know what to do in a facility where no one cares but you. I have seen patients with genuine urgent needs and literally nobody does anything about it. There is no reference to a social worker or nothing. Actually this is my first time hearing about referring anything to a social worker. It is not that I need a personal relationship with the patient however when I see patients needs go neglected, it gets to me and makes me want to do something. I just want to know what can be done in legal limits. Referring to a social worker is a fine alternative, especially when no one, not even the charge nurse, will do anything about these needs. As long as it gets done, I dont care who does it. It just puts you in a bad position when you are the only one the patient trust and you dont know what to do because the administration didnt instruct you on what to do in these situations and you know something should be done. It is a very bad position to be in. Great advice.

tariqblaze

tariqblaze

16 Posts

When running errands off duty, it is a patient privacy issue. And a conflict of interest. That is how it is stated in my own company policy. A personal relationship is what you are describing, and that is not allowed, as you have stated. Refer to social work.

What do you think about a personal relationship after the patient is no longer under care services? How long should be allowed before a relationship is pursued?

Pepper The Cat

Pepper The Cat, BSN, RN

Specializes in Gerontology. Has 36 years experience. 1,771 Posts

The problem is not so much the relationship with the pt you ate doing the extra favours for, but the pt you are not doing the favours for.

How does it make someone feel, when you see staff giving one pt extra treats such as candy or home made food. Why them and not me?

If I need something at the same time as your "preferred pt" needs something, will they always come first?

Silverlight2010

Silverlight2010

61 Posts

Give gifts, no. Exchange of contact information, no. Errands or favors...we take that on a case by case basis. Who is asking? What is the favor/errand? Why is the patient unable to do this themselves? Patient have any ulterior motives? Are any staff members put in a compromising position due to the request?

Some examples come to mind:

Patient A wants to order in takeout just for themselves and their nurse "who understands me, not like the other ones..." No thanks. (Attempt at staff splitting and manipulation anyone?)

Patient B, on strict bedrest and no visitors expected for some time. Bored beyond belief, anxious about upcoming tests. Patient asks if anyone going downstairs would be willing to take his $2 and get him the daily paper. There is almost always someone willing to do something along those lines. The exchange of cash is witnessed by a second staff member and the change returned with a receipt.

We feel we can be professional and still go the extra mile where and when it's appropriate.

DoeRN

DoeRN

941 Posts

The same with lending a phone for a phone call especially if the operator tells you that patients are not allowed long distance phone calls. Running errands outside of the facility for them. I dont see where the line is drawn here using this one specific example you used. If it is allowed to bring in gifts from outside the facility for a couples wedding' date=' what makes one occasion the exception over the second? Contact outside work doesnt have to be made but when it comes to gifts/favors/errands, where are the lines drawn?[/quote'] I hand the patients the phones located in their rooms, dial the operator or nursing office and tell them the patient needs to make a long distance call. Patients can make them but only through these avenues at my job because they can limit how many long distance calls are placed. I don't lend my cell phone out to patients. And the wedding was coordinated through Make a Wish and we received permission from administration to have the wedding for patient. She invited the staff to the wedding that was performed in a courtyard at the hospital. The hospital president and some of the higher ups attended too. I do not have contact with patients when the nurse patient relationship is over. Just like I'll run and grab an apple juice for a patient. If I have a cancer patient who won't eat regular food but wants potato chips I will run down to the cafeteria and get them some. I don't maintain a relationship with the patients outside of the hospital setting.

Not saying that most of us aren't compassionate but once you are in this career for a while you start to learn that you can't do everything for everyone. You will set yourself up for compassion fatigue

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Edited by DoeRN

Do-over, ASN, RN

Specializes in CICU. 1,085 Posts

Patient that I have taken care of many times. Patient is terminally ill, poor appetite, late evening, and needed to eat something. I asked what sounded good, reply "chocolate".

Yes, I took a buck out of my pocket and got a Snickers from the vending machine. Patient offered to pay me, I refused.

Am I going to buy treats for every patient? Of course not. BUT, if you are very likely to be dead in a matter of months, I will not hesitate to get you your favorite candy bar.

As for the outside relationships, I tend to agree with many of the previous posters. However, those of us that work in smaller community type hospitals are often caring for neighbors, extended family, co-workers, co-worker's family, etc.

DalekRN

DalekRN

194 Posts

I love hearing about the things being done for patients above and beyond. It's super heart warming. Recently I bought lemon slices for a pt who had lost her baby and was on a restricted diet so she could flavor her water and she was so grateful.... Totally worth it.

KRSLPN, LPN

Has 20 years experience. 67 Posts

I agree with the point of view of one of the other members.

The scenario, 2 patients in a room, this could be LTC or acute care. You agree to get patient #1 a bag of chips while on your break, you return, give the chips to that patient and patient #2 observes this. The next day patient #2 asks another nurse to pick them up a cup of coffee while on break. This nurse states, sorry I can't do personal favors for patients. Patient #2 now believes that patient #1 has gotten special treatment which could lead to complaints against you or animosity toward the other patient.

My remedy to this, and although it may sound "cold", I do not purchase anything nor do I lend money nor do I perform any function not related to nursing care. That way nobody can accuse you of anything and there are no misunderstandings.

AZ_LPN_8_26_13

AZ_LPN_8_26_13

461 Posts

I think things like letting patients use your cell phone, running errands for them, accepting or receiving gifts etc. is crossing a line. Personal caregivers or friends/family can do this but not healthcare professionals. You start doing things like this and they can lead you to a place you don't want to go.

P.S.: I have accepted things from patients - like for example a patient wrote a poem with pics with a color crayon thanking me for her care - I still have it stuck to my fridge door in the kitchen.

LadyFree28, BSN, RN

Specializes in Pediatrics, Rehab, Trauma. Has 10 years experience. 8,427 Posts

It is all about boundaries. There are other options for patients other than you personally providing your own cell phone' date=' a social worker can help with things that need to be done errand wise, and to give gifts sets up an expectation that you are the patient's friend and not their nurse. Use your resources available. Doing personal errands for a patient can be a violation of their privacy. Them using your cell phone can be a violation of yours. But again, most facilities have policies and rules regarding this.[/quote']

THIS is so important....we handle people in VERY vulnerable positions; the nurse-patient relationship is a very specific in terms of roles, and a constant assessment may be needed to ensure the integrity of it. One the best things we can do is learn polices and resources at our facilities in order to prevent miscommunication and potential ethical dilemmas and adhere to what's best for the patient.

Give gifts, no. Exchange of contact information, no. Errands or favors...we take that on a case by case basis. Who is asking? What is the favor/errand? Why is the patient unable to do this themselves? Patient have any ulterior motives? Are any staff members put in a compromising position due to the request? Some examples come to mind:

Patient A wants to order in takeout just for themselves and their nurse "who understands me, not like the other ones..." No thanks. (Attempt at staff splitting and manipulation anyone?)

Patient B, on strict bedrest and no visitors expected for some time. Bored beyond belief, anxious about upcoming tests. Patient asks if anyone going downstairs would be willing to take his $2 and get him the daily paper. There is almost always someone willing to do something along those lines. The exchange of cash is witnessed by a second staff member and the change returned with a receipt. We feel we can be professional and still go the extra mile where and when it's appropriate.

Although patients are vulnerable, they are human; and while their body is unhealthy, so may be their coping mechanisms; the example of patient A comes up in many forms; they will ask to use your cell phone, want you to run errands, want you to be their nurse, no one else; that gets a little hairy, regardless of setting. :yes:

Not saying that most of us aren't compassionate but once you are in this career for a while you start to learn that you can't do everything for everyone. You will set yourself up for compassion fatigue Sent from my iPhone using allnurses.com

THIS is a big one. :yes: :yes: :yes:

One of our biggest roles, to me is MAXIMIZING individuals where they are-empowerment...I rather have my patients if they are having emotional and economical distress to utilize the proper resources; I will refer to social work, or any local resources that I know of I will refer a patient to; as well as Psychiatry to assist; I will listen and identify what needs are imperative to be met; however, I am not the end all to resources; there are far more qualified people that can help and it also starts with the patient as well. A small errand, sure; bill problems? No; refer to social work, charity care, nursing office, or whatever resources that are in place. :yes: