Tipped? - page 4

This was too funny ... I had a patient on Saturday who was VERY high maintenance -- literally screaming (in my ear, ouch) in pain. Screaming. My charge nurse thought she was a psych patient! In any... Read More

  1. by   Medic09
    Quote from ThrowEdNurse
    Oh God, I would never get paid. My pts are indignet and unemployed and uninsured. My pts don't bath. My pts don't eat out, tip waiters, let alone tip nurses. God help me, I would never get paid!!

    Ditto, more than 50% of the time.
  2. by   MauraRN
    OK I'll bite; unethical to accept tip pursuant to board of regulation in nursing. Critically thinking; pt comes for a return visit, or brings in a family member and asks for "... that nice nurse that I gave a big tip to last time I was here." Do I now owe them more of my attention based on being indebted to the tipper? What about my other patients; will they feel slighted? Or will they sue me because I took better care of my big tipper? If big tipper guy came drug seeking, would he think I would be more willing to help his cause? What about co=workers? Will we all start grabbing up the likely big tipper patients and ignoring the homeless person who truly needs our attention?
  3. by   canoehead
    I don't want tipping to be a factor in my care. I don't want anyone to feel obligated to tip when they are having one of the worst days of their life, and I don't want to have to calculate tips and entitlement as part of my nursing priorities. It's hard enough juggling patients based on acuities. Don't tell me that tips won't be a factor in quality of care. PG survey results have people twisting themselves in knots- cold hard cash will make it even worse. I know nurses that request flat out that patients write their names on the survey, and spend extra face time with patients that agree. What about the confused, the indigent, the families going through a crisis? They don't need the extra hassle IMO.
  4. by   Riseupandnurse
    Absolutely, canoehead. That's one of the HUGE flaws with Press Ganey. If I have one patient who is A/O and will fill out a survey, and one who is out of it with no family members, which one does PG say to give the attention to? Huh-uh, no. Care goes to those who need it; that is nursing. I am NOT a customer service technician.
  5. by   nursel56
    MWBoswell, I think you didn't get reactions right away because, the idea of nurses working for tips like waitresses is just viscerally offensive and the "why" isn't immediately clear. But it's probably because waiters, porters, cab drivers, guys that dry our cars, and manicurists are tipped, doctors, teachers, managers, and other professionals aren't and we fit into the second category.

    However, things that used to be huge "no-no"s back in the misty eons(cue 1970s nostalgia) are commonplace, (OK, here I go) Doctors would not advertise, Pharmaceuticals would not make up catchy names for stuff and hawk it via TV, Patients wouldn't wear diapers, and grown men would not appear on Carl's Jr. commercials eating with their mouth open and food hanging out of their mouth.

    If the younger nurses don't see a problem with it, it will become reality eventually. Just the way things, evolve, I guess.
  6. by   mwboswell
    Quote from janhetherington
    Absolutely, canoehead. That's one of the HUGE flaws with Press Ganey. If I have one patient who is A/O and will fill out a survey, and one who is out of it with no family members, which one does PG say to give the attention to? Huh-uh, no. Care goes to those who need it; that is nursing. I am NOT a customer service technician.
    I don't know if I understand when you say "which one does PG say to give the attention to?"....

    Side note: When patients and families were surveyed in a research study, the #1 thing they most often reported that made the difference in "quality of care" was simply explaining things to them, it wasn't the amount of time spent, it wasn't the food/drinks/blankets/TV's; it was merely the health care worker telling them what was going on.

    When you give good nursing care to those who need it, you ARE giving good customer service - it's inevitable.
  7. by   bill4745
    I once was offered $5 as I was discharging (ER) an elderly man. It almost put tears in my eyes.
    Last edit by bill4745 on Jun 7, '09 : Reason: spelling
  8. by   canoehead
    Quote from mwboswell
    I don't know if I understand when you say "which one does PG say to give the attention to?".....
    If I was working for PG scores I'd spend my time with the alert and oriented patients that would remember my name, and forget about confused patients, or elderly without families. I would give lots of pain meds, and neglect ambulation, and deep breathing and coughing. I'd provide the diabetics with soft drinks and ice cream, and fluff pillows and bend straws without encouraging independence. My patients would get pneumonia and bedsores, and later die in the ICU, but they would THINK I was a fabulous, caring nurse.
  9. by   ThrowEdNurse
    Don't know about all hospitals, but ours only sends PG surveys to pts that were discharged home. Helloooo, that means the sick ones that we spend more of our time with and taking care of don't get surveys, they get admitted. The life sucking trolls with toothaches and STDS who go home after IM rocephin get to evaluate me!!
  10. by   Aneroo
    Quote from mwboswell
    Okay, I understand that - but I'm challenging you guys to think deeper than "just because I was told not to"....

    With the recent emphasis on "evidence based" practice, we have called to scrutiny things that we were just "taught" to do unquestioningly. Now we are starting to look at the reasons and rationales.

    So back to the question, yes, you may have been taught not to accept these things, but WHY???????

    Any takers?
    Because some nurses wouldn't treat all patients the same way, the same reason we have EMTALA. So someone with no job and torn clothes can come in and they should receive the same care as the rich dude (HA).
    Similar to the waitress who tends to the well dressed proper family but doesn't spend an equal amount of time or energy with the family that appears to be poor.
  11. by   TheNewCuteNurse
    What if they try to sue you??? As i been taught, you can help someone but if you accept payments and the pt c/o something being wrong...they can sue you. Just thinking of the worst.

    and congrats on ur 1st tip
  12. by   emtb2rn
    I've been offered tips as an RN, EMT and ski patroller. I just say "Thanks but I can't accept it. Please donate the money to your favorite charity".
  13. by   Knoodsen
    The hospital tells me that I cannot accept gifts that have any value, but I think they will take "donations". In fact, they seek them out. They have set a limit on the monetary value of snacks that I may accept. It's lower than the limit established for more important people, of course. My opinion? That's our culture. In many countries, the police augment their incomes with bribes. That is not acceptable here and yet those at the top may be bribed ad lib. They who lie, cheat, and steal are very concerned about my ethics.

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