first pt gave me a gift--what to do?

[Testa Rosa, RN]

BSN student with first pt on first clinical.

Pt. Cute as a button and sharp as a tack. That wonderful combination of smart and sweet with just enough edge to keep you hopping. End stage renal/CHF/diabetes and had been a nurse for years, so she knew the drill and she figured it out pretty quickly that I had missed a couple things on my care plan. Lost my confidence and then lost it even more when she insisted on calling in her CNA for toileting.

She was a complex pt and I learned a lot from her. I spent all day with her; shared nursing stories. But she was very private and would only allow me to do certain things.

She was an 82 yr old Filipino lady who looked better than some 50 year-olds I know. She had seven children and was well loved by the SNF staff.

She talked about how when her kidneys first failed that she did not want to do dialysis. That she had lived a good life and was prepared to die, but that her kids talked her into the treatment. She dreamt that her dead child told her there were still things she needed to do.

She was deeply religious and wanted to say a prayer for me. It was such a lovely prayer. At the end of our time together, she pulled out a bag of these wooden bracelets made up of flat panels depicting religious icons. I said that I couldn't accept gifts, but she insisted.

I noticed that several of the SNF staff had similar bracelets. I mentioned the gift to my clinical instructor who said I should return the gift and that I should not be accepting gifts in the first place. But, she didn't seem very adamant about it. It's really just a trinket, and I feel it would be rude to return it....and, honestly, I really want to keep it to remember my first (very memorable) pt.

I work with her again tomorrow. I should probably wear the bracelet, but am worried my instructor will see it and remember she told me to return it. I respect my instructor and don't want to do anything to disappoint. I also don't want to be rude to my first pt over a trinket (that I covet).

Any thoughts or feedback?

[VenaKavaRN]

I think it's absolutely wonderful that you connected this much with a patient so soon in your nursing experience!

I've only accepted one gift in my time, and it was from a patient that I will truly remember the rest of my life. We connected in a similar way you did with yours: we talked a lot about her feelings and fears, and reminisced about her recently deceased husband. She told me later that I had helped make her feel like a human being again instead of a lump of flesh.

I was back a few days later. I wasn't assigned to her that day, but she'd been asking my coworkers when I would be back and they told me that she wanted to see me. She hands me a card (addressed to "My Guardian Angel") and a box and inside is a little angel pin. Now, this woman was completely bedbound and spoke through a trach. She had gone to enormous trouble to have someone bring in these items and had then written the card herself. I would not have refused that gift for the WORLD. It's the most beautiful thing anyone has ever given me.

Personal anecdote aside, I think your patient was thanking you in the only way she knew how, and I don't think it was wrong to accept something like that. Also, technically you've already accepted it, and giving it back now would probably be construed as rude/hurtful by your patient. If she gave it out of sincere gratitude and appreciation, instead of 'payment' for something, it made her feel better to express that to you. Keep it in your pocket until you go in her room so your CI doesn't see, and I guarantee it will make the patient feel special to see you remembered it and are wearing it.

Definitely don't get in the habit of doing so (although I haven't had it happen extremely frequently lol), but once in awhile with a special patient who feels better for the gesture, I don't think is wrong.

[locolorenzo22, BSN, RN]

That happened to a friend of mine during our FIRST clinical exp at a low income apartment complex...she went up with an older resident, and the resident was so impressed she insisted on giving my friend a VERY expensive crystal vase....as we were postconferanceing.....the CI explained that as these patients didn't have much money or family, we fulfilled a need for new stimulation.....and that should be gift enough for us....(CI wasn't THAT ticked, but we ended up dropping it back off at front desk and CI wrote a note...)

[RN BSN 2009]

our rule of thumb is that if the gift is just symbolic-accept it

if it has a monetary value-thank the pt but remind the pt that it would violate your code of ethics

however... food offerings are graciously accepted at most facilities i've been to :lol2:

[Dolce, RN]

It really depends upon the nature of the gift. A long term patient of mine was in the hospital every 2 weeks or so for the same procedure. She would make little coasters out of netting material and yarn while she was recovering and on her last visit she gave them to me. I didn't want to accept them but I knew she wanted me to have them. I ended up throwing them away anyway (they smelled like cigarette smoke ). But, the gesture was nice.

I've had little things given to me by patients ($5 dollar gift certificates, flowers, etc).

One time a family gave me and several other caregivers a $50 gift certificate to a nice restaurant in town. We had cared for their dad as he was passing away. I thought that was an excessive gift and so I cleared it with my DON before accepting it.

I think it was perfectly appropriate for you to accept the bracelet--it didn't really have monetary value. It was just a special connection that you had with the patient. However, I don't think you should have to wear it in clinicals in front of your instructor. If the patient asks you about it just tell her that you left it at home.

[stiltarget]

its a test, give it back......just kidding

she is one patient you will never forget, now you have something to remember her by.

[JBudd, MSN]

General rule, don't accept gifts. In most places it is against policy as well. (In the long run, it prevents abuse by demanding gifts in return for good care. This isn't such a big thing in the US, but it does happen.)

Candy, flowers to the unit are generally shared and acceptable, but individual gifts are a no-no. That being said, it sounds like this lady has a large supply of the bracelets since you saw them on other people as well, you didn't solicit it, and its a cultural thing. Keep the bracelet, don't wear it at clinicals, and role play in your head how to graciously refuse things in the future. If people insist they want to do something, I tell them a letter to my boss (or your school) is the best thing they could do for me.

A gift I did accept was for something I did outside of the hospital. CA patient dieing, matter of hours, all the out-of-town daughters wanted to be there but had noone to watch their children at grandma's house. Was two boys, 9 or 10, old enough not to have to be cared for but young enough not to leave alone. I told them I would be in the house for the boys it they didn't care if I slept on the couch (coming off a night shift). They were very grateful, and later sent me a necklace that had belonged to Mom. Still have it, never worn it.

[Alternator81]

I think that is really sweet! I would treasure it! It doesn't sound like a diamond tennis bracelet, so I don't see anything wrong with it.