Is buying a present for a pt. appropriate?

LoriAlabamaRN · Oct 31, 2005

I'm actually the house supervisor for my LTC facility, and there's never been a problem. Even our CNAs will pick up trinkets for some of the residents on occasion, and actually there are signs posted by management for gifts to be given to residents for Christmas. Check with your supervisor, see what he or she thinks.

Also, the concept of pushing religious beliefs on people (proselytizing, right?) doesn't apply here... he has religious ties and literature. We provide bibles to residents who would like them, churches in the area donate them. We also have church services available for anyone who chooses to worship. As long as a bible fits with his religious beliefs, there should not be any problem with it.

rn/writer, RN · Oct 31, 2005

I have to agree that it's a good idea but I am nurse who has been in trouble more then a few time for unproffessionalism. I think that if you leave the book in his room and don't tell him who it's from that would be the best. Also the idea of giving him a bible might not be a good idea. I have nothing against church or bibles. But most places frown on nurses pushing their religious beliefs on to their patients. I'm not saything that you do, but from your nursing supervisors position you giving a religious gift might not send the signal that you want to send. I would leave the book for him and not tell him who it's from. That way if anything happens to the book the patient won't associate you with book. I also think that if he likes to read to get him hooked up with a libary somewhere. you buying him books every so often could get expensive. The patient might also feel guilty for having you do things for him because he may regaurd you as a friend now and not as a nurse.

If he's reading Psalms and liturgical items, she wouldn't be promoting her own religious beliefs but rather giving him more of his own.

To address the objections of others, there's a big difference between giving a gift to someone in an acute care setting and giving one to someone who is a resident in LTC. If you wanted to do something nice for a patient in a hospital, you could, perhaps, do something for them outside the facility, but how do you manage that when your work place is where the man lives?

I'd suggest a couple of things. First, speak with your manager about maybe getting the local library to provide shut-in service to the entire facility. This would benefit not only your gentleman but the other residents as well. You could, of course, whisper in his ear that he inspired the idea.

If the library doesn't have such a service, contact area churches, scout troops, vets organizations, frat or sorority houses, and other groups who might be looking for a worthwhile service project. Suggest that they collect donated books and magazines on a regular basis--say, quarterly--and bring fresh reading materials in for all the residents.

And third, if you are still so inclined and your manager has no objection, bring in the Bible for your resident, but come in on your own time and dressed in street clothes. This ought to serve as a demarcation between your professional role and your personal one and say to him that you see him as a friend as well as a resident.

As I said earlier, when you are speaking about residents in LTC, you have to take into account that you are working in the only home they now have. Just as you would have the option to visit any person in their place of residence, you can come to see him as if he lived in an apartment building.

I find it hard to believe that anyone with even a sliver of a heart would begrudge an 80-year-old man a bit of affection and attention.

I commend your for your caring spirit.

**RosesrReder, BSN, MSN, RN** · Oct 31, 2005

I also think it's appropriate.
With that said...if an anonymous person slipped this gentleman a Bible...whose to know who gave it. I tend to find the most pleasure of giving a gift if the person doesn't know it came from me. That way I can stand back and watch their true expression and they never know! :)

This is what I would do too. :)

Mandylou · Oct 31, 2005

I can speak from the other side of the fence on this issue. When my son was in the hospital, we were there a long long time. Anyway, my daughter's fourth birthday came around. One of my son's nurses came in for her night shift. A little later her husband showed up with their kids. Her kids gave my daughter a birthday present and cupcakes. It was the sweetest thing that someone has ever done for us and I will never forget her kindness. She had even made a birthday banner and hung it up in my son's room.

I guess you learn that things like that are not appropriate but I it is hard for me to find fault in it.

sbic56, BSN, RN · Oct 31, 2005

I can speak from the other side of the fence on this issue. When my son was in the hospital, we were there a long long time. Anyway, my daughter's fourth birthday came around. One of my son's nurses came in for her night shift. A little later her husband showed up with their kids. Her kids gave my daughter a birthday present and cupcakes. It was the sweetest thing that someone has ever done for us and I will never forget her kindness. She had even made a birthday banner and hung it up in my son's room.
I guess you learn that things like that are not appropriate but I it is hard for me to find fault in it.

Beautiful. Another exception to the rule. Empathy and caring are never inappropriate. Nurses are known for knowing that. :)

Daytonite, BSN, RN · Oct 31, 2005

I. . .am being taught no to gifts of any kind regardless of the reason. We are instead being taught to spend some time w/pt reading to them or talking ect.

I was taught the same also back in 1973. When I was in my BSN program we had to study all the major nursing theorists. We had some very lively discussions about giving patient's gifts, hugging patients, and saying that forbidden phrase, "everything is going to be OK". The fact is these things are not illegal and only the views of professionalism of some theorists. However, there are a couple of nursing theorists out there who say that these actions, within good taste and in an appropriate circumstance are indeed OK. Nursing is a service industry and really taps into our nurturing and giving nature. It is not normal to deny that part of humanity within us. It is why many of us went into nursing in the first place. It is why we flock by the hundreds to help others out when there has been a tragedy of some sort. Let me also add that the way we find out these little things about what a patient likes is because we did spend time with them listening and talking to them. Especially in long term care when you get to know some of your patients very well, your natural instinct to share with those you come to love, and I mean this in a platonic sense, comes out--can't be helped. Bring this argument up with your instructors.

babynurselsa, RN · Oct 31, 2005

I have given gifts several times. I have given outfits andsmall toys to some of my long term NICU babies. Once I left some gas money anonymously for an extremely poor out of town family beacuse they had difficulty coming to see their baby due to no gas money. I have also gifted some of my hospice patients.

These have all been longer term relationships where we have bonded on some level and I say the need. THese were given from the heart. I am a person before I am a nurse.

SmilingBluEyes · Oct 31, 2005

Inappropriate to me. It crosses a line I don't want to cross-----I think the best "gift" I can give anyone is the best possible care while they are with me. And a warm, genuine hug now and again.

although---I can see the NICU exception above. I guess, where I am, I would definately see it as crossing the line of professionalism for me.

rn/writer, RN · Oct 31, 2005

Inappropriate to me. It crosses a line I don't want to cross-----I think the best "gift" I can give anyone is the best possible care while they are with me. And a warm, genuine hug now and again.
although---I can see the NICU exception above. I guess, where I am, I would definately see it as crossing the line of professionalism for me.

I still think there's a major difference between giving a gift to a patient and giving a gift to a resident in the setting that is now their home. Especially if you do it on your own time.

(NICU kids who are in for a long time are sort of in between and gifts in that context are more directed to the parents than the patient.)

If done for the right reasons and without inviting a lot of attention, I believe there are ways to express kindness and help meet needs without crossing over into unprofessional behavior.

SmilingBluEyes · Oct 31, 2005

TO me, anyhow, "residents" are not patients.

mandykal, ADN, RN · Oct 31, 2005

I gave a big flower arrangement, one of those with small different plant pots to a resident. It was her b-day and she had no kids just a niece. But I didn't say it was directly from me but from the whole staff. I had it delivered because I didn't want to show who it came from. The plants survived for months and she smiled more often. :)

estrogen · Oct 31, 2005

I really really appreciate everyone's thaughts on this, the pros and the cons. All of them, without exception are valid. I would like to point our one thing though.

In this case me wanting to give this gentleman a gift is not just because I desire to be kind, or for me to feel good, or to in other ways satisfy my urges for charity. (Eventhough there wouldn't be nothing wrong with that either.) This man has noone. He is and has been for years completely incapacitated. We, the health care workers are the only people he EVER comes in contact with. This man, as I found out from his chart, has zero own resources. He cannot ask someone to go and buy him a book, or a video or audio tape. He can't ask someone to go buy him a new shirt, or even something good to eat (well, he doesn't eat, but if he did...) He is completely dependent on what others, provide for him, which, as you can imagine, are basicaly only the bare necessities - shelter, food, medical care. Not that there isn't anything to be said for occupational therapy, but really, how much diversion can they provide for him after years of staying in the same facility?

So to me this isn't (wouldn't be) about catering to any of my needs, like the desire to give someone a present, because I like them. To me this is a rather practical, more then somehow a spiritual issue.

To me it would be catering to his basic need for sensory stimulation, to me it would be essentially... well, nursing.