Need help with an ethical dilemma: taking gifts from patients

[WannaBeNrse]

Hi,

I am a first semester nursing student, and for my nursing ethics class, we have to do a project involving an ethical dilemma. Mine is about a home care nurse who has a terminally ill elderly client. The client wants to give the nurse an antique watch as a sign of his appreciation. Now, most work policies will tell you that this is unethical and therefore prohibited. My problem is, for the assignment, I have to argue the other side (accepting the watch), and find the legal background to support this. My instructor told me that there is something out there. I tried google but so far did not come up with anything. Where would be a good place to look for something like that? stateboard of nursing? state law? federal law? I am in Minnesota. Does anyone of you LNC's know off-hand if and how the law would back a nurse who takes an expensive gift from a client? Any help would be greatly appreaciated....

Thanks!!

[sirI, MSN, APRN, NP]

Hi,

I am a first semester nursing student, and for my nursing ethics class, we have to do a project involving an ethical dilemma. Mine is about a home care nurse who has a terminally ill elderly client. The client wants to give the nurse an antique watch as a sign of his appreciation. Now, most work policies will tell you that this is unethical and therefore prohibited. My problem is, for the assignment, I have to argue the other side (accepting the watch), and find the legal background to support this. My instructor told me that there is something out there. I tried google but so far did not come up with anything. Where would be a good place to look for something like that? stateboard of nursing? state law? federal law? I am in Minnesota. Does anyone of you LNC's know off-hand if and how the law would back a nurse who takes an expensive gift from a client? Any help would be greatly appreaciated....

Thanks!!

Hello, WannaBeNrse

I moved your thread to the General Nursing Student Discussion to attract a larger audience and better response.

Excellent ethical discussion. And, very difficult to be on the side accepting the gift/gratuity. This is better known as "boundary issues and boundary violations".

You should first check the Minnesota Board of Nursing (BON) Nurse Practice Act (NPA) and/or other Rules/Regulations).

As for laws that protect the nurse, I cannot offer any help there.

Some facilities will address in their Policy/Procedures something like the following:

1. Nurses cannot accept gratuities.
   
2. Nurses can accept gratuities if this practice does not violate any state or federal law or violate the BON/NPA.
   
3. Nurses can accept gifts of nominal value.
   
4. Nurses cannot accept gifts if based on reciprocal agreement (obligation) and/or capable of influencing the nurse-patient bond.
   
5. Nurses cannot accept cash gifts.
   
6. Nurses cannot accept gifts for personal benefit.
   
7. Nurses can accept non-monetary gratuities or gifts if the value is $50 or less.
   

One thing the nurse should be aware of are boundary violations and should ask him/herself the following questions and self-reflect:

• Is this what my fellow colleagues would do given the same situation?
  
• Is the gift given only to one nurse and not the entire nursing team?
  
• Is accepting a gift a part of the facility's routine practice?
  
• Are there facility policies/procedures addressing accepting gifts from patients?
  

So, start with your BON and see if it is addressed there.

Here is an interesting discussion from Medscape (you may have to register, but it is a free site):

http://medscapenursing.blogs.com/medscape_nursing/2008/05/should-nurses-a.html

And, if you can find this article, "Gifts from patients: what is acceptable?", it might be helpful. Try researching, The Kenneth B. Schwartz Center.

And, check with Hospice organizations for regulations especially caregiver roles.

I don't know if I was of any help at all. I do wish you luck on this very interesting ethical debate.