Doing favors or giving gifts for patients: Unacceptable?

Nurses Relations

Published

Is this a generally unwise thing to do? Giving gifts to patients, whether it is small like a piece of candy, or large like sending flowers. Is this something not generally accepted in the health care positions, or any positions in any career? We all know about teachers accepting apples from students and that has never been generally frowned upon so why the difference when healthcare is involved?

Or doing favors for patients such as a patient being admitted to a facility and has no way to contact their family because their phone is off and needs a phone card but is not allowed to leave the facility.

They have the money but just need someone to run and get it.

--Or they need to borrow your phone to make a quick call.

--Or rather would like you to run and get a meal for them from a restaurant with their own money.

It is not like giving a gift but rather doing a favor for a patient that is not necessarily in your line of care but is done out of friendship.

Is this behavior is not acceptable, under which guidelines is it? Maybe only when you are on break or off duty? Or is this still too questionable?

What are proper friendship limits in patient/practitioner relationships?

Does it mater if gender differences play a role in it?

If none of the above is acceptable, how much time should pass after a patient is dc'd before a friendship or personal relationship can be pursued?

It seems in healthcare so many practitioners become hardhearted to individuals situations. Some have issues but don't really need medicine, but care and compassion from a friend. If a practitioner cannot be a friend, it is hard for there to be complete healing, especially if said patient has no support system outside. Sometimes the practitioners are all the patient has. And sometimes these patients are really distressed and cant do a thing about it because it is "outside of everyone's scope of practice".

Where do the limits draw?

If an completely competent, A&O adult who say, has just had his knee replaced or for some reason just physically cannot get to the coffee place (which is on-site) hands me two dollars and asks if I could get him a coffee while I am already headed out to get one for myself, I don't see a problem with that. It's his money and he is responsible for it. I don't do it for everyone, and maybe that's a difference between Canada and the US. I am not afraid of being sued over $2.

The patients mental acuity has nothing to do with it. I agree that things may be far different in Canada. In the US there is this notion that all nurses are "rich" and if they sue you it will not be for $2. It will be the patients word against mine and I know enough to realize that I will lose. Even if admin believes me they will side with the patient. Nature of the beast. When I am faced with these situations it just never seems worth the potential fallout.

The patients mental acuity has nothing to do with it. I agree that things may be far different in Canada. In the US there is this notion that all nurses are "rich" and if they sue you it will not be for $2. It will be the patients word against mine and I know enough to realize that I will lose. Even if admin believes me they will side with the patient. Nature of the beast. When I am faced with these situations it just never seems worth the potential fallout.

I will get a patient a coffee if coffee is available to patients right there on the nursing pod and it's OK diet wise. I won't run to Starbucks or someplace like that for a patient, even if I'm going. Yes I'll do it for a coworker, but not a patient. Again, that is crossing a line.

The patients mental acuity has nothing to do with it. I agree that things may be far different in Canada. In the US there is this notion that all nurses are "rich" and if they sue you it will not be for $2. It will be the patients word against mine and I know enough to realize that I will lose. Even if admin believes me they will side with the patient. Nature of the beast. When I am faced with these situations it just never seems worth the potential fallout.

Vast difference, yes. I am selective about which patient I would do a coffee run for (and I will clarify that the coffee place is on-site, not away at Starbucks or anything). I know my manager would have my back if there was an issue, but around here an issue is likely to amount to a complaint only, not a law suit.

It's sad that that's what you have to deal with, but what can you do about it?

Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
Is this a generally unwise thing to do? Giving gifts to patients, whether it is small like a piece of candy, or large like sending flowers. Is this something not generally accepted in the health care positions, or any positions in any career? We all know about teachers accepting apples from students and that has never been generally frowned upon so why the difference when healthcare is involved?

Or doing favors for patients such as a patient being admitted to a facility and has no way to contact their family because their phone is off and needs a phone card but is not allowed to leave the facility.

They have the money but just need someone to run and get it.

--Or they need to borrow your phone to make a quick call.

--Or rather would like you to run and get a meal for them from a restaurant with their own money.

It is not like giving a gift but rather doing a favor for a patient that is not necessarily in your line of care but is done out of friendship.

Is this behavior is not acceptable, under which guidelines is it? Maybe only when you are on break or off duty? Or is this still too questionable?

What are proper friendship limits in patient/practitioner relationships?

Does it mater if gender differences play a role in it?

If none of the above is acceptable, how much time should pass after a patient is dc'd before a friendship or personal relationship can be pursued?

It seems in healthcare so many practitioners become hardhearted to individuals situations. Some have issues but don't really need medicine, but care and compassion from a friend. If a practitioner cannot be a friend, it is hard for there to be complete healing, especially if said patient has no support system outside. Sometimes the practitioners are all the patient has. And sometimes these patients are really distressed and cant do a thing about it because it is "outside of everyone's scope of practice".

Where do the limits draw?

There are many things involved here. Each nurse makes her own decisions...but there are professional guidelines that you just don't step over.

Have I gone to patients funerals? Yes. Have I done special things for patients? Yes. Have I let them use my phone briefly? In extreme cases...yes. Have I bought a newspaper? Of course yes..... Have I ran to the ran to the coffee machine? Hummmmm...not really as you can order or get the patient what they need for the cafe. Have I gone to the nurses lounge to get that coffee? Yes. Have I bought a lunch on my way into work and decided to let the homeless patient have a meal? Yes. Did I plan it? Maybe. Will I make a make run for them? No, they need to stay on their diets and I really can't consume my downtime running their errands.

I have snuck in a baby into the ICU for a patient that might not make it out of the OR. I bought pizza and beer for a 24 year dying patient from ovarian cancer because they had a taste for it. I went on a ambulance ride and donated my town off time for a vented patient that was dying from ALS so they could see their child skate in a competition. I have smuggled a dog into ICU because it was starving itself to death missing it's owner who was having an extended stay. I collected about 10 staff members to get a dying vented patient out to the pond on the property to feed the ducks. I broke the rules to bring a miniature horse to it's dying owner....in the hospital.

Do I do this ALL the time? No. Could I have been fired? Yes. Was I willing to take the risk? Yes. where most of my managers understanding....yes all but one....but when the article was printed in the newspaper how wonderful the facility was.....I was forgiven.

Have I ever dated a patient? No. Have I ever flirted with a patient? No. Have I maintained a relationship with a patient? No. Their family? Yes. twice....in 35 years. Have I accepted gifts? if they were made personally and of no monetary value...sometimes...with permission. Have I been offered money? Yes....and had them donate it to a charity or the facility.

With patients I am friendly...but I m not their friend. On a rare occasion I have become very vested in a patient and I have mourned/grieved the loss.

It's a fine line....if you try too much you will fizzle out.

Keep it professional. All the best.

There are many things involved here. Each nurse makes her own decisions...but there are professional guidelines that you just don't step over.

Have I gone to patients funerals? Yes. Have I done special things for patients? Yes. Have I let them use my phone briefly? In extreme cases...yes. Have I bought a newspaper? Of course yes..... Have I ran to the ran to the coffee machine? Hummmmm...not really as you can order or get the patient what they need for the cafe. Have I gone to the nurses lounge to get that coffee? Yes. Have I bought a lunch on my way into work and decided to let the homeless patient have a meal? Yes. Did I plan it? Maybe. Will I make a make run for them? No, they need to stay on their diets and I really can't consume my downtime running their errands.

I have snuck in a baby into the ICU for a patient that might not make it out of the OR. I bought pizza and beer for a 24 year dying patient from ovarian cancer because they had a taste for it. I went on a ambulance ride and donated my town off time for a vented patient that was dying from ALS so they could see their child skate in a competition. I have smuggled a dog into ICU because it was starving itself to death missing it's owner who was having an extended stay. I collected about 10 staff members to get a dying vented patient out to the pond on the property to feed the ducks. I broke the rules to bring a miniature horse to it's dying owner....in the hospital.

Do I do this ALL the time? No. Could I have been fired? Yes. Was I willing to take the risk? Yes. where most of my managers understanding....yes all but one....but when the article was printed in the newspaper how wonderful the facility was.....I was forgiven.

Have I ever dated a patient? No. Have I ever flirted with a patient? No. Have I maintained a relationship with a patient? No. Their family? Yes. twice....in 35 years. Have I accepted gifts? if they were made personally and of no monetary value...sometimes...with permission. Have I been offered money? Yes....and had them donate it to a charity or the facility.

With patients I am friendly...but I m not their friend. On a rare occasion I have become very vested in a patient and I have mourned/grieved the loss.

It's a fine line....if you try too much you will fizzle out.

Keep it professional. All the best.

This all sounds so fuzzy huggy and heartwarming, but where I work the management plays hardball. There, I just came right out and said it. You aren't going to see too many "read about it later in the paper" moments coming from our hospital. They are getting less and less disbursments and are looking for ways to cut costs including staff. I've said it here ad nauseum and I'll say it again - there are hard lines that shouldn't be crossed. Bringing beer & pizza into our facility will guaranteed get you fired, no if and's or well maybes, and there are people here who will waste no time ratting you out. By the book folks. That's how we play things these days. As much as we would like to "cut people a break" or what ever you want to call it

Every article I've ever seen about boundaries and professionalism in nursing always includes one guideline that I think is solid gold: Is this (thing that you are considering doing, whatever it is) something that you would do openly in front of your boss and coworkers? If not, you probably shouldn't be doing it. IMO, you cannot go wrong following that rule.

Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
This all sounds so fuzzy huggy and heartwarming, but where I work the management plays hardball. There, I just came right out and said it. You aren't going to see too many "read about it later in the paper" moments coming from our hospital. They are getting less and less disbursements and are looking for ways to cut costs including staff. I've said it here ad nauseum and I'll say it again - there are hard lines that shouldn't be crossed. Bringing beer & pizza into our facility will guaranteed get you fired, no if and's or well maybes, and there are people here who will waste no time ratting you out. By the book folks. That's how we play things these days. As much as we would like to "cut people a break" or what ever you want to call it
You are right.....I should have clarified....my pizza and beer episode was many years ago, a dying wish, cleared through the patients MD, at a catholic hospital and I got busted every time by the a certain Sister...who loved me. This was a time when we allowed poor patients to have real humanity and when nurses were rewarded for being kind. When co-workers and managers had your back....you're right....a different time.

I worked with an extraordinary group of physicians and worked for an extraordinary administration. When hospitals were run by physician boards and nurses were promoted because they were good nurses not because they had a degree. While we all had degrees....we never felt it necessary to elevate ourselves above the rest......Those were good days

I miss that facility very much but even they have changed in recent years. For all of the customer service line of baloney.....they really could care less about the patient in this day and age.

The horse and the ALS patient were about 7 years ago. That facility actually had a pet visiting policy, for dogs and cats, we just had to make adjustments for the horses hooves on the tile floor.

That being said it was still a hand full of moments over a 35 year career. A rare isolated extraordinary moment. So my advice was to choose those moments carefully.

My kind of nursing doesn't exist any more....and that makes me very sad. For us. For our patients.

You are right.....I should have clarified....my pizza and beer episode was many years ago, a dying wish, cleared through the patients MD, at a catholic hospital and I got busted every time by the a certain Sister...who loved me. This was a time when we allowed poor patients to have real humanity and when nurses were rewarded for being kind. When co-workers and managers had your back....you're right....a different time.

I worked with an extraordinary group of physicians and worked for an extraordinary administration. When hospitals were run by physician boards and nurses were promoted because they were good nurses not because they had a degree. While we all had degrees....we never felt it necessary to elevate ourselves above the rest......Those were good days

I miss that facility very much but even they have changed in recent years. For all of the customer service line of baloney.....they really could care less about the patient in this day and age.

The horse and the ALS patient were about 7 years ago. That facility actually had a pet visiting policy, for dogs and cats, we just had to make adjustments for the horses hooves on the tile floor.

That being said it was still a hand full of moments over a 35 year career. A rare isolated extraordinary moment. So my advice was to choose those moments carefully.

My kind of nursing doesn't exist any more....and that makes me very sad. For us. For our patients.

I didn't mean to sound harsh or anything but I just want to let people know not to put their jobs in jeperody with stuff like this. Yes, I really and truly wish we could do stuff like this for our patients and not get into trouble for it. If I could do that I probably would once in a while. But things being what they are, I think it's just best to play it safe and not risk your job. Most hospitals - even not for profit ones- are run like businesses and those types of decisions and judgements are levied against you nowadays

Specializes in Nursing Professional Development.
Every article I've ever seen about boundaries and professionalism in nursing always includes one guideline that I think is solid gold: Is this (thing that you are considering doing, whatever it is) something that you would do openly in front of your boss and coworkers? If not, you probably shouldn't be doing it. IMO, you cannot go wrong following that rule.

I STRONGLY agree with this. If you feel you have to sneak around ... you are probably doing something wrong.

Playing favorites with patients and breaking rules to give certain patients special favors usually ends badly. Most employers and professional organizations have guidelines to follow for a reason. If certain patients have special needs, there should be a legitimate way to meet them within those guidelines that does not compromise your professional relationship with the patient -- or your colleagues relationships with that patient.

Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
I STRONGLY agree with this. If you feel you have to sneak around ... you are probably doing something wrong.

Playing favorites with patients and breaking rules to give certain patients special favors usually ends badly. Most employers and professional organizations have guidelines to follow for a reason. If certain patients have special needs, there should be a legitimate way to meet them within those guidelines that does not compromise your professional relationship with the patient -- or your colleagues relationships with that patient.

No.....((HUGS)) you are right....I needed to be more specific. I wanted to point out that even if you do......it is rare and isolated and should not be a normal part of your job.

It sounded different in my head....;)

I was in social work for 10+ years before going to nursing school. I have always made it a point to draw clear, firm boundaries and remain ethical. Your anecdotes about the cigarettes and shoes made me tear up a bit. What wonderful examples of exceptions where a caring individual could make a huge psychosocial impact without crossing ethical boundaries or making a big financial contribution. Good for you!! Little things can have such an impact...

I agree there should be a kindness in spirit to patients!

With that thought... I was totally trusting, only to find out. That after devotingly, being by my husbands side 24/7 after his stroke,  his amputation of his leg. Talking to Dr's, never leaving his side.  I suffered an exhaustion breakdown. Only to come back at the SNF. To learn from him and this CNA, were having sexual relations.

The facility, has an 'in-house' investigations. With paid under the table obudsman and sheriffs. (Obudsman, because of their role played, I thought obudsman worked for the nursing facility) ((later I discovered that obudsman are supposed to be the people/patients defender).

Long story short, I go in last Christmas Eve...only to find, their relationship is still going.

I find A private radio, turned to this mexican channel. And a cookie box, that holds the heart balloon  my daughter and I gave to my husband...cut up in a hundred pieces. In which my husband gives me for a Christmas present. 

So there you have it!

Giving the gift of health and recovery is vital!

And patient kindness is crucial!

However, boundaries must be followed.

And rule of thumb...

One cannot allow themselves to be a fool, where trusting so much a healthcare provider, can leave you used, skewed and abused!

+ Add a Comment