Nurses Don't Accept Gifts

[roxannekkb]

I have a question to nursing students and those recently out of school. Are you still taught that nurses must never accept a gift from a patient? That doctrine was cemented into my head when I was student during the 80s, and into the heads of most of the nurses I worked with. When questioned, teachers would just say it was unethical.

In the years that I worked as a nurse, I accepted a number of gifts from patient families (I worked in the NICU). Many, because of their culture, would have been highly offended if I had refused it.

So my question is, if this philosophy is still taught? Is it still considered a cardinal sin (sorry, I went to a Catholic university) if nurses accept a gift from a patient or family?:kiss

[betts]

While a nurse in Indiana, was caring for an elderly married couple w/o any children or immediate relations whom owned a very large farm which they offered me if I'd take care of them at home till they passed on.

[Katnip, RN]

In school we've been taught repeatedly that accepting gifts is a violation of ethics. After all, how many people give lawyers or judges gifts? Not sure docs get offers of gifts. I'm not talking about that tin of homemade fudge (espcially if it's rocky road).

Nurses aren't waitresses. We don't expect tips.

It can also open you up to lawsuits.

For instance, an elderly patient gives her nurse a bracelet before dying. Later the family wonders what happens to granny's bracelet.... the family accuses nurse of theft.

Taking money from patients or their families could be looked at as bribes to pay for better care.

I know it's hard to tell someone to their face "no, I can't take this" but if you do it and explain that it's against your code of ethics, most will understand. If they still insist on giving money to someone, ask them to make a donation to a charity instead.

[Diana in Sweden]

I have accepted a gift

I was nuring a depressed refugee, she was having a really hard time of it and I had held her when she had cried and generally been there for her like any good nurse would. When she was discharged she gave me some silk flowers, I gratefully accepted and have saved them to this day. To have refused her would have driven the point home that she was different from me, accepting it made us just two women.

It wasn't a tip, it was a gift. I am happy I took them because it made her feel good. They also make me feel good.. I think I made a difference to her and I smile when I see them.

[Quickbeam, BSN, RN]

I was taught "no gifts, no exceptions" as a CNA and that has stood me in good stead during my RN career as well. (This was also true in my prior career as a probation officer for juveniles).

I think there can be a slippery slope effect of gift taking and it has always been easiest for me to just say no, kindly and politely. I have always prayed for people if they ask, and occasionally kept up correspondence ( families of my pediatric patients). But no gifts.

One time, when I was a probation officer, I supervised the daughter of a very wealthy Greek immigrants. The father was constantly trying to give me gifts, which were illegal for me to accept. He'd send fruit baskets to my home and I'd find gifts left on my car. I returned them all which he accepted with good humor. I discharged his daughter and about a year later, left that job to go to nursing school. On my first day of school there was a huge bouquet of roses waiting for me at the University, from the Greek father. I dropped him a nice note (I was now 1000 miles away) and gave the flowers to my new classmates.

[duckie]

I have accepted some small handmade items made by residents that they would make as therapy and their was of keeping busy and then they would give them to the staff of their choice as a way of saying thanks for being there. My biggest shock came from being named in a will and given a portion of the estate. That was totally unexpected.

[colleen10]

A few years ago my mum and I were on vacation in Florida when she came down with appendicitis and the only hospital around was a very teeny tiney one (about 10 rooms) on the next island. Far cry from Pittsburgh where you have a huge hospital on every corner.

She was so sick and it took them about 12 hours to finally diagnose her and call in the surgeon (from another island). Very scary situation. But when the surgeon got there he was so kind and sweet, great bedside manner. Took excellent care of her and his nursing staff at his office did great post op care.

When we made it back to the 'burgh my mum sent to his office a big basket filled with all kinds of Pittsburgh stuff like Clark Bars, Heinz condiments, etc.

From the side of the patient sometimes the appreciation you have for the medical and personal care you receive from the staff cannot be summed up in a Thank You. Even though it may be all in a good days work for you, sometimes it's just as important for the patient to feel good about showing their appreciation as it is for the nurse to get the gift and feel thanked.

[JohnnyGage]

Originally posted by cyberkat

In school we've been taught repeatedly that accepting gifts is a violation of ethics. After all, how many people give lawyers or judges gifts? Not sure docs get offers of gifts.

I know lawyers that have accepted gifts. Gifts are just that -- gifts. Bribes are different in that they are given and a favor is expected in return.

While I am a firm believer in ethical practice, I am also a firmly against zero-tolerance rules. Just think of the slippery slope that could lead to... teachers can't accept gifts because it might lead to favoring one student over another... parents can't accept gifts because they could get sued for favoring one child over another.

Of course I'm being facetious. If there is a question about a nurse's ethical practice and gifts have turned to bribery, that's one thing; however, if a nurse occasionally accepts a gift from a truly grateful patient or family member, I don't see any violation.

What about a nurse's ethical duty to respect different cultures. What if she refuses a gift and as a result a patient is insulted and refused to go the hospital again? (Yes, it's an extreme example.)

How about thank you cards? Are nurses more inclined to be more caring if they know that a thank you card or a good word might end up in their employee file? Best ban those too!

No one goes into nursing for the money -- or the gifts. If a nurse is letting gifts influence the work of caring then there are bigger issues at stake.

[nrw350]

Originally posted by JohnnyGage

I agree that you shouldn't expect a gift, but there are many times when I think it is appropriate.

When a patient is discharged from your unit and give candy and a card, that's OK.

If the little old lady you're taking care of gives all the nurses that took care of her a hand-knitted washcloth, that's OK but only if she would be offended if you didn't accept. In fact, I think that's a good rule anytime: if the giver would be offended that you didn't accept (as is the case with many cultures) than accept. If in your heart you feel you can't, then donate the gift elsewhere.

Certainly if the gift is given quid pro quo than it should not be accepted, but most patients, I've found, are only trying to be nice in return for the niceness given, and isn't that what it should be about anyway?

If a nurse is really so anti-reward, than why get paid? Do we give better care as our wages increase? Nope. Do I give better care in the hope of, or because, I've received a gift? No again.

All of the above are, naturally, only my humble opinion.

I really think that it should be the way as you describe it. Because I would think that some would stretch the current rule of no gifts so far as to include hugs in that rule. Surely there is not harm in a warm hug from a patient that truly appreciated the careing you have shown them?

[dawngloves, BSN, RN]

Use your best judgement. No, don't accept a $100 bill, but I've acepted a small teddy bear pin, a mug, a box of Godivas from pts or families. Never occured to me to say no and I feel no shame. Even the president can accept a gift under a certain dollar amount!

[flowerchild]

I have never been able to accept gifts from patients b/c it was against policy. I was told that the medicare guidelines are why we could not accept gifts. Medicare prohibits anyone accepting money, gifts, etc. that are over and above the payment made by MCA. Anyone else hear of this reason?

[JohnnyGage]

Originally posted by flowerchild

I have never been able to accept gifts from patients b/c it was against policy. I was told that the medicare guidelines are why we could not accept gifts. Medicare prohibits anyone accepting money, gifts, etc. that are over and above the payment made by MCA. Anyone else hear of this reason?

No, I have not. Interesting... I'd like to a) see the actual documentation and b) see how they go about proving something like that.

I'd like to clarify something I mentioned earlier...

A bribe is given with expectation of influencing an outcome in favor of the giver.

A gift is given spontaneously as an expression of affection or gratitude.

Payment is an exchange of an agreed upon amount of money or property for services rendered.

Nurses get paid. Bribes are unethical. Gifts (under most cercumstances) are OK.

[SeptSue]

I've accepted small gifts from patients and I believe they reflected patients' appreciation - a decorative box, a pair of earrrings, a rose.