Do any of you hand write thank you notes? If you do, what do you say? My facility sends pre-printed notes that all of us sign, but for the last month or so I've started sending a relatively generic hand-written note to all of my patients who are discharged home... I work on an oncology unit, so many of our families receive sympathy cards instead. With that said, what is or is not appropriate to say in a thank you note?
Here's what I typically say in my thank you notes:
"I wanted to tell you how much I enjoyed being your nurse during your stay on 12 East. You were a great patient and I'm so happy you're feeling better.
I hope you keep getting stronger every day!"
Lots of times I personalize the note with something I've learned about the patient or their family... and if I truly did not enjoy being their nurse or if they were NOT a very good patient (rude/demanding) I leave those parts out or replace them with something different.
What do you think?? I always use hospital stationary and never take patient info away from the hospital, so no HIPAA violations.
Doing it simply to boost numbers would be so sad... It would take away every bit of the sincerity if I was required to do it.
Your time with your patients is your job. May even be your mission, your calling. But this personal note writing is just not a good practice.
Patients have the right to leave everything that they have gone through at the door when they leave. Just as you need to learn to leave everything inside the hospital when you leave.
Some will see it as a nice gesture. Others will take offense that you are bothering them at home, and how the heck did you get my home address, I just want to live my life normally.....lots of things.
Overkill with the card from the hospital, then a personal note....your patients are not your friends outside of work.
You need to be confident in that you are a good nurse, with the best of intentions. You need to get to a place where you do not need affirmation from patients that this is so, after you write a personal note.
That's an incredibly extreme way to look at it. You have a fascinating imagination I get that you're trying to show me the potential consequence, but come on....
As I said before, I have contacted the higher-ups for permission… & being that I'm no dumb-dumb, I did it through email, to which they both replied & were both complementary. My nurse manager even told me, through email, about an email she received from a patient saying how much he appreciated my note.
Nosey Nancy's nasty comments & strong desire to make other people miserable like her are things we all deal with on a daily basis, except now Sally Sue, who only has about 3 months to live, will get to enjoy one extra smile in her heart. Shame on Nosey Nancy for trying to take that a way from her... But hey, some people are just turds who insist on sucking all the fun out of everything. Such is life :)
Our experience tells us this isn't imaginary. It's real. It happens. I've witnessed it, many many times. Pt X talks to Pt Y and opens a massive can of worms. It's not fiction or myth. It's what happens. Fortunately I've yet to be on the receiving end of it, but I can name several nurses - excellent clinicians and exemplary people - who have been. Right or wrong.
And I know I can think of a couple of times I dodged a bullet - and I wasn't even in the wrong!
Really, if I think about it, I've seen it other places - I saw it happen to cops when I was a military working dog handler. The public talks, and unfortunately sometimes their word carries more weight than our word + our unblemished records.
This isn't alarmism. It's experience.
Hold on to that email. I'm serious.
ETA: Just look at the percentages on your poll question. Look where the overwhelming majority of answers are. And patients also talk to management as you've seen, without your knowledge until ex post facto. You haven't lived until you're hauled in your boss's office for a complaint that isn't even true. THAT has happened to me (uh, no, didn't stick her twice with the same port needle, thank you VERY much), and thank God my boss knew me better than that.
I think that it is very admirable for you to be a support to your oncology patients, especially those that are terminal. I do not have any suggestions for your note but if you have the written approval of management to do what you are doing and you feel it is right, then continue to do so.
I understand the potential consequences of my kindness... I thank you all for taking time to repeatedly show them to me, even though that's not at all why I opened this thread.
Hey, what's your address? I'd like to send you a thank you note.
You have access to my email and PMs. Feel free.
And you indeed opened up this thread to get our opinions - or, at least, that's what you initially said. It's not our fault if our opinions are contrary to the reaction you were hoping to get.
We're not judging you nor are we trying to chastise you. Heck, we're trying to help and warn you.
I admire the fact that you are writing these notes. My main concern is that the patients who couldnt remember your name when they got home, now have a note from you that includes your name. In the cases where lawsuits are filed, they can pull out your card and include your name even if you did nothing wrong.
And you indeed opened up this thread to get our opinions - or, at least, that's what you initially said. It's not our fault if our opinions are contrary to the reaction you were hoping to get.
We're not judging you nor are we trying to chastise you. Heck, we're trying to help and warn you.
Point taken.
I wanted to know who wrote them. Now I know few do. Mission accomplished.
I wanted to know what nurses who wrote them thought would be appropriate to say. Mission accomplished.
Lots of you have made it clear that you feel sending a cheerful note to dying patients is unethical because they are no longer in my care. Lots if you say its a bad idea & don't want me to do it any more. Another mission accomplished.
I think it sounds nice, and is definitely coming from a good hearted person. I suppose some people might feel invaded by a note received at home, but they can just throw it out. Your notes are definitely less offensive than the bills they'll be getting.
My only concern that would make me say "don't do it" is if Nosey Nancy hears about these nice notes that some people get, but she's never gotten one. (maybe she's kind of a turd, or maybe you were extra busy that day) But she knows that her care is suffering because no one really likes her, and her feelings get hurt. There's such a storm of emotional issues, nurses can get caught in the crossfire...and you've just stuck your head up.
What percentage of patients are you writing to? If it's more than 10% I'd say you need to get some responses ready for people that ask how you pick and choose who you write to. My gut says you're doing this from the right place, with the right intentions, but in this world there aren't many people like you. Patients and other staff are going to wonder what your pay-off is. It's sad. I don't want to say "stop" but please know that you may open a can of worms no one could anticipate.
But some patients are really, really special. They'd be worth taking a bit of a risk for, and letting them know you're thinking about them could make their day. Yeah, I'd keep writing, but just be careful.
I only got to page 4 of this thread. Will keep reading but I wanna say regarding HIPAA: the issue about sending a patient a letter home that states you enjoyed being their nurse, etc clearly indicates that this person
1) was an inpatient
2) at this hospital
3) has cancer
You're giving away info that they have a right to be kept private. When we do those discharge phone calls and we must leave a message, it ONLY includes that we are such and such hospital calling for Mr. X, sorry we missed him, we'll try again later. This can be easily dismissed as a generic or telemarketing call or what have you. But it does NOT let on that this person was admitted and especially not what for. There are people with cancer who might actually be keeping it private from say, their children.
When I visit my PMD or GYN, I sign a form with options allowing them to use certain language on my answering machine. Do you see where I'm going with this?
Recently on a floor I worked there was a relatively healthy Patient A who was having a hard time dealing with Patient B down the hall who had dementia and kept calling out. Most visitors walking the halls were under the impression that he was being neglected. In reality he never remembered what it was he wanted but he was frequently rounded on and all sorts of comfort measures were observed.
Patient A took it upon herself to befriend Patient B and spent a considerable amount of time talking to him, fetching things for him, reorienting him. Everything she did was safe and appropriate. She eased the tension on the floor for all the other patients, she freed up time for the nurses and techs, and most importantly gave Patient B some ease of mind.
That night I left on her tray one of those "Caught in the Act" cards that co-workers issue to each other to compliment excellent care.
This happens on a daily basis on my unit and in my two clinics (we have a heme-onc and a BMT clinic that are separate areas and are separately staffed). Patient X finds out Pt Y has the same dx and they become chemo buddies. We have transplant pts who do the same thing. In fact, we have two patients who have taken to walking down the hall together, pushing their IV poles, giving each other moral support and discussing their chemo the way you and I would discuss what flowers we planted this spring. One is a pro, one's a newbie. I love that.
I don't think your leaving the card on Patient A's tray is the same as an RN writing a thank you note (??) to a discharged patient. The residents are, essentially, neighbors in their respective 'homes'. The inpatients here are 'neighbors' in a temporary home. And they are choosing to share this information with each other. I'm not the mediator nor the instigator.
BTW - I think what you did was incredible and a wonderful gesture!
There are people with cancer who might actually be keeping it private from say, their children.
When I visit my PMD or GYN, I sign a form with options allowing them to use certain language on my answering machine. Do you see where I'm going with this?
GOOD POINT.
We actually had a patient family member who wanted us to keep the patient's prognosis FROM HER (really?) and we had to tell him that, since she was of sound mind, we ethically couldn't. (She was very, very young with bizarrely advanced metastatic ovarian cancer. She would be sterile when we were done treating her and her prognosis was not good, to say the least. And we're supposed to keep that from her?) Uhm, wow.
Not the same situation. Just had to share that just to illustrate how far some people want to take this sort of thing.
But you're correct. I've had patients that didn't want people to know they were here, that they were dying, that things were not going to go well because they don't want to worry them. And if the wrong person opens the mail - WHAM!
I worked as a pharmacy tech when I was contemplating pharmacy school about eight years ago. We had a guy who would come in to pick up his antiretrovirals. His parents used the same pharmacy and we were under strict instructions to never, ever tell his parents what or why he came in here because he didn't want them to know. Plus, that's a HIPAA violation because pharmacists and techs are considered "covered persons".
The drugs were binned by last name. Person would come in, we dig in the bin, verify name (and supposedly DOB) and go on about our business. One day (not me - thank God! - I wasn't even working that day) someone handed this man's father the wrong medications.
You can imagine what happened. I'm glad I was off that day.
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I get that you're trying to show me the potential consequence, but come on.... 
jadelpn, LPN, EMT-B
9 Articles; 4,800 Posts
Your time with your patients is your job. May even be your mission, your calling. But this personal note writing is just not a good practice.
Patients have the right to leave everything that they have gone through at the door when they leave. Just as you need to learn to leave everything inside the hospital when you leave.
Some will see it as a nice gesture. Others will take offense that you are bothering them at home, and how the heck did you get my home address, I just want to live my life normally.....lots of things.
Overkill with the card from the hospital, then a personal note....your patients are not your friends outside of work.
You need to be confident in that you are a good nurse, with the best of intentions. You need to get to a place where you do not need affirmation from patients that this is so, after you write a personal note.