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Is it ever ok for nurses to accept gifts from patients?


Nursing Times blogger Martin Jones wonders if the NMC code on receiving gifts from patients is too inflexible?

My blog about the coalition government’s budget drew comments about “wallet envy” so it’s with trepidation that I approach the subject of gifts from patients.

The NMC code states that as a nurse I “must refuse any gifts, favours or hospitality that might be interpreted as an attempt to gain preferential treatment” and advises me to also check local policy.

Some time ago one of my patients returned from a trip to Africa. To my total surprise she had bought me a small gift. Unlike a box of chocolates, it was not a gift that I could easily share with colleagues by leaving it in our staffroom. I asked our administrator if I could enter the gift in a register that I imagined the trust would keep. I was told instead that I must refuse to accept it.

This seems to me an unnecessarily inflexible interpretation of NMC code. The patient had decided to acknowledge care received and had offered me a small present in a thoughtful act of reciprocation. There is certainly little scope to obtain preferential treatment in a HIV clinic. It seemed uncaring to hand it back.

With this in mind it’s been interesting to observe the experience of friends and family in education at the end of another academic year. One who is a head teacher has received bottles of wine, a pen, a set of coasters, ties, chocolate, coffee and olive oil. Another in a private school has been invited to houses and homes in various parts of the world, “the odd gold nugget from Guyana”, expensive booze, Jermyn Street shirts, etc. My wife, a teaching assistant in a local state primary school witnessed chocolates, photo-frames, mugs and soft toys: the goods that appear, each July on “thank you teacher” displays in shops.

Does any of this present-giving in education curry preferential treatment? My friends and family were astonished by the suggestion. These are simple expressions of gratitude, children and parents giving something at the end of a year of receiving. There is pleasure in both giving and receiving and no harm is done.

Without a whiff of wallet envy it does seem curious that patients and nurses are disallowed from similar transactions.


Martin Jones, Clinical Nurse Specialist HIV, East Sussex Downs & Weald.

Martin Jones has worked in sexual health and HIV since 1986


Readers' comments (32)

  • The NMC is so embroiled in disciplining and dealing with the more negative side of nursing pracitice it should be of little surprise that they are less aware of the concept of grateful "customers". Yet another finger of grip lost on reality.....

    Or perhaps it is a symbolic two fingers at the Houses Of Parliament where of course the NMC had it's own institutional dirty linen very publically aired a couple of years ago.

    A common sense approach should be the way forward, and with more public involvement in the running of hospitals, policies about low value personal gifts are in a great position to be reviewed.

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  • The NMC should be renamed the witchfinders general, like the poster above said they are only ever concerned with disciplining Nurses .

    Basically they can kiss my proverbial.

    If a patient wants to give me a box of chocolates as a thank you as they leave for example I will accept it gratefully and pass it round the nurses station.

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  • Many years ago I nursed a man who everyday called the nurses over and offered them a sweet. "Such a lovely man " we all said. One day he was in the toilet when the paper trolley arrived and missed is Daily Mail. It was a busy morning and he asked one of the nurses to nip to the paper shop for him. The nurse said she could go at lunchtime. That afternoon the staff nurse was reported to sister for being ungrateful, unkind and lazy.
    Beware the patient bearing gifts!

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  • There you go - you've given us a terrific example of how to discern what is appropriate and what is not, according to the TIME the gift is received. Teachers get theirs at the END of the year. Parents aren't buying preferential treatment for their student, although it could be said they are paving the way for younger siblings.
    Nurses should be able to receive gifts when the treatment is over, and the patient has been discharged.
    I agree that the gifts are better if 'share-able,' but a significant token for sharing a part of yourself with someone may only have meaning to you (a book on shared interests, a neck-scarf for shared concerns on aging or surgical scars) - and a realistic limit could be imposed. In the states, it has been an abysmal US$2 since the last millenium, when US$20 would be realistic now.

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  • L Stephens

    You're right Martin. Its all a bit unneccesary.If i was the kind of person to say 'its PC gawn mad' I would.But I'm not.What we all really want to know is what was this gift?
    I was given 2 bottles of nice wine by a relative of a patient of mine who died recently.I raised my glass to the man concerned and enjoyed the wine.Don't see anything wrong with that.

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  • Whilst working with adults with learning disabilities, most of whom I have known over several years, I have often been given gifts at Christmas, Birthdays etc. To refuse them would have been offensive and changed my relationship with them.
    This presented an ethical dilemma which I could never manage to get my head around, so I accepted them, informed my line manager,and recorded it in their daily notes. However, I could have been deemed to have breached the code.

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  • Personally, I think its rather offensive to a patient who, knowing nothing of our code of conduct, decides to buy a little present for someone who has cared for him and enabled his recovery. I can't see anything wrong at all by accepting a small gift in the manner in which it is offered. How embarrassed would the poor patient feel if you said no to a small gift. I assume that all we are talking about here is a token, not a house or a car. And a small token of thanks is far more appreciation than most of us get from our managers.

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  • debra fretwell

    i am a student nurse and baffled by all the rules and regs...i was given a book by a patients mother (am a paeds student) the other day, while i was removing her son's cannula i noticed the book she was reading and we chatted together with her son about books he liked which took his mind off having the cannula out.

    At the end of the day as they were going home she gave me the book, i accepted it and told my mentor who said it what fine. I think small tokens such as this are fine although i await the man with the keys to the aston martin with enthusiasm!

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  • As most token gifts of appreciation are given as a patient is discharged, how can that be interpreted " an an attempt to gain preferential treatment"...isn't it rather too late for that as they disappear out the door?

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  • Every time a patient gives me a £20 or buys me a bottle of good champagne, I tucks into my garter and raises a glass to the frowning killjoys of the NMC and burdensome weight of 'should, ought to and moral duty'.

    Florence Nightingale.

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