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What’s your agency’s policy?
With the holiday season upon us, so too is the season of gift giving. Co-workers give to each other, bosses give to their employees, and vice versa. It’s the rare company that would ban such expressions of friendship, although some may attempt to put a monetary cap on the office’s gift-exchange party. This is a completely different matter, however, when it comes to home health care workers and their clients exchanging presents.
So sensitive is the issue that most home care agencies have banned the practice altogether and instead have a formal policy in place forbidding their employees to either give or receive gifts from their patients. One such agency is Tulare (CA) Home Care. "We don’t allow our employees to accept gifts at all nor do we allow them to give gifts to our doctors," explains Sally Pierson, BSN, PHN, RN, director of patient services. That’s the official policy. As for unofficially, I trust my employees. They know what the policy is, and I trust them to adhere to it."
The specter of impropriety looms large over gift exchanges, and those with suspicious minds may believe that the patient who presents the largest or best gift will receive the best care in return. Then there’s the issue of patients who may already have little enough to share with their own families, let alone the nurses and aides who assist them daily. It seems the smartest move then is to simply ban gift exchanges.
Whereas this might make sense on the surface, dig a little deeper and a different picture emerges, says Greg Solecki, vice president of Henry Ford Home Health in Detroit, whose agency does have a formal policy forbidding the exchange of gifts between patient and caregiver. "I think that the field staff work so hard and are up against so many mutually exclusive scenarios that to come down heavy on a gift-giving policy would be absurd. Every day, in every city, somewhere along the worst block in the worst neighborhood, there’s a woman going into the back bedroom to care for a patient, and if that patient offers a gesture of gratitude, I’m not going to get uptight about it. They deserve that and more."
"However," he continues, "the party line is that our staff are not to accept presents, cash, etc. from patients. But I’m not naive. I know about the bonds established between patients and nurses. If patients insist, because we don’t want to seem ungrateful, we encourage them to make a contribution to the Henry Ford system.
Fargo, ND-based MeritCare Home Care also has a policy in place that strongly discourages health care workers from accepting gifts. "When it comes to food and things like that, we’re not so strict," says Jo Burdick, RN, MSN, executive director, adding that staff are strongly encouraged not to accept gifts of cash or the equivalent. She says there are, of course, exceptions to the gift-giving rule, such as when a patient and caregiver have worked together for a lengthy period of time and it "would be bad not to accept the present."
Tarrant Home Care in Fort Worth, TX, also has a policy forbidding employees to accept gifts. There is a caveat, however, explains Mike Parker, RN, clinical manager for the facility. "So long as [the gifts are] not valued at more than $25, our employees can accept [them], but were an employee to accept anything of greater value, it would be grounds for dismissal." Within this framework, if a patient insists on giving a gift of greater value, staff would encourage that person to donate to the hospital.
For the most part, the acceptance of gifts is frowned upon, although the consensus seems to be that gift giving isn’t a high priority on home care’s lengthy list of problems. "This whole thing is really not something we scrutinize closely," says Solecki. "It’s a don’t ask, don’t tell’ situation, and quite honestly, I don’t want to know about it [gift-giving]. It’s not one of my priorities when you have to contend with the rest of this absurdity occurring in the industry."
• Jo Burdick, RN, MSN, Executive Director, MeritCare Home Care, 720 Fourth St., Route 103, Fargo, ND 58122. Telephone: (701) 234-4892.
• Mike Parker, RN, Clinical Manager, Tarrant Home Care, 1500 S. Main St., Fort Worth, TX 76104-4917. Telephone: (817) 927-1266.
• Sally Pierson, BSN, PHN, RN, Director of Patient Care Services, Tulare Home Care, 869 N. Cherry St., Tulare, CA 93274-2207. Telephone: (559) 685-3411.
• Greg Solecki, Vice President, Henry Ford Home Health, 1 Ford Place, 4C, Detroit, MI 48202. Telephone: (313) 874-6500.