Career advice

What to do if a grateful patient wants to give you a present

For nurses, accepting gifts – even if offered with the best of motives – is fraught with risk
gift box

For nurses, accepting gifts – even if offered with the best of motives – is fraught with risk


Picture: iStock

It’s been more than five years since my mum passed away. Although I miss her every single day, there are certain times of the year that feel particularly poignant, such as Christmas.

As soon as the shops fill their shelves with festive treats and ‘must-have’ items I feel that familiar pain deep in my heart – this is yet another year that I can’t shower mum with presents.

I’ve come to realise that one of the things I miss most is shopping for Mum. Watching the sheer delight on her face as she opened her presents slowly and carefully always gave me such pleasure.

The glow we get from giving

Take a minute to think back to how you felt the last time you gave a friend or relative a gift, one that you had researched and chosen carefully. If it made you feel happy and warm inside, you aren’t alone.

According to US researchers at Stony Brook University in New York, the art of giving can release chemicals in your brain that produce a sense of joy and peace, sometimes called ‘giver’s glow.’

As much as a patient is full of good intentions, they are also in a vulnerable position, and without strict guidance for those looking after them, their generosity could be taken advantage of

Now imagine you are alone and poorly in a hospital bed. Perhaps your family are no longer with you or have moved far away. As Christmas approaches you too want to feel that ‘giver’s glow’ so you arrange to buy your favourite nurse a special gift.

You have never heard of the Nursing and Midwifery Council (NMC) code or the NHS England guidance on managing conflicts of interest, you just want to make your nurse smile.

There are patients in this situation in every hospital. Unlike them, however, nurses are all aware of the policies on accepting gifts from patients, and the reasons these policies exist.

As much as a patient is full of good intentions, they are also in a vulnerable position, and without strict guidance for those looking after them, their generosity could be taken advantage of.

Open to misinterpretation

Regardless of how much you like your patients, you know you must adhere to your employer's policies and the NMC code, which says you must ‘refuse all but the most trivial gifts, favours or hospitality as accepting them could be interpreted as an attempt to gain preferential treatment’.

I’ll leave it to your professional judgement to decide what constitutes ‘trivial’, so let’s look instead at how you can respond to your patients in an empathetic way.

  • Show respect – you need to find ways to meet your professional responsibilities whilst making the ‘giver’ feel heard and appreciated. If you simply recite a clause from the NMC code you risk alienating your patient. Irrespective of what else is on your ‘to do’ list, give your patient the gift of your time, just for a minute. Slow down and truly be with your patient. 
  • Be honest – in a kind but uncondescending way, explain why you can’t accept the gift or what you must do. Don’t put any blame onto your patient or make them feel guilty. Take ownership of the situation and make sure you offer genuine thanks. If your patient gets upset or is insistent that you take the gift, try to get the attention of another member of staff. If this isn’t possible and you feel that emotions are escalating, it may be best to get the nurse in charge to talk to the patient. 
  • Listen – take the opportunity to ask how your patient really is and listen to what is being said and not said. Despite the busy environment, hospitals can be lonely and isolating places, even more so during the festive period. You may not be able to accept your patient’s material gift but you can show your appreciation in other ways.

Mandy Day-Calder is a life/health coach and former nurse 


Further reading

Managing conflicts of interest in the NHS

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