Cash gifts for nurses: would it still happen if they had better pay?

Families’ tokens of gratitude can lead to awkward conversations for nurses – and poor pay in nursing does nothing to make it easier

Who hasn’t been given a gift by a well-meaning patient or their loved one as a thank-you for the care they received?

From chocolates, biscuits and flowers, to toasters, fish and weapons (I kid you not), nursing staff see all manner of presents.

Nurse’s case has divided opinion

Patients and their families don’t always get it right – North Korean weaponry aside – especially if they want their gift to be a surprise and so don’t ask for guidance as to what can be accepted.

Workplace policies and the Code make it clear that while unequivocally trivial gifts such as chocolates for the team are fine, high-value items such as cash for staff are not.

A recent case of a nurse who was struck off by the Nursing and Midwifery Council for accepting £100 in an envelope from a patient’s family has divided opinion in the profession. Some feel the regulator was too harsh, others point to the finding that the registrant had been dishonest in concealing the gift from her managers.

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This case has brought to the fore the often awkward conversations healthcare staff have to navigate with grateful patients, service users and their relatives about why they cannot accept a particular gift.

It is unsurprising that sometimes large sums of cash are presented to individual staff by people who feel nurses are underpaid and deserve more money.

Nurses’ low pay brings out public’s pity

That message may go unheard by government ministers but it is received loud and clear by the public, with two-thirds in a recent poll supporting potential strike action by RCN members over poor pay. Nursing topped the independent poll, which asked members of the public which profession makes the biggest contribution to society. The profession has been consistently named the nation’s most trusted since Ipsos Mori began polling on the issue in 2016.

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Patients and their relatives will always want to thank those who care for them at the happiest and saddest moments of their lives. However, if nurses were better paid and valued by politicians and employers, the public would not feel the need to show gratitude with cash ‘tips’ to top-up their low pay.

Flavia Munn is Nursing Standard editor