Article type: Letter to editor
Taking care of patients, especially patients who need long-term treatment, requires people who would involve themselves in every aspect of the patient’s life (1). Nursing in the cancer sector, like many other nursing areas, provides conditions in which nurses get to know patients and their families better. This familiarization allows nurses in cancer ward to express compassion and this helps the patients and their family to deal with cancer, but if they fail to do so, it can cause deep distress for caregivers. (1). Hence, most nurses working with patients with chronic diseases are confronted with such questions as: How on earth are you working in this ward or have you got accustomed to this ward? (2). working in chronic wards, such as cancer especially for children, is very difficult, but there are some incidences that can inculcate the sense of being effective. When after a painful procedure, you give a child a gift and in the next visit, the child gives you a pair of pins to return your favor and gives it happily, the human heart shakes. If you were in that nurse's shoes, would you accept this gift? Or would you say sadly: hospital policy is to refrain from accepting any gift from the patients. When the patient wants to thank his nurse, he tries to give the best of what he has. It is prohibited to take gifts from the patient, in accordance with administrative policies (3) or nursing ethical codes (4). In this challenge, if the nurse accepts a gift, he will violate the law or suffers from a torture of conscience, and if he does not, the patient may be upset about this. Creating a balance in this challenge is one of the problems of the nurse (5).
Some believe that doctors should never receive gifts because they may affect the standard of care or undermine working relationships. Others believe that accepting gifts in certain circumstances allows patients to express appreciation and enhance the link between the doctor and the patient (6).
Giving a present is a common human and ancient practice and receiving a gift is not restricted to nurses and has a long history in medicine, but it can also create many clinical and ethical questions (7). Medicine is a relationship based on trust; patients who trust doctors' recommendations and specialist expertise. If patients give doctors a gift, is it ethical to accept it? Andereck (2001) writes: " I believe that it is ethical, taking a few things into consideration." According to him, receiving gifts from a patient by receiving gifts from a company and a pharmaceutical and advertising company is different, and patients usually give a gift for appreciation and gratitude, charity or efficacy (8). Although it seems, in most cases, giving presents means "being grateful for being present, especially in difficult moments" (7).
For the author, many of these cases have arisen in which the family of children admitted to the oncology ward, with their personal interest, brought some figs or a few small pieces of whey or some local bread. The present author, who has 13 years of experience working in the pediatric oncology ward, believes that by accepting these home-made gifts, a pleasant feeling of usefulness can be created in patients / their families. Accepting gifts happily and sharing them with other patients and staff will makes the bad sense of bribery disappear, and prevents other patients from supposing that their nurses are better off with that patient because of the gift. Having a good relationship with a sick child can be a great help in tolerating his illness, so that he trusts his nurse even when he or she performs painful procedures. This sense can be achieved by taking a selfie or reading a childish poem. Families do this not with the intention of bribery but solely to appreciate the work of the nurse. In some cases, when it comes to offering financial gifts, they can be referred to charity centers in order to help the clients, and to raise the pleasant sense of giving a gift in that person.
It seems that having charity boxes in hospitals can help this matter, even if the nurses have different opinions concerning the above-mentioned issue, by measuring the conditions of their own wards, anyone can turn this hospital policy into a benevolent deed. Accepting gifts from a sick child can wake the feeling of nurse’s gratitude in his mind. Accepting gifts in manners mentioned above can strengthen the bond between a nurse and the patient.