Greatful Patient Leaves Gift - What do you do?

[Richard B the EMT]

I just had a weird thought (not the first, probably not the last):

The patient, or someone connected with the patient, just left a plate full of cookies, correct?

Is it simply a case that would be described by "Daffy Duck" as,

What food these morsels be!

Or...

Did the crew that worked the specific assignment have any problems with the patient or the patient's family? If yes, what might be mixed into the cookies? Did you just get a package of "Alice B Toklas" style cookies, with the LEOs notified that the station/garage/base has them, "Get the EMS people for possession of unauthorized recreational pharmaceuticals"?

Or, truly the worst case scenario, what poisons have been added to the mix?

[HERBIE1]

Many places have very strict rules on gifts. In these political times, anything you take could be viewed by someone as being unethical and by "catching" a public servant acting unethically, they may try to make a statement and put you in the trick bag. I've had many offers of gifts- come by my diner and I'll buy you dinner, free hair cuts, discounts on products, etc. I've never taken someone up on that. Taking cash is another matter- especially if you work for a public agency. Be very careful. On a few occasions, I've accepted a couple dollars at the repeated insistence of a very grateful patient/family member or a gift card from Starbucks and see no real harm in that.

As was noted, common sense should dictate your actions. Often during holiday season, people are in a "giving" mood. If you work in a residential area, you tend to know the neighbors and they often bring by food, fruit, cookies, and cakes. Some people feel the need to express their gratitude by more than just a thank you and in many cultures, it is considered offensive and very rude to refuse a gift.

A good rule to live by here-trust your inner voice. We use that voice all the time when treating patients and trying to figure out whether the person is ready to code.

If the offer makes you feel odd, or you think you would have a hard time justifying it to a boss, politely decline the offer.

I'm with Richard- I always make a joke about on offer and say an "atta boy" letter to the mayor or bosses would be sufficient and to tell them we're not as bad as they think we are. If they write the letter- great. If not, that's fine too. We all know that people are far more willing to register complaints than they are compliments.

I just had a weird thought (not the first, probably not the last):

The patient, or someone connected with the patient, just left a plate full of cookies, correct?

Is it simply a case that would be described by "Daffy Duck" as,

Or...

Did the crew that worked the specific assignment have any problems with the patient or the patient's family? If yes, what might be mixed into the cookies? Did you just get a package of "Alice B Toklas" style cookies, with the LEOs notified that the station/garage/base has them, "Get the EMS people for possession of unauthorized recreational pharmaceuticals"?

Or, truly the worst case scenario, what poisons have been added to the mix?

It's sad to think someone would try to poison or drug you, but you just never know. I seem to recall an incident where a plate of pot laced brownies, left as an alleged thank-you, were ingested by an entire fire house. Possible- yeah. Likely- probably not. I'd still be careful, especially with homemade treats.

[reaper]

If someone ever decides to drop off a new car as a thank you, then my partner can suck eggs. It is all mine!!!

[Riblett]

I think this definitely depends on the nature of the gift. We frequently receive small gift baskets containing fruit, chocolate, etc. Many people have baked cookies or a cake and brought them to the station. I think refusing a clearly personal gift like small baked goods is very rude. Especially when it is a little old lady or a kid making it. In that case, it should be graciously accepted and shared with the department.

(Before partaking, I always look at which crew received it. Sometimes I worry if the crew could have somehow pissed the patient off, and granny could have added a little Exlax to the banana pudding. )

Larger gifts or monetary gifts should not be accepted. If they want to make a donation or something, I usually recommend the county EMS fund. With a $60 annual donation, everyone in their household will pay no out of pocket expenses for any EMS service. Their insurance still gets billed, but they are not charged any co-pays or expenses beyond what their insurance covers. If a patient refused to take no for an answer, donate it in their name. Maybe ask them to donate some new stuffed animals to the agency instead, or use the money to buy them. We carry them for comforting children during their ride in the ambulance, but rely on donations since the agency does'nt actually budget for them. If a patient left a cash gift that could not be identified or returned, I would suggest that it be donated to the county EMS fund or some stuffed animals.

[rock_shoes]

If Grandma or little Becky bake you some cookies, say thank you and share them with the rest of the crew. If someone tries to give you money, a gift certificate etc. the answer must always be thank you but I can't accept. If they persist suggest a few charities like the Heart and Stroke Foundation or your local hospital's auxillary.

[cynical_as_hell]

I have not seen a policy with my company about the acceptance of gifts. I know that we have always been told not to though. In most cases in my area, the patient brings to the station a plant, cake, donuts, cookies, ect... We politely say thank you, listen to whatever they have to say and then if it's food, throw it away once they are gone. I know that sounds mean, but you never know what they put in the food they have brought you, if anything. We look at it as it's better safe than sorry. I don't know of anyone that has had a past patient try to give them gift cards or cash.

[croaker260]

So do you accept it?

Do you refuse it?

Is it ethical?

Is it moral?

Depends on what it is.

Cookies? no problem. teddy bears for ambulance? No Problem.

Beer? Money? Dirty Pictures and a phone number? Say thank you very much, put a smile on, and then as soon as the door is shut, turn it in up the chain of command with a letter documenting that you did so.

Problem solved.

[HERBIE1]

I have not seen a policy with my company about the acceptance of gifts. I know that we have always been told not to though. In most cases in my area, the patient brings to the station a plant, cake, donuts, cookies, ect... We politely say thank you, listen to whatever they have to say and then if it's food, throw it away once they are gone. I know that sounds mean, but you never know what they put in the food they have brought you, if anything. We look at it as it's better safe than sorry. I don't know of anyone that has had a past patient try to give them gift cards or cash.

Obviously any company or municipality rules should dictate your actions. Many do have ethics policies- we have mandatory annual ethics training- but a better barometer should be your own personal morals and ethics. If a situation/gift feels weird or awkward, it's probably wrong. Think about that inner voice we use all the time. It's the one that tells us that a seemingly stable patient might be ready to crash, or a seemingly cooperative, calm psych patient is ready to snap.

Trust that inner voice- it will get you out of more tough spots than all the training in the world.

[Dustdevil]

Trust that inner voice- it will get you out of more tough spots than all the training in the world.

Unfortunately, another news story each day shows us just how many EMS providers have no inner voice.

[rock_shoes]

Unfortunately, another news story each day shows us just how many EMS providers have no inner voice.

And the depressing truth comes forth....