Employees who receive gifts risk committing bribery and simultaneously undermining trust in healthcare.

This article is written based on Swedish conditions but can perhaps be an inspiration for those interested in other countries.

Receiving gifts from residents or relatives as a healthcare worker can be a crime. It is important to consider the ethical aspects of accepting gifts. Gifts should not influence your professional judgment or treatment of residents. Being aware of and attentive to any potential conflicts of interest is crucial. Healthcare staff need to have a clear and ethical stand when it comes to accepting gifts. By following the organization's policy, being transparent, and avoiding personal or cash gifts, healthcare professionals can contribute to creating a professional and trustworthy environment for the residents and their relatives. It is about showing gratitude and appreciation in a way that is compatible with the high ethical standards that the healthcare sector demands.

Foto: Mostphotos

Management of Gifts in Healthcare

In eldercare facilities around Sweden, there often arise special relationships between healthcare staff and the residents or their relatives. These relationships can sometimes include gifts as a gesture of gratitude or appreciation for the care and help provided. Being offered gifts is part of working life in healthcare, but it is important to follow certain guidelines and have a clear and ethical stance on this.

Healthcare staff are usually not allowed to accept gifts from an individual or relatives. At the same time, it can be hard to refuse a small gift as the individual risks getting hurt. Accepting a gift can be seen as a bribe. Moreover, others can suspect that it is possible to buy better treatment or other benefits. It is quite common that relatives want to treat the staff with a cake or buy flowers, a box of chocolates, or other items. This gift is shared with the team instead of becoming a personal gift.

Healthcare staff occasionally receive offers of gifts. Some want to give a tip, others want to give an individual employee a flower voucher. Jewelry, artwork, and clothes are also given as gifts. This type of gift to an individual employee can be perceived as bribes.

Sometimes donations come to a nursing home. It can then be a larger sum of money that is to be used for a specific purpose, for example, activities or adding a touch of luxury to the residents' lives. This can be accepted if it benefits all the residents of the eldercare facility.

An employee who received an inheritance from a resident was sentenced in the district court. In addition to repaying the nearly three hundred and fifty thousand kronor inherited, they also had to pay 40-day fines. This despite the fact that the person had stopped working at the facility before the inheritance was received. The court saw it as an improper reward for the work the employee had done for the resident. Thus, the employee was guilty of bribery.

Most organizations and companies in healthcare and social care have policies and rules for accepting gifts and benefits. A gift does not have to have a high value. The important thing is whether the gift in any way can cause the employee's independence to be questioned.

Advice for Employees in Healthcare

1. Follow the business policy
Most eldercare facilities have a policy or guidelines for handling gifts. It is important that employees are aware of and follow these guidelines. Policies can vary depending on the eldercare facility, but they usually contain guidelines for which gifts are acceptable and how they should be reported.

2. Be transparent
It is important to be transparent when it comes to accepting gifts. If you receive a gift from a resident or their relatives, inform your supervisor or responsible staff. This helps create openness and trust and reduces the risk of misunderstandings.

3. Avoid accepting cash
It is generally a good practice to avoid accepting cash as gifts. Cash can be hard to trace and can give rise to suspicions of undue influence. Instead, you can thank the sender for their kindness and suggest other ways of showing appreciation.

4. Avoid personal gifts
It is important to avoid accepting personal gifts, especially if they have a high value. Accepting expensive or personal gifts can create an uncomfortable dynamic between healthcare staff and the residents or their relatives. It is best to explain that you appreciate the thought but cannot accept personal gifts.

5. Accept symbolic gifts
Symbolic gifts such as thank you cards, flowers or homemade gifts are usually seen as more appropriate and acceptable. These gifts are less likely to create problems and can still express gratitude in a meaningful way.

6. Thank the gifts in a respectful way
No matter what kind of gift you get, make sure to thank the sender in a respectful and appreciative way. It is important that those who give gifts feel valued and respected.

Reflection Questions - Gifts
Nursing Assistants and Caregivers:
- What is your attitude towards gifts in your workgroup?
- How do you handle a situation where a resident or relative wants to give you something?
- Have you been offered gifts personally at any time?

Manager, Nurse, Occupational Therapist and Physiotherapist:
- What do you do to manage the issue of gifts in your unit?
- Do you have a written routine or policy for how gifts should be handled?
- Is the question of gifts brought up during the introduction?
- Is it discussed at staff meetings?
- Which gifts do you consider okay?

Residents and Relatives:
- Were you aware of this?  

Erland Olsson
Medical Accountable Nurse
Better care every day

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