1. Salladay, Susan A. RN, PhD

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I work in a rehabilitation unit, where I recently cared for a delightful 79-year-old Polish woman recovering from hip replacement surgery. During long days in rehab, she shared wonderful stories about her youth in Brzeg, Poland-the same area where my grandparents lived. Turns out she'd not only gone to school with my grandparents, but she also had many class pictures of them. She had her husband bring them to the hospital. When she was discharged, she gave me some to keep.

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Now my newly hired nurse manager says that I must return the pictures or be fired for violating the hospital policy that forbids accepting gifts from a patient. I was flabbergasted!! These old pictures have no dollar value but great sentimental worth for my family.


My experience with this patient wasn't much different than with most of my other rehab patients, except for the gift of the old pictures-which I really don't want to give back. Am I out of line?-F.G., N.J.


I don't believe that you acted unethically. It would be different if your patient had given you antique jewelry or something else valuable. But this gift seems both harmless and caring, hardly worth firing a valued employee over. This may be one of those times in which the "letter of the law" (or policy, in this case) conflicts with the spirit behind it.


Review your hospital's policies and procedures for accepting gifts. Most policies allow some wiggle room for gifts of appreciation that have no monetary value. Because your manager is new, she may be interpreting your hospital's policy more strictly than another manager would.


Ask to speak with your manager privately. Present your side of the story and your interpretation of the policies and ask if she's willing to compromise. I think your position is valid, and she may agree when you present the facts as clearly as you have here. If not, consider pursuing the matter through your human resources grievance system.