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Ethical Practice


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You are an LPN providing foot care services in the community. One of your clients offers you a $10 tip to show her appreciation for the excellent care you provide. What is the best action for you to take?

A: Accept the tip and use it to buy something nice for your client.

That’s not correct. Generally, LPNs do not exchange gifts with clients. Where it has therapeutic intent, a group of nurses may give or receive a token gift. LPNs return or redirect any significant gift, such as a tip. LPNs begin, maintain and end nurse-client relationships in a way that puts the client’s needs first. See Professional Standard 4: Ethical Practice and Boundaries in the Nurse-Client Relationship Practice Standard.

B: Respectfully decline the tip and explain why it is not appropriate for LPNs to accept tips.

Correct! LPNs return or redirect any significant gift, such as a tip, and explain why in a sensitive manner. LPNs begin, maintain and end nurse-client relationships in a way that puts the client’s needs first. See Professional Standard 4: Ethical Practice and Boundaries in the Nurse-Client Relationship Practice Standard.

C: Accept the tip because refusing it would offend your client.

That’s not correct. LPNs do not engage in any activity that results in inappropriate financial or personal benefit to themselves or loss to the client. LPNs identify ethical issues, recognize potential conflicts and take action to prevent or resolve them. See Professional Standard 4: Ethical Practice and Boundaries in the Nurse-Client Relationship Practice Standard.

D: Thank your client and accept the tip because it’s okay for LPNs to accept tips that are under $20.

That’s not correct. LPNs consider why the client has offered the gift/tip and the value and appropriateness of it. When refusing a gift, such as a tip, explain why in a sensitive manner. LPNs identify ethical issues, recognize potential conflicts and take action to prevent or resolve them. See Professional Standard 4: Ethical Practice and Boundaries in the Nurse-Client Relationship Practice Standard.

LPNs understand, uphold and promote the ethical standards of the nursing profession. LPNs who violate a boundary can harm both the nurse-client relationship and the client. LPNs may violate a boundary in terms of behaviour related to favouritism, physical contact, friendship, socializing, gifts, dating, intimacy, disclosure, chastising and coercion. See Professional Standard 4: Ethical Practice and Boundaries in the Nurse-Client Relationship Practice Standard for more information.​

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