The question of tips

Without further word, a green wad is shoved into my hand; I can just barely make out the “20” written on it before I’m shoving it back.
“I can’t take this,” I say…and it feels like the millionth time. (Just last week I had to shake out my pockets after a suspiciously handsy-hug a resident gave me. Sure enough, one-dollar bills had tumbled out.)
“Well, I want you to have it,” the man in front of me says, as he shoves the money back into my hand and attempts to curl my fingers over it.
“I’m not allowed to accept tips,” I reply, uncurling my fingers and, for good measure, clasping my hands behind my back.
He sighs. His mother is a resident here and…how shall I put this…she thinks the world of me. This is the third attempt her son has made to give me a tip; the third time I’ve had to refuse.
“Just don’t tell your boss,” he suggests.
“First, I’m a terrible liar. Second, I can’t accept the money on principle. Look, it’s very nice of you to offer, but you’ve already paid for her care.”
“Yes, but I want you to thank you for the great care that you, personally, have given Mom and I want you to keep it up. I do that with tips, like I would tip a great waiter.”
“Yes, but it’s a slightly different relationship here,” I say. “Besides, it won’t make a difference in the level of care; I can’t give the resident down the hall less care than your mom because her family can’t or won’t tip me. That would be unethical. I don’t know how to put this, but you’ve got to trust me to provide my own motivation for your mom’s care. If you just want to thank us…we can’t accept cash, but nobody’s got a problem with families bringing food for the staff.”
He nods, not looking very convinced and I hustle out of the room. No matter how many times I have that conversation, no matter what shape it takes, it’s still as awkward as all get-out. I know where he’s coming from: in America, we’re used to giving tips for good service–especially for what we consider high-end or exceptional service. And I’m not going to deny that it would be nice to receive tips.
But I also know that long term care is already a crushing burden on so many of these families. I know that the family of the resident in the next room would love to offer me a tip but they really can’t afford it. I know that if the long term care industry were to add the expectation of tips, that it would push a lot of these families over the financial edge.

The next day, there’s a big bowl of candy sitting in that room. There’s a note attached: “Staff, please help yourselves.”
I grin and grab a big handful. It is nice to be appreciated.

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