Wednesday, December 8, 2010

The power of touch

On one of the groups I belong to out there in internet land, there has been discussion on when to use medical gloves when giving vaccines. The truth is, gloves don't protect us from needles sticks, and in most cases, patients don't bleed when given an injection. There is no need to wear gloves when giving vaccinations, unless the practitioner has a reasonable expectation they'd come in contact with infectious fluids. In the event you think I've lost my mind, the CDC is the organization that has set forth these guidelines on gloving. What concerns me is the subtext on that thread that there are nurses who wouldn't dream of touching a patient for any reason without gloving first. There is, and I quote, " a squick" factor associated with this concept. For those who don't know what that means, like me, I looked it up on Urban Dictionary. Squick is a "physical sense of repulsion upon encountering a concept or situation one finds disgusting." While each nurse will have a differing opinion on the subject of gloving, what I really want to talk about is the words we use to describe patient care.

In my experience in the ICU, I can recall plenty of staff walking into a room and donning a pair of gloves as they do. Nothing was done without this article of protective equipment, including hand holding. So extreme are the precautions some take, that no thought at all is given to the depersonalization of the human in the bed. Imagine lying in a bed with tubes placed in every possible spot of your body and the only thing you feel when another person touches you is pain. With all of the pain receptors located in the skin, I can only imagine how this may feel to some people. Worse, imagine having such a highly infectious disease, that no person can enter your room without impervious gowns, hairnets, gloves and masks. You'd be in isolation--truly alone. What a horrific feeling that must be. The important factor we forget is that touch can bring pain, but it can also be soothing and pleasurable.

Touch can heal.

I vividly recall one of my patients, a new diabetic with an astronomical blood glucose level and dehydration so severe, there were no peripheral IVs to be had for love nor money. She would die without an IV. As the surgeon placed a central venous catheter, I held this patient's hands in mine. Words like squick never entered my mind, but I do recall praying for the surgeon's success. About six weeks later, I ran into this woman in a store. She recognized me, but she looked so different and healthy that I didn't have a clue who she was until she told me. She thanked me for holding her hands that day and getting her through such a critical illness.

Handholding, human touch and gentle words make a difference to those in trouble and need. We, nurses, are caregivers and when we examine our individual practices, we should keep all aspects of patient care in mind--especially those that deal with the psyche.

Since the advent of antibiotic resistant bacteria, I think more and more medical staff are fearful of touching their patients. In my own practice, the first thing I do is take the hand of most patients in my own bare hands ( and I'm not insane here--I wouldn't take the hand of someone oozing goo and gore from their extremities unless I was wearing gloves). I hold in my head the knowledge that along with soap and water, my own intact skin will protect me from anything untoward while I minister to those who need to feel the touch of another human being.

What I'd really like to see is words like squick go away when discussing how we think of, and interact with, the human beings who come into our care.


Denise said...

Completely agree with you there. You are one of the good nurses out there.

I have a few pet peeves I've made along the way working in nursing homes and doing private duty.

jeannette said...

In my short experience most people who work on the hospice department are more sensitive towards the human conditions than other medical dept.!
Since I'm not a nurse and am not exposed to severe infectious diseases, I feel that I don't have a right of speaking.

Mimi said...

Rudee, I popped over her to say thanks for your comment at mine, and for signing up as a follower.
What a beautiful, sensible, caring post, I wish all medical people would read this. My Mum was a nurse, she would have been 89 today if she were still alive, and I'm thinking of her so much as I read this. It's exactly how she would have felt too.
As an aromatherapist, I have seen the power of touch, and it should not be underestimated.
Well done!

daylily (Queenmothermamaw) said...

Dear Rudee just visited Nolly Post and she is so having a rough time. I next came to your post and was so proud to read this. You are so right. It does not take long to spot what is not proper to touch and by using that gut feeling to first minister to another human is what makes one a special nurse. I am so proud to know of you and hear your experiences. Blessings

Ruth said...

As a fellow nures I whole heartedly agree with Rudee, touch is so important. I wear gloves but only when coming in contact with yicky things and I seem to wear them a lot. I do know that I wear them a whole lot less than many of my younger colleages - perhaps they are not taught the importance of touch.
There is the science and then the Art of nursing the science is taught but the Art is something you have.

Brenda said...

Thank God for you Rudee. You are a blessing to your patients. The human touch and kindness can perform miracles.

Finding Pam said...

Rudee, you are a wonderful nurse. Your care and kindness is so touching. I can imagine how much better you make everyone feel.
Touch is so important.

My mother was a nurse like you that could make everyone feel so much better just by being around her.

It is a true gift you have.

Devon said...

You are so right! I think this all began in the early 80's with the AIDS epidemic and thus the birth of Universal Precautions... which essentially means treat everyone as though they have a highly communicable disease.

Hand holding and touch evokes compassion and love... very healing!

Well done Rudee!

Miss 376 said...

Having spent a stressful three hours at the dental hospital yesterday, I appreciate what you say. A touch is a little thing, but it goes a long way and is remembered for a long time

The Bug said...

Maybe it's because (despite my hypochondria) I'm really so healthy, but I've never taken precautions like gloves very seriously. I remember when I was the office manager of an MRDD facility & took the required CPR training. There was some gizmo to use so you wouldn't actually have to put your lips to the other person's lips. I just couldn't understand using one of those - even though a lot of our residents were TB carriers & had other issues. Mostly I was concerned about giving THEM illnesses, not getting them myself.

Barbara said...

You're a born nurse. You're also a very good writer. Perhaps one day you could combine the two...

Empress Bee (of the High Sea) said...

i enjoyed reading this. i don't feel the same but it's just my "nuttiness" going on here. i don't like to touch people (except sarge and my children). i like people, in fact i LOVE people but i am not a touchy person. i think it might have come from my cold childhood. i think about it and think it should have made me want to touch but it didn't. strange, huh? but i love that you do this for people because i know i am NOT in the majority here.

hugs (from afar!), bee

Anonymous said...

As a kind and touching person I agree with you..but the medical glove visual is upsetting. Ever since my Urology visit, the site of medical gloves, and the snapping sound made when put on, makes me nervous.

ztoamom said...

Like the very first post of yours I ran across and read, this one made me cry. It is so true - those who need love are sitting before us in their bare naked skin and their bare naked need. How can we deny them the healing which comes from that skin-to-skin connection. Yes, yes, the caveats and disclaimers, but you are right - your intact skin was designed to keep you safe: and to let humanness pass through.

CT said...

I remember when I had my firstborn, nurses would'nt hold her or let me hold her when she cried. She had mild respiratory problems and she kept kicking open the crib she was placed in (at two days old, mind you) So when nurses would'nt see, I'd place my hand in her tummy... that's all it took for her to quiet down and go to sleep