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.