I wrote this for students in a nursing class -- you might find it interesting because it gives you a look on the other side.
Nurses touch patients. There is a right way to do this and it can be learned.
I
begin with my experiences as a patient, in hospitals, clinics, and
doctors’ offices, going back to childhood. When the nurse or doctor
touched me, putting their hands somewhere on my body, it always felt
good.
It’s kind of difficult to describe how it felt -- sort of warm and cool at the same time, and both comforting and firm.
If a doctor or nurse touched me and it didn’t feel good, I would get out of there really fast, but this has never happened.
The
nursing student might recall experiences of being touched by health
care people. Did it always feel good? Try to remember how it felt.
New
nursing students are not used to touching people in the way that
doctors and nurses do, especially the men. It’s a little scary and it
feels awkward and embarrassing, but think of it simply as a skill,
something you can learn, something that you will get better at with
practice and experience.
Consider
the body. In our culture, for the most part, the safe areas are the
arms, shoulders, neck, head, and the feet below the knees.
I
like to make a “get acquainted” touch when I first meet a patient at
the hospital, usually by putting my hand on their arm for a second. This
gives the patient a chance to get used to me. It gives them a chance to
object -- with words, rarely, but more often with a kind of flinching
that can be quite subtle. It’s hardly ever happened to me, but if that
does happen, I back off a few feet, and give the patient some space, and
begin to talk instead.
If
I have the time, but often enough I’m dealing with a necessity and must
act fairly quickly. I still go through an approach procedure, even if
it’s very compressed in time. “Hello, I’m Fred, I’m the Nursing
Assistant and I’m going to help you move into a more comfortable
position so that you can eat your dinner.” Then I come closer, but a
hand on their shoulder or arm, pause for a moment to see that it’s okay,
and then go ahead and prop them up or help them move to a chair.
I
sometimes deal with cranky, irritable, delusional, and violent people. I
get hit, scratched, bitten. One time an older patient, a stroke victim,
threatened to throw a hot cup of coffee in my face -- that was a little
scary, but usually it’s not scary, just very unpleasant. I really don’t
like it when patients act like this. It hurts my feelings, and it feels
just as bad if I see one of the other nurses get treated this way --
but it’s been a part of nursing for a long time. Very sick people are
simply not responsible for their behavior -- they are sometimes very
frightened and in pain -- who could blame them?
Nurses
¬never respond to a disruptive patient with an attitude of “getting
even.” If you can’t literally “take it on the chin” with a smile, then
you should not be in nursing. Which is to say that the patient can touch
you in a bad way, but you must always touch them in a good way?
This
has never been a problem for me, but I always monitor my emotional
balance. I strive to be sympathetic and yet professionally detached.
Some patients are more fun to be with than others. It’s all right to
like someone, but within a fairly narrow margin. You still owe the very
best of care to those patients who are not exactly your cup of tea.
Consider
Mr. Jorgenson in Room Three. He is getting to be a pretty unhappy
fellow. He keeps yelling, “Where’s my shoes? This is a prison. I’m
leaving.”
But
he can’t leave. He’s too sick, and if he tries to get out of bed, he’s
going to fall down and hurt himself. His desire to leave the hospital is
rational, so the nurse can agree with that, but we cannot, ever, let a
patient hurt themselves or someone else. So, a dialog begins with Mr.
Jorgenson, and it might go on for hours. “Mr. Jorgenson, I understand
how you feel. Of course you want to go home, but you’re too sick to get
out of bed. You really need to be in the hospital right now. We’re going
to get you better and get you out of her as soon as we can…”
Back
to touching. The private part of the body is everything between the
shoulders and the knees. We do not go here without the patient’s
permission. Even if the patient is asleep, unconscious, or delusional,
we always announce verbally our intentions. “I need to check your brief,
Mr. Jorgenson. It might be time for a change.” The patient then has the
opportunity to refuse permission.
Touching
in this area is intimate. I think that “intimate” is the right word.
It’s not sex, it’s not love, it’s not even friendship -- it’s health
care, it’s what we have to do when we have to do it, and we’re good at
it. And you will be good at it too, with practice and more experience.
I
continuously verbalize as I’m working. “Yes, it looks wet. I’m going to
change your brief and clean you up a bit....This cloth might feel a
little cool...I’m going to turn you over on your side for just a bit...”
--all said in that calm, matter-of-fact tone of voice which the nurses
are so good at using. You will get good at it too.
This
is not the time for “visiting” or being friendly or sociable, and,
please, no jokes. Curiosity of a professional nature is good because
that’s how we learn. We work with human bodies, which are very
interesting. They come in all sizes and shapes. And every part has a
name -- and we only use the professional names. You will learn them and
use them.
When
you’re learning to do this work on the private parts of the body, watch
your own thoughts and feelings -- if you’re too nervous, if you have
inappropriate or unprofessional thoughts and feelings that persist and
do not go away -- then, seriously, maybe you shouldn’t be in nursing.
You’ll be doing yourself, the patients, and the whole world a big favor,
if you are completely honest with yourself. No blame, just look for
some other kind of work.
But you’ll probably do just fine.
Then,
when the procedure is finished, the brief is changed, and the covers
are back on, we can go back to being sociable and talk about the
baseball game or any other thing.
Generally,
an older patient, or one who has been sick for a long time, is very
used to being handled. This is where the beginner gets experience and
where the nursing staff will assign you. If you are a little nervous or
tentative, the older patients either won’t notice or won’t mind.
Just take a deep breath, pause for a moment, and do it.
More Bonus Stuff
FARM NEWS from Fred Owens
Man dies in torch fire accident on farm
ELTOPIA, Wash. (AP) -- A man was killed in an accident on a farm near Eltopia.
The
Franklin County sheriff's office says 75-year-old Everett D. Monk was
cutting scrap metal in a field with a torch Saturday when his clothes
caught fire. The Tri-City Herald reports he apparently died of burns.
A friend found the body.
That was the news story. Just
those few words. It was in the paper last year, but I kept this file
because I wanted to think about this man, 75-years-old, and his name was
Everett D. Monk.
I thought of calling his people in
Eltopia to find out about his life, but I didn't need to do that. I
found I could read his whole life story from this news item.
He
was out in the field cutting scrap metal with his torch in early
December. It was cold out there in the sage brush country. This was in
eastern Washington, with low hills and no trees -- just wheat fields
lying fallow in the winter sun.
This is where you could
research it -- you can find things on the Internet. You could find what
the weather was like in Eltopia on the day that Everett Monk died. But
it was almost surely sunny and cold -- that's the typical winter
weather, and it's good working weather.
Everett
Monk was 75, but he didn't want to sit around the house. He had been a
working man all his life. He grew up on a farm and started doing
serious chores every day since he was ten years old. Starting work at
the age of ten, driving the pickup around the ranch and handling tools.
So
he worked every day for 65 years, until December of last year, and he
wasn't going to just sit around in his easy chair on that last day. He
just wasn't used to that.
Instead he got dressed and went
out. There was a "bone yard" -- a pile of rusted out implements and
machinery -- but it was a good hundred yards from the house.
The
bone yard was a little bit out of sight, and his family was gone to
town. There's not that much to do in December on a farm. That's when you
have the time to work on some projects -- like making modifications on
a piece of farm equipment.
You can't just buy a hay baler and use it, but you need to adapt it to the special conditions of your own piece of land.
Everett Monk knew how to do that, and his welding tools were in the back of his pickup that cold and windy day.
I'm not sure about that -- was the wind blowing? Or was it calm?
Because he began cutting the scrap metal and working in a careful way.
Then
the accident happened. Maybe it was calm and then, all of a sudden,
the wind picked up, and blew a spark from the torch to the sleeve of
his jacket, and he may have been distracted by a sudden noise over the
hill, and the spark settled on his coat sleeve and began to burn, and
the wind picked up and he was on fire.
He was on fire.
And he was shocked. Did he drop and roll on the ground, which is what
you are supposed to do if your clothes catch on fire?
I
could call the sheriff or the friend who found his body and ask them --
if he just fell down, or if there was evidence that he dropped and
rolled on the ground. But that doesn't really matter too much.
A
friend found his body. Everett Monk was dead, after working on the
farm all his life. He may have suffered in agony from his burns, or he
may have gone quickly from the shock.
But it was over. Everett Monk, the farmer from Eltopia in eastern Washington, may he rest in peace.
He could have stayed in the house on that day in December. He could have just taken it easy, but he was used to working.
