When clinical options are exhausted, says student nurse blogger Erin Docherty, nurses would do well to remember the power of a helping hand
Over the last two years or so I have worked with acutely ill patients as well as long-term care.
Working in the acute wards, I am privileged to see the vast improvement in patients’ condition on a day-t0-day basis, more often than not through combinations of medication and counselling treatments.
Although it can be very satisfying working in these wards and seeing rapid developments, I also enjoy the long-term wards, where every baby step can lead to an improvement in life quality.
I am currently on placement in a psychiatric elderly ward. The majority of my patients have advanced dementia as well as the other side-effects of old age - hypertension, type 2 diabetes, cardiac problems etc.
Meal times are great for assessing these patients and socialising. But I do feel these areas are overshadowed by the vast number of pills accompanying their cheesy baked egg.
It can be hard work ensuring patients comply with their medication and even harder to try and explain the need for these pills. One patient’s asks what good they are doing, while another when says ‘aye, shovel them in’. It can be tough to make these mealtimes positive. To an extent I can sympathise with their views.
So far this blog has only discussed medication, but I don’t thinkthis is the only answer. On entering the living room last week, I saw one of our ladies yelping in pain. Although she could not communicate her discomfort I knew from the past that it was likely she needed assistance to the toilet.
On leaving the facility, freshly changed into pyjamas and fluffy bathrobe, I took her back to the cosy living room and sat her on the sofa. Adding a footstool and a blanket to her already comfortable posture, I could see the beginnings of tears. She was still in discomfort.
She had been given pain relief and her regular medication only an hour earlier, in medicinal terms there was nothing else I could offer her. I sat beside her wishing I could do more and at that moment she took my hand. Not in a desperate or aggressive manner, more in a child-like way that says ‘I need you, don’t leave me’. I sat with this lady for a good half hour, hand in hand, not a word exchanged and upon the changeover of shift she was dozing contentedly in the chair.
So what did I learn? The power of touch. It is a grey area among my university colleagues. Some would say it is inappropriate to hug a patient, hold their hand or stroke their hair, regardless of age or insight. Others say that, under certain conditions, it is entirely appropriate.
Reflecting back now, I realised that this lady did not need another pill. She was suffering from the same gastric problems we all do. What she needed more than anything was comfort, touch.
Surely in the nursing field we have to realise that part of holistic care is appropriate touch. A hand massage when an elderly lady is distressed cannot be inappropriate.
Now that nurses perform venapuncture, ECG’s and many more clinical skills previously performed by doctors, it is touching that sets us apart. The papers are full of stories of inappropriate touch in a professional capacity, which is obviously inexcusable, but isn’t it sad that these stories overshadow cases where the power of touch brought comfort and healing?
A nurse has to be many things to a patient: listener; a comforter; a professional; friend. We are human, and all these skills involve some sort of therapeutic involvement. Hopefully, with new procedures being brought in and policies forever changing, these incidents of inappropriate touching will vastly reduce. And hopefully, as nurses become educators and researchers, we can develop more thinking into the power of touch.
As a student nurse, I cometimes feel like Bambi - caught in the headlights and out of my depth.
But this lady didn’t need me to know all the answers or be a nurse prescriber, she simply needed me to be there.