REFLECT

Model stories written by young professionals/students.

  

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The Healing Touch

When extra efforts express compassion and care to patients are needed.We should spend as much time “being with” our patients as we do “looking at” our patients.  

 

We are in a quaint, lavish nursing home located outside of the city. It is very beautiful and comfortable; it feels like a home. I follow the RN into one of the rooms to meet Ms. Jane (name has been substituted for privacy). Ms. Jane is now well into the later years of life. She is mostly unresponsive. The on staff nurse informs us that starting just the other day, Ms. Jane was considered to be actively dying. She is lying still on her side, not moving at all, but her eyes are open. The RN feels her fingers and toes, checks oxygen levels, and uses a stethoscope to listen to Ms. Jane’s lungs and heart. When the RN lifts her arm, she appears to wince in pain. If there is anything she wants to say or to even let out a groan of pain, her attempts are inaudible. However, there is a clear difference between the grimace and the plain serene expression which it replaced. The RN also notices it and gently strokes her head. As she continues with her examination, she begins singing along with the Christian hymns playing in the room. She pauses to explain to me that Ms. Jane spent the better part of her years doing missionary work. The RN began working with Ms. Jane while she still had some movement and was able to communicate.

While waiting for a member of the nursing home’s staff to join us, the RN sits in a chair next to the bed and holds Ms. Jane’s hand. The other nurse enters and explains a sore on Ms. Jane’s left foot and on her rear end. They roll her over a little more to examine the sores. This doesn’t seem to bother Ms. Jane, at least not as much as lifting her arm had done.  When they’re done they wash their hands, and the other nurse leaves the room. The RN I am with sits down and speaks a little with Ms. Jane as she holds her hand. I wonder to myself, now that Ms. Jane is actively dying and may only have a couple of days at most, is this the RN’s way of saying goodbye just in case? The RN kisses Ms. Jane on the head, and we leave.

As may have been evident in the narrative, I was particularly observant of physical contact made between the RN and patient. In this instance, due to the limited patient responsiveness, it was rather difficult to quantify interactions. Since verbal communication was limited, physical contact seemed to be an appropriate way to observe and analyze the interaction. In total, there were 12 distinct occasions/purposes of physical contact. Six were for medical purposes (e.g. checking her pulse, looking at the sore on her foot, rolling her over to examine the sore), and six were for personal communication (e.g. holding her hand and stroking her hair).

Now, it should be stated that not all physical contact is appropriate or recommended for various patients. However, the purpose of hospice is to elevate the quality of life of those receiving end of life care. Families can’t be with them all the time and it can be a hard thing to come to terms with death. To feel loved, appreciated, and that one lived a worthy life in their own eyes are important factors for these patients. The RN while fulfilling her nursing duties spent just as much effort helping her patient emotionally and socially. Nurses have to make physical contact with people: giving injections, checking sores, giving baths, checking pulses and respiration, checking temperature, etc. However, the RN I was with (probably subconsciously so) made a point of making just as many personal physical contacts and she had for medical intents. An interesting fact on this statistic is that in general the medical related touches were sandwiched by the personal contacts; the RN began and ended with the personal displays of physical contact. These extra efforts are what most expressed compassion and care to me as a third party witness. We should spend as much time “being with” our patients as we do “looking at” our patients.

- S Maxwell Scalf