How touch can calm patients

So, Megen at Not Nurse Ratched wrote post recently about therapeutic presence.  The following passage really caught my attention: “Question is: are there more things in nursing, Horatio, than science can explain? Can we touch patients and zap them with calmness or take away their pain? Can we, by our mindset during our provision of care, substantially affect our patients’ outcomes? Can any of this be taught? Can we do it on purpose? I don’t know. That situation has captured my attention, though, because the flip side must also be true—if I despise my patient, she can probably tell that too, regardless of how tightly I’m controlling my behavior.”

Little backstory:  A few weeks ago I had a laparoscopic cholecystectomy.  Basically, a very nice surgeon made a few incisions into my abdomen, inserted a camera and some wrenches or something, and took my gall bladder out.  I had never had surgery before.  Never been intubated.  I have been on “the bed side” quite a few times, but never for surgery.

A week elapsed between the time we decided to do surgery and the time the surgery actually happened.  It was a really hard week for me as I was very anxious about the whole thing.  I’m not even sure what exactly it was that I was nervous about.  I trusted my surgeon completely, I had full confidence in the hospital I was having surgery at, and I know it’s a procedure that is done thousands and thousands of times a year with a very low complication rate.

Still … well, I guess I have never been completely unconscious in a room full of people who were looking at my insides.  I have never relied on a machine to breathe for me.  I had never been under general anesthesia before.  Basically, I was going to be vulnerable and exposed.  One of the biggest things that caused me angst, though, was that I would wake up still intubated.  The anesthesiologist assured me I wouldn’t remember being intubated at all.  That was helpful.  I believed him.

Anyway, I was supposed to tie this in with the passage at the top, wasn’t I?  The point is that I was very nervous and the morning of the surgery found me in the pre-op area holding back nervous tears, sometimes unsuccessfully.  I had the footies on, had the gown on, admission assessment was done, IV inserted and then we were just hanging out waiting for the surgeon.

One of the nurses who would be with me in the OR came to wait with me and she was genuinely so sweet and caring.  Her general demeanor really put me at ease.  We really were just waiting for the surgeon to show up; it was about 10 minutes past when I was supposed to go in.  I was in the middle of mentally deducting stars from my future Yelp review of him when he finally showed up.  We had a little chat, and then he left to go scrub.

In the meantime, a second OR nurse showed up in my little pre-op area.  When the surgeon left, and it was time to go, I started crying a little again.  The first nurse was at my side and was very sweet and reassuring.  The second nurse was behind me, to help push the gurney to the OR.  When she realized I was upset, she put her hands on my head.

I am not a touchy-feely person.  When my patients are distressed, I’ll put my hand on their hand or arm and that’s about it.  Before this experience, if you had asked me what would reassure me if I was upset, touch would actually be way down on the list, and touching my head?  No way.  But for whatever reason, her hands on either side of my head was exactly what I needed right then and I was immediately calmed by it.

Why? Why would someone find solace in something they would normally consider to be annoying?

By the time we got into the OR, I was ready for some pharmaceutical assistance.  I moved over to the table, and as the nurse was strapping my arm to the board, the anesthesiologist appeared next to me.  I told him I could really go for a nice intravenous cocktail anytime and he said he already injected some Versed.  The last thing I remember saying is, “Well, I don’t fee…”  Heh.

I woke up in the recovery room and felt nausea and pain.  All I had to say was “hurts” and “sick” and I was out again.  The next thing I remember was being asked to scoot over to my bed on the surgical floor.  I said yes when they asked if I wanted some morphine for pain, and dang!  That stuff really burns.

I went home later that day and my recovery was very uneventful.  I was really amused to see that my incisions were covered in skin glue. No dressings at all.  Just 4 incisions with a coating of glue over them.

Anyway, I had barely even remembered what the OR nurse did until I read Megen’s post.  I think she’s on to something.

“Gina” is an intensive care nurse who blogs at code blog – tales of a nurse.

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  • Anonymous

    Ah , spiritual healing . :-)

  • http://twitter.com/USMCShrink Kevin Nasky, DO

    I agree, though unfortunately not applicable in mental health because of boundary issues.

  • Anonymous

    Sounds like Reiki. I was recently trained in Reiki and I have been able to use it on a few patients, as well as myself. About a month ago I had a needle biopsy done on a suspicious mass in my breast. I gave myself a Reiki treatment and I never felt a thing! Not even the pinch and burn of the lidocaine.. I have used it to calm down a COPD pt who was very tachypnec and panicking, and I have used it on a friend undergoing chemo for breast cancer.

    I wish hospitals would offer workshops for their employees to have the training..

    • http://profile.yahoo.com/5NXC4XOB4LWCQP5R4APFZJHLSI Laurence

      Some hospitals do offer training in Healing Touch, a more clinical Therapeutic touch therapy than Reiki. I received my training in Healing Touch at a Catholic Hospital where I work as a chaplain.

  • Anonymous

    I still hate being touched, especially when I’m a patient.  Glad your nurse made you feel better, but that would have freaked me out.

  • Anonymous

    I have had a few procedures under anesthesia….what I remember was that for each one of those, a nurse held my hand until I was ‘under’, which was so comforting. 
    At one time, I worked on an inpatient dermatology unit.  We saw the worst of the worst in terms of skin diseases.  One thing we were told over and over again is that TOUCH was part of our therapy.  So many of those with severe skin disease were NEVER touched in the outside world.  I make it a point to offer touch to some of the older people I see in church.  I am sure that some go weeks without the touch of another person. 

  • nomidazolam

    Give me the human interaction, touching etc. but leave out the damn Versed!

  • http://www.thehappymd.com/ Dike Drummond MD

    Great post Gina,

    Of course touch can calm and soothe and relax a patient … and anyone in a stressful experience. Just look at what parents do with their children … and what adult children do with their elderly parents … in the hospital. They sit on the bed and hold a hand or touch a shoulder.

    As a doctor how you touch someone, from your initial handshake to how you set a fracture is incredibly important and an energetic transfer between you and the patient.

    Just imagine a patient … hurting and scared and you come in with a limp wristed handshake or when you examine them your touch is fluttering and uncertain … that is NOT going to help anything. A firm handshake and a gentle/firm touch during the exam is key. That plus a word or two of encouragement and a huge portion of the patients anxiety is dissipated.

    As the anxiety is calmed … so is pain, fear, suffering, blood pressure, adrenaline levels, blood sugar in a diabetic and so much more.

    Touch your patients, touch your children, touch your spouse … do it from a place of love and empathy and ask permission first … and watch what a huge difference it makes.

    My two cents,

    Dike
    Dike Drummond MD
    http://www.thehappymd.com

  • Daniel H Beegan

    Right after Christmas in 1980, I fell on black ice walking home from the bus stop and broke my hip. I was taken to a small hospital, sadly now closed, in Milwaukee. I remember a night when I was really anxious. It was after the successful surgery to put in a metal plate. The nurse who came on at 11 p.m. was having a very quiet night and I expect was a little bored. Seeing I was awake, she came into my room and we talked for two hours. She answered all my questions, soothed my worries and I feel made a huge difference in my recovery.

  • Anonymous

    In the ICU we would encourage patients families to touch them and to gently message their arms, hands, etc. since touch is one of the last sensations that we loose and I am convinced (not scientific) that comatose patients feel the loving caresses. As a patient lay dying and alone he talked to the DOD (doctor of the day) of his fears of dying alone. The physician staid with him, holding his hand and comforting him while he died. That physician’s standing in my eyes grew enormously that day. When I was very sick recently, my cat came and licked my hand and snuggled with me, purring all the while; he knew that I needed loving touches.

    • Anonymous

      Molly, your eloquent, compassionate message was ruined for me — a longtime hospice and palliative care nurse/manager/program director — simply because your spelling and grammar were so incredibly awful in your posting. Spell Check would have been no help because context and real- world grammar are irrelevant to those programs. Therefore, your physician “staid” with the patient;
      “staid” is perfectly good word but very far from being appropriate in that sentence.

      I had an extraordinarily demanding nursing professor in nursing school who would never tolerate even one, let alone the half dozen whoppers in your post. We became good friends, and I have enjoyed several dinners at her home. She never tolerated sloppiness or laziness: as nurses we have an obligation to present a polished, professional presence on a team.

      • Anonymous

        Wow you sure got out of bed on the wrong
        side. One error was all, and I did spell check it and grammar checked it. Thanks for your not so
        friendly reminder. There are no whoppers in my post just one typo. You have
        some serious ego issues. You have no tolerance for a single typo. I would hate
        to be your patient as I suspect you are very critical of them and intolerant of
        them too. I can only pray that our paths never cross as you might
        have problems with my gait.

      • Anonymous

        You rote 2 hole paragpraphs to critisyze one tiepo?  I’m spichless.

        • Anonymous

          Thanks EmilyAnon!

      • Anonymous

        Sigh!   Nurses like you are why I am leaving the field and going into Psychology.  I am a professional hand holder and my surgeon performing eyelid surgeries without sedation is amazing testimony.  Molly is not transcribing, or charting for that matter.   My recommendation for you is to take 2 chill pills and lighten up.  If you continue your rigidity, gallstones, strokes and heart disease will overcome your nastiness.  I pray you have peace in your life.  

      • Anonymous

        When I worked in eye surgery I would hold patients hands while they received their well placed injections.  I would pray with them if they requested and took my time to do it.  I was known for going above and beyond and have the cards to prove it.  In the end, I let the small stuff stress me out and the gallstone was 3.5 cm.  I am now at risk for pancreatic cancer and all because of grouchy ass people like you!  Instead of telling patients that took their anger out on me or nurses with over inflated egos, exactly how I felt I smiled and I did my job.  If you are unhappy as a nurse, by all means go do something else!!  Please do not burden the rest of us with your bad attitude.  I have been the patient and the nurse and I remember every jerk that treated me less than human.  Are you on drugs?  Are you a troll? Why would be so mean?   Nobody said nursing is easy, but damn, you take it to another level of “crappy day”.  Yes I used two exclamation points, got it!!

        • Anonymous

          I am genuinely sorry that I offended a number of nurses, as well as others, I guess. I made no personal attacks, I pointed out minor errors that I probably should have ignored. The fact is I am a very strong advocate for Reiki and other “complementary” therapies. It works, and not just for patients. The peace and sweet relief that comes with any of several “high touch” therapies is a real gift.

          No nursing is not easy. I have NEVER treated any patient poorly or as “less than human.” I suppose that I merit that sort of character assassination, but I criticized the writer’s spelling and grammar — not her as a person, let alone as a fellow provider. Nursing is not my first career — I was a teacher and writer, then a consultant before going back to school to obtain a BSN.

          Again, I apologize. The internet can be a dangerous place these days. If you care, I am presently disabled and barely surviving. All the cautions about caring for one’s back evaporate when your patient is falling from bed. That precious bedside space is one that I have always approached as if it was holy — it often is!

          Precisely why I have offended you so deeply puzzles me.
          As a writer one endures often stringent criticism en route to a stronger script or poem — it ISN’T personal.
          I too am a “professional hand holder”. I am actually considered to be exceptionally kind and empathetic with patients and their families. I honestly do not understand the level of negativity. Please do not worry about the remarkable variety of ailments I am supposed to be at high risk for. I was not kidding in referencing a very strict, yet incredibly compassionate professor in nursing school — who has been a friend for over 15 years. You know, as they say, it is not stress that can be lethal but our responses to it!

  • http://www.facebook.com/profile.php?id=100000386943379 Mark Christian Shaw

    Some people are just intuitive using touch to calm and relax. My wife is a beauty therapist and remedial masseuse which requires quite a bit of touching as you can appreciate. Many worried and anxious clients have walked out of her rooms without a care in the world. She is especially fond of helping the sick and dying and speaks first hand of the comforting power of touch.

  • Anonymous

    Very eloquently said, Sir.  To save money and avoid unpredictability on the table, my surgeon would offer patients to have eyelid surgery without sedation.  I would hold the patients hand and tap the back of their hand while the surgeon placed the anesthetic.  The patients healed faster with great results and never vomited from the medications.  
    I am now studying Psychology with an emphasis on using animals in the healing process.  I volunteer as an equine specialist that assists mental health professionals in equine assisted psychotherapy.   

  • Anonymous

    Sometimes all we have to offer is a gentle touch, quiet caring words and even tears.

  • http://www.facebook.com/drjoe.kosterich DrJoe Kosterich

    For centuries doctors understood the value of “the laying on of hands”. Lawyers, protocols ,technology and political correctness have destroyed this valuable asset

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