It Goes Both Ways

As nurses in LTC facilities, we care for the residents in many ways. Beyond that, we care about them. But is the caring really one sided? Or do our residents care about us too? We are important to our residents, not just for what we do for them as nurses. In many cases, they see us more than their own families. We're not just that person who passes out medications, we are people they care about. Perhaps...it goes both ways. Nurses Announcements Archive Article

Having worked in long term care for some time, first as a CNA, now as a nurse, I know how important touch is to the residents. A hug, a hand on the back or shoulder, even a quick squeeze of the hand lets residents know that they are not alone, that someone cares.

Residents in long term care often suffer from lack of meaningful physical contact. Often, the only touch they experience is during personal care, which by necessity is conducted professionally. Knowing this, at work I frequently touch residents on the back, shoulder, arm, hand, and yes, even a hug sometimes. I've seen this kind of touch cheer, comfort, encourage, and calm.

With all the emphasis on what we do for the residents, we tend to think about what we can do for them. How touch can benefit them. But what about the residents, what they can do for us?

Not that we should go to work expecting the residents to do things for us. But the residents do have something to offer. They are not "done," their meaning in life did not end when moved into the nursing home.

One of my residents showed me that they do still have something to offer, and sometimes, I'm the one who needs the benefits of touch.

You know how busy and stressful it can be working in LTC. Some days go pretty smoothly, but others are filled with interruptions in the form of family members with questions or concerns, calls to or from doctors, orders to transcribe, requests for PRN medications, falls, skin tears, changes in condition, critical lab values and on and on.

I was having one of "those days,"not the worst, but stressful and terribly busy. Amidst the running to and fro, trying to get everything done and everyone taken care of, I passed Viola (name has been changed) in the hall. Viola was one of those residents who always has a smile and a kind word. She always had a positive attitude, even when facing a wound that didn't want to heal.

Viola rarely asked for PRN medications, so I was surprised and bit concerned when she stopped me in the hall. Instead of asking for something though, she said "Can I give you a hug?"

I quickly replied, "Of course!" and bent down to hug her in her wheelchair.

As we hugged, she said "I know your job is hard, but you're a great nurse. I want you to know that."

I walked away from that brief encounter with a lighter step and a new perspective. It had never occurred to me that a resident would give me encouragement. Viola helped me see that we are important to our residents, not just for what we do for them as nurses. In many cases, they see us more than their own families. We're not just that person who passes out medications, we are people they care about.

Sometimes, I'm the one who needs a hug.

I have always been a 'toucher', 'hugger', and people person. Many instances of making an impact on others....

I also always talk to pts, whether they are comatose or not. Had 2 middleaged AA that never spoke, finally respond to me after a couple of years. Complete sentences. Said I was usually the only one who talked to them, so they never bothered to respond to anyone else. (one was a tube feed that was running slow. She told me "It has been slow all day for everyone else too." The other when I said "How's it going today?" replied, " I have a headache. Could I have some Tylenol?" Shocked the daylights out of me both times. But they went right back to silence again after that day.) Fluke maybe, rare lucidity, who knows. But still rewarding to know I had touched something.

To the new grads, these are the moments that you will remember as meaningful. Be your patient's advocate. Help families. Humans are hard-wired to NEED touch, affection, attention. Grab for the gusto with every patient you can. It will be returned a 1000 times.

Not a hugger or a toucher BUT i talk to every patient. And like you I have had one respond that nearly sent me into a panic! It was that shocking. I always state what I am going to do before I DO IT, whether the pt is ressponsive or not. I HATE when other nurses or the aides tell me " he can't understand you" or " he isn't oriented" DUH I KNOW that is most likely right but maybe they do.........

Specializes in Geriatrics/family medicine.

Wow the other day my patient watched as I did her breathing treatment, then her bolus feeding along with her medications. When I finished everything and started to wheel her out to the hallway, she said to me thank-you and one day I know you will be head nurse because you are good. That sure lifted my spirits and made me have an extra spring in my step the rest of the shift no matter how crazy it got lol.:bow:

Specializes in Peds Medical Floor.
I have always been a 'toucher', 'hugger', and people person. Many instances of making an impact on others....

In the '70's, when they had decided AIDS could be caught just by reading about it, I took a fresh pitcher of water into an AIDS pt's room. He burst out crying. He said "I have felt so worthless, everyone wearing gloves, masks, and full protective gear around me. You made me feel human again, by not wearing gloves." I told him, I was just setting down the pitcher, if I were doing pt care, I would be gowned up. He said that was fine, but just seeing a real face and real hands was such a boost for him.

Another was crying at breakfast. "I can't stand this no salt (cardiac) diet any more." We talked & I asked him what he wanted if he could have ANYTHING for one meal. "A chili hotdog with everything!" 7:30 am I called his doctor and requested this. "NO!" I said the pt was 80 yrs old, had lived a good life, and if life made him that miserable now, what difference would one dog make? Dr. reconsidered and said IF I could get one from dietary now, he could have whatever he wanted for this ONE meal. (HAHAHA) Dietary came up with TWO footlong dogs, cheese, chili, onions, ketchup, mustard, & relish with French fries and a Coke. Pt later told dr he could stick with new diet restrictions if he was allowed one day a month to look forward to whatever he wanted. Dr. agreed and all were happy.

In the 80's another AIDS pt, that no one would draw labs on or start an IV in. Same outcome when I did both with no gloves. When reprimanded, I replied that I took care of AIDs when they said it was NOT contagious and NO precautions were necessary. If I didn't get it then, I was not worrying. Never did get anything from a patient.

In the 90's I started in LTC. One resident crocheted 'straps' onto Christmas dish towels for everone to hang on their refrigerators. As a Jehovah's Witness, I was concerned when she gave me a small, wrapped box. "I remembered." I opened a towel with a cottage and small children & animals around it rather than a Christmas theme. Yes, they appreciate our care and respond in kind.

When 'STATE' decided nicknames were degrading, I had a nearly blind DAKA who always called me Sugar and Momma Bighips. With 'STATE' watching as I walked in at 7am, he hollered out "Hey Momma Bighips. Give me some sugar." I walked over and said "Hey, BigMan.", gave him a hug, and watched my DON and ADON drop their jaws. I looked right at 'STATE', as this was a FAMILY demonstration, nothing degrading here, and she was laughing out loud. No cites either. ; )

I also always talk to pts, whether they are comatose or not. Had 2 middleaged AA that never spoke, finally respond to me after a couple of years. Complete sentences. Said I was usually the only one who talked to them, so they never bothered to respond to anyone else. (one was a tube feed that was running slow. She told me "It has been slow all day for everyone else too." The other when I said "How's it going today?" replied, " I have a headache. Could I have some Tylenol?" Shocked the daylights out of me both times. But they went right back to silence again after that day.) Fluke maybe, rare lucidity, who knows. But still rewarding to know I had touched something.

To the new grads, these are the moments that you will remember as meaningful. Be your patient's advocate. Help families. Humans are hard-wired to NEED touch, affection, attention. Grab for the gusto with every patient you can. It will be returned a 1000 times.

Just to expose my youth and ignorance....there was a time they thought AIDS wasn't contagious? Wow. Just goes to show you that the "experts" don't always have it right!

When I worked in LTC I hated not being able to have nicknames. I'd never call someone something if they didn't like it, but some people liked being called Grandma. Momma Bighips lol.

I also had an incident with someone who "didn't speak." I said, "Merry Christmas!" as I worked nights as a CNA and always wished the residents a happy whatever or merry whatever if I had to wake them up after midnight. Made them less grumpy about being woken up. :) She said it back and I almost fell over. I said, "Irene you've lived her for years and haven't spoken to anyone." She said, "Just haven't felt like it." Never heard her speak again after that lol.

I used to give residents back scratches and hugs too. That's probably the only thing I really miss about LTC. I was having the WORST night one night when I was still a CNA and this resident Sarah says, "Honey what's wrong? Usually you are more talkative when you get me ready for bed. Are you having a bad day?" And I did boo hoo a bit about school, and stuff going on in my life. She patted my hand and said, "It's ok, honey. Tell mama all about it." Such a sweet lady.

I also never saw the point of enforcing heart healthy diets or even diabetic diets (within reason - don't want anyone going into a coma lol) on someone who's 80 or 90 and hates their food.

Specializes in Renal; NICU.

I know from experience that it's the nurse that many times needs a hug or a touch. I have had a parent of my NICU baby acknowledge that I needed a hug after watching us work over a very ill/dying baby for a shift or even for days. I'm sure the residents of a LTC facility see it all, too. They need to give comfort, too, as much as receive it.

BTW, for 'state' to render these PC rules, they have overlooked the 'person'. With that resident's permission, nicknames, touch, a hug should be as essential as food and medicine. If I'm in your LTC, please hug me, hold my hand when I'm afraid, ask me about being a nurse all those years ago, and call me Sandi, you little whippersnapper!! haha.

Specializes in Renal; NICU.

Oh, and puree' up some Chinese for me if I have no teeth!!!!

Specializes in Geriatrics/family medicine.
Wow, what a wonderful story! I am a new grad RN and have an interview tommorow in an LTC. Most have implied that it is an inferior job. This really upsets me as I see nursing not as getting into something "prestigious", I got into nursing because people, all people, need caring. Sorry, don't mean to ramble. I am excited about the opportunity to work with the elderly. Wish me luck on the interview! Thanks :)

all the best and I agree with others its the suits that ruin it for us and the patients we are trying to care for:bow:

Specializes in Geriatrics.

I'm with you, Dianne! Good luck :)

Specializes in SNF/LTC.
BTW, for 'state' to render these PC rules, they have overlooked the 'person'. With that resident's permission, nicknames, touch, a hug should be as essential as food and medicine. If I'm in your LTC, please hug me, hold my hand when I'm afraid, ask me about being a nurse all those years ago, and call me Sandi, you little whippersnapper!! haha.

AS I understand it, nicknames are allowed, but it must be in the care-plan that the patient likes to be called by that nickname.

Specializes in LTC, Float Pool, Ortho, Telemetry.

I love this story because it goes along with my feelings about working in LTC also. I "cut my teeth" so to speak as an LPN in LTC for the first 1 1/2 years of my career and then went on to work in a hospital for the next 14. I remember when I started working in the hospital it took me a long time to stop thinking and worrying about the residents that I had left behind. They had that much of an impact on my life and had taught me some valuable lessons about compassion and caring for others.

I went on to obtain my RN and then my BSN over the years I worked in the hospital and thought that I would always work there. I also implemented simple touch, kind words, smiles, and yes hugs into my patient care when and where it was appropriate. I have never had a patient complaint against me. Circumstances beyond my control brought me back to LTC last year and I have had many mixed emotions about it. It seems that Nursing ingrains in Nurses that working in LTC is somehow substandard and a step back or down. I worried I would lose my skills and or that I would be wasting all of the education that I had so rigourously obtained.

I was hired to work on one specific unit and that suits me because I am a homebody and like to get comfortable in one place. I take care of 26 residents from 7-11 pm and then pick up both halls at 11 until 7:30 am for a total of 46. I never should have worried about losing my skills, lol! I use them everyday and then some. I am assessing my residents while I am talking to them, giving them their meds, changing dressings and so on. I am starting IV's, drawing blood, using and replacing g-tubes, changing foleys, straight caths, wound vacs, trach care and management, respiratory treatments, and the list goes on and on. Not to mention, talking to doctors, writing and transcribing orders, dealing with Pharmacy, taking care of family issues, supervising my CNA's and charting, charting, charting.

In the midst of all of this, this past year I have grown to love each of my residents for who they are. I have listened to stories from their past, talked about current events, calmed their fears, held their hands, dried their tears, given hugs, made their rooms safe by running off the imaginary dogs and cats, fed them, laughed with them,showed them pictures of my family and looked at pictures of theirs, and very skillfully managed to get their minds off of that husband, wife, or mother they just can't seem to find.

I have also had the priviledge of holding a hand as a special person left this world for the next and made it a more comfortable passing. There can be no greater priviledge. So now when someone says "I can't believe you are working in a Nursing Home again", I just smile and say "Yes I am and I love it." There are actually many opportunities that I can eventually take advantage of, because of my experience and education, within the LTC system. I don't know about any of that right now, I am just enjoying the moment.:loveya:

Specializes in Geriatrics/family medicine.

LTCangel good for you! i guess as long as we get to be nurses and care for our residents doesn't matter where we work.

wow! i got teary-eyed while reading this. Thank you for the wonderful post.

And THIS is why I love working LTC!