Back rub program

jer053171 · Dec 3, 2008

I appreciate all the input. I do realize this is something that I will have to work through and understand the importance of the healing touch. Thank you all again for your time and insight.

picurn10 · Dec 3, 2008

We have to do 15 back rubs in basic clinical checkoffs. It does feel strange to me for some reason, and I noticed most of the students left it until the last minute. I think it's because its something most of us only do with people we're very close with, and it doesn't have a clear cut medical purpose. I mean, yes, it helps the pt in many ways, but it's not like a pt needing a foley and then you do xyz and that's done.

I remember when my mom was in the hospital and her nurse gave her a backrub and I thought it was weird. But then when they taught us I was like "oh, that's why she gave a backrub!"

queenjean · Dec 3, 2008

I try to give all my pts backrubs, but not in the "can I give you a backrub?" way. I usually ask if they want some lotion on their back when I'm doing HS care, or when I am getting ready to help them back into bed from being on the commode. While I'm applying the lotion, I knead their shoulders and neck a little. If you have a particularly grumpy pt, offer to put some lotion on his/her back and then put your thumbs into it for a few minutes. They won't be grumpy any more. Usually while I'm putting on the lotion and start kneading, the pt says something like "Oh, right there, that feels so good" which to me is an invitation to continue. If they don't say anything, I usually ask, "Does it feel better if I put some thumbs into it? Your shoulders seem a little tight." If they say it doesn't feel good or act like it makes them feel uncomfortable, I just finish putting on the lotion and call it good.

The air is dry, the sheets are rough, and they all--30 yr olds to 90 year olds--have probably spent more time than usual on their backs while sick. I know I personally hold a lot of tension in my shoulders, and two minutes of someone working on it with their thumbs is enough to realign my universe!

I think a lot of our older pts don't get touched enough. Sure, they get changed, assessed, and bathed; but there is something gentle and luxurious about getting a little lotion on your back. I've had little old guys about cry while giving them a back rub, and I wonder--when was the last time someone just touched them in a normal, nice way, without gloves, without a purpose (like an assessment)? About half of the very elderly will comment at some point during the back rub "My husband/wife used to do this for me; I can't remember the last time someone's given me such a good back rub." We're talking a two minute back rug, folks, not a half hour massage. It takes so little time but makes them so happy.

I don't always get time/opportunity to do back rubs, and pts don't always say "yes" when I ask if they need some lotion on their back. But the ones who do absolutely love it.

The cookies? That's just stupid. Then you'd have to do mouth care all over again! Do you leave a mint on their pillow, too, after you've made the bed? Are they expected to leave a tip for housekeeping when they are discharged?

missjennmb · Dec 3, 2008

I was suprised about the cookies part too. I always thought we were supposed to drill health into people's heads (nicely of course!). Do you not offer the service to a diabetic who shouldnt have sugar or an overweight person who doesnt need the calories?

I don't know. I think that a big problem we have in our society is using junk food for thank you's instead of just saying thank you. It starts when we're young and becomes an integral part of us before we hit adulthood. (myself included) I would much rather have a back rub or a foot rub and some fresh clean sheets or scented lotion or *something* than junkfood, and somehow I doubt they'd taste like Grandma's anyways. :)

And I agree totally about the elderly not getting touched enough. I see it a lot at the nursing home, where they don't want to let go when its time for me to leave because they look forward to our visits so very much. But I do use gloves. We have a lot of patients with extensive epithelial shedding and I would not be comfortable doing it skin on skin. Maybe thats why it doesnt make me feel uncomfortable, because its not "intimate" to me when I'm wearing gloves, be it rubbing lotion on the back/feet/legs/whatever or changing briefs or whatever. I do give lots of hugs though. :)

MrsBradyMom · Dec 3, 2008

I'm graduating next week & we learned the importance of back rubs! I don't mind at all, and in fact, I give foot rubs to my elderly ladies. I wear gloves, so it's not as intimate. I have even been known to carry bottles of nail polish with me to LTC rotations for moments of down time. I would give my ladies mini-pedi's. They thought this was the greatest gift.

It's sad that when I get a job I probably won't have time for that anymore.

NurseLoveJoy88, ASN, RN · Dec 3, 2008

I don't mean to sound rude... but, its not about you its about the PATIENT ! There are alot of procedures us nursing students and nurses may not " feel comfortable with" however, if its part of our job in promoting the pts. quality of life than it needs to be done. First we must examine ourselves and confront any feelings of uneasiness and deal with it. Maybe you should really think hard about whether or not this is the career for you. I don't think I'll ever be comfortable with some nursing procedures, however I find ways to cope... and in my heart my goal is to be compassionate and competent in my nursing career. Did you know that back rubs are a pain relief measure ? So its just as important as given meds, or using other pain relief techniques. Its okay not to " feel comfortable", Just try ways to cope with it. Best of luck

NurseLoveJoy88, ASN, RN · Dec 3, 2008

How did things evolve into nurses feeling uncomfortable giving the patients back rubs? Have we gotten that unfeeling? Is this the result of too much daycare instead of mommies taking care of their kids and nurturing them? Giving back rubs was taught as part of my nursing curriculum 30+ years ago in basic nursing fundamentals in first semester. It promotes circulation and relaxation and gives you time to interact with the patient. A back rub, a clean gown and a clean draw sheet (many don't know what that is) was expected to be done on every patient as part of their am and pm care when they were hospitalized--a practice that started to be abandoned when hospitals went to all RN staffs in the 80s and nursing assistants started disappearing from the halls. It is why that bottle of lotion appears in the admission packs. This activity is quite refreshing to a patient who lies is a bed all day. I say that if a nurse is afraid to touch a patient they do not belong in this profession. And that is my . If there are younguns who are offended, so be it.

I agree 100 % percent:redpinkhe

AtomicWoman · Dec 3, 2008

If you have ever spent a considerable amount of time confined to bed, even ambulatory, you would know how much better the patient will feel after a backrub. I had a severe case of the flu 7 years ago. I could only get out of bed to go to the bathroom and to shovel down a bowl of soup in the kitchen for 10 days. By the 5th day, my back was hurting me so bad, I would have killed for a backrub! :) I finally had my cat sit on my back because the pressure made me feel better.

So yeah, when I become a nurse, if someone asks for a backrub, even if they are ambulatory, I will know where they are coming from. :)

KIMYNURSE2B · Dec 4, 2008

I am in NS now

We offer/give back rubs with am care to EVERY pt who gets a bedbath.

Not everyone wants one.

yetanotheramanda · Dec 4, 2008

Wow, I guess I'm the only one who thinks it's not a big deal that you are a little uncomfortable with giving back rubs. I mean, we do a LOT of things in nursing school that we are initially uncomfortable with...who out there felt just peachy about sticking a tube in some stranger's uretha the first time?

My point is...it's just one of those things. There is a benefit to the patient, so we overcome our uncomfortableness and get on with it. I commend you for asking for the opinions of others in order to get different viewpoints.

vixnnet · Dec 4, 2008

While I can understand the energy and intimacy it takes to rub someones back, it seriously isn't that big of an expectation. I work on people's bodies all day (Massage). If you start doing it, it won't be that big of a deal - its a part of caring, healing, and holistic approach.

back2thebooks · Dec 4, 2008

Very interesting thread. I originally thought that even as a patient, I would feel a bit uncomfortable with a backrub. It is less clinical than a foley insert, a bedbath, etc., --- and I would think it would feel awkward. But now, after reading some of the replies of previous patients who were in bed for weeks on end (my longest hospital stay was a week), I've seen another side of it.

I don't think it has anything to do with Mommies putting their babies in daycare these days, as Daytonite suggested. Although I am a Stay-at-Home-Mom by choice, I certainly understand how some Moms have to work--it doesn't mean the Mommy is cold and unwilling to nurture.