giving a massage after a bath..?

Agnes Anne · Oct 7, 2007

I try to offer a quick foot massage when checking for pedal pulses and edema. I'm already there, have the covers untucked and have their sox or booties off so why not?. I think it's a nice way to end the assessment... most folks have SUCH dry feet! :nurse:

NoviceRN10 · Oct 7, 2007

Boy! Has nursing changed. When I was in nursing school, back and foot massages were taught as part of the AM and PM care. It was done to stimulate the circulation of people who were confined to bed. Do they even teach what AM and PM care are anymore? Probably not as times have changed and everything is about getting the patient in and out of the acute hospital ASAP. Thank you Medicare and the insurance companies.

My pathogenic micro professor told us that the reason people are discharged from hospitals so quickly these days is to prevent them from being exposed to additional illnesses they could catch from all the germs lurking in the hospital. Is he wrong? I can see both sides of the coin, expense vs potential health risks if you hang around.

elkpark · Oct 7, 2007

My pathogenic micro professor told us that the reason people are discharged from hospitals so quickly these days is to prevent them from being exposed to additional illnesses they could catch from all the germs lurking in the hospital. Is he wrong? I can see both sides of the coin, expense vs potential health risks if you hang around.

Of course he's not wrong, but, given all the other ridiculous cost-saving practices imposed by the insurance companies, it seems pretty obvious that they're primarily concerned with saving $$$.

Daytonite, BSN, RN · Oct 7, 2007

My pathogenic micro professor told us that the reason people are discharged from hospitals so quickly these days is to prevent them from being exposed to additional illnesses they could catch from all the germs lurking in the hospital. Is he wrong? I can see both sides of the coin, expense vs potential health risks if you hang around.

Ha! Ha! Ha! Is this professor a nurse? Do they work in a hospital? I don't think so. Any hospital administrators or anyone involved in hospital management will flat out tell you that the time a patient spends in the hospital has to do with how much money the hospital is going to get paid by the person's insurance company--period. Medicare led the field with this when they came out with DRG (Diagnosis Related Groups) back in the 1980s and told hospitals that these lumps sums for a patient's diagnosis was how they were going to pay for a person's hospital stay, not based on the number of days or amount of stuff they used. Consequently, if Medicare only pays 4 days for pneumonia and the hospital can get the patient discharged in 3 days, exposure to additional illnesses has nothing to do with the early discharge. While your professor does have a valid point and hospital employees have to be vigilant about spreading germs, it is NOT the reason people are discharged quickly.

marilynmom, LPN, NP · Oct 8, 2007

Yes, in my BSN program the very first class we were taught AM and PM care and massages and how to do them....I have only had the opportunity to give a patient during my hospice (community) clinicals a foot and hand massage.

DaFreak71 · Oct 8, 2007

I try to offer a quick foot massage when checking for pedal pulses and edema. I'm already there, have the covers untucked and have their sox or booties off so why not?. I think it's a nice way to end the assessment... most folks have SUCH dry feet!

We were taught the merits of giving back rubs, but outside of OB I just don't do that. Mostly because clinical is way to hectic anyhow and I can assess their skin and increase circulation to the back while I'm bathing them. Secondly, I'm just not comfortable with it. I don't even let massage therapists give me back rubs. Not my cup of tea.

Conversely, I will give foot rubs to diabetic patients and to anyone with dry/cracking skin. I suppose if a clinical instructor were standing over me I might be inclined to go through the motions of doing it, but in reality, outside of the first semester (where we focus on geriatric patients) the instructors don't care if we do it or not. They know we're trying to give meds, do assessments, histories, carry out doctors orders, etc. Our clinicals last 4 hours twice per week and that leaves precious little time to offer such luxuries as a back rub.

Just my :twocents: , but if it's required at your program, do it.

I asked my husband who is a RN how many times he has given a patient a back rub/how many times his co-workers give back rubs and he laughed. I even asked my second semester instructor how often she gives backrubs (she works weekends at the hospital) and she she just rolled her eyes and said "in theory it would be great, but in the real world it just isn't done much anymore". So do what you have to do, but I don't do it if I can get away with it.

Flame away.

SuesquatchRN, BSN, RN · Oct 8, 2007

I just don't have time but when I do, particularly for the elderly, I do it in a heartbeat. Some of them are very starved for touch and lotion rubbed into their dry, fragile old skin is luxury.

queenjean · Oct 8, 2007

I think you can make time. I ALWAYS offered back rubs to my pts when I worked med surg. When I was getting them ready for bed, I would help them brush teeth/do dentures, and then I'd give them a warm damp wash cloth for face, hands, bum; and then I'd say something like "Do you want me to put some lotion on your back?" and I'd spend five minutes or less doing the back rub.

Not everyone wanted it, and some nights I truly didn't have time But usually if you have to turn and change someone, you can do a quick 1-2 minute backrub when you turn them at some point. When you assist someone to the bedside commode, when they sit back down on the bed, you can have them sit for a minute while you do a quick lotion massage on their back. Even one minute is nice for them, lets you get in a good assessment of the skin on their back, and one minute is no skin off your back.

The best way to get a grumpy, disgruntled patient in a good mood is to put lotion on their back and spend a few minutes kneading some stiff back muscles.

Cherish · Oct 8, 2007

I thought this was the norm. In my CNA class we were taught to give a 3-5 minute back rub, you could assess the condition of there skin at this point too, and maybe help prevent a bed sore by promoting circulation to this area. I noticed a lot of the elderly patients enjoyed it and even stated that they enjoyed when the students came around because usually they never received back rubs during normal bed baths from the employed CNA's. If you do not have the time, then you do not have the time. But if there is some time for even a 1-2 minute back rub maybe the patient will enjoy this and appreciate you even more.

halo425 · Oct 8, 2007

I'm in Process one my instructor and book always find a way to include a backrub into care. We were taught AM and PM care also. we have not been taught the actual technique, but it has been mentioned many times.

blueheaven · Oct 23, 2008

Wouldn't this be the same as a back rub?
We learned to do those when I was in nursing school, back when dinosaurs roamed the earth. They were done after the bath and, often, at bedtime. It is relaxing for the patient, is a comfort measure, and offers an excellent opportunity to assess the skin.
Nothing sexual about it. I don't recall ever having a patient misinterpret a back rub as anything sexual.

ROFL on the dinosaurs!!!!!!!!!!!!! I am too. We did back rubs routinely for the patients and never had a patient think I was "hitting on" them. All were and are appreciative for this comfort measure.

missjennmb · Oct 24, 2008

I'm having a hard time understanding how this could be sexual in any way shape or form? You have to clean their private parts, put in catheters, check their testicles for lumps and you think a BACK RUB is sexual? I just cant see where you're coming from on this. As for the "I dont like them" comment... I don't like them from strangers either, or from almost anyone other than my husband and even then only when I want it, but that doesnt mean I feel as if I cannot give one to someone who craves the touch and is feeling ill or uncomfortable, or otherwise would be made more comfortable/healthy by a quick rub down. Isnt that what nurses do? Provide a holistic approach to making/assisting patients/clients/residents feel better? I highly doubt a 90 yr old grandma with dry cracked paperthin skin is going to be thinking sexual thoughts when you rub her back.

I know that I'm a bit heated, as a result of coming from one of my first clinicals and seeing how much all of the residents in LTC craved attention and NEEDED that extra attention. I just can't imagine being hardened against that in any way at all and its hard to see refusing therapeutic touch as anything else.

I really am not trying to come across abrasive. I am just not understanding the whole sex = back rub connection I guess.