I am finishing up my very last clinical for nursing school. 180 hour preceptorship on a psych unit. We have a mix between addicts, mood and thought disorders, depression, Suicidal and Homicidal Ideations, Auditory and Visual Hallucinations and everything in between. It's a VERY busy unit. Some of the patients have some serious mental health issues. Some get involuntarily committed because they were deemed to be a threat to themselves, some were admitted because of overdoses.
I have worked on a med surge, Tele, Neuro unit for almost 2 years now. When patients get discharged, it isn't out of the ordinary for them to try to give us a thankful hug. Hugs are amazing. As humans, we crave touch. Hugging releases all the "feel good" feelings and is a healthy action to have in your life.
So, my question is. Why is it so taboo, so to speak, to hug a patient that is on a psych unit?
Now I understand that looking out for your safety is important. Being a good judge of character is vital and taking your safety and the safety of others into consideration is of utmost importance. On a psych unit especially, there is always a chance of having pedophiles, rapists, murderers, stalkers, etc but isn't that a chance you take on any unit? Shouldn't safety precautions be taken on every unit?
Why do health professionals add to the stigma of mental health by avoiding touching their patients at all costs? As if they have a invisible plague that encapsulates their body and the only way to pass it is through touching?
I had a young patient that was all smiles for 2 weeks. He never complained. He never showed any other emotion other than happiness. An overdose scared the crap out of him and he realized how lucky he was to be alive. The last day I worked with him, he had a moment of clarity. He realized all the bad he'd done. All the people he hurt. All the damage he'd done and he broke down sobbing in the middle of the unit. As a human being, he needed a hug. I gave him a hug, asked him of he wanted to walk with me and talk to help him calm down. It helped. 20 minutes later, he had calmed down and put a few things in perspective.
I was immediately reprimanded for being "too close" with a patient.
But isn't that the point of being a psych nurse? To help your patients with coping skills? Show them a healthy way to calm down and react? I dont want to be a conveyer belt nurse. Just passing out meds, patient after patient and asking the generic assessment questions every day. I want to help. I want to make a difference. I want my patients to know that someone cares about them and is rooting for them to succeed.
So, I'd like to know. Do you hug your patients?
All the nurses I've asked so far have said that they either don't or that there's a grey area and while they shouldnt, they either give side hugs or just don't make a habit of it.
I appreciate all of your input. I see both sides. Some of you admitted that you have hugged your patients in the past and I still feel that there is definitely a grey area for some while there are strict boundaries for others. I was a massage therapist for 10 years before becoming a nurse so touch has always been a huge part of therapeutic healing for me. I completely understand that the two fields are very different. I also completely understand that situational awareness is very important. The patient I hugged was on a psych unit but wasn't there for behavioral or violent issues. I had worked with him on almost ever shift I had for over a week so I didn't feel unsafe making that decision. Sometimes as a human, we just need a dang hug and while I don't plan on hugging all of my patients or making a habit out of it, I think that sometimes exceptions could be made. I sincerely appreciate everyones feedback though and as a new nurse, you all definitely helped shine a new light on the topic for me with your views and experiences. It's hard for a person that is a natural hugger but it's something I know I will have to dial back especially since psych is my favorite field and where I'd like to stay as a nurse.
Specializes in Hospice, corrections, psychiatry, rehab, LTC.
On 4/18/2019 at 7:21 AM, Yahni said:
So, my question is. Why is it so taboo, so to speak, to hug a patient that is on a psych unit?
It has a lot to do with maintaining professional boundaries. Some people with mental illness may misinterpret your display of affection as romantic interest, and they may react badly or be emotionally damaged when they find out that it isn't. Some may even go as far as to stake out the parking lot after you leave, to see where you go after work. These are often people who are disconnected from reality. Keeping involvement strictly professional is the best approach.
Specializes in Psych, Addictions, SOL (Student of Life).
On 5/2/2019 at 3:06 PM, Yahni said:
The patient I hugged was on a psych unit but wasn't there for behavioral or violent issues. I had worked with him on almost ever shift I had for over a week so I didn't feel unsafe making that decision.
Let's take a real life scenario that happened some years ago in my community. A young man was in a psych facility and although the nurse involved never said anything to lead this patient on. It was quite clear the patient "connected" with her on what she thought was a therapeutic level. When it came time to discharge the patient she gave him a hug and wished him well. Five days later she was dead.
The patient took her hug as a sign she was attracted to him. He lurked in the parking lot and followed her home. When she refused his advances he killed her.
I would never hug a patient. I'm a strong believer in boundaries. I can show compassion with my words. I also would never want my actions to be misconstrued and end up with a lawsuit for sexual assault. My pedi patients get fistbumps if they initiate it, but nothing more.
Specializes in Hospice, corrections, psychiatry, rehab, LTC.
On 5/5/2019 at 8:01 PM, hppygr8ful said:
Let's take a real life scenario that happened some years ago in my community. A young man was in a psych facility and although the nurse involved never said anything to lead this patient on. It was quite clear the patient "connected" with her on what she thought was a therapeutic level. When it came time to discharge the patient she gave him a hug and wished him well. Five days later she was dead.
The patient took her hug as a sign she was attracted to him. He lurked in the parking lot and followed her home. When she refused his advances he killed her.
You just never know with psych patients.
Hppy
Precisely my point about detachment from reality and misinterpretation of what is supposed to be a supportive gesture as a sign of romantic interest.
In 10 years, I've hugged 2 patients. I had a long-term nurse-patient relationship with both of them.
Otherwise, no: as a rule, I do not hug. Fist bumps, handshakes, and perhaps a pat on the arm or shoulder is the extent of it. And even then, I'm reluctant to even do that.
I am finishing up my very last clinical for nursing school. 180 hour preceptorship on a psych unit. We have a mix between addicts, mood and thought disorders, depression, Suicidal and Homicidal Ideations, Auditory and Visual Hallucinations and everything in between. It's a VERY busy unit. Some of the patients have some serious mental health issues. Some get involuntarily committed because they were deemed to be a threat to themselves, some were admitted because of overdoses.
I have worked on a med surge, Tele, Neuro unit for almost 2 years now. When patients get discharged, it isn't out of the ordinary for them to try to give us a thankful hug. Hugs are amazing. As humans, we crave touch. Hugging releases all the "feel good" feelings and is a healthy action to have in your life.
So, my question is. Why is it so taboo, so to speak, to hug a patient that is on a psych unit?
Now I understand that looking out for your safety is important. Being a good judge of character is vital and taking your safety and the safety of others into consideration is of utmost importance. On a psych unit especially, there is always a chance of having pedophiles, rapists, murderers, stalkers, etc but isn't that a chance you take on any unit? Shouldn't safety precautions be taken on every unit?
Why do health professionals add to the stigma of mental health by avoiding touching their patients at all costs? As if they have a invisible plague that encapsulates their body and the only way to pass it is through touching?
I had a young patient that was all smiles for 2 weeks. He never complained. He never showed any other emotion other than happiness. An overdose scared the crap out of him and he realized how lucky he was to be alive. The last day I worked with him, he had a moment of clarity. He realized all the bad he'd done. All the people he hurt. All the damage he'd done and he broke down sobbing in the middle of the unit. As a human being, he needed a hug. I gave him a hug, asked him of he wanted to walk with me and talk to help him calm down. It helped. 20 minutes later, he had calmed down and put a few things in perspective.
I was immediately reprimanded for being "too close" with a patient.
But isn't that the point of being a psych nurse? To help your patients with coping skills? Show them a healthy way to calm down and react? I dont want to be a conveyer belt nurse. Just passing out meds, patient after patient and asking the generic assessment questions every day. I want to help. I want to make a difference. I want my patients to know that someone cares about them and is rooting for them to succeed.
So, I'd like to know. Do you hug your patients?
All the nurses I've asked so far have said that they either don't or that there's a grey area and while they shouldn't, they either give side hugs or just don't make a habit of it.
What are your thoughts?
Don't hug your psych patients. For all the reasons you stated. Like safety and because of their crimes - rape, murder, etc.
Make a difference by staying alive and well. there are limits in life.
What is a side hug? Do you mean other than a full frontal hug? Never do a full frontal. I mean really.
It has a lot to do with maintaining professional boundaries. Some people with mental illness may misinterpret your display of affection as romantic interest, and they may react badly or be emotionally damaged when they find out that it isn't. Some may even go as far as to stake out the parking lot after you leave, to see where you go after work. These are often people who are disconnected from reality. Keeping involvement strictly professional is the best approach.
And some have no conscience and could kill without hesitation or thought.
As a fairly new adolescent psych nurse, I’m not sure if I should post, but... I’m a 25 year RN and I guess I think I know everything... lol. I do not hug my patients, I just don’t. However I have no doubt that they know I care for them. There are other ways... I am a closet “ya get a honey bun for good behavior” nurse. I know it’s not best practice, I know it’s not documented, but I swear, I see a difference.
Its not just honey buns, lol. It’s other small things too. I bring q-tips, which aren’t allowed on the units, and allow the ones who are allowed, to clean their ears once a week. Small things, I’ve learned, mean so much to some of these girls.
I just graduated from Massage Therapy school. So I understand the importance of showing compassion and empathy towards others.
Makes sense because you went to massage school. Touch is not always therapeutic as you will soon find out. Some victims of abuse may not be too happy to receive hugs. I will advice that rather than forming such a strong opinion on something you know so little about, be open to learning.
Specializes in Psych, Addictions, SOL (Student of Life).
On 6/2/2019 at 3:16 AM, carap566 said:
As a fairly new adolescent psych nurse, I’m not sure if I should post, but... I’m a 25 year RN and I guess I think I know everything... lol. I do not hug my patients, I just don’t. However I have no doubt that they know I care for them. There are other ways... I am a closet “ya get a honey bun for good behavior” nurse. I know it’s not best practice, I know it’s not documented, but I swear, I see a difference.
Its not just honey buns, lol. It’s other small things too. I bring q-tips, which aren’t allowed on the units, and allow the ones who are allowed, to clean their ears once a week. Small things, I’ve learned, mean so much to some of these girls.
Did I mention that I love love my job?
Cara RN
As someone who has been an adolescent psych nurse for almost 20 years I caution you against offering rewards for good behavior. It set's up unrealistic expectations and places other staff in the position of being the mean nurse that enforces rules, boundaries and treatment goals. While I have empathy for my patients I don't feel sorry for them. Most adolescent psych patients are 100% behavioral. Tearing up their homes or hitting parents/siblings because someone took their phone/video games away. I rarely see a true schizophrenic or bi-polar. When I do their treatment is somewhat different but boundaries must always be enforced.
At our facility we have a points system where the patients earn points for everything they do from making their beds in the morning, going to groups, not cursing etc......The goal is to get 10,000 points which is entirely doable the way the system is laid out. Any thing over 10,000 they can use to buy items from the unit store. When someone comes in a offers a reward outside this system it throws the whole unit dynamic off.
We recently had a young lady who was a terror on the unit in an out of restraints, multiple emergency meds ect. We found out that one of the nurse was offering her candy if she behaved - the problem was she wasn't there all the time so it set up a problem with those of us who enforce the rules.
OMG, absolutely not....there are very good reasons why hugging psych patients is against the rules everywhere and it is for your protection. It is not professional to hug your patients and sets a bad precedent for new nurses. Boundaries must be enforced in order to maintain a therapeutic relationship. Hugging psych patients is a setup for disaster. Your entire career will be compromised sooner or later if you choose to do this. Please refrain from this harmful practice.......
Yahni
4 Posts
I appreciate all of your input. I see both sides. Some of you admitted that you have hugged your patients in the past and I still feel that there is definitely a grey area for some while there are strict boundaries for others. I was a massage therapist for 10 years before becoming a nurse so touch has always been a huge part of therapeutic healing for me. I completely understand that the two fields are very different. I also completely understand that situational awareness is very important. The patient I hugged was on a psych unit but wasn't there for behavioral or violent issues. I had worked with him on almost ever shift I had for over a week so I didn't feel unsafe making that decision. Sometimes as a human, we just need a dang hug and while I don't plan on hugging all of my patients or making a habit out of it, I think that sometimes exceptions could be made. I sincerely appreciate everyones feedback though and as a new nurse, you all definitely helped shine a new light on the topic for me with your views and experiences. It's hard for a person that is a natural hugger but it's something I know I will have to dial back especially since psych is my favorite field and where I'd like to stay as a nurse.