Psych Nurses. Do you hug your patients?

[Yahni]

Hey Everyone,

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.

What are your thoughts?

[K8e]

I worked on a med/surgery unit as well as psych clinic. I never initiate hugs w patients in either field. A hug may be innocent enough to you, but there is no way in knowing how your patient will interpret that hug! Nursing boundaries are put in place for a reason- for the safety of the patient and safety of the nurse.

I think you have a kind and generous heart, but you must tread carefully when it comes to the nurse-patient relationship.

[apsychRN]

On 4/18/2019 at 9:21 AM, Yahni said:

Hey Everyone,

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.

What are your thoughts?

It’s totally ok to give a hug as long as you feel comfortable with what the hug conveys. Most of the hugs I’ve given & received are hugs of appreciation from patients. A thank you for everything you did to help me. Is extremely rare for a hug of comfort until I’m positive of what those tears really are. So mad they could and are crying? A phone call or visitor that upset them? How paranoid are they at this moment? Most don’t want to be touched and certainly never walk up behind a psych patient.

Most physical touch is very effective when someone is in a full blown panic attack once you have their attention. I had a patient in to see the Dr via telemed. A therapist was sitting next to her & I behind my desk. She was very calm, answering appropriately etc & all of a sudden burst out screaming & crying while hitting herself in the face (actual fist into face) I look at the therapist expecting her to “do something “ (I’m not sure exactly what) and she just raised her arm bent at elbow & gave the patient a couple of pats on the shoulder ? My mind was screaming That’s it! That’s all you got! My Lord help! That’s when she begin to bang the back of her head into the concrete wall.. I ran around my desk calling her name (this was very scary situation for all of us) and bent down to a little below her level trying to get her attention, I finally got a quarter of a second eye contact with her and I grabbed one of her hands and brought it to my chest while calmly as I could speak told her I needed her to breathe with me, to feel the rise & fall of my chest. It seemed a whole day had gone but it was only a few minutes when she finally began to look me straight on while I exaggerated each rise & fall of my chest & felt safe enough to gently grab her other arm & placed it with the other on my chest until she could breathe on her own. I had my other hand on her chest to feel her breaths trying to get her to sync with me. That’s when I learned the therapist strict rule of no touch! However I am a hands on nurse after all & I had no other quick idea on how to get her to stop harming herself. (There was blood, sweat, tears, bruises & lumps but nothing too serious). I came out exhausted from what the therapist called Transference. So after she was assisted back to her room & I went back to my office with the Dr & therapist is when it dawned on me that all the Dr could see from the comfort of his home ? (because it’s telemedicine) was a big blue blur! My butt because I was between the big screen where he sat & the patient. How embarrassing! I apologized and he laughed at me and said how helpless he felt having to watch & hearing it all. All in all the outcome was as good as it could have been I suppose but it was a real eye opening experience for me to witness how hard someone can hit themselves and do self harm. It’s not to be taken lightly.

Anyway keep in mind that just because you feel a hug or some type of physical touch is appropriate or you would want a hug in a situation doesn’t mean that person thinks the same thing & wants one too!