Suspended for touching a child's head and face

Published

Hi my fabulous ER sisters and brothers. I'm an older nurse and have been in the ER for 5 years. In my 30 years of nursing I have always used touch therapy. I find showing compassion and tenderness goes a long way to soothing a patient. I have just received a 2 day suspension for touching the head and face of a child. There was no parental complaint and nothing was inappropriate but they used the words "inappropriate touching" and said that it was too intimate. I'd really like to know how many of you will casually pat a child's head or caress a cheek when soothing or reassuring a pediatric patient. I have done this my whole career and never had a problem so I'm struggling to understand what I did wrong and why it's a problem all of a sudden.

Specializes in Ambulatory Care.

The only consolation for me, would be that if you told this story to other nurses, most of them would find it ridiculous. Sometimes you just have to take it as a lesson learned and know that your intention was pure.

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Specializes in Community health.

I do 100% agree on the wording “inappropriate touching.” If that is in print anywhere, I think you need to demand that it be changed. Today, that phrase means the same as “sexual touching,” even if it didn’t mean that in the past. If a teacher at my child’s school was suspended for “inappropriate touching, what would I assume? And so would everyone else. You haven’t been accused of sexual touching, so that needs to be re-worded.

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I’m really sorry that happened to you. I do that all the time with my patients (adult population in various settings; med surg, stepdown, ICU). It’s unfortunate that this resulted in disciplinary action, all from having a KIND heart. With your experience, you can go anywhere. If your work doesn’t see that you were being compassionate, they don’t deserve you. We need more nurses who show compassion and empathy. Good luck!

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37 minutes ago, AlwaysLearning247 said:

I’m really sorry that happened to you. I do that all the time with my patients (adult population in various settings; med surg, stepdown, ICU). It’s unfortunate that this resulted in disciplinary action, all from having a KIND heart. With your experience, you can go anywhere. If your work doesn’t see that you were being compassionate, they don’t deserve you. We need more nurses who show compassion and empathy. Good luck!

I am going to challenge you, @AlwaysLearning247. ?

I would not touch a patient's face in attempt to convey caring. That action does not convey that.

Let's lighten this up a little for the purposes of explaining. We've all seen cartoons, memes, greeting cards with the elderly aunt/grandma/relative who has to make a big show of giving the kiddo a great big bear hug and kiss because they are so happy to see them. Or pinching cheeks, "my how you've grown!"

These things might make the do-er happy, but they do not make the receiver comfortable AT ALL.

Putting your hands on someone's face in attempt to convey caring? It had better be someone with whom you have an intimate personal relationship. Children don't even like that sort of touch from distant relatives - - to say nothing of strangers with whom they have zero relationship.

We do have a duty to abide by what makes patients comfortable in this area, not what makes us comfortable.

We should be able to discern that touching a patient is categorically different than the appropriate ways we may touch those with whom we have various kinds of intimate relationships and whom we know well enough to know their preferences and consents.

37 minutes ago, AlwaysLearning247 said:

It’s unfortunate that this resulted in disciplinary action, all from having a KIND heart.

Based upon my reading of the OP, I agree.

BUT. This discussion cannot veer toward "X" (touching) is KIND, and those who don't do it can't understand because they aren't KIND.

Kindness itself involves, at its very core, a basic understanding of and respect for others.

37 minutes ago, AlwaysLearning247 said:

We need more nurses who show compassion and empathy.

What we need is more people that understand the numerous ways that nurse offer compassion and empathy that do not involve "showy"/demonstrative means.

I think that is a major theme with regard to this topic. Too many people think that overt sappiness, very demonstrative and emotive actions are the only ways to display kindness, compassion, and empathy....as opposed to someone like me who believes that the #1 best way to show these things is to do the technical and cognitive aspects of my job as best I possibly can.

In the ED, we have a rapport that spans an average of, what? An hour or less for someone with a hurt arm? We are not there for everyone's emotional fulfillment. Kindness is huge - - sure!! But, aside from tragedies or major stressors where the patient or family may reach out for a hug or pat us on the back/arm, or express their own need for appropriate human touch, we aren't there for that!

And that's exactly why some people are guaranteed to look askance at facial touching under the circumstances. I'm not just making this up or declaring my opinion, the patients themselves know that they aren't there for that and they know that we aren't either.

I will say again what I said earlier. We do not need to try to evoke heart-throbbing, tear-jerking, lovey-dovey emotions in order to convey that we care.

**Everything else I have posted still stands. Frankly I suspect the OP is being bullied for reasons that may not even be related to this.

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Specializes in PMHNP-BC.

How crazy. I’m in my 20’s with 5 kids and NEVER would have thought twice about it. In my personal opinion we are too sensitive to many things and feel entitiled to being “wronged”.

Sad thing is.. I went to a follow up appointment with my toddler this week and gave him a quick Kiss on the cheek when picking him up. The PA stopped and gawked at us, as if wondering why I didn’t ask him for permission to kiss his cheek, seriously? I don’t ask for permission to kiss or hug my kids (ages 7 and under). Sorry but they BETTER give their mama a kiss, plus they love it.

The Parenting culture has taken an unfortunate turn in this country...

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10 minutes ago, JKL33 said:

I am going to challenge you, @AlwaysLearning247. ?

I would not touch a patient's face in attempt to convey caring. That action does not convey that.

Let's lighten this up a little for the purposes of explaining. We've all seen cartoons, memes, greeting cards with the elderly aunt/grandma/relative who has to make a big show of giving the kiddo a great big bear hug and kiss because they are so happy to see them. Or pinching cheeks, "my how you've grown!"

These things might make the do-er happy, but they do not make the receiver comfortable AT ALL.

Putting your hands on someone's face in attempt to convey caring? It had better be someone with whom you have an intimate personal relationship. Children don't even like that sort of touch from distant relatives - - to say nothing of strangers with whom they have zero relationship.

We do have a duty to abide by what makes patients comfortable in this area, not what makes us comfortable.

We should be able to discern that touching a patient is categorically different than the appropriate ways we may touch those with whom we have various kinds of intimate relationships and whom we know well enough to know their preferences and consents.

Based upon my reading of the OP, I agree.

BUT. This discussion cannot veer toward "X" (touching) is KIND, and those who don't do it can't understand because they aren't KIND.

Kindness itself involves, at its very core, a basic understanding of and respect for others.

What we need is more people that understand the numerous ways that nurse offer compassion and empathy that do not involve "showy"/demonstrative means.

I think that is a major theme with regard to this topic. Too many people think that overt sappiness, very demonstrative and emotive actions are the only ways to display kindness, compassion, and empathy....as opposed to someone like me who believes that the #1 best way to show these things is to do the technical and cognitive aspects of my job as best I possibly can.

In the ED, we have a rapport that spans an average of, what? An hour or less for someone with a hurt arm? We are not there for everyone's emotional fulfillment. Kindness is huge - - sure!! But, aside from tragedies or major stressors where the patient or family may reach out for a hug or pat us on the back/arm, or express their own need for appropriate human touch, we aren't there for that!

And that's exactly why some people are guaranteed to look askance at facial touching under the circumstances. I'm not just making this up or declaring my opinion, the patients themselves know that they aren't there for that and they know that we aren't either.

I will say again what I said earlier. We do not need to try to evoke heart-throbbing, tear-jerking, lovey-dovey emotions in order to convey that we care.

**Everything else I have posted still stands. Frankly I suspect the OP is being bullied for reasons that may not even be related to this.

I may have come off as the only way to show compassion and empathy is by you touch, I do work in a different setting, not with kids. I take care of mostly critically ill patients and you can get a feel for their personalities. You do have a point, the ER doesn’t allow you to create a relationship, as patients are only there for a short amount of time. I’m not saying you have to be all “touchy” to show you care. I certainly do not stroke all of my patients’ faces, etc. I will say, I have comforted my patients, such as, rub their back, stroke their hair, hold their hand, sit next to them and talk, to etc. I do know when and when not to do it. I think everyone has their own opinion on ways to show you care and I didn’t mean that you literally have to touch someone to show that.

I do not think what the OP did was inappropriate at all. However, it should be a reminder to be mindful that not all people like to be touched and that it really depends on the situation.

I agree that we need more people who show empathy and compassion, and that doesn’t involve touching. I never stated anywhere that nurses “must touch their patients to prove that they are compassionate”. Having a kind heart could be something as simple as grabbing a warm blanket, explaining a procedure to your patient, putting yourself in their shoes, motivating them to get out of bed and walk, etc. In regards to the OP touching her patient’s face - OP was being compassionate and caring, in my opinion. Do I think this should have been grounds for suspension? Not at all!

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Specializes in Peds ED.
7 minutes ago, Thanksforthedonuts said:

How crazy. I’m in my 20’s with 5 kids and NEVER would have thought twice about it. In my personal opinion we are too sensitive to many things and feel entitiled to being “wronged”.

Sad thing is.. I went to a follow up appointment with my toddler this week and gave him a quick Kiss on the cheek when picking him up. The PA stopped and gawked at us, as if wondering why I didn’t ask him for permission to kiss his cheek, seriously? I don’t ask for permission to kiss or hug my kids (ages 7 and under). Sorry but they BETTER give their mama a kiss, plus they love it.

The Parenting culture has taken an unfortunate turn in this country...

This isn’t about parenting, this is about nursing, and being an empathetic and caring nurse requires respect for a patient’s bodily autonomy. Not all patients, regardless of age, will be comfortable with touches like that.

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38 minutes ago, AlwaysLearning247 said:

I never stated anywhere that nurses “must touch their patients to prove that they are compassionate”.

I understand, and thank you for your reply, and I didn't say you did. I meant that I hoped the conversation would not veer that way.

Over all I meant to refer to (and purposely mentioned) a general theme that is not uncommon in nursing. I wasn't talking about you personally and I'm sorry if that wasn't clear. ?

If you pay attention over time, you will see that it isn't uncommon for nurses who are less demonstrative to be thought of as not being as kind, compassionate, and caring. Well, that is a problem in its own right because it is not necessarily true, first of all, but it is also a problem in the context of this conversation, because the close association of demonstrative actions (comforting touch) with kindness is part of what makes some nurses think that touch is always a way to show kindness/compassion/caring and is perhaps one of the main ways to show those things.

All I am saying is that for more than one reason it would be nice if we could actively acknowledge some of the less-demonstrative nursing actions as also being caring/kind/compassionate.

I agree with you about situations where touch that is truly therapeutic is being provided. And to be fair, there are a lot of those situations.

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Specializes in Urgent Care, Oncology.

Kinda hoping the OP will chime in and give us a bit more insight into the situation.

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Specializes in Critical Care.

Sigh. Patients and their families are making it more and more difficult to provide compassionate care. They keep reporting and suing us which is making us have to chart or and give more robotic care. It’s sad.

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I am so sorry this happened to you. This is scary. I like touching my patient’s hands all the time and to think that this happens is crazy to me. Thank you for sharing your story.

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Specializes in Pediatrics, Pediatric Float, PICU, NICU.
1 hour ago, headofcurls said:

Sigh. Patients and their families are making it more and more difficult to provide compassionate care. They keep reporting and suing us which is making us have to chart or and give more robotic care. It’s sad.

You can’t blame a patient/family if they don’t want to be touched - that is their prerogative and we should respect those boundaries. And compassionate care doesn’t mean touching, especially if you don’t know if that person wants to be touched intimately on the cheek. I would be uncomfortable if my care provider stroked my cheek.

The issue isn’t that the patient or family didn’t want to be touched, it is the extreme reaction management had to it. Be mad at management, not the patient and family.

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