"People brought all their sick to him and begged him to let the sick just touch the edge of his cloak, and all who touched him were healed." Matt. 14:35-56
I arrived at the house ahead of the ambulance that was bringing the patient home, and noticed the gathering clouds of a summer storm sweeping its arms around towers of humid air, ready to release the tension of the hot day. The family met me at the door and I went around the room, shaking hands with the patient's daughter and granddaughter. The elderly husband, came in last, shuffling a bit, but smiling and extending his hand in greeting. The granddaughter bent over conspiratorially to whisper, "He has dementia."
I asked a few questions about medical history and explained some of the process of admission to hospice care. We heard the ambulance pull up, it's loud back-up "beep, beep" bringing our conversation to a stop. We all looked beyond the hospital bed that stood parked by the front window, to see the ambulance driver rush around to the rear just as the first raindrops fell.
When they brought her in, she clutched her sheet over her face and wiped the rain out of her eyes but then kept wiping as more water sprung out in tears. Her face crumpled as she wept and her family rushed over, trying to determine if she was in pain. She smiled through her tears and said, "I thought I would never see this place again."
I walked around to the other side of the bed, took her hand gently in mine and introduced myself. While I helped her finish wiping the rain from her face, I noticed her bright blue eyes, set in pale skin, framed by soft white hair. She was quite lovely for a woman her age, and her smiling eyes added to her beauty.
Just then, he husband came over from the corner where he had been trying to get out of the way. He reached down and took her other hand and sat down beside her. He caressed her fingers and then leaned over to kiss her. The tears came again, this time to the eyes of those of us watching the scene unfold.
As I continued my assessment, I touched her forearm gently while taking her blood pressure and asked questions about the pain. Before inspecting her abdomen where an erosive cancer had left a draining wound, I donned gloves and asked permission with eye contact. Then with the help of family, we turned her over gently so I could inspect her skin, noting several red places on her back and coccyx. Her mobility was impaired by the of pain of a recently fractured vertebra. That together with significant weight loss and poor intake, contributed to many skin integrity issues.
After a careful assessment and lots more questions about bowel and bladder function, pain, and respiratory status, I worked with her granddaughter to get her positioned with pillows and one of her own quilts so that she could rest from her transfer. Through all this, her sweet husband stood nearby holding her hand gently in his. While I offered the touch of compassionate care, he offered her the comfort of a well-worn and enduring love.
After we finished signing the requisite paperwork, I gathered my things and stood. Then I waited to take a cue from the granddaughter and daughter, reading their non-verbal communication to see if they would welcome a gentle hug or if a handshake would again be more appropriate. Sensing their need for a comforting touch, I offered a sideways hug to the daughter and reciprocated the granddaughter's approach for a full hug, then moved over to squeeze the patient's shoulder gently. Her husband, now seated beside her on the bed, simply nodded his goodbyes.
As I walked down the front steps, papers in one arm and computer bag in the other, I thought again about the beauty of the touch between the patient and her husband. I wondered about how touch plays a part in healing.
Although the patient had a terminal diagnosis, and was weak and frail, the husband's touch was clearly healing, bringing her comfort and peace at a difficult time. I wondered about my role as a professional nurse and my use of touch during this interaction and in others. I asked myself questions about touch: when is it therapeutic and when is it invasive? How do I know where the fine line is that separates those two? How can I be a better listener so that I see and interpret non-verbal communication?
I wondered, too, about how our necessary protective barriers separate us from our patients. With gowns, gloves, face shields, how do we continue to convey warmth and provide for a healing touch? In the home, it is admittedly easier, as family members and nurses sit side-by-side on a couch, signing papers, a natural closeness happens. But what about in other settings?
I have been blessed to be a person with relative good health and only a few opportunities to pass through the medical system during times of crisis. But those times touch and posture stand out, in stark relief: the doctor who crouched down to eye level in the ED to tell my beloved sister, "This is the end of the road;" the nurse-midwife who recited the Lord's prayer in the delivery room while holding my hand; the nurse who held my forearm gently to steady me as she told us our teenage son's CT scan was okay after he had a serious bike wreck. The touches were all brief, but the healing they brought continues to warm my heart.
A touch can make all the difference. As nurses, we learn from experience and also from modeling what is appropriate touch and how to employ touch with compassion and respect.
That evening, as the setting sun peaked out again from the spent clouds, I stepped over puddles and looked back over my shoulder, to see the warm glow of light coming through the patient's picture window, framing the family members as they moved about the room, holding onto the love that held them together.
Joy Eastridge, RN, BSN, CHPN
