As student nurses some of the main buzz words we hear during our first year, centred around effectively communicating with patients, are empathy and compassion, phatic communication, active listening, humanised care, empowerment, respect and trust.
All important and powerful nouns, which send us out into placement with the determination to interact with patients in a meaningful way.
In practice, I have also learnt that human touch can often communicate a thousand words without the need for a single utterance.
“During a first-year placement in endoscopy, I experienced an inspiring example of the power of touch”
Touch is the first sense to develop in infants – the importance of skin to skin contact as soon as the baby leaves the womb is widely recognised – and it therefore stands to reason that it would continue to remain central to our needs as adults. Research even attributes touch to enhanced sleep regulation, increased immunity to fight infections, improved heart rate and blood pressure, and better mental health outcomes.
During a first-year placement in endoscopy, I experienced an inspiring example of the power of touch when I accompanied a patient into the procedure room for a gastroscopy – he was self-assured, talkative and did not appear nervous. I monitored him throughout, and verbally reassured him while taking regular observations.
At the point the scope moved around the first bend of the large colon and the patient experienced increased pain and discomfort, I sensed him staring into my eyes as a non-verbal indication of rising panic and vulnerability. I immediately took his hand and held on tightly for the remainder of the procedure.
Afterwards in recovery he told me he would never forget the significant difference it made to him when I held his hand – the simplicity of touch belying the importance of the comfort it gave.
Research into the impact of Covid-19 on patients’ physical and mental wellbeing is ongoing, yet it is already acknowledged that the requirement to maintain distance has had a profound effect on the incorporation of touch in nursing, leading perhaps to a more task-orientated approach to provide physical comfort over and above emotional comfort.
This is also known as instrumental touch: the necessary touch required to carry out procedures or direct care, such as personal hygiene and toileting, changing dressings or taking observations, and can be directly contrasted with expressive touch – the touch which conveys support and compassion, and which is central to developing a therapeutic relationship with the patient.
As we move forward from the pandemic, and as the next generation of nurses, we need to be even more aware of the powerful tool touch provides in patient communication and person-centred care. We need to become increasingly versed in the impact of touch on both the conscious and the unconscious: evidence indicates that touch has the potential to stimulate a response from unconscious patients when other methods of interaction have failed.
Of course, touch is not always appropriate or welcomed by the patient and preferences must be taken into account.
As student nurses we are learning to evaluate physical and psychological care, and adapting to patients’ responses to touch forms an important part of this ongoing learning curve.
Georgia Fox is a registered nurse degree apprentice at Bournemouth University