Touch as affirmation.
Illustration by Julianna Paradisi
“May I hug you?”
My patient and I had just finished a rather lengthy conversation, the kind of authentic communication that reaffirms the humanity connecting us all—the number one reason I love being a nurse. Sitting in a chair across from me, she reached out her hand for me to shake. I sensed she felt the same connection I did, but was too shy to ask for more.
“May I hug you?” I asked.
Tears formed in her eyes as she stood and we hugged. The circle was complete.
Not everyone is comfortable being touched.
I’m a hugger. I connect easily with patients and throughout my career have given and received more spontaneous hugs than I can hope to count. Lately though, for a variety of reasons, I’ve begun to ask permission before hugging a patient.
Foremost, I’ve developed a stronger advocacy towards the right to personal boundaries. I am not you is a good thing to remember when meeting anyone for the first time, whether they are a patient, coworker, or a child. Not everyone is comfortable being touched.
‘Handshake free zones.’
A while ago, I met a new resident while visiting a patient in her hospital room. After introducing ourselves, I reached out my hand to welcome the new resident. She stared at my hand, withholding hers, as our patient watched. I withdrew my hand as inconspicuously as possible, slightly embarrassed. It occurred to me the resident might subscribe to establishing “handshake free zones” in hospitals, an idea gaining popularity in our era of super infections.
Paradoxically, at a personal appointment with a physician new to me, she reached out her hand to shake mine. Although I shook her hand, for some reason she mistakenly interpreted a hesitancy on my part and went to great lengths to explain she always washes her hands before entering her exam rooms.
PTSD, sensory disorders, and the #MeToo movement.
Preventing the spread of infection is only one consideration, however. Due to media articles and reports, I’m more sensitive to the fact uninvited touch can cause anxiety for people with sensory disorders, some forms of PTSD, or who are victims of abuse. They might not feel comfortable communicating their discomfort in a health care setting where they are dependent on the help of physicians and nurses who represent authority.
The #MeToo movement has successfully heightened boundary sensitivity in the workplace as well. I became a nurse during an era where nurses and physicians interacted in ways that by today’s standards could potentially be viewed as harassment. For instance, sometimes shoulder rubs were exchanged between colleagues while charting notes at the nurses’ desk. Was it suspect then too, but we were too naive to notice? Nothing ever came of shoulder rubs, at least in my experience, but it’s been about 20 years since I last saw a doctor giving a nurse a shoulder rub at the nurses’ desk. Just saying.
Asking permission.
Developing sensitivity to patient and coworker comfort levels with touch isn’t an admission that hugging or shaking hands is bad, but an acknowledgment of them as individuals with their own likes, dislikes, and preferences. It’s now part of my practice to ask permission before automatically hugging a patient or new acquaintance.
While working in an independent living facility with older adults, I have learned to be compassionate and have a greater sense of empathy than what I already had. I feel that it is extremely important to build connections with your patients. All while setting personal boundaries that are comfortable to both oneself and others. There may come a time where an event can cause emotional toll on someone, especially with the loss of a loved one. While working with geriatrics I have attempted to be a shoulder to cry on, if the patient was comfortable enough with me I would ask if they needed a hug. Hugging relieves all that stress that one may have bottled up and even helps in reducing blood pressure. I feel that it is important to use the sense of touch, all while keeping safe/comfortable personal boundaries. If you are not sure, just ask as the blog post describes, “May I hug you?”. It’s as simple as that and if a patient refuses the kind gesture, just move along with your day and do not take it as them being rude. Everyone has their own customs/cultures and each person should be respected for their beliefs. While, some may appreciate the kind gesture and it may even make their day. Don’t be afraid to be there for someone, when they truly need it.