Nursing Care: Is There a Middle Ground Between High-Tech and Hands-On?
Nursing Care: Is There a Middle Ground Between High-Tech and Hands-On?
Nurses who have been involved in our profession for numerous years have witnessed a fragmentation and erosion of what was once a deeply caring and nurturing art and science. For many, the practice of nursing always included a back rub, a bed bath, straightening the bed, and fluffing pillows—all the while observing and communicating with the central focus of our work, the patient.
Today, "nursing care" is delivered in eight-second segments, and largely consists of arranging machinery and providing medication when machines cannot. However, we are approaching a crossroads in health care. Through their voices and pocketbooks, consumers are demanding health care be more personal, gentle, and consistent with their values and beliefs.
In his new book, John Naisbett talks about this state of awakening, as evidenced by Buddha in the Eastern religions, and advises us to be aware of the consequences of technology.1 He suggests that as we increasingly rely on technology, we should balance that technology with an increase in touch.
Touch is the most ancient and universal form of communication. Drawings on pyramid walls from thousands of years ago show people using hands on others. Touch has long been the characteristic that distinguishes nursing from other professions. As specialization increases, the role of touch can continue to define what nurses do. In view of our role as health advocate and promoter, nurses are licensed to touch and must do so regularly, with our unique body of knowledge that treats a person as innately whole.
Should Touch Be Taught in Nursing Programs?
Nursing can be defined as the art and science of human caring. We need only review the components of caring suggested by Milton Mayeroff2 and Sister M. Simone Roach3 to come to know the unique professional role of nurses. While all humans are innately caring, according to Boykin and Schoenhofer4 nursing is unique in its capacity to care scientifically and artistically. In the caring moment, nurses utilize compassion, competence, and conscience with the intention to assist in healing. Nursing is functional, it is ethical, and it is creative. We must practice and learn to touch gently and with intentionality.
As the nursing interventions classifications suggest, there are many levels of touch. Nurses should continue the fine tradition of gentle massage and touch and must develop the capacity to effect change in another through gentle intentional touch. Those who wish to further their education with specific forms of massage therapy can become licensed nurse massage therapists.
A machine may be able to deliver medication at established time intervals, but no machine will be able to operate as only humans can—with a deep, caring nature and the ability to convey that caring while assessing the moment-to-moment condition of a patient’s physical, mental, emotional, and spiritual well-being. Machinery can assist nursing with the technical needs, but it takes the heart, soul, and mind of an educated, connected nurse to make a difference in the patient’s inner wellness.
As Naisbett reminds us, ". . . by reflecting on technology, new and old, in the context of what is good for humanity, we can glimpse a kind of wisdom that encompasses more than rational intelligence. We must look through a lens that includes empathy, respect, and a sense of awe . . . the human capacity to love is at least as impressive, if not more so, than the human capacity to know."1
We must look through the unique lens of nursing with our authentic and competent presence and an intentionality that says, "I’m here to know you as person." No machine has ever been invented that can provide authentic human presence; no machine ever will.
References
1. Naisbett J. High Tech, High Touch: Technology and Our Search for Meaning. New York: Broadway Books; 1999.
2. Mayeroff M. On Caring. New York: Harper & Row; 1971.
3. Roach MS. The Human Act of Caring. Ottawa, Canada: Canadian Health Care Association; 1987.
4. Boykin A, Schoenhofer S. Caring in nursing: Analysis of extant theory. Nurs Sci Q 1990;3:149-155.
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