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One of the many awful things that infectious diseases do is come between people at the most basic level by interrupting the natural instinct to touch someone who is in pain or unwell.
A high risk of onward transmission was the case in the past, with diseases such as bubonic plague and tuberculosis – it remains so now with Ebola virus disease and Covid-19. Thankfully, in the modern clinical setting – supplies permitting – nursing staff can protect themselves with personal protective equipment (PPE).
However, wearing so much PPE during the coronavirus pandemic has thrown up another problem for nurses: it can inhibit their ability to deliver compassionate care. Wearing gloves reduces the therapeutic impact of touch, and masks render facial expressions invisible, making communication with some patients very difficult.
“Dr Brown has urged the profession to develop new ways of showing compassionate care”
In the clinical article featured on our cover this month, Annemarie Brown, from the University of Essex, highlights how a combination of social distancing and PPE make it difficult for nurses to use touch and expression to show compassion. For some, she warns, witnessing a person’s distress and being unable to relieve it through therapeutic touch or compassionate gestures may result in low levels of compassion satisfaction. This can lead to compassion fatigue, which can have a negative affect on nurses as well as their patients.
Dr Brown has urged the profession to develop new ways of showing compassionate care, especially as Covid-19 shows no sign of abating. Some clinicians have already come up with ways to mitigate the effect of masks: they now wear a laminated photo of themselves smiling, along with their name, to help put patients at ease.
Even the government seems to have taken notice. It announced last month that it would soon be delivering 250,000 clear, anti-fog face masks to help support better care for people who rely on lip reading and facial expressions to understand what is being said to them, such as those with impaired hearing, learning disabilities, autism or dementia. It’s a welcome move but, given earlier difficulties obtaining standard PPE, supplies may not stretch far.
As Dr Brown says, the pandemic will change how nurses interact with patients for the foreseeable future. I anticipate that the profession will, once again, do what it does so brilliantly – find a range of innovative solutions to deal with the problem.