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. 2023 May 31;10(9):5838–5842. doi: 10.1002/nop2.1860

The nurses' touch: An irreplaceable component of caring

Joseph Andrew T Pepito 1, Faustino Jerome G Babate 2, Wireen Leila T Dator 3,✉
PMCID: PMC10416036  PMID: 37255491

Abstract

Background

Touch is an integral part of human interaction. Health care makes significant use of touch, and for most healthcare professionals, it is indispensable to their practice. An essential and inevitable facet of the nursing profession is the touching of patients during the provision of care. Unfortunately, touch is seldom considered in the nursing framework today.

Aims

To emphasize the importance of touch in contemporary nursing practice in a highly technological environment.

Materials and methods

A search was conducted on February–May 2022. The initial search identified 84 articles and the final analysis included 38 articles that met the inclusion criteria (touch; touch in health care; touch and nursing; touch and technology; nursing and technology; nursing and caring; touch and caring).

Results

The nurses' touch will always be an irreplaceable component of caring in nursing.

Discussion

There can be no substitute to the expressive touch of a nurse. As the technological revolution in nursing is inevitable, it is imperative that nurses consider how much these technologies impact the nurse–patient relationships.

Conclusion

The study emphasized the importance of touch in contemporary nursing practice. The study found that the nurses' touch will always be an irreplaceable component of caring in nursing. The finding will have an impact on nurses and patients situated in highly technological healthcare environments.

Keywords: healthcare technologies, nursing, nursing care, nursing touch

1. INTRODUCTION

Touch is an integral part of human interaction; it is manifested relationally, socially, culturally, and professionally (Cekaite & Goodwin, 2021). Touching, and concurrently being touched by another person, is an essential aspect of being human (Heatley Tejada et al., 2020). Context and culture also influence the experience of interpersonal touch (Sorokowska et al., 2021) which is important in consideration of healthcare. Healthcare makes significant use of touch, and for most healthcare professionals, it is indispensable to their practice (Cahan et al., 2020).

Touching patients during the provision of care is a significant and necessary facet of the profession of nursing (De Luca et al., 2022). Regrettably, the nursing framework in contemporary times seldom considers the importance of touch. It is the objective of this study to emphasize the significance of touch in contemporary nursing practice where the environment has become highly technological in nature. Nurses must not ignore chances for the administration of touch to patients even if they are inundated with tasks, regardless of how brief those chances are. Touch is vital as it engenders sympathy and humaneness in the experience of the patient and nursing care.

2. METHODOLOGY

Journal articles included in this study were chosen by determining their relevance to answering the study's main objective which is emphasizing the significance of touch in contemporary nursing practice. A search was conducted in February–May 2022. Databases used in this study include: CINAHL; PubMed; Scopus; Emcare; and Health & Medicine (ProQuest) and Google Scholar. The journal articles were reviewed to create a discussion on the significance of touch in contemporary nursing practice. The journal articles were also screened for reliability and credibility by determining where the journal article was published from. This study only uses journal articles from established journals such as Nursing Ethics, Journal of Advanced Nursing, PLoS ONE, New England Journal of Medicine, Frontiers in Digital Health, and Journal of Clinical Nursing. The initial search identified 84 articles and the final analysis included 38 articles that met the inclusion criteria (touch, touch in healthcare, touch and nursing, touch and technology, nursing and technology, nursing and caring, touch and caring).

2.1. Touch

Touch is the earliest sense to develop in humans, but it is frequently overlooked in terms of its complexity both as in human interaction and as a sense (Green, 2017). Touch has been seen as a ‘silent language’ and is an important component of non‐verbal communication (Speed & Majid, 2020). Physical contact with others is a language that modifies behaviour and affects emotions (Jakubiak & Feeney, 2017). Touch is indispensable in nursing practice. Touch increases communication between nurses and patients (Sekerdej et al., 2018), it ensures the feeling of self‐esteem by individuals (Jakubiak & Feeney, 2019) and as a result, reduces the psychosocial problems of patients.

The use of touching with interest and support messages such as sincerity, interest, trust, courage, willingness to help, and empathy together with the professional‐functional relationship will strengthen the nurse–patient relationship. The way a nurse touches patients and significant persons of the patient plays a significant role. This is why a holistic approach with respect for the patient is needed to make the patient and their significant persons feel secure hereby, avoiding unnecessary suffering (Airosa et al., 2016). There is a significant therapeutic value when a moment of compassionate touch and eye contact is allowed to happen between a patient and a nurse (Thakur & Sharma, 2021; Wanko Keutchafo et al., 2020). The right prerequisites for touch need to be created in order to be regarded as positive. The caring touch deepens the bond between the nurse and the patients through the recognition of the emotional situation (Airosa et al., 2016).

2.2. The highly technological nursing environment of contemporary healthcare: Benefits and drawbacks

As technology advances, so does its influence on healthcare. Technology has also drastically changed nursing practice as an emerging technology has allowed nurses to improve efficiency and communicate more effectively (Garcia‐Dia, 2020). Nurses must now possess the technical skills to operate new technologies (Leonardsen et al., 2020). The rapid and advanced development of technologies are expected to significantly influence the practice of nursing in the coming future. Cutting‐edge technology in health care includes the following:

  • Healthcare providers are able to monitor the condition of patients without being physically close through the use of Remote Patient Monitoring (RPM) devices (Mantena & Keshavjee, 2021). Benefits to RPM include better patient outcomes, faster response time, and drastic cost reductions over time. RPM in conjunction with Telehealth reduces the need for patients to travel to get healthcare (Haleem et al., 2021). RPMs use medical software to monitor the blood pressure, weight, heart rate, respiratory rate, blood sugar, etc. without the patient having to go to a hospital (Tabacof et al., 2021).

  • Digital therapeutics are for patients that have chronic illnesses that require ongoing care from their healthcare providers (Santoro et al., 2021). This care can include patient education, medication adjustment, symptom monitoring, and behavioural changes (Dang et al., 2020). Digital therapeutics are sophisticated software programs that can be accessed on a patient's smartphone or a personal computer that provide patient education, medication adjustment, symptom monitoring, and behavioural changes to patients. Digital therapeutics programs also report information about patients to their healthcare providers that allows monitoring of the patients without having to see them regularly, and determine health problems much earlier than when a patient needs to wait for an appointment (Yan et al., 2021).

These advances in technology have enriched the quality of life and lengthened lifespans (Mois et al., 2019). Remote patient monitoring and digital therapeutics are examples of technologies that have made healthcare more accessible to patients but do not require the physical presence of the nurse to give care to the patients. Technology has given us many advances in healthcare but with these technological developments comes an inevitable consequence that we have to consider: that, in the drive to digitize every facet of the healthcare journey, we are potentially losing the ‘human touch’ that characterizes care interactions. In the march to progress, devices that require no contact between the nurse and the patient, automated digital technologies, and other digital interactions have made facilities that nurses are trying to help are missing out on the critical touch points that patients recall and depend on (Karlsson et al., 2022).

Current and emerging health technologies present an impediment to the creation of relationship between nurses and patients which is indispensable for care that is compassionate and centred on the needs of the patient (Dean et al., 2017). Subtle cues and responses to them such as face‐to‐face verbal communication or human touch epitomize what patients and nurses perceive as caring (Thomas et al., 2019). Care by definition is about caring for all facets of human needs and the human elements like empathy, compassion, and the heartening touch of another human being (Durkin et al., 2021; Goodrich, 2016; Weiner & Auster, 2007). These human elements are critically important to the quality of care. It is the interpersonal connection which is responsible for much of the satisfaction in the healthcare role (Mehra & Mishra, 2021; Nápoles et al., 2009). There is a risk for compassion fatigue and burnout in nurses that result from the loss of relationship or distancing from the patients (Aslan et al., 2022).

2.3. Preventing the Over‐Technologization of nursing

The objectification of persons happens when nurses merely implement and accomplish tasks in nursing practice. These types of situations can render persons to be perceived as ‘objects of care’ (Locsin, 2017). The nurse may only be concerned about the completion of his/her tasks and as technology becomes even more efficient in the future, the true core of caring in nursing which is the provision of care to patients that is grounded on a mutual understanding of the different dimensions of the patient (physical, emotional, psychological, spiritual; Karlsson & Pennbrant, 2020) may not be practised in nursing.

Healthcare technologists create sophisticated technologies that enhance the efficacy, productiveness, and calibre of healthcare service. Unfortunately, a preponderance of technologies utilized in nursing practice was not designed or produced by nurses (Dykes & Chu, 2021). Nurses are commonly just the users or technicians of healthcare technologies (Glasgow et al., 2018). Nurses should be included as consultants in the design of technologies used in nursing practice (Pepito & Locsin, 2018). This innovative role is necessitous because no other profession has a better understanding of the needs of nurses than nurses. If nurses do not start to have a deeper insight and participate in the development and implementation of sophisticated technologies in their practice, the interests of patients and the nursing profession will suffer. There is a need to include emotional engagement with patients in the design of technologies in nursing practice to guarantee that the element of touch in nursing practice will not be lost (Joseph et al., 2017).

2.4. Nursing implications

Anecdotally, there have been some complaints from patients that touch has become less common especially during hospitalization, with patients reporting deprivation from touch that is brought upon by the use of sophisticated technologies, increased nurse‐pateint ratios, and burned‐out nursing teams. In the nurse–patient relationship, touch is applied for the communication of needs, the provision of comfort, to decrease stress, and for the demonstration of affection (De Luca et al., 2022). Touch provides benefits to both the patient and the nurse and is linked to the phenomenon of caring (Sandnes & Uhrenfeldt, 2022). Nursing practice revolves around a comprehensive approach to health and wellness (Jasemi et al., 2017). In the fulfilment of responsibilities on the provision of essential care to patients, nurses have perhaps unintentionally substituted their focus from the comprehensive approach which is considered as the foundation of nursing practice, to a task‐oriented approach that only attends to the physical needs of the patients.

A comforting touch has demonstrated positive effects on patients and provision of comforting touch will strengthen the nurses' connections with their patients and concurrently meeting their human needs (Durkin et al., 2021). From an encouraging hand on the patient's hand to a cool hand on a feverish forehead, one of the hallmarks of caring, healing, and compassion is touch. Even as technology becomes increasingly central to healthcare, skin‐to‐skin contact is an art that must continue to be a preeminent principle of nursing care. The therapeutic use of touch should still be fundamental to patient care. Although nurses are often pushed to their limit, the therapeutic use of touch can alleviate the patients' feelings of touch deprivation. For instance, the placing of the nurse's hand on the shoulders of the patient, establishing eye contact with the patient while explaining the plan of care. The 15 seconds of comforting touch during the delivery of patient education is a significant moment that is filled with the potential for connection with the patient. There can be no substitute for the expressive touch of a nurse when a patient has been given a diagnosis of cancer and the nurse holds the patient's hand to let her know that she is there for her. Sometimes, patients need extra emotional support and holding a hand can be very effective. That moment between the nurse and the patient can define the type of relationship the nurse and the patient will have.

3. CONCLUSION

Is touch still an important element in nursing practice? Answering this question can provide a crucial path for contemporary and future nursing engagements in human caring. Technological developments will continue to increase rapidly in the coming years, but good health care practice continues to be firmly rooted in person‐centred care. What has been seen in contemporary nursing practice is that nurses tend to focus more on the clinical psychomotor skills and technical aspects of their profession at the expense of addressing patients' emotional and psychological needs. Nurses must pay conscientious attention on what is the best method of augmenting and integrating technology into nursing practice without risking interpersonal relationships at the heart of the nursing profession. One of the most consequential responsibilities of nurses today is their participation in technological innovations. In this way, nurses will be able to safeguard the indispensable element of humanness in the creation of technologies that propel human health care. The nurses' touch will always be an irreplaceable component of caring in nursing. As the technological revolution in nursing is inevitable, it is imperative that nurses consider how much these technologies impact the nurse–patient relationships. We should not sacrifice our humanity for the sake of efficiency in healthcare.

AUTHOR CONTRIBUTIONS

Joseph Andrew T. Pepito wrote the manuscript with input from Faustino Jerome G. Babate and Wireen Leila T. Dator.

FUNDING INFORMATION

This research received grant from Princess Nourah bint Abdulrahman University Researchers Supporting Project (PNURSP2023R220)

CONFLICT OF INTEREST STATEMENT

None declared.

4.

5. ETHICS STATEMENT

The article does not need an ethical approval statement as there is no human/animal involvement in the study.

ACKNOWLEDGEMENTS

The researchers would like to acknowledge Princess Nourah bint Abdulrahman University Researchers Supporting Project, Riyadh, Saudi‐Arabia

Pepito, J. A. T. , Babate, F. J. G. , & Dator, W. L. T. (2023). The nurses' touch: An irreplaceable component of caring. Nursing Open, 10, 5838–5842. 10.1002/nop2.1860

4.1. DATA AVAILABILITY STATEMENT

The data that support the findings of this study are available in the following databases: CINAHL, PubMed, Scopus, Emcare, Health and Medicine (ProQuest) and Google Scholar.

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Associated Data

This section collects any data citations, data availability statements, or supplementary materials included in this article.

Data Availability Statement

The data that support the findings of this study are available in the following databases: CINAHL, PubMed, Scopus, Emcare, Health and Medicine (ProQuest) and Google Scholar.

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