Philosophic reflections on the meaning of touch in nurse-patient interactions

In this paper I examine the meaning of physical touch as it occurs in the nurse-patient interaction. There are two aspects of the nurse-patient relationship that are found in most nurse-patient interactions which together have profound implications for nurses as practitioners and as individual human persons. The first is the clinical intimacy of the nurse-patient relationship where nurses touch, rub, smooth, clean, dress and otherwise physically interact with patients. The other is the existential crisis, the possibility of loss, suffering and death that lurks at the horizon of most, if not all, healthcare encounters. Edmund Husserl, Merleau-Ponty and more recently Robert Sokolowski argue that tactile sensations and resultant perceptions are fundamental to all sensory perception. Further, they argue that tactile sensation is fundamental for the ongoing constitution of 'my' self as a person and for the development and exercise of human intersubjectivity. If tactile interaction is crucial to the development of our very selves as persons and a significant aspect of our interaction with patients includes direct or observed tactile sensations and if further these sensations occur around the context of existential crises for our patients, then nurse's very selves as persons are being challenged by these interactions. Here, then I examine the philosophical argument for the role of tactile sensations in our human development and briefly look at contemporary neurophysiologic research that supports this philosophical account. I then suggest ways such physical intimacy can lead to a strengthening or weakening of the person of the nurse and the nursing interaction and end with some thoughts about ways to support nurses in these activities.