Fear of intimacy

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Jacqueline Vance, RNC, CDONA/LTC
Jacqueline Vance, RNC, CDONA/LTC

In·ti·ma·cy — Noun: Close familiarity or friendship; closeness; A quality suggesting closeness or warmth.

I'm not writing about where one partner is hounding the other about fear of opening up and getting close. What do they say — “It's me, not you”? What I am writing about is fear of getting close to our residents. (I'm Nurse Jackie — not Dear Abby.)

I know sometimes “we” are trying to protect ourselves from getting hurt since many of our residents leave this world while under our care (due to the process of aging and chronic disease). But surely that can't be the only reason.

Why are we so scared of intimacy when as caregivers our job almost requires it? Caregivers are supposed to pitch in and do the work. The problem is, our “work” is people. In addition, in the long-term care setting, we get to have our residents for quite a length of time. Even our post-acute residents stay on average 21 days. Intimacy is what makes a good caregiver a great one. And shouldn't we all strive for greatness?

However, the reach toward intimacy relies on us to open our hearts. Kind of like we have to say hello first, know what I mean? When someone is chronically or terminally ill and is being provided physical care, he or she can find it very difficult to also ask to have their emotional needs met.

Personally, I found it difficult to ask for help for the physical needs, even after surgery. And I am grateful to the wonderful nurses who created intimacy and made it possible for me to accept care. So, this means that those nurses paid attention to what I was “not saying.”

Paying attention involves a lot more than monitoring the resident's physical wellbeing (most of us are pretty good at that). You let a person know that you're paying attention by listening attentively, making eye contact and by being aware of “non-verbal” communication. 

This includes how the person holds his or her body, tension, and perhaps lack of eye contact (which may indicate embarrassment or humiliation). We need to read our residents like a mystery book, looking for the clues that help us solve the case like the stories detective.

When you are “present” and even vulnerable with your residents, your residents are more likely to be honest, transparent and open. Certain behaviors such as constantly ringing the call light to be sure “someone” is there, can be improved when that bond between caregiver and resident is formed.

If I feel you care about me, not just physically care for me, I am likely to trust you, verbalize my needs and not “test” you.

So, yeah, in developing intimacy it is “you.” You have to take the first step.  But I promise, the rewards will be worth it. When what you do for a living touches your heart and becomes a mission, not a task, that is life changing.  

Just keeping it real,

Nurse Jackie

The Real Nurse Jackie is written by Jacqueline Vance, RNC, CDONA/LTC, an APEX Award of Excellence winner for Blog Writing. Vance is a real life long-term care nurse. A nationally respected nurse educator and past national LTC Nurse Administrator of the Year, she also is an accomplished stand-up comedienne. She has not starred in her own national television series — yet. The opinions supplied here are her own and do not necessarily reflect those of her employer or her professional affiliates.

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The Real Nurse Jackie

The Real Nurse Jackie is written by Jacqueline Vance, RNC, CDONA/LTC, a 2012 APEX Award of Excellence winner for Blog Writing. Vance is a real life long-term care nurse. A nationally respected nurse educator and past national LTC Nurse Administrator of the Year, she also is an accomplished stand-up comedienne. The opinions supplied here are her own and do not necessarily reflect those of her employer or her professional affiliates.

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