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The Honoring of the Hands
PERSONAL REFLECTIONS The Honoring of the Hands Eunice K. M. Ernst, CNM, MPH No one really knows where the honoring or blessing of the hands originated. It is found in different forms in Native American lore, Aboriginal lore, Judeo-Christian religions, and wedding and baptismal ceremonies. More recently, it is appearing in nursing and midwifery. All of these ceremonies reflect the spiritual aspects of the dedication and the purpose for which the hands are being honored or blessed. It is appropriate to honor a nurse-midwife’s hands, for she is present at the beginning of an infant’s journey. Birth is a spiritual event just as death is a spiritual event; they herald the beginning and end of every soul’s journey on earth. But why pick the hands of a new midwife? All of the senses are important. They are all used to receive and communicate information to your brain to be synthesized, based on the knowledge you have gained throughout your life and in your recent midwifery study, to make an assessment of the situation in which you find yourself. Why? Because the hands are special. The hands give as well as receive. They can communicate reassurance when the situation does not allow words or when words fail. Through touch they can express confidence, caring, and compassion. They diagnose, comfort, and even heal. You must develop all of your senses, for you will use them all as a midwife. But you will use your eyes, ears, and hands the most. When a mother comes to you, at a glance you will note her appearance, demeanor, posture, grooming, facial expression, movement, and how she looks at you. Does she make eye contact, and in those eyes is there trust, fatigue, or fear? Does she smile? You will look into her eyes and wait and listen to her response when you ask, ‘‘How are things going for you?’’ or some such open-ended question. Listen to what she is saying and to what she may not be saying as you put together all of the information coming to your brain in those first moments of contact. Does she feel that she is important to you? That what she is saying is important and that you are listening? That her visit is about her, not you, and not the chart or the schedule or the bustle of others in the clinic? Be sure that your hands and your touch communicate warmth, strength, skill, compassion, and confidence. Communicate through your touch that the mother is safe with you and can relax—that you know what you are
Eunice K. M. (Kitty) Ernst, CNM, MPH, DSc(Hon), FACNM, is the Mary Breckinridge Chair of Midwifery at the Frontier School of Midwifery and Family Nursing. She served as President of the American College of Nurse-Midwives from 1961-1963 and 2007-2008.
152 Ó 2009 by the American College of Nurse-Midwives Issued by Elsevier Inc.
doing and are sensitive to her needs. Move your hands surely and gently as you palpate her body and infant or examine her most intimate body parts. Explain in advance each movement you make. When a mother is in the stress of labor, your hands will communicate most of what she needs to know. Develop your touch and use it to carry her through the most intense physical and emotional event of her life. When, finally, she trustingly delivers her infant into your competent hands, return her gift to you. Place her new love to her breast where she or he wants most to be and belongs. Before you leave her, put your hands to her tired back and with a massage communicate that she has just proved herself to be a true Olympian. Before the advent of invasive technology, the senses, and especially the hands, did it all for the midwife. Your hands are still as perfect or better if you take the time to hone their skills. They are portable and always with you. They require no outside energy force, equipment, or setting. They can do their work in glaring light or in the dark. They can do their job anywhere, anytime. Think about it! What a marvelous piece of equipment you own—and its potential! Protect your hands and keep them clean and ready for use. Don’t paint them for you don’t need to draw attention to them or show them off. They like the way they look and are humble in their performance. This art of the hands comes naturally to some, but most of us must practice it. The Disney folks tell us that all providers are performers on stage the moment we interact with our audience, and our audience is the person we serve. To perform well we need to practice, to rehearse our lines and body language. Role play with one another to gain the practice you need to become efficient and effective in using your hands. The hands of the midwife and the way we gather and interpret our sensory information are what make midwifery different. This is what John Nesbitt, the futurist, meant when he wrote in 1981 that the high-touch care of midwives and birth centers will be needed to balance the growth of the high-tech care in modern obstetrics. So, cultivate all of your senses but take special care of your hands and never underestimate what your hands can do. This is what we want to communicate to you as we bless and honor your hands on this day. Use them to glorify your God and in your service to the never-ending needs of childbearing women and families. Your hands will help to make this world a better place. These remarks were delivered at an honoring of the hands ceremony for nurse-midwifery students.
Volume 54, No. 2, March/April 2009 1526-9523/09/$36.00 doi:10.1016/j.jmwh.2008.11.005
Eunice K. M. (Kitty) Ernst, CNM, MPH, DSc(Hon), FACNM, is the Mary Breckinridge Chair of Midwifery at the Frontier School of Midwifery and Family Nursing. She served as President of the American College of Nurse-Midwives from 1961-1963 and 2007-2008.
152 Ó 2009 by the American College of Nurse-Midwives Issued by Elsevier Inc.
doing and are sensitive to her needs. Move your hands surely and gently as you palpate her body and infant or examine her most intimate body parts. Explain in advance each movement you make. When a mother is in the stress of labor, your hands will communicate most of what she needs to know. Develop your touch and use it to carry her through the most intense physical and emotional event of her life. When, finally, she trustingly delivers her infant into your competent hands, return her gift to you. Place her new love to her breast where she or he wants most to be and belongs. Before you leave her, put your hands to her tired back and with a massage communicate that she has just proved herself to be a true Olympian. Before the advent of invasive technology, the senses, and especially the hands, did it all for the midwife. Your hands are still as perfect or better if you take the time to hone their skills. They are portable and always with you. They require no outside energy force, equipment, or setting. They can do their work in glaring light or in the dark. They can do their job anywhere, anytime. Think about it! What a marvelous piece of equipment you own—and its potential! Protect your hands and keep them clean and ready for use. Don’t paint them for you don’t need to draw attention to them or show them off. They like the way they look and are humble in their performance. This art of the hands comes naturally to some, but most of us must practice it. The Disney folks tell us that all providers are performers on stage the moment we interact with our audience, and our audience is the person we serve. To perform well we need to practice, to rehearse our lines and body language. Role play with one another to gain the practice you need to become efficient and effective in using your hands. The hands of the midwife and the way we gather and interpret our sensory information are what make midwifery different. This is what John Nesbitt, the futurist, meant when he wrote in 1981 that the high-touch care of midwives and birth centers will be needed to balance the growth of the high-tech care in modern obstetrics. So, cultivate all of your senses but take special care of your hands and never underestimate what your hands can do. This is what we want to communicate to you as we bless and honor your hands on this day. Use them to glorify your God and in your service to the never-ending needs of childbearing women and families. Your hands will help to make this world a better place. These remarks were delivered at an honoring of the hands ceremony for nurse-midwifery students.
Volume 54, No. 2, March/April 2009 1526-9523/09/$36.00 doi:10.1016/j.jmwh.2008.11.005