Monday, July 9, 2012

NURSING PROCEDURE “BACK MASSAGE”


1.  Definition
Relaxation is the act of relaxing the mind and body, and can also be defined as the state of being relaxed.
Relaxation therapy is learning the different ways of how to reduce the body's stress response. The stress response might be in terms of tight muscles that clench up because of stress.
A relaxation technique (also known as relaxation training) is any method, process, procedure, or activity that helps a person to relax; to attain a state of increased calmness; or otherwise reduce levels of anxiety, stress or anger. Relaxation techniques are often employed as one element of a wider stress management program and can decrease muscle tension, lower the blood pressure and slow heart and breath rates, among other health benefits.
Relaxation is the way to make our mind or body more relaxed. No physical or psychological stress.
Relaxation techniques are particularly effective for chronic pain and gives several advantages, among others :
ü  Relaxation will reduce the anxiety associated with pain or stress
ü  Reduce muscle aches
ü  Help individuals to forget the pain
ü  Increase the period of rest and sleep
ü  Improve the effectiveness of other pain therapies
ü  Reduces feelings of helplessness and depression arising from pain

Massage done to manipulate the tissue in rhythm. Effects on tissue physiology and psychological effects on the psychic clients. In physiology, message causes peripheral vasodilation which increases the exchange of nutrients and metabolic waste products. Vascular stimulation relaxes back muscles, causing psychological and emotional comfort of the client. Massage is generally done at ekstremitas, neck, back.
Massage is an activity done by pressing the body / muscle gently to make someone more comfortable.
1.      Stroking (effleurage) is an activity use surface hand, this move follow vena sirculation.
2.      Kneading (petrissage) is  a squeezing movement by holding the tissue between the fingers.
3.      Tapping (tapotement) is movement by using the edge of the hand to stimulate circulation ulnar
4.      Friction is circular motion using the palm of the hand, carried out in the direction of the vena circulation to the heart
5.      Vibrasi is an activity using the palm of the hand to provide vibration


Ø  Back massage
Back massage is usually given in conjunction with the activities of bathing the client. Can also be done on other occasions when a client seems to have a risk of developing skin irritation due to bed rest.
The goal is to do a back massage to enhance relaxation, reduce muscle tension, and stimulate circulation.
Performed a back massage is contraindicated in clients with vertebral fractures, rib fractures, burns, open wounds, bleeding, or heart attack. Indications of a back massage is performed on a patient bed rest
The desired outcome of the procedure back massage are :
-          Clients feel refreshed and relaxed, as evidenced by verbal or nonverbal response
-          The blood supply to the muscles and skin of the back, evidenced by a change in skin color and warmth
-          Clients who feel pain to feel more comfortable after a back massage, as evidenced by non-verbal and verbal response.


Ø  Procedure back massage
a.      Pre Interaction Stage
1.      Check nursing note and medical report of the patient
2.      Identify clients’s need of back massage
3.      Assess clients’s conditions:
a.     Condition of clients’s body which will be given  massage
b.    Illness characteristic of clients
4.      Wash hands
5.      Prepare the equipment :
a.       Blanket
b.      small bowl
c.       lotion
d.      towel
e.       gloves
6.      Wash your hands

b.      Orientation Stage
7.      Giving a greeting by calling the clients and explain the procedure action.
Dialog : “Good morning sir, I’m nurse Nyoman, how are you today?
at this morning, I would like to massage your back. This procedure is aimed to improve your blood circulation. I need 20 minutes for this procedure”.

c.       Work Stage
8.      Give oportunity for clients to complain and ask a question before doing procedure
Dialog : before doing this procedure, do you have any question? or sigh?
9.      Keep the clients’s privacy
10.  Handwashing
11.  Use the gloves
12.  Advice clients retell nurse if  the condition gets better or worse after massage
Dialog : “please tell me if you feel sick sir”.
13.  Set the position of the client
Dialog : “excuse me sir, I would like to set your potition”.
14.  Scrub the lotion on hand surface and then well doing massage (10 minutes)
Dialog : “now, I would like to massage your body sir”.
15.  Starting massage with stroking move start from the hip to soulder for eight times. change the massage move with kneading and friction technique (like a strocking massage).
16.  Finish the massage with vibration technique
17.  Clean lubrication residue from client’s back
18.  Help client take shirt and set comfortable position
19.  Hand washing


d.      Termination Stage
20.  Evaluate procedure result ( subjective and objective)
21.  Give positive reinforcement for client
Dialog : “ Sir, I am finished giving massage to you, how do you feel?”.
22.  Contract next meeting (procedure, time, place)
Dialog : “For the next 15 minutes, I will give you a medicine in this place”.
23.  Finish the procedure
Dialog : “ Before I leave, do you have any question?”.
“thanks for your cooperation sir, good morning.”

e.       Dokumentation Stage
Write down the procedure on the nurse documentation.



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