Massage and Standard Precautions

 *IMPORTANT ANNOUNCEMENT*

As of May 15 2020 independent massage therapy locations may re-open as part of Responsible  ReStartOhio . The Ohio Medical Board has released new mandatory and recommend best practices as we move forward in minimizing exposure risk  To COVID-19 while also balancing the important need for therapeutic massage.  Please review the following link for specific information regarding new mandatory guidelines initiated by the Ohio Medical Board.  Please continue reading for a comprehensive list of current and new changes to our existing policies. Feel free to reach out with any questions that you may have.

 

https://coronavirus.ohio.gov/static/responsible/State-Med-Board-Massage-Acupuncture-Cosmetic-Therapy.pdf?fbclid=IwAR3a2mohNXMGOzeyQDVFAPiglj9_7Guze2SrQ0hXy7MnR59H0nIQF2S_1h0

[Edited:May 12 2020.]Thank you for joining me during this discussion of standard precautions and it’s implications within massage therapy. As a nurse and massage therapist,  I think this is a very important topic to share with my clients and  with the community at large. Because I possess a dual license in each profession, I and my practice entity are  ethically bound to follow the legal and public health directives. such as the executive orders recently administered by the Ohio Department of Health during the COVID-19 pandemic. In addition, this massage practice follows the recommendations as described by the CDC and WHO

While, massage therapists can be considered ‘essential workers’ at any other time, however during a pandemic, our skills and knowledge can be used to serve those who are actually on the frontlines~caring for patients, food and medicine supply chain, public health and safety etc. As the state of Ohio begins it’s re-opening plan, Inthera Massotherapy LLC will also initiate a gradual re-opening that will include the continued use standard precautions, cleaning and sanitizing  protocols, client intake and appointment spacing.

“Standard precautions in health care are meant to reduce the risk of transmission of bloodborne pathogens from both recognized and unrecognized sources. These precautions are the basic level of infection control precautions, which are to be used, as a minimum, in the care of all patients. Among, source control measures, respiratory hygiene/cough etiquette, developed during the severe acute respiratory syndrome(SARS) outbreak in 2003, is now considered part of standard precautions”-CDC

https://www.who.int/docs/default-source/documents/health-topics/standard-precautions-in-health-care.pdf?sfvrsn=7c453df0_2

For the massage therapist, the risk of encountering body fluids(OPIM) or blood borne pathogens is very low. In addition, due to it’s non-invasive nature, massage therapy provides a supportive environment for healing, especially after an acute health crisis. However, airborne pathogens may be transmitted from host to host without appropriate respiratory hygiene~ which may include masks or eye shields. See below for current and upgraded Standard  Precautions Procedures and Sanitizing Protocols according to new guidelines by Ohio Medical Board.

Solo Practitoner

•  Currently-One client at a time. Therefore current guidelines of social distancing are satisfied
•  Currently-Personal time and attention for thorough intake and assessment
• Currently-Supports and follows  current health directives and recommendations
• Currently- Low touch office. Massage tools are used by one practitioner

Hand Hygiene

• Currently-Wash hands before and after each client, after eating and touching dirty surfaces
• * New Change*~Clients will wash/sanitize hands before and after each session

Respiratory Hygiene

• Re-schedule appointment if febrile, coughing/excessive sneezing or other acute symptoms
•  *New Change*~ Therapist will wear mask to cover nose and mouth.
• Wash hands after removal of mask or other PPE
•  *New Change*~Client may have option to wear(“must be allowed to wear” a mask based on clinical assessment. *Client must provide own personal mask*

Client Intake/Appointment Spacing

•  Currently-Clients are encouraged to use the scheduling software Soapvault when booking/ changing their appointments and for completing the online intake form. This is a paperless transaction
• * New Change*~ In order to clean and sanitize effectively between clients, there will be an expanded 60 minutes  break between appointments.This will still allow time for post-session consultation and feedback
• *New Change*~Please arrive no more than 10-minutes for your scheduled appointment time. No need to wait in the car.

Cleaning/Sanitizing Protocols

•  Currently-Cleans surfaces i.e. massage table, face cradle,  massage chair ,massage tools before and after each use.
• *New Change* Impermable covers as recommended
•  Currently-When applicable for table massage-sheets and other linen are changed after each client and stored until ready for laundry
•  * New Change*~Provide permable barrier when indicated
•  Currently-Clean pajamas for each Thai Massage session
•  Currently-Sanitize high touch surfaces using recommended disinfectant products such as Lysol, Mar-V-cide
•  Currently-Clean and sanitize high use, high touch common areas such as reception, doorknobs, bathrooms
•  Currently-Frequent vacuuming, floor care and observation for small pests

Introducing Nurse Massage Therapy

I am a nurse. I am a massage therapist. And I’m not the only called to this unique yet professional calling where the emphasis is directed toward the holism, health and healing for our clients and communities. Massage techniques were an essential part of nursing curricula in the 1800’s through 1960’s.  In my own nursing education, I recall learning basic back rub techniques that were used at hs care(care given at night prior to the patient going to sleep.) The act of touching, in a non-clinical manner, did promote a sense of calm within the patient and surprisingly within myself as well. The power of informed touch is a guiding principle within nursing, massage and other healing modalities that are not rooted in allopathic medical model. It would be many years(27 to be exact) before I would return to the holistic foundations in nursing via massage therapy. According to the philosophy of National Association of Nurse Massage Therapists(NANMT), “Nurse Massage Therapy is grounded in nursing theory and implemented within the context of the nursing process. It possesses a specialized body of knowledge and therefore represents a distinct specialty in professional nursing practice. Nurse Massage Therapists provide professional services in various practice settings and receive fair reimbursement for their services. Nurse Massage Therapy affirms nursing as both an art and a science whose primary purpose is to provide health care services that nurture and strengthen clients’ ability to heal themselves.”

So what does all that mean? In reality, nursing education encompasses a wide range of multi-disciplinary courses. More than just learning ‘nursing stuff’, RNs/LPNs are required to study psychology, sociology, cognitive and physical development along the human lifespan. We also study pharmacology, statistics and research methodologies too. It is because of this comprehensive approach in education and patient care that allows nurses and other nursing personnel to be the backbone of our health care system.

Fast forward to my massage education, I was mildly confused when my instructor said “Anyone can give a massage but only a massage therapist can perform therapy”  In other words, a massage therapist is educated to understand the complex interrelationships found within the human biological systems. A deeper look and knowledge of ALL the muscles, tendons/ligaments, nerves and kinesiology is required. A massage therapist understands  that the simple of act of touch is a human endeavor, encrypted within our DNA. The very development of the mammalian physiology is built upon the sensory experience of being touched. The term Mother’s Touch sums up this concept very well. Yet beyond the superficial act of touch, the massage therapist affects the health and well-being of  clients not only through the manipulation of the soft tissues of the body but also by directly interfacing with the nervous system. And that folks, is where the magic happens!

The melding of these  two disciplines have continued to meet at different intersections throughout history. Brought forward to the modern age, nurse massage therapists now stand as a recognized nursing specialty. One that is gaining traction and recognition among the public and other healthcare professionals As nurses operating within a holistic framework, it is imperative that NMT, work “to balance the trend of impersonal, technologically oriented healthcare”  one that reduces the human being into a collection of symptoms and diseases.

In my own experiences in caring for people, I have come to see the wisdom of providing care along a spectrum, rather than a fixed point of ‘illness’ or ‘wellness’. I have also noticed changes within myself as I continue to study and practice multiple touch therapies. I would venture to say that my ‘massage’ hands/fingers/elbows vital information about the health of the client to my ‘nursing’ brain where it is analyzed and processed in a coherent fashion. The benefits of nursing and massage, safely and effectively combined for effective health and wellness care.

References:

https://www.ncbi.nlm.nih.gov/pubmed/20682916

http://www.nanmt.org/index-1philosophy.html