working in a hospital

Hospital-based massage could involve giving chair massages to physicians and nurses during breaks; providing massage to outpatients; bringing soothing touch to the elderly or dying; or providing massage to inpatients in one of many inpatient areas, including pre- or postsurgery, oncology, pregnancy or pediatric wards.

No matter what form massage takes in a hospital, it has several key differences from massage practiced in other locations. When working in a hospital, the massage therapist must act as part of a team with other medical professionals—which brings unique challenges and opportunities.

 

1. Know the main contraindications to massage.

It is always best to ask the nurse or doctor what contraindications might be of concern. Some common contraindications, according to the book Exploring Hospital-Based Massage, include hemophilia, coagulopathy, low platelet count, bone metastasis, an unstable spine or other posture limitations, osteoporosis, neutropenia, phlebitis, thrombophlebitis or deep vein thrombosis. Care should also be taken to avoid wounds, bedsores, broken bones, tumor sites, injection sites, surgical sites and inflamed areas.

 

2. Have an eye for details.

For massage therapists who love to follow the rules, a hospital is a great place to work. As a hospital employee, you will be expected to meet the same compliance policies as all other hospital staff, including but not limited to health screenings, such as tuberculosis testing, annual flu shots, mandatory epidemiology training and dress codes.

 

3. Be a team player.

In some cases, hospital-based massage therapists may join rounds with physicians and other members of the health care team. In this setting, you must have outstanding communication skills— you may be asked the benefits of massage for a specific patient or diagnosis—be an excellent listener, have a basic knowledge of medical conditions and terminology, and have a full understanding of your scope of practice.

 

4. Work with focus.

A massage therapist’s scope of practice when working in a hospital is often more narrow than it is in other environments. For instance, range of motion is left to physical therapists. When treating inpatients, often the massage therapist’s focus is comfort care. Hospital-based massage allows a clinical approach, while some modalities are prohibited. For example, you may be an expert in aromatherapy, but the hospital may not allow you to practice it.

 

5. Understand you won’t have control over the environment.

In private practice you can lower lights, turn on soft music and know no one will interrupt. In a hospital, the room may be ever-changing. The patient may hear conversations from the patient in the next bed; family members may watch the massage; the patient may be eating lunch; a phlebotomist may be waiting to take blood; a physician may be giving test results. Create the most relaxed atmosphere you can, but understand it is not a private session room.

 

6. Keep up with massage research.

Be prepared to provide evidence-based research when speaking to hospital staff. You’ll need to understand the physiological effects and benefits of massage so you can explain why hospital-based massage should be recommended.

 

7. Know your patient population.

You will see a wide range of conditions and diagnoses when working in a hospital. You need to be willing to research each patient’s diagnosis, understand how massage will affect the patient, and be willing to ask questions of nurses and physicians. Many hospitals require advanced training to work with special populations such as oncology patients.

 

8. Be gentle.

Gentle massage to scalp, neck, back, feet and hands, with a focus on being palliative, soothing and calming rather than on addressing sore or tight muscles, meets patients where they are—a critical, scary, stressful, painful point in their lives.

 

9. Maintain clear boundaries.

In a hospital, you often deal with people in crisis, so working in this venue can be more challenging emotionally than a private practice setting. You have to be more grounded, more able to let go of your work when you get home, and more able to have boundaries.

 

About the Authors

Karen P. Armstrong, L.M.T., N.C.T.M., is manager of clinical massage at Beaumont Health, which has several locations in Michigan, and teaches oncology and hospital massage continuing education through Beaumont’s Schools of Allied Health. Laura Koch, L.M.T., founded the Hospital-Based Massage Network in 1995, for the purpose of helping massage therapists provide soothing and humanizing touch to hospital inpatients throughout the U.S. and abroad.

 

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