Water
Nancy Robertson, DNP Feb 22, 2022
As I watch a snowstorm move in over the Rocky Mountains, the necessity of water comes to mind. Today’s snowfall will melt into flowing rivers, filling reservoirs, offering a balm for our scorched Denver landscape and the hope that this summer will not again fill our hearts with the terror of fire. Even with the critical importance of water, it never occurred to me its value in impacting the symptom burden of the seriously ill.
I am in the process of updating a lecture on fatigue management in the seriously ill population. As I bury myself in the recent literature, the evidence-based guidelines reveal very little brand-new information about managing fatigue. Practice guidelines continue to stress the importance of identifying the etiologies of fatigue, treating identified underlying causes, considering the application of pharmaceuticals, and assuring patient education on the use of energy conservation techniques. All-important guidelines but nothing surprisingly new.
Then I searched the nursing literature specifically. And found, with great interest, a recent study by Japanese investigators about the effect of tub bathing on physical and psychological symptoms of those patients with advanced cancer. Hayashi and colleagues conducted an observational, controlled study involving 42 participants and a tub bathing intervention. Outcomes were measured using the Edmonton Symptom Assessment System- revised Japanese version and three items from the Cancer Fatigue Scale. Comparing data collected on bathing and non-bathing days, the investigators found that on the days when tub bathing was done, tiredness was impacted positively. And not only tiredness, anorexia, anxiety, pain, and depression measures all improved. While the study sample was small, their results speak to the effectiveness of simple human care. Something easy to overlook in our highly medicalized world.
It appears water replenishes not only our earth but has the potential to calm the fiery suffering that can accompany the end of life.