Post by medic09 on Jul 18, 2011 17:37:38 GMT -5
Healthcare workers during a fast
It seems fairly simple that not working on a fast day is the better option, when possible. This is not always possible, for a variety of reasons. For the purpose of this discussion we should leave Yom Kippur out, since it is an obligation from the Torah and has its own detailed and well-discussed halachot. I would point out that Rav Neuwirth equates also the 9th of Av to Yom Kippur; but this is not a universally agreed upon approach. The 9th of Av is nonetheless of rabbinic origin as far as its halachic status, and its equation to the other rabbinic fasts is alluded to by Z'charyah (8:19). Of course, for any practical application one should consult with their rav.
Rav Neuwirth succinctly states (מדריך הלכתי לאחיות בבתי חולים, פרק י) under the heading for the Fast of Gedaliah, "a nurse who has difficulty working appropriately on a fast day is permitted to eat. This applies only for the fasts like Fast of Gedaliah, 10th of Tevet, Fast of Esther, and the 17th of Tammuz; but not for Yom Kippur and the 9th of Av." As noted, the 9th of Av is indeed generally treated more strictly than the other rabbinic fasts; but it is still not identical to Yom Kippur as becomes apparent when discussing individual halachic questions.
One of the useful places to learn a valid approach to these situations is in the halachic works written for soldiers in the IDF. In both frameworks, the individual is engaged in a mitzvah (defense of society, or patient care) and the welfare of others depends upon the individual soldier or worker's actions. These are considerations that may require ab initio a more lenient approach than otherwise used. In addition, once a nurse, physician, etc. has to work, there are some additional considerations that can affect their ability to carry out their duties properly. These include issues of grooming, since an unkempt appearance or bad breath can actually effect our interaction with patients.
The simplest issue to deal with is probably washing. There is a custom to not wash one's body with hot water from Rosh Hodesh Av through the 9th of Av. Ashkenazim generally avoided washing the entire body (such as a shower or bath) even with cold water; but would wash face, hands, and legs with cold water. Sefardim generally only do this during the week of the 9th of Av. The Yemenites generally did not do this, but only avoided entering a bath house or sauna (but permitted showering); while some were more strict as above. The source for this custom is in any case not from the g'mara, but later sources in the Rishonim.
It should be clear that the custom prohibits only 'bathing for pleasure'. Rav Z'chariah ben Shlomo writes in הלכות צבא (פרק סט) "someone who sweats much from work, or security activity, or very hot weather, is permitted to wash in cold or tepid water." The Rema notes in the Shulhan Aruch (או"ח תקנ"א טז) that is is permitted to wash for a mitzvah, such as a woman preparing for mikvah, or someone accustomed to shampoo his hair with hot water before each Shabbat. A nurse or other professional who is concerned about hygiene, excessive sweat, or body odor while working with patients may take all this into account on the days they work. There is no question that washing one's hands or using sanitizer after patient contact is permitted and obligatory due to its proven ability to limit the spread of pathogens in the patient care environment. It should go without saying that if one has noticeable 'dirt' on their hands such as blood, etc. that it is permitted and obligatory to wash one's hands or other areas (fluids sometimes splash on one's face, hair, arms, etc.) as needed.
It is important to note that Rav Yosef Tzvi Rimon (צבא כהלכה, pg. 267) discusses the notion of a 'delicate individual' in this context. In masechet b'rachot we learned that Rabban Gamliel bathed even on the night immediately after his wife's death. When his students questioned him, noting that such washing is normally forbidden, he replied, איסטניס אני - I am a delicate individual, and so exempt from this halacha. In the halachot of mourning in the Shulhan Aruch (יו"ד שפ"א:ג), Rav Yosef Karo notes Rabban Gamliel's position as the halacha, adding "not everyone who claims 'I am delicate' is allowed."
Rav Rimon notes that in the reality of modern times, with our present standards of hygiene and also dealing with hot climates, it is reasonable to say that all of us are included in the category of 'delicate'; and that our washing is not for pleasure in any case, but rather for cleanliness. Therefore, he writes, it seems reasonable that out of respect for ourselves and others (כבוד הבריות) it is even desirable to wash during the nine days leading up to the 9th of Av. This, he says, is the opinion of Rav Elyashiv and Rav Sheinberg as presented in Shut Divrei Hachamim. In any case, he suggests that one should limit how often and how long one showers based on the conditions and needs. One should shower with cold water if they can, or add some hot water if it is too uncomfortable to shower with only cold.
On the 9th of Av it is forbidden to wash, and even to stick one's finger in water. This is, however, still a prohibition of 'washing for pleasure'. As above, a nurse or other patient care worker who has any noticeable 'dirt' on their hands or elsewhere may and must wash as needed to remove the dirt. Similarly, when leaving patient contact one must wash or use sanitizer as required for purposes of infection control.
Tangentially, it is interesting to note that Rav Shlomo Min Hahar and Rav Shlomo ben Zechariah both write that soldiers who return from patrol and have aching feet are allowed to wash them for relief, since this is considered therapeutic and not for pleasure. This is already brought in the Shulhan Aruch (או"ח תקנ"ד:יד) regarding someone coming from a journey on the 9th of Av. It may even be, in my opinion, that a nurse would find this applicable after an especially long time on their feet. As always, one should consult their rav.
Next we will look at drinking, eating, and 'tasting' on a fast.
It seems fairly simple that not working on a fast day is the better option, when possible. This is not always possible, for a variety of reasons. For the purpose of this discussion we should leave Yom Kippur out, since it is an obligation from the Torah and has its own detailed and well-discussed halachot. I would point out that Rav Neuwirth equates also the 9th of Av to Yom Kippur; but this is not a universally agreed upon approach. The 9th of Av is nonetheless of rabbinic origin as far as its halachic status, and its equation to the other rabbinic fasts is alluded to by Z'charyah (8:19). Of course, for any practical application one should consult with their rav.
Rav Neuwirth succinctly states (מדריך הלכתי לאחיות בבתי חולים, פרק י) under the heading for the Fast of Gedaliah, "a nurse who has difficulty working appropriately on a fast day is permitted to eat. This applies only for the fasts like Fast of Gedaliah, 10th of Tevet, Fast of Esther, and the 17th of Tammuz; but not for Yom Kippur and the 9th of Av." As noted, the 9th of Av is indeed generally treated more strictly than the other rabbinic fasts; but it is still not identical to Yom Kippur as becomes apparent when discussing individual halachic questions.
One of the useful places to learn a valid approach to these situations is in the halachic works written for soldiers in the IDF. In both frameworks, the individual is engaged in a mitzvah (defense of society, or patient care) and the welfare of others depends upon the individual soldier or worker's actions. These are considerations that may require ab initio a more lenient approach than otherwise used. In addition, once a nurse, physician, etc. has to work, there are some additional considerations that can affect their ability to carry out their duties properly. These include issues of grooming, since an unkempt appearance or bad breath can actually effect our interaction with patients.
The simplest issue to deal with is probably washing. There is a custom to not wash one's body with hot water from Rosh Hodesh Av through the 9th of Av. Ashkenazim generally avoided washing the entire body (such as a shower or bath) even with cold water; but would wash face, hands, and legs with cold water. Sefardim generally only do this during the week of the 9th of Av. The Yemenites generally did not do this, but only avoided entering a bath house or sauna (but permitted showering); while some were more strict as above. The source for this custom is in any case not from the g'mara, but later sources in the Rishonim.
It should be clear that the custom prohibits only 'bathing for pleasure'. Rav Z'chariah ben Shlomo writes in הלכות צבא (פרק סט) "someone who sweats much from work, or security activity, or very hot weather, is permitted to wash in cold or tepid water." The Rema notes in the Shulhan Aruch (או"ח תקנ"א טז) that is is permitted to wash for a mitzvah, such as a woman preparing for mikvah, or someone accustomed to shampoo his hair with hot water before each Shabbat. A nurse or other professional who is concerned about hygiene, excessive sweat, or body odor while working with patients may take all this into account on the days they work. There is no question that washing one's hands or using sanitizer after patient contact is permitted and obligatory due to its proven ability to limit the spread of pathogens in the patient care environment. It should go without saying that if one has noticeable 'dirt' on their hands such as blood, etc. that it is permitted and obligatory to wash one's hands or other areas (fluids sometimes splash on one's face, hair, arms, etc.) as needed.
It is important to note that Rav Yosef Tzvi Rimon (צבא כהלכה, pg. 267) discusses the notion of a 'delicate individual' in this context. In masechet b'rachot we learned that Rabban Gamliel bathed even on the night immediately after his wife's death. When his students questioned him, noting that such washing is normally forbidden, he replied, איסטניס אני - I am a delicate individual, and so exempt from this halacha. In the halachot of mourning in the Shulhan Aruch (יו"ד שפ"א:ג), Rav Yosef Karo notes Rabban Gamliel's position as the halacha, adding "not everyone who claims 'I am delicate' is allowed."
Rav Rimon notes that in the reality of modern times, with our present standards of hygiene and also dealing with hot climates, it is reasonable to say that all of us are included in the category of 'delicate'; and that our washing is not for pleasure in any case, but rather for cleanliness. Therefore, he writes, it seems reasonable that out of respect for ourselves and others (כבוד הבריות) it is even desirable to wash during the nine days leading up to the 9th of Av. This, he says, is the opinion of Rav Elyashiv and Rav Sheinberg as presented in Shut Divrei Hachamim. In any case, he suggests that one should limit how often and how long one showers based on the conditions and needs. One should shower with cold water if they can, or add some hot water if it is too uncomfortable to shower with only cold.
On the 9th of Av it is forbidden to wash, and even to stick one's finger in water. This is, however, still a prohibition of 'washing for pleasure'. As above, a nurse or other patient care worker who has any noticeable 'dirt' on their hands or elsewhere may and must wash as needed to remove the dirt. Similarly, when leaving patient contact one must wash or use sanitizer as required for purposes of infection control.
Tangentially, it is interesting to note that Rav Shlomo Min Hahar and Rav Shlomo ben Zechariah both write that soldiers who return from patrol and have aching feet are allowed to wash them for relief, since this is considered therapeutic and not for pleasure. This is already brought in the Shulhan Aruch (או"ח תקנ"ד:יד) regarding someone coming from a journey on the 9th of Av. It may even be, in my opinion, that a nurse would find this applicable after an especially long time on their feet. As always, one should consult their rav.
Next we will look at drinking, eating, and 'tasting' on a fast.
