Stroke Rehabilitation - a Student Nurses Case Study

Topic: Stroke Rehabilitation

The aim of this assignment is to introduce the author (student) to the multifaceted role of rehabilitation, which affects most patients at some time in their treatment and to facilitate their awareness and understanding of the role of nurses within the team. The principles of rehabilitation will be approached through consideration of patient needs. The author will use the Rooper, N.Logan and Tierney model of nursing (2000) for daily activities of living. The author will examine the theoretical principles of rehabilitation and the role of the multi-disciplinary team. The education and support provided to the patient and carer will be addressed. As a student the author will describe the level of competency and degree of responsibility which is utilised in the caring for patients recovering from the effects of a stroke.

In Britain Strokes or Cerebrovascular Accident (CVA) claims the second highest mortality each year, about 9% Department of Health (2004) . A stroke or CVA refers to a group of diseases that have in common a reduced blood supply to a portion of the brain. While Isaacs (1983), Thompson (1987) , defined a cerebrovascular accident as a sudden attack of weakness affecting one side of the body, resulting from an interruption to the flow of blood to the brain (by thrombosis, embolus or ruptured aneurysm). A stroke can vary in severity from a weakness in a limb to profound paralysis and considerable impairment. There are different types of strokes, for example there is thrombotic or embolic occlusion resulting in infarction Simon, Thompson, and Morgan (1990) or spontaneous rupture of a vessel resulting in intracerebral or subarachnoid haemorrhage.

By rehabilitating the female patient who will remain anonymous due to the NMC (2002) Code of conduct to protect patient confidentiality she will gain some level of independence throughout the assignment the patient will be referred to as "Mary", who is 64 years old. Mary was admitted to the ward after suffering a

Cerebrovascular Accident (CVA) or Stroke, her symptoms included weakness in both legs, limited mobility in her right side, and dysphagia (abnormality in swallowing). Mary lives with her 75 year old husband. Mary requires assistance with personal hygiene care. Mary was admitted to the ward for complete assessment. According to Davis, O'Connor (2004) Assessment is the first stage of the problem solving approach whatever model of care is used it will be the activity of the health care professionals. After Mary's assessment she was recommended for rehabilitation and a Computerised Tomography (CT) Scan.

Rehabilitation is defined as an active and dynamic process by which a disabled person is helped to acquire knowledge and skills in order to maximise physical, Psychological and social function. It places emphasis on maximising functional ability and limiting disability. Barnes, Ward (2000).

As a student the author will describe the level of competence and degree of responsibility which is utilised in the rehabilitation of patients on this placement. This assignment is also aimed at the author's developmental pathway with progression in adult nursing from novice level through to the competent practitioner level.

The author had to devise a care plan for all of Mary's contributing or associated problems. By using Roper, Logan, and Tierney (2000) activities of daily living the author was able to assess and plan her care. The mentioned model of nursing is used by the trust to promote daily activities of living. The author was allocated on several shifts with a mentor to care for Mary's health needs. A safe environment was very important to maintain because Mary's mobility was restricted.

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