Three Problems I had as a Stroke Victim as a Nurse.
Are we looking at the stroke patient as human?
Daniel E. Wimer, RN, BA, & Life Coach
Persistence meris a virtue that tries men souls!
Overview:
The Healthcare business is a business but we as nurses somtimes forget the patients's needs.
Participants will be able define the type of strokes and recognize the symptoms of Silent, Ischemic, and Hemorrhagic strokes.
Participants will be able to distinguish between Aphasia and Apraxia.
Participants will be able understand the inability to communicate strikes fear in the stroke victims heart.
The American Stroke Association (ASA) data show that approximately 700,000 people in the US have stokes every year; 500,000 are first attacks and 200,000 are recurrent attacks. These stats are personal since I have had three strokes, the last one in September of 2006.
Silent strokes. My first stroke was a silent type, similar to a silent heart attack. The doctors found evidence of a first stroke on a CAT scan after following my second stroke. For obvious reasons silent strokes are only detected after they have happen.
Ischemic Strokes. Within three days of my second and third stroke, 80% of my symptoms went away. Not all strokes are ischemic, about 80% are, and not all of them resolve as quickly as mine did. The source of the stroke is often a blood clot traveling to the brain from elsewhere in the body. This type of stroke the blood flow is block or greatly reduced, in the brain, or the vessel goes into spasms.
Hemorrhagic Strokes are less common but more deadly than an ischemic stroke according to the ASA. When a blood vessel bursts in the brain, the effect is usually catastrophic, resulting in a quick death.
1. We are not doing “good’.
The lost of communication was frustrating when I had my strokes. Strokes leave your mind intact but your body does not want to work. MOST males do not like the impersonal “WE.” “How are we doing tonight?”I am doing lousy and I hate the world how about you, says he?” “Besides which, I cannot talk, you idiot” or thoughts to that effect. The use of the impersonal “WE” is so pervasive in the helping professions. I fear that the PC Police will force us to continue use “we”. The use of “we” is offensive because you are not asking how I feel. It has become a barrier to commutation. You are talking at me, about me, but you really do not care about my answer.
Two of the most common problems of stroke victims are Aphasia and Apraxia.
Aphasia is the partial or total loss of the ability to articulate ideas or compare spoken or written language, resulting from injury or disease.
Apraxia is the inability to perform learned movements on comma, it is understood and there is willingness to perform the movement. Both the desire and the capacity to move are present but the person simply cannot execute the act. The client fells trapped.
The hospital where I was taken after my third stroke had a stroke unit but I had recovered very quickly so they placed me on a Cardiac floor for heart monitoring. The nurses kept asking me about my chest pain level. They had apparently never read my chart and did not know that I was there as stroke patient. I had a commutation problem mine was aphasia what was thier exuse? Two days later I was able to let them know my diagnosis since I had somewhat regained my ability to talk.
Lesson 1: Stroke patients normally hear everything but cannot act on their needs. Plain writing pads works best or “Yes or No” type questions are best. Pay attention to the patient chart. A real problem for the stroke patient is that they feel helpless; they fear that no one will know when they need help. Checking on them hourly is very important to them and eases their fear.
2. Do not choke your patient before it is His Time to Go!
We all have had patients that we would kill if the opportunity came up. We are in the helping profession after all. I have had three major strokes and multiple focal seizures. My last stoke was in September of 2006 but I want to deal with my second stroke in AUG 2005. I had this stroke in my bathroom. I could stand but not walk. My wife put me in a chair with wheels and we waited for EMS. EMS had to carry me down the hall, down three steps to place me on the gurney. I weighed, at that time, around 300 lbs. Meanwhile, I was steadily going downhill, I could not talk or move myself. In the process of getting out the chair my head fell to my chest. I had lost all control of my neck muscles. The EMTs stopped to access their situation but not my status.
Meanwhile, I was running out of air, and I could not tell them, or anyone else for that matter. The need for air is bothersome, to say the least. The hour (an hour to me at least) that it took to carry me down the stairs was filled with increasing terror on my part. I started to have tunnel vision, a sign of hypoxia. By now, I really wanted air, Really, REALLY, WANTED LOTS OF AIR. Finally, the EMTs placed me on the gurney. They lowered my head and my head flopped up to back to normal position. Suddenly, I felt better; I had no more tunnel vision and I felt the air going into my lungs.
Lesson 2: A soft Cervical Collar will stabilize the neck in case the stroke victim loses their neck muscle control. The collar is a quick, efficient, and cheap way to help the victim regain his cool.
3. Men are not like women!
Lately, a local clinic, nearby, instigated a new policy that staff will not use terms like “Honey,” or the horrible appellation “Sugar.” I can guarantee that a female VP wrote the memo. Not surprising 95% of nurses are women; therefore; they view actions as needing action plans, in which most men see as no problem. They do not treat men as men. I, as a patient, with or without a stroke, felt more at ease with the friendly “Honey.” Women, however, especially those in power, take offense over the perceived slight and are more rigid in their relationships. Men are not like women. (Nurses should read. “Men are from Mars and Women are from Venus.” by John Gray, Ph.D.).I, as a man, want to know the facts, when he can get out and go back work. I could less about you calling me Mr. Wimer. I do like a homey atmosphere; friendly is the key. Men need a different approach
By the way, when you leave my room do not say to me,” Have a good one!” Do you mean, “Have a good day, a good stroke, or a good BM?” I have been a RN for over 20 years and still this saying grates on my ears.
Lesson 3: In the search for PC equality, the mangers, they have taken the patient’s individuality and destroyed it, even shredded it. They have turned to being mangers not Leaders. ROne of the surest ways is to retain their name; my name is Dan not Mr. Wimer. By necessity, a hospital is not home but the stroke patient needs to feel at home as much as possible. Friendly staff with a few ‘Honeys’ thrown in helps their stay be ‘user friendly’.
After View: What have you learned?
The air we breathe is better when one is not choking. Using a soft cervical collar is a handy device to stabilize a patient. When you are transferring a person, double-check his airway for air going in and out.
Stroke patients’ communication problem is called Aphasia. The pervasive “WE” is impersonal. Pay attention to the patient chart, read at least the diagnoses. Stroke patients feel very alone, helpless and afraid. Check on them more frequently.
Again, I say Men are not like Women. The fear of lawsuits has made hospitals less friendly. We can put back humanness in our dealing with others.
Bonus Tip: Humor is a very, very helpful for the stroke patient, for that matter anyone is helped by humor. On the second day of my third stroke, I showed my neurologist a new skill that I had learned which I was able to pick my nose with my left hand and we laughed. My wife was appalled by the comment but my doctor understood my point. You have a choice in life and I choose to face my problem with humor. Laughing about yourself makes you less depressed and willing to take on the hard task of rehabilitation.
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About the Author: Daniel Wimer is a Life Coach, RN, public speaker. He is the Chief Ethical Officer of D.E.WIMER, RN and Associates, Inc, and partners with individuals, corporations and organizations to help them change strategically change to experience success. To access more complimentary coaching resources contact us at www.DanielWimerLifeCoach.com
