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Nursing care given by general staff hospital nurses to a selected group of patients who had experienced a cerebrovascular accident Patrick, Geraldine Grace Louise

Abstract

The purpose of this study was to identify the nature of nursing care given by general staff hospital nurses to a selected group of patients who had experienced a cerebrovascular accident. Six hemiplegic patients who had experienced a cerebrovascular accident one to three weeks before the period of observation were selected for the study. The data were compiled from direct observations and from a nursing history which included an interview with the patient and/or his nearest relative, and data from his chart. The observed behaviour of twenty-nine general staff hospital nurses, six patients, and other members of the rehabilitation team were recorded in the form of anecdotal notes by the non-participating nurse-researcher. Each patient was observed for two days, the mean length of observation time per day was 6 hours and 49.4 minutes. The data were categorized into ten basic nursing care activities. Basic nursing care as defined by Henderson, meant helping the patient with activities related to his basic needs or providing conditions under which he could perform them unaided. The data were further organized into desirable activities, as outlined in the literature, and undesirable activities that were observed. It was demonstrated that many nurses in the study helped patients with most of the ten activities, however, few nurses provided conditions under which they could perform them unaided. Food and fluids were fed to patients who could have fed themselves with a little encouragement. Bowel and bladder training was not seen as an important factor in the care of the patient who had experienced a cerebrovascular accident. Nurses seldom included exercise during the bath and frequently left the patient in the chair for prolonged periods. Nurses demonstrated that they did not understand the importance of communication with patients who had experienced a cerebrovascular accident, nor did they appear to be aware of the concept of a rehabilitation team. The recommendations were: 1. that an orientation to the total picture of rehabilitation of the patient who had experienced a cerebrovascular accident, in the acute hospital, specialized unit and in the home, be provided for graduate general hospital nurses. 2. that existing knowledge in relation to the nurse's role in the rehabilitation of the patient who had experienced a cerebrovascular accident be compiled and made accessible to general staff hospital nurses. It is now primarily in journals that these nurses do not normally see. 3. that general staff hospital nurses learn to communicate more effectively with patients who have experienced a cerebrovascular accident, with their families and with other members of the rehabilitation team.

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