Human Misery, Human Victory
The disabilities caused by a cerebrovascular accident (CVA) can render a patient a virtual prisoner in his own body. Sometimes rehabilitative efforts are to no avail. However, the numerous patients who prevail and regain their previous levels of function are testimonies to the reaffirming difference rehabilitation nursing can make, one life at a time.
For starters, I work as a staff nurse at a specialty rehab hospital. Rehabilitation nursing involves assisting patients and their families to manage short-term, progressive, and long-term impediments and disabilities in ways that constructively facilitate the highest level of function possible.
My place of employment receives a substantial share of patients who are disabled as the result of cerebrovascular accident (CVA), better known as stroke. CVAs are all too common in American society. In fact, stroke is the third leading cause of death in the United States, only trailing behind heart disease and cancer. And even though stroke causes less than ten percent of total deaths in the US each year, it is the main culprit behind significant long-term disability in this country.
Unfortunately, my coworkers and I get to see the human suffering and sheer agony left in the aftermath of the merciless CVA. Vibrant individuals who once worked and played, lived and loved, and dreamed and dared with the fiercest independence have now been rendered unable to perform the most basic activities of life. Too many stroke victims are dependent on others in order to be fed, toileted, clothed, showered, groomed, turned, and stimulated. A stroke is life-altering, but definitely not in a good way.
Sometimes we cannot understand the jumbled word salad that passes through the lips of a frustrated patient with expressive aphasia who knows exactly what he wants to say, but cannot say it. Alternatively, the roommate afflicted with receptive aphasia doesn't understand what we are saying to him. Far too often, many patients have been robbed of their ability to speak at all. Their flaccid hands cannot write on a message board or even point to a drawing to indicate what they want. Numerous patients are stripped of their ability to swallow and must receive their nutrition, fluids and medications through feeding tubes. The impediments caused by a CVA can leave a patient a virtual prisoner in his own body.
The job of the staff at the rehab hospital is to restore as much function as realistically possible to our patient populations. We receive post surgical cases such as laminectomies, limb amputation, hip and knee replacements, and colectomies. We also care for patients who are debilitated from medical conditions such as pneumonia, uncontrolled diabetes, chronic obstructive pulmonary disease, Parkinson's disease, and exacerbation of congestive heart failure. However, the majority of our patients have had strokes.
A dedicated team of physicians, nurses, physical therapists, occupational therapists, speech language pathologists, dieticians, and other staff try to work wonders with the one to three weeks of inpatient rehabilitative services. Sometimes the effort is to no avail, since some patients end up discharging to a long term care facility due to lack of progress with their various therapies. These patients are truly heartbreaking and I often wonder what becomes of them and their families.
However, light awaits us at the end of the tunnel. Many of the same patients who rolled into the rehab hospital on a stretcher with the inability to walk, talk, or eat, end up enjoying small daily victories that snowball into greater things when they discharge to home with a steady stroll, clear speech, and a low salt diet. The majority of our patients prevail, and their triumphs are the same events that enable me to return day after day.
Every now and then I become disturbed by the utter level of human anguish and deferred dreams caused by stroke. However, intense rehab makes positive changes in patients' lives. I choose to focus on the patients who victoriously overcome their impediments because these people are constant reminders of the reaffirming difference we can make, one life at a time.Last edit by Joe V on Mar 14, '13
About TheCommuter, BSN, RN Senior Moderator
TheCommuter is a moderator of allnurses.com and has varied workplace experiences upon which to draw for her articles. She was an LPN/LVN for four years prior to becoming a registered nurse.
TheCommuter has '10' year(s) of experience and specializes in 'Case mgmt., rehab, (CRRN), LTC & psych'. From 'Fort Worth, Texas, USA'; 35 Years Old; Joined Feb '05; Posts: 35,366; Likes: 62,347.5Mar 14, '13 by SwansonRNVery nicely written, I feel like this belongs in a magazine!3Mar 15, '13 by brandy1017I remember seeing a tv news report about using robotic skeletons over the leg of a stroke patient to help them walk and even using a special treadmil that holds the patient upright. I'm not sure if the robotic skeleton used electrical impulses to help the patient walk I think it might have worked that way. But who are these lucky persons that get to try this new state of the art equipment, it is not the average person but probably either rich or a VIP like Gabbie Gifford or someone with excellent insurance or living near a state of the art medical research facility. It is so sad to see someone unable to eat that is the worst!
I hope the new medicare ruling that people with chronic conditions are not being denied therapy due to a lack of progress like it used to be will be given new hope and chance to get better even if it takes longer than the standard treatment! A class action lawsuit brought this hopeful positive change about with medicare and therapy and I hope the rest of insurers follows suit!1Mar 15, '13 by amygarsideGreat article, it made me feel the triumph after much heartaches and frustrations.1Mar 15, '13 by prep8611I work neuro sx icu and i am SO impressed by the work the rehab teams do. We send out people we never thought would stand again and they coming walking in months later. Makes my job worth it and it wouldn't be possible without the rehab team.1Mar 15, '13 by CrunchRNBeautifully written Commuter and what important work you all do. I cannot think of anything more important than helping people gain a quality life again.2Mar 15, '13 by VickyRN GuideI used to have clinical groups on the General Rehabiitation Unit in a large teaching hospital. North Carolina has the dubious distinction of being the "buckle" of the Stroke Belt in the US. In fact, two counties in NC - Edgecombe and Greene - have gained notority as the Number 1 and Number 2 counties in the US (respectively) in terms of incidence of stroke.
I oftened assigned the same patients to different students in my clinical group over the course of two to three weeks. The progress we saw in these patients was phenomenal. One was a former nurse who had suffered a devastating stroke who would talk the students through a head-to-toe assessment on herself! We met some amazing individuals who inspired us in countless ways. Never underestimate the potential and power of the human spiritLast edit by VickyRN on Mar 15, '132Mar 20, '13 by AndyRNNicely written. I am also a (certified) rehabilitation nurse. It gives me great pleasure to care for patients in the acute rehabilitation setting. Seeing them walk again after lying in a hospital bed for an extended period of time or just be able to do the simplest task of feeding themselves, is such a joy. People take very basic tasks for granted but I have learned through caring for this patient population that life is precious. Thanks for the post. It was a great read.
Andy40191Apr 7, '15 by suzy12, BSN, RNNicely written, you sound like a very caring empathetic nurse
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