Stroke Nurse - First Visit

On the 5^th Feb 2015 and totally out of the blue a letter arrived from my Local Community Stroke Team.

The letter informed me that they had received a referral from the hospital that I had attended after my Stroke. Something that I was not told would happen.

The sender of the letter informed me that Local Community Stroke Team's role “ … is to offer support, explanation (sic) about the stroke, ensure you understand your risk factors and medications and monitor you (sic) blood pressure etc.” And then asked “I would be grateful if you could contact the number above to let me know if you would like my input and support: I will then try to arrange a visit to your home.”

The writer went on “I hope this letter finds you well and I look forward to hearing from you.” An interesting comment considering that I was a little over three weeks post Stroke.

The letter was signed

“Kind regards

RP

Community Stroke Associate Practitioner”

What kind of request was that?

Of course I would welcome her input.

The line about finding me well was a little strange as she knew that I had had a stroke, so how was it going to do that?

The most important thing for me was the fact that such an organisation existed came as a complete surprise: a pleasant one, but a surprise nonetheless. In fact I had every reason to believe that I would not be seeing anyone from any form of community based health organisation as on my discharge notes it clearly said that there was no need for transfer to Community Rehabilitation as well as there being no indication for a Social Service / Community Care Plan to be put in place (See: Information. What Information?, 02/03/2016).

Needless to say that I phoned the number at the top of the page very rapidly, only to have to leave a message. Having left my telephone number I had nothing left to do but wait, which lasted for two days. When RP did phone back we arranged for her to come to the house on Friday 13^th Feb at 09:00. It’s a good job that I’m not superstitious.

As the morning of the 13^th arrived and not really knowing what to expect my partner and I awaited RP’s arrival. The partner was working in the office and called down to say that a car had passed the house twice so she thought the Stroke Nurse had arrived. A fact confirmed by Bruce who barked to let us know that there was someone coming to the house. I opened the door and Bruce ran out, tail wagging, to investigate the new arrival. A pleasant looking lady in a blue nurse’s uniform and carrying a black leather bag reached down to pat Bruce and then walked up to introduce herself.

Having offered the new arrival a drink, which she declined, we settled down at the kitchen table. The first thing she asked was “How was I?” With my dissatisfaction with the treatment that I received from the medical profession during the last few hours of my time in hospital still fresh in my mind I let the frustration come following out. There was also some truth in the fact that I believed, at the back of my mind, that I had somehow brought this stroke on my self by not remaining on my meds in 2010 (See: Horner’s Syndrome, 30/03/2016) and in some way knew that I was going to get a wigging from yet another member of the medical profession, so probably tried to get my defence in first. So much so that RP had to ask me to back off, and quite rightly so. Once I had calmed down I apologised and explained where the frustration / anger had come from. As she was always going to RP explained that she was not from the acute sector and what was in the past was just that. With no option but to accept the obvious truth of her comments I suggested that we start again.

RP opened her bag and withdrew an old fashioned Blood Pressure reader and stethoscope which she placed on the table. She then dug out an A4 ring binder which she handed to me. The image on the cover was of a blue, computer generated, slightly feminine human showing the right shoulder, neck and face from the ear forwards. The title of the folder was PATIENT INFORMATION PACK. The finale thing she took from her bag was a blue CL sized folded form entitled STROKE RISK FACTOR MANAGEMENT PLAN onto which she had already written my name, address, date of stroke, type of stroke (L Pontine Infarction) and her contact details. L Pontine Infarction is the medical way of saying that I had had an obstruction to the left side of my brain which resulted in local death of the tissue. RP then took my Blood Pressure which measured 160 / 102.

We then began to talk. The first thing RP asked was what had happened, so I went through the story again (Attack, 22/11/2015) , including my time in hospital (See: Hospital - Admission, 25/11/2015.; Hospital - Inpatient, 03/12/2015; Hospital - Discharge, 07/12/2015).

At this point my partner joined us. After introductions RP went on to tell us the good news: that having had a stroke it was very unlikely that I would have another. Of course the figures supported that assertion but it was not easy to believe when you have just gone through one.

The finale subject that RP talked about on this first visit was the whole issue of Risk Factors. I should definitely stop smoking: not a problem as I have never smoked, unless you count the odd cigar after a damn good meal and at New Year. There was the usual advice to reduce the alcohol intake, lose weight, eat healthily and to reduce stress. There was a difference of opinion between my partner and I as to the degree which each of the Risk Factors impacted on me. This was a discussion that RP quite rightly refused to get involved in, but only ticked High Blood Pressure and High Cholesterol in the “Your risk factors have been identified as.” Section of the Management Plan.

With that we conformed the next visit for the morning of 19/03/15 and RP left us.