http://www.stratfordbeaconherald.com/2016/05/25/local-mp-tours-stratford-hospital-stroke-unit
It's the registered nurses' mantra at Stratford General Hospital from the moment a stroke patient comes through the door of the emergency department right up until they're in rehab.
Perth-Wellington MPP Randy Pettapiece got a tour of the journey a stroke patient will go on at Stratford General--which is one of the province's Integrated Stroke Units.
Pettapiece wasn't playing hookey from his duties. The tour was part of the Registered Nurses' Association of Ontario's 16th Annual Take Your MPP to Work event.
“We have the expertise and equipment to take care of patients in a timely manner and try to get the best outcomes for them and their family,” said Tasha Vandervliet, RN.
A patient having stroke symptoms will see a doctor within about seven minutes and then go for a CT scan. The registered nurse will hook the patient up to a monitor, start IVs and deal with blood pressure and heart rate. The nurse will stay with the patient as they go for the CT scan which helps determine whether the stroke is caused by a blood clot or by a bleed.
If it's a bleed that requires surgery the patient will go to London to see a neurologist if it's a clot, medication is started as soon as possible and the patient stays in Stratford.
“The goal is they get medicine within an hour from the time they walk in the door. It's incredibly fast,” Vandervliet said.
Ideally, the clot busting drug should be administered within four hours of the last time the patient was in a normal state or it has no effect, she said.
The patient then goes up to the intensive care unit where one-on-one attention is provided.
“We're constantly assessing, if we notice any major changes, it's an emergency,” said Catherine Walsh, Perth Chapter RNAO president.
Nurses are checking blood pressure and other signs every 10 to 15 minutes during the acute care period.
Nurses in ICU will look at a patient's level of consciousness, ask questions, see if the patient can follow commands, speak and see properly.
“This is the period where they have the most emotional stress. They have full functioning thoughts but can't express them,” Vandervliet said.
On the other hand, she has watched patients regain function after having the drugs administered in time.
“When it works, it's the most beautiful thing,” she said.
When a patient leaves ICU they go to the stroke floor. They start rehabilitation just down the hallway and work with the same team during that period which may include language pathologists and dieticians in addition to RNs.
Patients are typically ready for rehab within five to seven days. All rehab patients dine together at tables rather than in bed.
Patients also work with nurses from the stroke prevention team. The goal is to catch patients who are having mini strokes and get them treatment before they have a major stroke. However, they also follow patients who have had a major stroke through the process.
Nursing care extends outside the hospital too as patients continue to recover at home.
Pettapiece suggested stroke patients need to call 911 and forget about what the neighbours might think in order to get timely treatment.
Walsh stressed RNs are a critical part of care and their jobs should be protected. She said it's not about different levels of nursing but about having the right care provider available at the right time.
Pettapiece suggested maybe something has to change in the system to protect those jobs.
“There's guys my age you're going to have to look after and I hope you're there,” he said.
lcudworth@postmedia.com
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