Acute stroke nursing is an exciting venture. I have witnessed and had the privilege to be part of the development of an acute stroke service in line with the Department of Health’s 2007 National Stroke Strategy.
Our team - 13 band 6 senior stroke support nurses - ensure our hospital in the east of England has a member of staff available 24/7 to respond to a hospital pre-alert for a thrombolysis call.
We work closely with our medical, nursing and ambulance colleagues in the emergency department (ED) to ensure accurate handover, rapid assessment, and essential investigations - after all, time is brain. The FAST campaign (Facial weakness, Arm weakness, Speech problems, Time to call 999) has been hugely successful with the public, enabling call handlers to allocate finite resources to attend in a timely manner and arrange urgent retrieval to ED.
While many of our ED colleagues look to us to make decisions, we remind them our role is to facilitate the correct pathway to ensure the best possible outcome. We advise them to empower a decision with the service user.
Are we witnessing a transient ischaemic attack – TIA or mini stroke? Is this a suspected infarct or haemorrhage? Is the patient in atrial fibrillation? Is this the cause of the symptoms with a clot thrown off? What about the carotid arteries? Do we need to request a computed tomography (CT) angiogram as well as a CT head scan to look at a possible referral to one of our partner hospitals for thrombectomy? If so, what was their pre-morbid Modified Rankin Score?
We not only liaise with our colleagues when a service user is unable to make an informed treatment decision. We discuss and support their next of kin using terminology that won’t baffle or confuse. We ask about their loved-one’s prior wishes to help guide us as professionals with our interventions.
Naturally all this can happen quickly, so capturing times of events or interventions in our documentation is absolutely crucial. All our data is fed into the Sentinel Stroke National Audit Project (SSNAP) to gauge our service's efficiency and look to make timely quality improvements.
Secondary prevention, working alongside our different therapy teams to ensure best possible rehabilitation, is all part of our service, which is a complete marriage of skills and knowledge. I certainly hope that the new Health Secretary’s emphasis on a refocus towards public health and prevention will empower better outcomes for all.
*Beep-beep-beep-beep… stroke alert, ed resus, eta 15 minutes*
Right, best I grab my assessment pack and head down. Thank you for reading about my passion. Maybe I’ve sparked an interest in stroke nursing with you. I hope so - I can’t envisage doing anything else in my nursing career.
