Trauma nursing



Title Trauma nursing: an advanced practice case study
Author(s) Kim Robertson
Journal The Canadian Nurse
Date 1999
Volume 95
Issue 4
Start page 18
Abstract During the course of his lengthy hospitalization, as he moves from emergency to rehabilitation, [Ben] will experience at least five different units and an ever-changing team of nurses, physicians, social workers, physiotherapists, occupational therapists, dietitians, students and more. The emergency advanced nurse practitioner could be the constant player on Ben's team. That person could ensure continuity and co-ordination of care. He or she could be Ben's source of information and facilitate accurate communication between Ben, his family and all other health care professionals. Ben needs to come to some understanding of the trauma that has occurred in order to be able to incorporate it into his life and move on. Who better to assist him in this process than an expert nurse who is skilfully able to analyse and treat his responses to the traumatic event and who has been with him since admission? One practical application of the model was my negotiation with physicians for the use of patient-controlled analgesic and a more therapeutic daily dose of morphine. Ben's physical pain then became better managed and he felt he had more control over it. With the pain under control, Ben could assist with dressing changes by turning and lifting his leg. To minimize his pain and anxiety, I wrote out a care plan for the nurses describing exactly how the dressing was to be done. His improved pain control also seemed to diminish his feelings of fear and uncertainty. Ben started seeing physiotherapists regularly and preparing both physically and psychologically for the prosthesis. He welcomed a visit from another amputee who reinforced that what he was experiencing was a process of adjustment. Ben continued to be angry about his altered body image, and although it was important for him to realize that his was a normal and natural response, how he expressed this anger remained an issue. Because family members were prime targets for his anger, for these were the people with whom Ben felt most comfortable, it was important for his family not to internalize these expressions of his frustration. As indicated by the communication model, I counselled both Ben and family members in this area. Ben agreed to see a psychologist weekly and welcomed the opportunity to talk about his experience. He began to adjust to his altered body image, although, as yet, this acceptance is not a permanent state. Genuine adjustment generally occurs after a prosthesis has been fitted and when the individual has re-established feelings of self-worth.
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