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48
A Jumble Sale was organized during the year by the staff attached
to the District Nurses Home and the proceeds allocated to a summer
outing for old people, and during the Christmas period 32 parcels
were distributed to deserving old people in the area.
The following case study prepared by a member of the district
nursing staff illustrates the part played by a district nurse in
the rehabilitation of a domiciliary patient after a cerebral
haemorrhage, and the importance of simple exercises prior to the
referral of the case to a hospital outpatient physiotherapy clinic
if this should be indicated.
Male patient: Aged 62 years.
Occupation Carpenter.
Referred to District Nursing Service as Cerebral haemorrhage for
daily general care.
information obtained at first visit All routine facts necessary
for nursing association records. Number in family: one, his wife.
Condition at first visit. Fully conscious. Marked left hemiplegia
speech slurred, movements of normal respiration difficult. Pale
tearful and despondent showed no reaction to normal conversation.
This condition was in no way helped by his wife who sobbed wildly
by his bedside.
Routine nursing care Bed position moved to allow view from window.
His wife accompanied me to another room. Her image of a 'stroke was
one of utter helplessness. She was consoled, informed and instructed.
As a great part of the nursing, physical and psychological, would
depend upon her she reacted well to this and liked the idea of
working together . This all important first visit is the basis
on which to build the good relationship professionally, which should
exist at all future visits.
Second and consecutive visits Taught simple exercises of affected
limbs. Asked to make vowel sounds. All this in the presence of his
wife, to enable her to continue same. During the day this she did
with enthusiasm and by the seventh day there was some improvement.
The doctor visited three times weekly and prescribed mild sedation.
Two small dishes were given to the patient, one containing small
pins. He was taught to transfer them one at a time to the other dish
using thumb and fingers of the affected hand. This he did continually
and was soon able to use soap and face cloth, and so wash himself.
Breathing exercises were carried out two hourly. This increased the
patient s morale and he would tell me daily of some returning movement
and go through his programme of exercises for his visitors. He sat
up twice daily, placed both feet flat on the floor and rose to a
standing position with the help of his wife who was assisting his
recovery. The room furniture was now adjusted to enable him to have
plenty of leverage for walking. This he did morning and evening